Bulimia nervosa

What is bulimia nervosa?

Bulimia nervosa, usually shortened to bulimia, is characterised by cycles of eating large amounts of food, known as bingeing, and then purging that food through vomiting, abuse of laxatives, excessive exercising, or a combination of all three.

A serious illness, the longer term effects of bulimia can be extremely damaging both physically and mentally but early intervention and treatment can be very effective. Anyone can be affected by bulimia, but it does tend to affect more females than males, and those in teenage years to early adulthood. There is also evidence of those with a family history of eating disorders or mental illness being at higher risk of developing bulimia.

If you are concerned that you, or someone you care for, may have Bulimia nervosa it is important that you make an appointment with a GP as soon as possible.

Signs and symptoms of bulimia nervosa

Signs of bulimia include:

  • Eating large amounts of food on a regular basis, often secretly, and even when not hungry
  • Going to extreme or unusual lengths to obtain food for a bingeing episode
  • Purging after eating, either by vomiting, using laxatives or over exercising
  • Obsessively organising daily routines around bingeing and purging episodes
  • Feelings of anxiety around eating, mealtimes and eating in front of others
  • Hoarding supplies of food
  • Frequently checking weight
  • Comparing weight/body shape with others
  • Withdrawing socially, irritability and mood swings

Symptoms of bulimia include:

  • Fluctuating weight; weight loss or gain, although weight can also remain within normal ranges overall
  • Vomiting, especially after meals
  • Electrolyte imbalances
  • Bloating, constipation, and stomach pain
  • Fluctuating blood sugar levels
  • Feelings of faintness, fainting and mood swings
  • Irregular or stopped periods
  • Tiredness and sleeping problems
  • Teeth problems
  • Low confidence and self esteem
  • Difficulty concentrating
Treatment for bulimia nervosa in adults

Currently, NHS treatment for bulimia in adults (18+) is offered in two stages. Not everyone will need to go through both stages.
Stage one is focused on a guided self-help programme that will enable you to identify what triggers a binge-purge episode. It will also encourage you to consider what you eat, create appropriate meal plans, and find ways to cope with difficult feelings.

For those needing additional support, generally after completion of the self-help programme over 4 weeks, stage two offers cognitive behavioural therapy (CBT) for up to 20 sessions. CBT involves talking with a therapist to explore what may be the underlying causes and how to better manage difficult feelings and emotions.

Adults may also be prescribed antidepressants to support recovery in conjunction with talking therapy. In particular, antidepressants can help with feelings of anxiety, depression or help with obsessive compulsive disorder (OCD) which those with bulimia can also experience. Antidepressants should never be used alone in the treatment of bulimia and are rarely prescribed to those under 18 years of age.

Treatment for bulimia nervosa in children and young people

Children and young people under 18 years of age may be offered either CBT or family therapy (FT). Family therapy involves talking to a therapist either alone or with family members, usually those they live with, to discuss how family and loved ones can offer support to get better.

Usually, treatment is offered on an outpatient basis. However, if you or your loved one is very unwell, or outpatient treatment is not proving helpful, inpatient treatment may be required. This may be in a hospital or in a specialist eating disorder treatment unit depending on the area you live, the severity of your illness and any other factors specific to you.

Find out more information on NHS treatment for bulimia

If you are concerned that you, or someone you care for, may have Bulimia, we are here to help. Please book a 1:1 support call or take a look at our peer support groups. Our team of staff and volunteers have lived experience of eating disorders. They can listen to your worries and provide practical guidance to help you take positive steps towards getting help and recovery.

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