Understanding Bulimia Nervosa

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What is Bulimia Nervosa?

People with bulimia are caught in a cycle of eating large quantities of food (called bingeing), and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging).

Someone with bulimia will place a strong emphasis on their weight and body shape and may see themselves as much larger than they are (links to Body Dysmorphic Disorder).

Bulimia nervosa can, and does, affect anyone of any age, gender, ethnicity or background.

Bulimia Nervosa’s Impact on Health

Bulimia can cause serious physical complications, for example, frequent vomiting can cause problems with the teeth, and people may go to lengths to make themselves sick which could cause them harm. Laxative misuse can seriously affect the heart and digestive system.

Signs and Symptoms of Bulimia Nervosa

•Sufferers are often a “normal” weight and often hide their illness from others, it can be very difficult to spot from the outside.

•Purging behaviours such as misuse of laxatives or diuretics, self-induced vomiting, fasting, and excessive exercise.

•Binging and (some) purging behaviours typically occur in secret

•Triggered by negative moods, the binge temporarily alleviates the depressed or negative mood.

•However, guilt and self-loathing typically follow shortly after a binge.

Diagnostic Criteria for Bulimia Nervosa

A. Recurrent episodes of binge eating. Binge eating is defined as:

• Eating in a discrete period of time, (e.g. within a two-hour period) a far greater amount of food that what most individuals would eat in a similar period of time under similar circumstances.

• A sense of lack of control during the episode (feeling like they cannot stop eating or control the amount that is being eaten).

B. Recurrent inappropriate compensatory behaviours in order to prevent weight gain (purging behaviours such as, misuse of laxatives or diuretics, self-induced vomiting, fasting, excessive exercise).

C. The binge eating and purging behaviours both occur, on average at least once a week for three months

D. Self-evaluation is unduly influenced by body shape and weight

E. The disturbance does not occur exclusively during episodes of anorexia nervosa

What are the Treatment Options for Bulimia Nervosa?

•Meal planning, nutritional education

•Antidepressants (SSRIs)

•Focus on ending bingeing and purging behaviours

•Cognitive Behavioural therapy to address resistance to change, body image and thoughts around food. This might involve keeping thought & feeling record when eating (a tool I use within my coaching app)

•Motivational Interviewing and Enhancement therapies (also used within this app)

•Dialectical Behaviour Therapy, to help develop skills for distress tolerance and emotional regulation