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It was ten years ago when I became bulimic. I had always worried about my weight and how I looked. I thought I looked fat, no matter what the scale showed or anyone said. But I had never made myself throw up — not until after college. I felt stressed out after graduating from college. I was very overwhelmed with my new job and turned to food to feel more in control of my life. Sometimes, I'd eat a lot of food and throw it up. Other times, I'd throw up a normal meal. At the time, it seemed like the only way I could cope with my stress. Luckily, I got help from a doctor, after a friend talked to me about the problem. It took a lot of work, but I am better now.
Bulimia nervosa (buh-LEE-me-ah nur-VOH-suh), often called bulimia, is a type of eating disorder. A person with bulimia eats a lot of food in a short amount of time (binging) and then tries to prevent weight gain by getting rid of the food (purging). Purging might be done by:
A person with bulimia feels he or she cannot control the amount of food eaten. Also, bulimics might exercise a lot, eat very little or not at all, or take pills to pass urine often to prevent weight gain.
Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, bulimics:
Many people think that eating disorders affect only young, upper-class white females. It is true that most bulimics are women (around 85-90 percent). But bulimia affects people from all walks of life, including males, women of color, and even older women. It is not known for sure whether African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native people develop eating disorders because American culture values thin people. People with different cultural backgrounds may develop eating disorders because it's hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.
Bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part.
A person with bulimia may be thin, overweight, or have a normal weight. Also, bulimic behavior, such as throwing up, is often done in private because the person with bulimia feels shame or disgust. This makes it hard to know if someone has bulimia. But there are warning signs to look out for. Someone with bulimia may use extreme measures to lose weight by:
Someone with bulimia may show signs of throwing up, such as:
People with bulimia often have other mental health conditions, including:
Someone with bulimia may also have a distorted body image, shown by thinking she or he is fat, hating her or his body, and fearing weight gain.
Bulimia can also cause someone to not act like her or himself. She or he may be moody or sad, or may not want to go out with friends.
Bulimia can be very harmful to the body. Look at the picture to find out how bulimia affects your health.
It may be safe for young people to be treated with antidepressants. However, drug companies who make antidepressants are required to post a "black box" warning label on the medication. A "black box" warning is the most serious type of warning on prescription medicines.
It may be possible that antidepressants make children, adolescents, and young adults more likely to think about suicide or commit suicide.
The FDA offers the latest information, including which drugs are included in this warning and danger signs to look for, on their website at http://www.fda.gov.
Yes. Someone with bulimia can get better. A health care team of doctors, nutritionists, and therapists will help the patient recover. They will help the person learn healthy eating patterns and cope with their thoughts and feelings. Treatment for bulimia uses a combination of options. Whether or not the treatment works depends on the patient.
To stop a person from binging and purging, a doctor may recommend the patient:
CBT is a form of psychotherapy that focuses on the important role of thinking in how we feel and what we do. CBT that has been tailored to treat bulimia has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy for a person with bulimia may be one-on-one with a therapist or group-based.
Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration (FDA) for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes. ("Relapse" means to get sick again, after feeling well for a while.)
Active bulimia can cause a woman to miss her period sometimes. Or, she may never get her period. If this happens, she usually does not ovulate. This makes it hard to get pregnant. Women who have recovered from bulimia have a better chance of getting pregnant once their monthly cycle is normal. If you're having a hard time getting pregnant, see your doctor.
If a woman with active bulimia gets pregnant, these problems may result:
If a woman takes laxatives or diuretics during pregnancy, her baby could be harmed. These things take away nutrients and fluids from a woman before they are able to feed and nourish the baby. It is possible they may lead to birth defects as well, particularly if they are used regularly.
If someone you know is showing signs of bulimia, you may be able to help.
Adapted from "What Should I Say? Tips for Talking to a Friend Who May Be Struggling with an Eating Disorder" from the National Eating Disorders Association.
For more information about bulimia nervosa, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:
Content last updated July 16, 2012.
Resources last updated June 15, 2009.