What is bulimia?

Bulimia nervosa is an eating disorder. People with bulimia are very concerned about body shape and size and are afraid of gaining weight. They may crave food and find ways to eat a lot of it fast. This binge eating is often set off by stress or an emotional upset. After overeating, people with bulimia may feel guilty, uncomfortable, or ashamed. They may vomit, use laxatives, or exercise excessively to get rid of the food they ate.

Counseling to understand the condition and to learn ways to reduce stress is a big part of treatment for bulimia. Nutritional counseling can help you learn how to eat a healthy diet. It may help to have your family take part in family counseling so that they can support you. Treatment with medicines such as antidepressants also can help.

People who have bulimia follow a strict diet to try to lose weight. But over time, hunger or stress can trigger binge eating. People with bulimia may then purge to avoid weight gain. This starts the cycle of binging and purging that becomes a habit.

Vomiting causes the body to release endorphins. (These are natural chemicals that make you feel good.) Over time, people with bulimia may vomit even if they haven't eaten too much. Repeated vomiting, fasting, exercising too much, or misusing medicines will lead to serious, long-term health problems.

Health problems caused by bulimia include tooth and mouth problems, dehydration, weakness and fainting, and damage to the esophagus. Mental health problems may also occur along with bulimia. This may make treatment take longer.

After bulimia becomes a pattern, it is very hard to return to normal eating without help. But bulimia can be treated. And most people who seek treatment get better.

People with bulimia binge eat on a regular basis. To avoid weight gain, they may make themselves vomit, exercise very hard or for a long time, or misuse laxatives or other medicines. They tend to base how they feel about themselves on how much they weigh and how they look.

Bulimia can be treated with counseling and sometimes medicines. If a person has another health problem along with bulimia, more treatment may be needed. (For example, with depression an antidepressant may be used.) And it may take longer to get better.

Cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are types of counseling used to treat bulimia. In CBT, you learn how to change negative thoughts that you may have about food, your weight, and your body. You learn to change negative beliefs about yourself. In IPT, you learn how relationships can affect binge eating and purging.

These are long-term treatments. It may take weeks or months before you notice changes. You may need treatment with counseling and maybe medicines for more than a year. But getting treatment early can prevent serious health problems. And learning how to manage stress while you recover can make recovery easier.

There is no single test that can diagnose bulimia. But the illness may have a visible effect on your health and eating habits.

If your doctor thinks that you may have an eating disorder, he or she will check you for signs of problems caused by your diet and purging, such as poor nutrition or electrolyte imbalances. The doctor will do a physical exam. He or she may ask questions about your medical history, including your physical and emotional health. It's common for another mental health problem to play a part in an eating disorder. This may include problems such as depression, anxiety, or obsessive-compulsive disorder.

You may have blood tests or X-rays to check for signs of poor nutrition.

Experts don't know what causes eating disorders such as bulimia. But they may be caused by a mix of family history, social factors, and personality traits. Some things may make you more likely to have bulimia, such as a family history of eating disorders, dieting often, or having a poor body image.

Bulimia is a type of eating disorder. People with bulimia will eat a larger amount of food than most people would in a similar situation, in a short period of time (binge). Then, to prevent weight gain, they may vomit, exercise too much, or use medicines like laxatives.

Although it isn't part of the treatment of bulimia, relieving stress can help during recovery. Techniques for managing stress include:

Writing.

Expressing yourself in writing can be a very effective way to reduce your stress level.

Expressing your feelings.

Talking, laughing, crying, and expressing anger are normal parts of the emotional healing process.

Doing something you enjoy.

A hobby or other healthy leisure activity that is meaningful to you can help you relax. Volunteer work or work that helps others can be a powerful stress-buster.

Learning body-centered relaxation.

This includes breathing exercises, muscle relaxation exercises, massage, aromatherapy, yoga, and the traditional Chinese relaxation exercises called tai chi and qi gong.

Learning stress-reducing activities.

These include learning how to relax your body through mindfulness-based stress reduction, meditation, imagery exercises, listening to relaxing music, and using humor.