Bulimia nervosa is an eating disorder and mental health condition.
People who have bulimia try to control their weight by severely restricting the amount of food they eat, then binge eating and purging the food from their body by making themselves vomit or using laxatives.
As with other eating disorders, bulimia nervosa can be associated with:
Learn more about the causes of bulimia nervosa
Binge eating and purging
Eating disorders are often associated with an abnormal attitude towards food or body image.
Everyone has their own eating habits – for example, people with a food intolerance need to avoid eating certain foods to stay healthy. However, people suffering from eating disorders tend to use their eating habits and behaviours to cope with emotional distress, and often have an abnormal or unrealistic fear of food, calories and being fat.
Because of this fear, people with bulimia nervosa tend to restrict their food intake. This results in periods of excessive eating and loss of control (binge eating), after which they make themselves vomit or use laxatives (purging). They purge themselves because they fear that the binging will cause them to gain weight, and usually feel guilty and ashamed of their behaviour. This is why these behaviours are usually done in secret.
Such binge-purge cycles can be triggered by hunger or stress, or are a way to cope with emotional anxiety.
Signs of bulimia nervosa include an obsessive attitude towards food and eating, an overcritical attitude to their weight and shape, and frequent visits to the bathroom after eating, after which the person might appear flushed and have scarred knuckles (from forcing fingers down the throat to bring on vomiting).
Read more about the symptoms and warning signs of bulimia
Bulimia can eventually lead to physical problems associated with poor nutrient intake, excessive vomiting or overuse of laxatives.
Read more about these complications of bulimia
Who is affected by bulimia nervosa?
As with all eating disorders, women are much more likely to develop bulimia than men.
However, bulimia nervosa is becoming increasingly common in boys and men. There are an estimated 1.6 million Britons suffering from some form of eating disorder, and reports estimate that up to 25% may be male.
Recent studies suggest that as many as 8% of women have bulimia at some stage in their life. The condition can occur at any age, but mainly affects women aged between 16 and 40 (on average, it starts around the age of 18 or 19).
Bulimia nervosa can affect children, but this is extremely rare.
What to do
If you have an eating disorder such as bulimia, the first step is to recognise that you have a problem. Then, you need to visit your GP for a medical check-up and advice on how to get treatment.
If you think someone you know has bulimia nervosa, talk to them and try to persuade them to see their GP.
There are also many support groups and charities you can approach for help, including:
Read about diagnosing bulimia
The first step towards getting better is to recognise the problem and to have a genuine desire to get well.
There is strong evidence that self-help books can be effective for many people with bulimia nervosa, especially if they ask a friend or family member to work through it with them.
If this is not suitable or is unsuccessful, your GP can refer you for treatment to an eating disorder service, where you may be offered a structured programme of cognitive behavioural therapy (CBT). Some people may also benefit from antidepressant medication (fluoxetine), as this can reduce the urges to binge and vomit.
Read more about the treatment of bulimia