Patient Awareness

Bulimia Nervosa : Understanding Eating Disorders

Bulimia Nervosa
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Bulimia nervosa is a psychological eating disorder characterized by repeated episodes of overeating and an obsession with the control of body weight. It is based on the patient’s dissatisfaction with their body image.

While they fear food, they consume it in huge quantities. Binge eating is in response to depression, stress and other feelings related to body weight and shape. Irrational eating brings a feeling of calmness but the self-loathing brought on by overeating soon replaces the short-lived euphoria.


Bulimia nervosa is usually less about food and more to do with psychological issues and feelings of lack of control.

Psychological factors: 

While there is currently no definite known cause, the psychosocial factors may include family disturbance or conflict, sexual abuse, maladaptive learned behavior, the struggle for control or self-identity, cultural overemphasis on physical appearance and parental obesity. Bulimia nervosa is commonly associated with depression, anxiety, phobias and obsessive-compulsive disorder.

Cultural factors: 

Eating disorders have historically been a problem found in girls and young women. Seeing images of flawless, thin females everywhere makes women believe that “thin” is good and that their worth is based on how slim they are.

Family factors:

If you have a mother or sister suffering from this condition, you are more likely to suffer from the same. Parents who think looks are important, diet themselves or criticize their children’s bodies are more likely to have a child with bulimia nervosa. 

Biological factors:  

Genes, hormones and chemicals in the brain may be factors in developing bulimia nervosa.


Bulimia is associated with a number of physical symptoms. Binge eating by itself rarely causes serious medical complications but it is associated with nausea, abdominal distension and cramping, slowed digestion and weight gain.

Self-induced vomiting, on the other hand, may have severe medical consequences, including:

  • Erosion of tooth enamel, particularly on the molars and maxillary incisors. Loss of tooth enamel is irreparable.
  • Magnification of the salivary glands.
  • Scars and calloused areas on the knuckles from contact with the teeth.
  • Irritation of the throat and esophagus from contact with stomach acid.
  • Tearing of mucous membranes in the upper gastrointestinal tract or perforation of the esophagus and stomach wall. Perforation of part of the digestive tract is a rare complication of bulimia but is potentially fatal.

Other physical symptoms associated include irregular menstrual periods or amenorrhea; petechiae (pinhead-sized bruises from capillaries ruptured by increased pressure due to vomiting) in the skin around the eyes and rectal prolapse (the lowering of the rectum from its usual position).


To manage the binge and purge process, it is extremely essential to seek medical help. The most effective way to get rid of bulimia nervosa is both psychological and medical treatment.

As a possible first step, patients should be encouraged to follow an evidence-based self-help program. As an alternative or additional first step to using an evidence-based self-help program, adults may be offered a trial of an antidepressant. Cognitive behavior therapy should be offered to adults with bulimia nervosa.

Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a health care professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

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