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Patient education: Bulimia nervosa (The Basics)

Patient education: Bulimia nervosa (The Basics)

What is bulimia nervosa? — Bulimia nervosa, often just called "bulimia," is an eating disorder in which people have episodes of overeating. These overeating episodes are called "binges." After overeating, people then use unhealthy behaviors to rid their bodies of the food and avoid gaining weight. These behaviors are called "purges."

Bulimia is more common in females than males. It usually begins in the teen or early adult years.

Many people with bulimia are a normal weight for their height. Because their weight appears healthy, other people might not know that they have an eating disorder. But it's important for people to get treatment, because bulimia can cause serious problems.

What are the symptoms of bulimia? — People with bulimia:

Binge at least once a week for 3 months or longer – During binges, people eat a much larger amount of food than normal. When they overeat, they usually feel out of control, guilty, afraid, or ashamed.

Purge or exercise after they eat – To avoid gaining weight after overeating, people:

Make themselves vomit

Exercise too much

Use medicines to make themselves vomit, urinate, or have bowel movements

Judge themselves based on their weight and body shape – They feel good about themselves if they are thin and feel bad about themselves when they think that they are overweight.

Is there a test for bulimia? — No. There is no test. But your doctor or nurse should be able to tell if you have it by doing an exam and talking with you about your eating habits, behaviors, and thoughts.

Your doctor or nurse will do tests to check your health, because bulimia can lead to many health problems. You will probably have:

Blood tests

Urine tests

An electrocardiogram ("ECG") – This test measures the electrical activity in your heart and records your heart rate and rhythm (figure 1).

What problems can bulimia cause? — Bulimia can cause different kinds of health problems. That's because people vomit too often or use certain medicines too much. These health problems can include:

Dehydration – This is when the body loses too much water. It can make you feel thirsty, tired, dizzy, or confused, and have dark yellow urine.

Feeling very tired

Irregular menstrual periods

Belly pain, bloating, and trouble having bowel movements

Damage to the esophagus (the tube that connects the mouth to the stomach)

Damage to the teeth, gums, or cheeks

Problems with the heart, kidney, and glands

People with bulimia can also have:

Depression – This is when people feel very sad, empty, or hopeless most of the time, or do not enjoy the things that usually make them happy. In addition, people can have trouble with their sleep, appetite, energy, memory, or concentration. Some people with depression think about hurting themselves. If you are thinking of hurting yourself, call your doctor or nurse right away or go to the hospital. In the US, you can also call or text 988 to reach the Suicide & Crisis Lifeline.

Anxiety – This is when people worry a lot or think about certain things over and over.

Problems with alcohol or drug use

How is bulimia treated? — Treatment for bulimia involves:

Psychotherapy – Psychotherapy involves meeting with a therapist to talk about your feelings, thoughts, and life. Different kinds of psychotherapy can be helpful, including:

Working one-on-one with a therapist

Group therapy – You can join a group for people with eating disorders.

Family therapy – You and your family can work with a therapist.

Medicines – Some medicines that treat depression can also help treat bulimia.

A healthy eating plan – You can work with a dietitian (food expert) to make a healthy eating plan. If you are underweight or overweight, the dietitian can make a meal plan to help you get to a healthy weight.

Most people with bulimia can be treated at home, but some need to be treated in the hospital. It depends on the person's weight, symptoms, and health problems. Treatment for bulimia can be hard work, and it can take a long time. A complete recovery can take years.

What happens after treatment? — Many people get better with treatment. But people with bulimia often "relapse." This is when their symptoms and unhealthy eating patterns return.

To help prevent a relapse, follow your treatment plan and keep seeing your therapist. If you start to have symptoms again, let your family, therapist, or doctor know as soon as possible so that you can get help.

More on this topic

Patient education: Anorexia nervosa (The Basics)
Patient education: Generalized anxiety disorder (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Medicines for depression (The Basics)

Patient education: Depression in children and adolescents (Beyond the Basics)
Patient education: Depression in adults (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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