How does bulimia work

Top of the page. Topic Overview What is bulimia nervosa? What causes bulimia? You may be more likely to have bulimia if: Other people in your family are obese or have an eating disorder. You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.

You are often on a diet or you exercise too much in order to lose weight or change your body shape. Have a poor body image, or feel that your body should be slim like many people in the media. You are the type of person who tries to be perfect all the time, never feels good enough, or worries a lot.

You are dealing with stressful life events, such as divorce, moving to a new town or school, or losing a loved one. Bulimia is most common in: Teens. Like other eating disorders, bulimia usually starts in the teen years. But it can start even earlier or in adulthood. But boys and men have it too. What are the symptoms? People with bulimia: Binge eat on a regular basis. They eat larger amounts of food than most people would in a similar situation, in a short period of time 2 hours or less.

During a binge, they feel out of control and feel unable to stop eating. Purge to get rid of the food and avoid weight gain. They may make themselves vomit, exercise very hard or for a long time, or misuse laxatives, enemas , water pills diuretics , or other medicines. Base how they feel about themselves on how much they weigh and how they look. Any one of these can be a sign of an eating disorder that needs treatment.

How can you know if someone has bulimia? A person may have bulimia if he or she: Goes to the bathroom right after meals. Is secretive about eating, hides food, or will not eat around other people. Exercises a lot, even when he or she does not feel well. Often talks about dieting, weight, and body shape.

Uses laxatives or diuretics often. Has teeth marks or calluses on the back of the hands or swollen cheeks or jaws. These are caused by making oneself vomit. How is it treated? What should you do if you think someone has bulimia?

Talk to him or her. Tell the person how much you care and why you are worried. Urge him or her to talk to someone who can help, like a doctor or counselor. Offer to go along. Tell someone who can make a difference, like a parent, teacher, counselor, or doctor.

The sooner your friend or loved one gets help, the sooner she will be healthy again. Cause The cause of bulimia is not clear, but it probably results from a combination of genetics, family behaviors, social values such as admiring thinness , and other things that can put someone at risk such as perfectionism. Symptoms Symptoms of bulimia include: Repeated binge eating, or eating larger amounts of food than most people would in a similar situation, in a short period of time 2 hours or less.

Frequently getting rid of the calories you've eaten purging by making yourself vomit, fasting, exercising too much, or misusing laxatives, diuretics , ipecac syrup, or enemas. Misuse of these medicines can lead to serious health problems and even death. Feeling a loss of control over how much you eat. Feeling ashamed of overeating and very fearful of gaining weight. Basing your self-esteem and value upon your body shape and weight.

Thinking about food, your body, or dieting so much that it distracts you from other tasks. Other signs that a person may have bulimia Common signs that a person may have bulimia are when the person: Is very secretive about eating and does not eat around other people.

Sneaks food or hides food in the house. You may notice that large amounts of food are missing. Has frequent weight changes. For example, the person may gain and lose large amounts of weight in short periods of time. Has irregular menstrual cycles. Seems preoccupied with exercise. Seems to be overusing laxatives and diuretics.

Has low levels of potassium or other blood electrolyte imbalances. Looks sick or has symptoms such as: Tooth decay or erosion of tooth enamel. Sore gums or mouth sores. Dry skin. Loose skin. Thin or dull hair. Swollen salivary glands. Bloating or fullness.

Lack of energy. Teeth marks on the backs of the hands or calluses on the knuckles from self-induced vomiting. Feels depressed, anxious, or guilty. Shoplifts food, laxatives, or diuretics. Drinks large amounts of alcohol or uses illegal drugs and may have substance use disorder. Warning signs of possible suicide in children and teens can include being preoccupied with death or suicide, giving away belongings, withdrawing, being angry, or having failing grades.

Warning signs and possible triggers of suicide in adults can include depression, giving away belongings, a recent job loss, or divorce. If you or someone you know shows warning signs of suicide, seek help immediately.

What Happens When you have bulimia, you judge yourself harshly on your body weight and shape. Health problems caused by bulimia include: Tooth decay, toothaches, swollen gums, gum disease gingivitis , and erosion of tooth enamel. These are caused by acid in the mouth from vomiting. Electrolyte imbalances and changes in metabolism that can lead to heart problems, such as arrhythmia and even death. Dehydration, which can lead to weakness, fainting, or kidney damage. Inflammation or tears of the esophagus , which may cause bloody vomit.

Fainting or loss of consciousness, usually because of low blood pressure. Low body temperature. Suicide risk when feeling discouraged about having bulimia or a relapse or about ongoing body image issues. Long-term problems with bowel movements because of laxative misuse. Substance use disorders , which occur in more than one-third of those with bulimia. Borderline personality disorder , which more commonly occurs with bulimia than with other eating disorders.

Anxiety and anxiety disorders. Obsessive-compulsive disorder. Social anxiety disorder or other phobias. Panic disorder or panic attacks.

What Increases Your Risk The risk for bulimia or another eating disorder is greatest if a person: footnote 2 Has a biological parent, brother, or sister who has an eating disorder or who is overweight or obese.

Is overly concerned with weight or struggles with symptoms of depression. Is overweight and is starting a restrictive diet.

