Bulimia

What is bulimia?

People with bulimia go through periods of eating a large amount of food very quickly and then purging their body of the food. This might involve making yourself sick, taking laxatives so that you poo or exercising excessively – or a combination of these.

People with bulimia often give themselves strict rules about eating and exercising and can become distressed if they break these rules. 

Bulimia can lead to a cycle of bingeing and purging where you feel out of control and ashamed, which makes you do it more.

What are the key symptoms of bulimia?

The main symptom of bulimia is the repeated cycle of binge eating, followed by an episode of purging. This can have a huge impact on daily life and affect relationships.

Other common signs of bulimia include:

• Irritability and mood swings

• An obsessive relationship with food

• Being preoccupied with bodyweight

• Being critical of your body weight and shape

• Behaving secretively

• Losing interest in social activities

• Feeling self-conscious about eating in public

What causes bulimia?

It’s normal to overindulge in food from time to time, but the binges associated with bulimia are very different. People often binge to help them cope with overwhelming feelings and emotions. This can be linked to:

• Having a family history of eating disorders or depression 

• Criticism of your weight, body shape or eating habits

• Feeling pressure from friends or society to be a certain weight or because of your job, like modelling, dancing or sports 

• Feelings of anxiety, inadequacy, low self-esteem or loneliness

• Sexual abuse

What are the longer term effects of bulimia?

The constant cycle of bingeing and purging can have negative effects on your health, including:

• Teeth problems caused by frequent vomiting

• Bad breath or sore throats

• Heart and digestive problems, due to using too many laxatives 

• Stomach problems, like feeling bloated, constipation and abdominal pain

• Self-harm

• Irregular periods

• Tiredness

• Swollen hands and feet

• Bone problems, like osteoporosis

How is bulimia diagnosed?

It can be a big step to talk to a doctor if you think you have an eating disorder but remember that they’re there to listen and help and you won’t be judged or blamed. 

It might help to take a friend or relative along or to write down some questions and notes about your symptoms before you go.

A doctor will start by asking you about how you’re feeling, your eating habits and any symptoms. They’ll look at your overall health and check your weight, and if they think you have bulimia, you’ll be referred to a specialist team who will create an individual treatment plan for you.

How is bulimia treated?

The main type of treatment is talking therapy to help you address the reasons why you’re bingeing and purging, and understand how to change your negative patterns of behaviour. 

Types of talking treatment can include:

• Cognitive behavioural therapy (CBT) – addressing the thoughts and feelings behind your eating disorder and learning to change your behaviour.

• Guided self-help – working through self-help materials with a therapist to help you learn about the triggers that lead to the binge-purge cycle and find ways to cope with your feelings.

• Self-help and support groups – getting support by talking to others in a similar situation and sharing your own experiences with them.

• Family therapy – if you’re under 18, you may also be offered family therapy, where you and your family can get help together by talking to a therapist.

If you’re also experiencing other conditions, like anxiety or depression, a doctor may recommend antidepressants to help to treat these.

These self-care steps can help to minimise the damage caused by vomiting regularly:

• Stay well-hydrated by drinking plenty of fluids to replace what you’ve lost

• Look after your teeth by not brushing your teeth immediately after vomiting, which can erode the enamel

Can you recover from bulimia?

It can take time, but most people with bulimia recover with the right support and treatment. The sooner you seek specialist support, the better your chances of making a full recovery.

When should I get help for bulimia?

It can be easier to hide bulimia from others than with an eating disorder like anorexia, but bulimia is a serious condition that requires medical help. If you’re worried that you, or someone you know, might have bulimia, it’s important to talk to a doctor as soon as you can for the best chance of recovery.

Having the support of a friend or family member can be helpful. They can help you recognise your symptoms are real and make sure you get the support you need.