Nature and Nurture? Examining the Causes of Bulimia Nervosa

Bulimia nervosa is a serious illness that affects an individual’s life in a variety of ways. In most cases, professional treatment will be required to prevent this disorder from continuing to progress. In order to treat bulimia nervosa successfully, it is helpful to understand how the disorder develops in the first place. However, the cause of bulimia nervosa is not always clear-cut. In fact, many different issues and factors can contribute to the development of this disorder. Below is some basic information about bulimia nervosa, the possible causes of bulimia nervosa and how these factors may contribute to the development of the disease.

About Bulimia Nervosa

Bulimia nervosa is one of the most common eating disorders. This disorder is characterized by a cycle of disordered eating behaviors that typically includes binge eating and some form of purging. To purge after binging, clients may engage in self-induced vomiting, abuse of laxatives and/or excessive exercise. Regardless of the specific bulimia nervosa symptoms a client experiences, the disorder requires prompt treatment.

In many cases, an individual who has bulimia nervosa will not be aware of the disorder or will not be willing to admit that a problem exists. For this reason, it is important for family and friends to be able to recognize the symptoms and signs of bulimia nervosa. Some of the most common bulimia nervosa symptoms and signs include:

  • Physical symptoms, such as changes in weight, stomach cramps, abnormal lab findings, sleep problems, dizziness, brittle hair and nails, muscle weakness, poor immune system functioning, fainting and feeling cold all the time
  • Emotional symptoms, such as mood swings, irritability, fear of eating in public, discomfort in social situations, withdrawal from friends and family members and extreme concern with body shape and weight
  • Behavioral symptoms, such as evidence of food rituals, purging behaviors, binge eating, meal skipping, disappearing after meals, stealing or hoarding of food, drinking excessive amounts of water and using excessive amounts of mints or mouthwash

People who have this disorder may also show signs of bulimia nervosa in their appearance. For example, they may wear baggy clothes to hide their body, have discolored teeth, have swelling in the jaws or cheeks, have calluses on the backs of knuckles or hands and/or look bloated.

Showing some bulimia nervosa symptoms does not necessarily mean an individual has the disorder. In order to determine if a problem exists, individuals who may have bulimia nervosa need to speak with a trained professional who can evaluate signs and symptoms and determine if bulimia nervosa treatment is necessary.

Possible Bulimia Nervosa Causes

Researchers have identified several different types of factors that may contribute to the development of bulimia nervosa. These factors include:

  • Developmental factors
  • Biological factors
  • Psychological factors
  • Sociocultural factors

In most cases, researchers believe that the disorder develops because of a combination of issues.

Developmental Factors

Childhood development plays an important role in how adults think and function. Positive and negative experiences children have in their younger years will impact their lives for many years to come. Some of the experiences a child has during their developmental years may contribute to the development of bulimia nervosa later in life. For example, researchers have discovered that childhood trauma and abuse are strongly associated with the development of eating disorders, including bulimia nervosa. Other types of trauma that may raise the risk of someone developing bulimia nervosa include bullying, loss of a parent, divorce of parents and any other life-altering experience.

Researchers are not sure about the exact mechanism that causes bulimia nervosa to develop in people with a history of trauma. However, some theorists believe that trauma may disrupt the nervous system, causing people to become unable to deal with uncomfortable emotions properly. Instead of managing these emotions with healthy coping mechanisms, people who have experienced trauma may turn to disordered eating. Certain types of trauma, such as sexual abuse, may also cause an individual to develop low self-esteem, which may lead to the development of an eating disorder as well.

Biological Factors

In some cases, bulimia nervosa may develop as a result of genetic factors. Genetic material is passed down from parents to children at the beginning of life. Certain genes may contribute to the development of bulimia nervosa, although scientists have not yet identified any specific genes associated with the disorder. However, eating disorders like bulimia nervosa tend to run in families, which indicates that some genetic component is likely present.

At this time, there is no way to alter genetic material. If an individual possesses genes that contribute to bulimia nervosa, he or she cannot do anything to change it. However, the disorder can still be treated.

Other biological factors that may contribute to the development of bulimia nervosa include imbalances in hormones and/or neurotransmitters. Hormones, which are natural chemicals found in the human body, are responsible for regulating all of the body’s different processes. Imbalances in these chemicals may make it more likely for someone to develop bulimia nervosa. Likewise, imbalances in neurotransmitters may also be problematic. Neurotransmitters, which are chemicals found naturally in the brain, are responsible for maintaining mood and facilitating brain cell communication.

