Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food — and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or do excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal.
Bulimia can be categorized in two ways:
However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method.
If you have bulimia, you're probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. Because it's related to self-image — and not just about food — bulimia can be difficult to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications.
Bulimia signs and symptoms may include:
When to see a doctor
Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader or someone else you trust. He or she can help you take the first steps to successful bulimia treatment.
Helping a loved one with bulimia symptoms
Because most people with bulimia are of normal weight or even slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include:
The exact cause of bulimia is unknown. There are many possible factors that could play a role in the development of eating disorders. But biology, emotional health, societal expectations and other factors increase your risk.
Factors that increase your risk of bulimia may include:
Bulimia may cause numerous serious and even life-threatening complications. Possible complications include:
Preparing for your appointment
Here's some information to help you get ready for your appointments, and what to expect from your health care team.
What you can do
Write down questions to ask your doctor, such as:
Don't hesitate to ask questions at any time if you don't understand something.
What to expect from your doctor
Your doctor will ask additional questions based on your responses, symptoms and needs.
Tests and diagnosis
When doctors suspect you have bulimia, they typically perform:
Your doctor may also request an X-ray to check for broken bones, pneumonia or heart problems and an electrocardiogram (EKG) to look for heart irregularities.
These tests help doctors determine if you have bulimia or another eating disorder, such as anorexia or binge-eating disorder.
Diagnostic criteria for bulimia
Even if you don't meet all of these criteria, you could still have an eating disorder. Don't try to diagnose yourself — get professional help if you have any eating disorder symptoms.
Treatments and drugs
When you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder. Treatment generally involves a team approach that includes you, your family, your primary care doctor or other medical provider, as well as a mental health provider and a dietitian experienced in treating eating disorders. You may have a case manager to coordinate your care.
Here's a look at bulimia treatment options and considerations:
Ask your mental health provider which psychotherapy he or she will use and what evidence exists that shows it's beneficial in treating bulimia.
Nutrition education and achieving healthy weight
Treatment challenges in bulimia
Lifestyle and home remedies
Although you can't treat bulimia on your own, you can build on your treatment plan. In addition to professional treatment, follow these self-care tips for bulimia:
Although complementary and alternative therapies to reduce bulimia symptoms have not been studied, some therapies, such as those below, may help achieve the goals set by you and your health care team.
Risks of herbs and dietary supplements
Coping and support
You may find it difficult to cope with bulimia when you're hit with mixed messages by the media, culture, coaches, family, and maybe your own friends or peers. So how do you cope with a disease that can be deadly when you're also getting messages that being thin is a sign of success?
Coping advice for parents
Here are some suggestions for supporting your child:
Remember that eating disorders affect the whole family, and you need to take care of yourself, too. If you feel that you aren't coping well with your teen's illness, you might benefit from professional counseling. Or ask your child's doctor about support groups for parents of children with eating disorders.
Although there's no sure way to prevent bulimia, you can steer someone toward healthier behavior or professional treatment before the situation worsens. Here's how you can help:
Last Updated: 2012-04-03
© 1998-2016 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
Terms and conditions of use