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Bulimia nervosa is an eating disorder in which a person binges and purges. The person may eat a lot of food at once and then try to get rid of it by vomiting, using laxatives, or sometimes over-exercising.
People with bulimia are preoccupied with their weight and body image. Bulimia is linked to depression and other psychiatric disorders. It shares some symptoms with anorexia nervosa, another major eating disorder.
Because many people with bulimia can stay at a normal weight, they may keep their condition a secret for years. If not treated, bulimia can lead to problems from not getting enough nutrition. It can cause life-threatening complications.
Signs and Symptoms
People with bulimia may have the following signs and symptoms:
What Causes It?
No one knows what causes bulimia, although there are several theories. Genes may play a part. Women who have a sister or mother with bulimia may be at higher risk of developing the condition.
Families may put too much emphasis on achievement, or be overly critical. Psychological factors may also play a part including having low self-esteem, not being able to control impulsive behaviors, and having trouble expressing anger.
Some people with bulimia may have a history of sexual abuse. People with bulimia may also cope with depression, self-mutilation, substance abuse, and obsessive-compulsive behavior.
Cultural pressures to look thin can also play a part, particularly among dancers and athletes.
Who's Most At Risk?
These people are at higher risk for developing bulimia:
What to Expect at Your Provider's Office
Often, people with bulimia are ashamed of their condition and do not ask for help for many years. By then, their habits are harder to change. If you have symptoms of bulimia, talk to your doctor as soon as possible.
The doctor will check for physical signs such as thin tooth enamel and enlargement of the salivary glands, as well as signs of depression. Laboratory tests may show chemical changes caused by bingeing and purging. Your doctor or a mental health practitioner will do a psychological exam and ask about your feelings and your eating habits.
People with bulimia may need a combination of treatment including psychotherapy, family therapy, and medication. It is important for the person with bulimia to be actively involved in their treatment.
Doctors often prescribe antidepressants for bulimia, usually those called selective serotonin reuptake inhibitors (SSRIs). They include:
Prozac is the only antidepressant approved by the Food and Drug Administration to treat bulimia. Some studies suggest that similar drugs, such as Luvox, may work even better.
Some studies have found that Prozac and other antidepressants may cause some children and teenagers to have suicidal thoughts. Children who take these drugs should be watched very carefully for signs of suicidal behavior.
People with bulimia may not be getting the nutrients their bodies need. Your health care provider may prescribe potassium or iron supplements, or other supplements to make up for any loss.
Complementary and Alternative Therapies
Psychotherapy is a crucial part of bulimia treatment. Many people with bulimia have good results from cognitive behavioral therapy, which teaches you to replace negative thoughts and behaviors with healthy ones.
Other mind-body and stress-reduction techniques, such as yoga, tai chi, and meditation, may help you become more aware of your body and have a more positive body image. One 6-week clinical trial showed that guided imagery helped people with bulimia reduce bingeing and vomiting, feel more able to comfort themselves, and feel better about their bodies and eating. More studies are needed to see if guided imagery has long-term benefits.
Always tell your health care provider about any herbs and supplements you are thinking about using.
Nutrition and Supplements
Although there aren't any supplements that specifically treat bulimia, some may be good for your general health and well-being. Also, people with bulimia may not get enough of some vitamins and minerals, which can affect their health. A better diet or taking supplements can help.
Follow these nutritional tips:
If you aren't getting enough of some nutrients, your doctor may suggest the following:
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment.
These herbs are not used to treat bulimia specifically, but may be good for general overall health:
There are no scientific studies on using homeopathy to treat bulimia. However, an experienced homeopath will consider your individual case and may recommend treatments for both your underlying condition and any current symptoms.
There are no scientific studies on using acupuncture to treat bulimia. However, a trained acupuncturist may be able to recommend treatments for your overall health. Many inpatient treatment centers for eating disorders include acupuncture in their treatment plan. Studies have found that acupuncture can be helpful in treating addictive behaviors and anxiety in general. That may help people with bulimia who are in recovery.
Therapeutic massage can be an effective may be part of a bulimia treatment plan. In one study, 24 teen girls who got massage therapy for 5 weeks did better than a group of girls who didn't get massage. Massage worked quickly, too: Women in the massage group were less anxious and depressed right after their first massages. They also had better scores on the Eating Disorder Inventory, which helps health care providers assess psychological and behavioral traits in eating disorders.
It's very common for people with bulimia to relapse after treatment. They may need long-term care.
Possible complications from repeated bingeing and purging include problems with the esophagus, stomach, heart, lungs, muscles, or pancreas. People with suicidal thoughts or severe symptoms may need to be hospitalized.
Women with bulimia may find pregnancy emotionally difficult because of the changes in their body shape. The mother's poor nutritional health can affect the baby. Women who have stopped having periods because of bulimia will be unable to become pregnant.
Because bulimia is usually a long-term disease, a health care provider will need to check the person's weight, exercise habits, and physical and mental health from time to time.
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Review Date: 12/16/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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