Psychological Factors

Psychological factors have also been implicated in the development of bulimia nervosa. People who have this disorder often exhibit signs of other psychological disorders, such as borderline personality disorder, bipolar disorder, anxiety and/or depression. Bulimia nervosa may also be linked to self-harming behaviors, such as cutting.

Sociocultural Factors

For many clients, sociocultural factors play an important role in the development of this condition. Modern society places extreme value on physical appearance. As a result, many people, especially adolescents, are tempted to engage in extreme behaviors in order to maintain an appearance that fits in with society’s expectations. One of the behaviors often used to lose weight or maintain a low weight is binging and purging, which is the defining feature of bulimia nervosa.

Body image issues and self-esteem problems are common among people with bulimia nervosa. Scientists believe that images in the media, as well as the influence of peers, are largely responsible for creating these problems.


Some people have personality traits that make them more likely to develop eating disorders, such as bulimia nervosa. For example, people who are perfectionists may be more likely to turn to disordered eating habits in order to maintain a pleasing appearance. People who are more prone to anxiety and nervousness may also be at a higher risk of developing this disorder.

Identifying Bulimia Nervosa Causes

It is often difficult or impossible to identify one specific cause of bulimia nervosa. Every client is different, and most clients have a disorder that developed as a result of more than one causative factor. However, looking into the causes of bulimia nervosa is essential in order to determine the best course of treatment. For example, someone who has bulimia nervosa related primarily to a history of sexual abuse and a tendency toward perfection may need a different treatment protocol than someone who has bulimia nervosa because of genetic factors and issues with body image. For this reason, treatment professionals need to explore each individual client’s background carefully to identify the specific factors that were most likely to have contributed to the disorder. With this specific information about bulimia nervosa causes, treatment professionals will be able to design a treatment protocol tailored to each client’s specific needs.

Bulimia Nervosa Treatment 

When someone has been diagnosed with bulimia nervosa, getting professional treatment is highly recommended. However, not all bulimia nervosa treatment programs are the same. For this reason, it is essential for anyone seeking bulimia nervosa treatment to weigh their options carefully in order to find the right program for their needs.

Bulimia nervosa treatment programs differ considerably with regard to the way they view the disorder, as well as the approach to treatment. For example, some treatment programs may be based on the idea that bulimia nervosa is always the result of some form of psychological trauma, while others may consider bulimia nervosa to be a product of genetics and environment. Because research has shown that bulimia nervosa causes can vary considerably from one client to the next, a treatment center’s perspective on the cause of bulimia nervosa is an important consideration for any potential client. In general, it is best to look for a treatment center that views each case of bulimia nervosa as unique and seeks to discover what factors may have contributed to the individual client’s disorder.

Bulimia nervosa treatment programs may approach the treatment of the eating disorder in a number of ways. Some programs rely solely on psychotherapy, while others may utilize medical care, alternative therapies and other treatment approaches instead of or in addition to psychotherapy. In order to maximize the chances of achieving a full recovery, it is best to look for a program that offers a wide range of treatment options and will customize treatment programs to meet the needs of each unique client.

Other factors clients and/or loved ones of people with signs of bulimia nervosa should consider when comparing treatment programs include:

  • The facility:In many cases, the treatment of bulimia nervosa requires clients to enter a residential facility. The accommodations available vary widely from one facility to the next, with some treatment centers being much more luxurious than others. Potential clients should consider the accommodations available at different facilities before making a choice.
  • The treatment program’s reputation:One of the best ways to determine the effectiveness of a given treatment program is to learn about the program’s reputation. Before entering a treatment program, clients should read third-party reviews and testimonials to learn about the experiences of people who have already completed treatment.
  • Success rates:Another important measure of a program’s effectiveness is its success rates. Clients and/or their families should inquire about success rates before enrolling in a bulimia nervosa treatment program.
  • Cost:For many clients, the cost is one of the most important considerations when comparing bulimia nervosa treatment programs. The cost of different treatment programs can vary considerably. In addition, while some treatment programs accept insurance, others require clients to pay the entire cost of treatment out-of-pocket. Clients should understand the full cost of treatment as well as their payment options before beginning the program.

Finding the Right Program

When someone is experiencing bulimia nervosa symptoms, finding a treatment program as soon as possible is highly recommended. Oliver-Pyatt Centers is a nationwide leader in the treatment of eating disorders, including bulimia nervosa. This facility serves people with eating disorders in a comforting and supportive environment. Treatment is available for those with complex cases, including those who have co-occurring substance abuse or mental health disorders.