In crisis?  Call or text 988 | Text "NEDA" to 741741

Eating Disorder Facts
Understanding

Bulimia Nervosa

Bulimia nervosa is characterized by a cycle of binge eating followed by compensatory behaviors — such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise — in an attempt to "undo" the effects of binge episodes.

Also known as: BN, Bulimia

Affects approximately 1–1.5% of women and 0.5% of men in their lifetime

People with bulimia nervosa often feel a loss of control during binge episodes, consuming large amounts of food in a short period. This is followed by intense guilt, shame, and fear of weight gain, leading to compensatory behaviors.

Unlike anorexia, individuals with bulimia often maintain what appears to be a "normal" weight, which can make the disorder harder to detect. However, the medical consequences of the binge-purge cycle are severe and can be life-threatening.

Bulimia nervosa often co-occurs with anxiety, depression, substance abuse, and self-harm. The shame cycle associated with bulimia can be deeply isolating, but effective treatments exist and recovery is achievable.

Recognize

Signs & Symptoms

Evidence of binge eating — disappearance of large amounts of food, empty wrappers or containers
Evidence of purging — frequent trips to the bathroom after meals, signs of vomiting
Excessive exercise, especially after eating
Unusual swelling of the cheeks or jaw area (parotid gland swelling)
Calluses or scars on the back of hands and knuckles from self-induced vomiting
Discoloration or staining of the teeth, increasing cavities
Fluctuations in weight, both up and down
Creating lifestyle schedules to make time for binge-and-purge sessions
Withdrawal from friends, family, and activities
Hoarding food, eating in secret, or stealing food
Understand

Causes & Risk Factors

No single cause has been identified. Eating disorders arise from a complex interplay of genetic, biological, behavioral, psychological, and social factors.

Genetic vulnerability — family history of eating disorders or mental illness
Brain chemistry imbalances, particularly serotonin and dopamine systems
History of dieting or restrictive eating patterns
Low self-esteem and negative body image
Perfectionism and difficulty expressing emotions
History of trauma, especially sexual trauma
Peer pressure and cultural idealization of thinness
Participation in appearance-focused sports or activities
Health Impact

Health Consequences

Eating disorders have serious medical consequences and can be life-threatening if untreated.

  • Electrolyte imbalances — can lead to irregular heartbeat and potentially heart failure
  • Inflammation and possible rupture of the esophagus from frequent vomiting
  • Tooth decay and staining from exposure to stomach acid
  • Chronic irregular bowel movements and constipation from laxative abuse
  • Peptic ulcers and pancreatitis
  • Chronic dehydration
  • Irregular or absent menstrual periods
  • Swollen salivary glands giving a "chipmunk cheek" appearance
  • Kidney problems from chronic dehydration and laxative/diuretic misuse
  • Increased risk of suicidal behavior
Healing

Treatment Approaches

01 Cognitive Behavioral Therapy for Bulimia (CBT-BN) — the gold standard treatment, focusing on breaking the binge-purge cycle and changing distorted thinking patterns
02 Interpersonal Therapy (IPT) — addresses relationship issues and social functioning that maintain the disorder
03 Dialectical Behavior Therapy (DBT) — helps develop healthier ways to manage emotions without turning to binge-purge behaviors
04 Nutritional counseling — establishing regular, balanced eating patterns and challenging food rules
05 Medication — fluoxetine (Prozac) is FDA-approved for bulimia nervosa and can reduce binge-purge frequency
06 Group therapy — connecting with others in recovery to reduce shame and build support
07 Treatment for co-occurring conditions such as depression, anxiety, or substance use disorders

There is hope

Recovery is possible with the right help.

Talk to a professional who specializes in eating disorder treatment.

Find Help Near You
FAQ

Frequently Asked Questions