Has certain personal traits such as perfectionism. Struggles with cultural and social factors such as admiring thinness. When should you call your doctor? Call your doctor immediately if you or someone you care about has been diagnosed with bulimia and now: Is not able to pass urine. Notices that his or her heart skips beats or beats slower than normal. Has severe belly pain, is vomiting up blood, or has black, sticky stools that look like tar.

These signs may mean that there is bleeding in the digestive tract. Call your doctor to discuss bulimia if you or someone you care about: Binges and then purges to get rid of food.

Is concerned about weight and is embarrassed about eating behaviors. Shows signs of an eating disorder, such as secretive eating habits, a preoccupation with body image, or an unhealthy appearance. Watchful waiting Taking a wait-and-see approach called watchful waiting is not appropriate if you think you or someone you know may have an eating disorder. Who to see Bulimia may be diagnosed and treated by the following health professionals: Family medicine physician Psychiatrist Psychologist Physician assistant Nurse practitioner Licensed mental health counselor Registered dietitian.

Exams and Tests There is no single test that can diagnose bulimia or any other eating disorder. Common exams and tests for a possible eating disorder include: Questions about your medical history, including your physical and emotional health, both present and past.

A physical exam to check your heart, lungs, blood pressure, weight, mouth, skin, and hair for diet problems. Screening questions about your eating habits and how you feel about your health. A mental health assessment to check for depression or anxiety. Blood tests to check for signs of malnutrition, such as low potassium levels or other chemical imbalances.

X-rays , which can show whether your bones have been weakened low bone density by malnutrition. Early detection Early, accurate diagnosis and treatment of bulimia can decrease the chances of long-term health problems and even death in severe cases. Treatment Overview Treatment for bulimia involves psychological counseling and sometimes medicines such as antidepressants.

Initial treatment Initial treatment depends how severe the bulimia is and how long you have had it. If you have no other conditions that need treatment first, then treatment for bulimia usually consists of: Medicines. Antidepressants such as fluoxetine Prozac, for example , are sometimes used to reduce binge-purge cycles and relieve symptoms of depression that often occur along with eating disorders.

They work best when combined with counseling. Psychological counseling. Two types of counseling are useful in treating bulimia. In CBT you learn how to change negative thoughts that you may have about food, your weight, your body, or beliefs about yourself.

In IPT you learn how relationships—and feelings about those relationships—affect binge eating and purging. The goals of CBT are: To use nutritional counseling to help you learn how to eat three meals and two snacks a day and avoid unhealthy diets. To reduce concern about your body weight and shape. To understand and reduce triggers of binge eating by examining your relationships and emotions. To develop a plan to learn proper coping skills to prevent future relapses.

The goals of IPT are: To identify relationships that are connected to binge eating and purging. To learn how emotions that come up from these relationships are related to binge eating and purging. To help correct these relationship patterns, so that you won't binge eat or purge in response to bad feelings. Ongoing treatment Continuing treatment will depend on the how long you have had bulimia and how severe it is. Men are often less likely to exhibit noticeable symptoms or seek appropriate treatments.

This can put them at risk for health problems. Not everyone with bulimia is ultra-thin. Anorexia causes a large calorie deficit, leading to extreme weight loss. People with bulimia can experience episodes of anorexia, but they still tend to consume more calories overall through bingeing and purging. This explains why many people with bulimia still retain normal body weights. This can be deceptive to loved ones, and can even cause a doctor to miss the diagnosis.

This eating disorder causes more than just unhealthy weight loss. Every system in your body is dependent on nutrition and healthy eating habits to function properly. When you disrupt your natural metabolism through binging and purging, your body can be seriously affected. Women with bulimia often experience missed periods. Bulimia can have lasting effects on reproduction even when your menstrual cycle goes back to normal. Antidepressants have the potential to improve bulimic symptoms in people who also have depression.

It has been found to help prevent binges and purges. Bulimia is treatable, but symptoms often come back without warning. According to ANAD, only 1 out of 10 people seek treatment for eating disorders. For the best chance at recovery, identify your underlying cues and warning signs.

For example, if depression is your trigger, then pursue regular mental health treatments. Seeking treatment can help prevent relapses in bulimia. The real solution for long-term weight maintenance is a sensible diet and exercise plan. Bulimia ultimately disrupts normal weight maintenance, which sets up the body for greater challenges as the eating disorder progresses.

Working to develop a healthy body image and lifestyle is a must. See a doctor right away if you or a loved one needs help treating bulimia. Bulimia nervosa is a potentially life-threatening eating disorder. Read about the symptoms and treatment options. If you're concerned that someone close to you may have bulimia, let them know you're worried about them and encourage them to see a GP.

You could offer to go along with them. Read more about talking to your child about eating disorders and supporting someone with an eating disorder. Your treatment plan will be tailored to you and should take into account any other support you might need, such as for depression or anxiety. If you're over 18, you'll probably be offered a guided self-help programme.

This involves working through a self-help book, and often includes keeping a diary and making a plan for your meals. You'll be supported by a therapist during this process. You may also be offered cognitive behavioural therapy CBT. Read more about treatments for bulimia. Bulimia can eventually lead to physical problems associated with not getting the right nutrients, vomiting a lot, or overusing laxatives. Bulimia is often a vicious cycle of binging and purging, triggered by things such as hunger, sadness or stress.