Bulimia Nervosa

What Is Bulimia Nervosa?

Bulimia nervosa is an eating disorder characterized by a cycle of binge eating episodes and compensatory purging. The most common method of purging is by by inducing vomiting, but taking laxatives, fasting and/or exercising excessively are also common. Per the DSM-V, a bulimia nervosa diagnosis must typically meet the following criteria:

  1. The individual’s shape or weight has an unreasonable influence on his or her self-evaluation.
  2. The individual experiences recurrent episodes of binge eating, which involves eating an unreasonable amount of food during a short period of time. During this episode, the individual will feel that he or she cannot control the binge eating episodes.
  3. The individual compensates for binging by exercising, fasting, taking medications and/or inducing vomiting.

These behaviors must occur at least once a week for three months to qualify for a diagnosis of bulimia nervosa.


What Causes Bulimia Nervosa?

Specific bulimia nervosa causes vary from one person to another, so the precise cause of bulimia nervosa is difficult to pinpoint. However, researchers believe that this disorder usually develops because of a combination of different biological, environmental and/or psychological factors. For environmental factors, bulimia nervosa may be related to societal pressures, such as unrealistic expectations for body weight and shape. Biological factors include a person’s biological sex (people assigned female at birth are more at-risk, although bulimia nervosa affects men as well) and genetics. People whose parents have experienced bulimia nervosa are more likely to experience it themselves. There is also a link between other mental health disorders such as depression and anxiety and most eating disorders, including bulimia nervosa.

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Pathophysiology of Bulimia Nervosa

In 2018 Oliver-Pyatt Centers (OPC) began a comprehensive research study, approved by an Institutional Review Board, in order to assess treatment outcomes in our Residential, PHP and IOP levels of care. Specifically, clients who consent to participate in our research study complete a series of questionnaires upon admission, transfer to a new level of care (stepping up or down), as well as upon discharge from our eating disorder treatment programs. Additionally, we obtain follow-up data for clients who consent at specified time-points after their discharge.

The purpose of these questionnaires is multifaceted. Primarily, it represents our commitment to personalized treatment planning. This data provides a snapshot of each individual’s distinctive symptom presentation on measures of eating disorder symptoms, depression, anxiety, functional impairment, and trauma reactivity. This information deepens our understanding of the clinical challenges specific to each client and as a roadmap for exploration of the factors that may be maintaining the eating disorder.

Signs And Symptoms of Bulimia Nervosa?

Aside from the diagnostic criteria set out in the DSM-V, the behavioral symptoms can vary from person to person. The diagnostic criteria of this disorder may include:

  • Repeated episodes of binging, which means eating a large amount of food in one sitting.
  • Forced purging following an episode of binge eating.
  • Loss of control during episodes of binging.
  • Unreasonable fear of weight gain.
  • Preoccupation with weight and/or body shape.

Even if an individual is experiencing these symptoms, they may still be reluctant to seek bulimia nervosa treatment. However, family and friends may be able to detect the disorder by looking for some telltale behavioral symptoms. Some of the most common signs of bulimia nervosa include:

  • Avoidance of eating in front of others.
  • Fasting or strict diets attempting to lose weight.
  • Going to the bathroom during or right after meals.
  • Fluctuating weight.
  • Sores or calluses on the hands or knuckles.
  • Swelling of the face, cheeks, hands and/or feet.
  • Excessive exercise.
  • Negative body image and/or preoccupation with weight gain.
  • Damaged gums and teeth.

Bulimia Nervosa Health Risks

Bulimia nervosa, if left untreated, can lead to a variety of health complications. According to the Mayo Clinic, some of the most common bulimia nervosa side effects include:

  • Severe tooth decay and gum disease
  • Irregular heartbeat, heart failure or other heart problems.
  • Co-occurring mental health disorders like personality disorders, anxiety, substance abuse disorder, and depression.
  • Digestive disturbances.
  • Dehydration, which can lead to other complications like kidney failure.
  • Abuse of drugs or alcohol.
  • Low self-esteem.
  • Tendencies toward self-harm.

Bulimia Nervosa Recovery and Eating Disorder Treatment Programs

Because bulimia nervosa can have so many severe implications for an individual’s mental and physical health, early intervention is highly recommended if possible. The sooner someone receives treatment, the easier it will be for them to make a full recovery.

Bulimia nervosa treatment programs are designed to help individuals to identify the underlying causes of their disordered eating behaviors and restore their relationships with food and eating. In general, the most effective bulimia nervosa treatment programs are those that customize treatment based on the needs of the individual. For example, the program should begin with a thorough medical and psychological evaluation of the client intended to identify the factors that led to the development of the disorder, as well as the complications of the disorder that require medical treatment. Based on this information, the facility can develop a treatment approach tailored to that specific individual.

 You can see more about on our blog about bulimia nervosa here.

Effective bulimia nervosa treatment programs are available. If you or a loved one is struggling with bulimia nervosa, please contact us today.