(Bulimia Nervosa)


Bulimia is an eating disorder. People with bulimia are overly worried about their weight and body image. They binge and purge their food. Bingeing is eating large amounts of food. Purging is using vomiting, laxatives, or diuretics to get it out of the body. Exercise may be used to replace purging, or it may be used with it. The cycle is done to stop weight gain.

Causes    TOP

The cause of bulimia is unknown. It appears to be a mix of your genes, way of life, and environment.

Risk Factors    TOP

Bulimia is more common in young women. Your risk is also higher for:

  • Low self-esteem
  • Feelings of helplessness
  • Wanting to be perfect
  • Fear of gaining weight
  • Not being happy with weight and size
  • Pressure to be thin
  • Other people in your family have the same problems
  • Emotional stress
  • Prior obesity or anorexia
  • Other mental health problems such as depression or anxiety
  • Substance misuse
  • Way of life that highlights being thin as ideal

Symptoms    TOP

People with bulimia have a normal weight. But, their habits are not healthy.

Bulimia may cause:

  • Eating of large amounts of food at one time
  • Feeling like eating is not in your control
  • Forced vomiting
  • Taking of laxatives, enemas, diuretics, or diet pills
  • Too much exercise
  • Mood swings
  • Problems with impulse control
  • Misuse of alcohol or other substances

Physical problems with bulimia:

  • Belly pain
  • Heartburn
  • Menstrual problems
  • Swollen cheeks and jaw
  • Sore throat
  • Swollen glands in the mouth and throat
  • Bloating
  • Stained or chipped teeth—because of contact with stomach acid
  • Cuts or scars on back of hands—from scraping skin on teeth during forced vomiting

Bulimia may lead to:

  • Dental and throat problems from stomach acid
  • Changes in body chemistry and fluids

Diagnosis    TOP

The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to bulimia. You may also have:

  • Blood tests—which can also detect drug use
  • ECG—to check how the heart is working
  • A psychological exam


Heart EKG
Bulimia can lead to severe heart problems.
Copyright © Nucleus Medical Media, Inc.

Treatment    TOP

The goal is to keep weight in a normal range in a healthy way. This is done by stopping harmful behaviors and thought patterns. For serious bulimia, care may start in a hospital.

This can be done with:

Nutritional Support

You will learn how to eat a healthful diet. You will also learn what your healthy weight and calorie goals are.


Cognitive behavioral therapy (CBT) helps you learn to handle stress. You will change how you think. This will help you gain control of your feelings. You will also find out the cause of the problems you’re having.. Therapy may be alone or with a group.

Medicines    TOP

Medicines will depend on other problems you may have. The most common are:

  • Antidepressants—To balance brain chemicals. They may not be as useful without counseling.
  • Vitamins and minerals to keep up adequate nutrition.

Prevention    TOP

Healthy attitudes about food and your body help prevent bulimia.


Bulimia Nervosa Resource Guide for Family and Friends
NEDA—National Eating Disorders Association


Canadian Mental Health Association
National Eating Disorder Information Center


Bulimia nervosa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114924/Bulimia-nervosa. Updated July 16, 2018. Accessed August 31, 2018.
Bulimia nervosa. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/eating-disorders/bulimia-nervosa. Updated March 2018. Accessed August 31, 2018.
Bulimia nervosa. Office on Women's Health website. Available at: https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/bulimia-nervosa. Updated August 28, 2018. Accessed August 31, 2018.
Eating disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml. Updated February, 2016 Accessed August 31, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 8/31/2018

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