Bulimia Nervosa

An Often-Misunderstood Pattern of Behavior

Characterized by regular episodes of binge eating in which a person consumes large quantities of food, bulimia nervosa also has a follow-up phase in which he or she purges with laxatives or by vomiting. There is a feeling of loss of control that accompanies bulimia nervosa. Though bulimia nervosa is more common than anorexia nervosa, many people have both eating disorders.

Between one and three percent of United States teenagers are affected by bulimia nervosa.

Criteria for Bulimia Therapy

In order to be diagnosed with bulimia nervosa, certain criteria must be met. One of the most common signs of bulimia nervosa is repeated episodes of binge eating followed by purging. In many cases, this binge eating occurs in secret and without other people present. After a binge, the person often has intense feelings of regret and guilt concerning their food intake. In many cases, these binges follow periods of time when the person attempts to restrict what they eat as well as the amount.

A cyclic disorder, this period of restriction is then followed by binge eating and then purging. After purging, a person with bulimia nervosa often feels a sense of well-being and comfort. Sometimes, feelings such as intense happiness and euphoria are also present. On average, this cycle of binge eating episodes and related purging behaviors needs to occur at least one time per week over a period of three months in order to qualify as bulimia nervosa.

While a person with anorexia nervosa is often underweight, the same is not necessarily true with those who have bulimia nervosa. This can sometimes make it difficult for others to notice if a person has this eating disorder because it is not as physically obvious. Both bulimia nervosa and anorexia nervosa often have a strong genetic connection. Bulimia nervosa, however, does not occur only in conjunction with episodes of anorexia nervosa.

Signs That Bulimia Treatment Is Needed

Women need treatment for bulimia eating disorders more often than men. In addition to binge eating that’s undertaken in secret, other signs that a person has bulimia nervosa include visiting the restroom right after eating in order to vomit, taking laxatives, diet pills or diuretics in order to purge and harsh exercise regimes. Mood swings, fatigue, a fear of not being able to stop eating on their own, swollen glands and weight fluctuations typically between 10 and 15 pounds are other common signs that bulimia nervosa treatment is warranted.

Sometimes it can be difficult for those people who are close to a person with bulimia nervosa to notice a problem. Though they might be of a normal weight, a person with bulimia nervosa feels overweight and sees themselves as such. Some signs that might be visible to family, friends, coworkers or school personnel include purchasing large quantities of food that disappear quickly or suddenly eating large quantities of food, empty packages of medications such as diuretics, diet pills, emetics and/or laxatives in the trash, regularly going to the restroom immediately after eating and spending a great deal of time exercising.

Food Rituals and Other Behaviors to Look For

The development of food rituals — in which a person eats only a certain type of food or food group, for example — along with being uncomfortable while eating around other people, fear of eating in public, skipping meals, drinking large amounts of water and stealing or hoarding food are all signs that those people who are close to the person with bulimia nervosa might notice.

In addition to creating rituals with food itself, a person who needs bulimia treatment might also schedule her life and/or activities to make time for bingeing and purging, might dress in baggy clothes to hide her body, might diet frequently, could have extreme mood swings and withdraw from friends and activities she once enjoyed.

Finding Treatment Facilities for Bulimia

Bulimia treatment options often include a stepped approach consisting of support groups, counseling, and medication. Because many people who have bulimia nervosa also have co-occurring conditions, a return to their healthy self requires treating these as well. Substance abuse, self-injury, and impulsivity are conditions that often occur at the same time that a person has bulimia nervosa. Working with a recovered staff that uses a treatment plan based on truth without judgment provides the support and resources needed to facilitate a fully recovered existence.