What Is Bulimia Nervosa?

Bulimia nervosa, commonly known as bulimia, is a severe and potentially life-threatening eating disorder characterised by a distressing cycle of episodes of binge eating and purge behaviour. Individuals with bulimia experience episodes of secretive and uncontrollable overeating, during which they consume large amounts of food. Following these episodes, they resort to purging methods, which involve unhealthy behaviours aimed at eliminating the excess calories they have consumed. This distressing pattern poses immediate risks to physical health and affects mental and emotional well-being.

As one of the various eating disorders, bulimia is part of a group of mental health conditions that revolve around an unhealthy preoccupation with food and body weight. This fixation can lead to devastation on an individual’s life’s physical and psychological aspects. People with bulimia nervosa often find themselves trapped in a cycle of guilt, shame, and anxiety surrounding their eating behaviours, further deepening their emotional distress. The secretive nature that a person has to binge and purge can lead to a sense of isolation and hinder individuals from seeking the help they desperately need.

Bulimia nervosa’s impact extends beyond the physical act of bingeing and purging. It frequently fosters an unhealthy obsession with unrealistic body shapes and ideals, leading individuals to evaluate and critique their appearance constantly. This self-critical mindset eternalises a cycle of dissatisfaction and self-esteem issues. The constant pursuit of an idealised body size or shape can dominate a person’s thoughts, disfiguring their ability to engage fully in life’s activities and experiences. It is crucial to recognise that bulimia is a serious and severe condition with complex consequences, emphasising the importance of early intervention, professional support, and understanding from friends and family.

What Causes Bulimia?

While bulimia nervosa lacks a specified cause, researchers assume that the causes of bulimia are a complex interaction of various factors, such as:

  • Genetic predisposition
  • Learned behaviours
  • Family history
  • Traumatic events
  • Deficiencies in serotonin
  • Influence of popular culture and media

Individuals with a family history of eating disorders are at an increased risk, indicating a genetic predisposition. Traumatic events in one’s past and the impact of societal and cultural norms can also shape the development of bulimia. A notable aspect that emerged from a 2019 review and prior research is the potential connection between bulimia and deficiencies in serotonin—a crucial neurotransmitter that regulates mood, appetite, and sleep.

This suggests symptoms may have a biological underpinning to the disorder. Consequently, while the exact causative mechanisms remain unknown, the prevalent influence of popular culture and media, which idealise specific body types, use notable pressure on self-perception and self-esteem. Emotions like stress, distress, and a sense of loss of control can contribute to the onset of bulimia, highlighting the role of emotional well-being.

Symptoms of Bulimia

Bulimia nervosa presents a range of signs and symptoms that encompass behavioural and physical indicators. From a preoccupation with body image to a secretive binge-purge cycle, it is crucial for early intervention and support to recognise the signs.

Additionally, people with bulimia may resort to excessive use of dietary supplements, products and herbs for weight loss. Recognising and understanding these indicators is vital for facilitating timely intervention and providing essential support.

Physical Symptoms

The eating disorder takes a toll on the body, leading to various physical symptoms of bulimia:

  • Dental issues, such as enamel erosion due to self-induced vomiting
  • Engaging in recurrent episodes of consuming abnormally large amounts of food in a short time
  • Dehydration
  • Frequent bathroom visits, especially post-meals
  • Tooth sensitivity and discolouration
  • Muscle weakness
  • Excessive exercise or vomiting to prevent weight gain after binges
  • Irregular menstrual cycles
  • Gastrointestinal problems, including stomach acid reflux and constipation
  • Facial swelling, particularly around the cheeks and jawline
  • Episodes of fainting
  • Bloodshot eyes

Psychological Symptoms

Often, the symptoms of this eating disorder can be hidden, with individuals binging and purging in private. Warning signs may manifest as empty food wrappers and laxative packaging. Psychological and behavioural symptoms can impact the overall physical and mental health of the individual.

The psychological symptoms of bulimia nervosa include the following:

  • Struggles with depression, anxiety, or substance misuse
  • Being fixated on body shape and weight
  • Living with an intense fear of gaining weight
  • Overwhelming guilt or shame regarding eating habits
  • Social withdrawal from friends and family
  • Experiencing a sense of lack of control 

These manifestations may differ from person to person, and psychological changes and physical effects can become noticeable over time.

How Is Bulimia Diagnosed?

Diagnosing bulimia nervosa involves a comprehensive assessment by healthcare professionals. The medical history and symptoms will be discussed during this process, and an open and honest conversation is essential for accurate diagnosis. The healthcare provider will inquire about eating habits and behaviours to understand the eating disorder. 

This includes evaluating whether people experience repeated episodes of binge eating, a perceived lack of control over their eating during these episodes, and engagement in purging behaviours. Moreover, the impact of body weight and self-image is also considered.

Though there are no specific tests dedicated to diagnosing bulimia nervosa, healthcare providers may conduct various tests to assess the impact of the disorder on overall health. These tests could involve:

  • Blood work
  • Urinalysis
  • Kidney function assessments,
  • Electrocardiogram (EKG) to monitor potential cardiac complications resulting from the disorder 

The diagnosis process may also include a psychological examination focusing on the perception of body image. Sometimes, additional tests might be performed to eliminate other potential causes of weight changes. Open communication with healthcare providers is crucial throughout this diagnostic journey. 

Bulimia in Girls

As a severe and life-threatening eating disorder, bulimia nervosa can negatively impact adolescent girls’ lives. It often emerges during adolescence, marked by significant physical and emotional changes. Girls with bulimia may exhibit recurrent episodes of ingesting large amounts of food in a short time, accompanied by a sense of loss of control. This distressing behaviour is often followed by attempts to compensate, such as purging through vomiting, excessive exercise, or strict dieting. The psychological toll of bulimia on young girls is profound, as it can lead to feelings of guilt, shame, and low self-esteem, worsening the cycle of binging and purging. Early detection, intervention, and supportive care are crucial in helping these girls regain a healthy relationship with food and their bodies.

The societal pressures surrounding body image and appearance can contribute to girls’ vulnerability to eating disorders. The pursuit of an unrealistic and narrow beauty ideal, often perpetuated by media and peer influences, can fuel feelings of inadequacy and drive unhealthy eating behaviours. Moreover, the emotional challenges of adolescence, such as identity development and peer acceptance, can further heighten the risk factors of developing an eating disorder. Family and social support, along with professional guidance, play key roles in addressing bulimia nervosa in girls. We can empower young girls to overcome the disorder and lead healthier, happier lives by fostering a supportive environment that promotes self-acceptance and body positivity.

How Is Bulimia Treated?

Many people with bulimia use a combination of therapies, including psychotherapy, person-centred approaches through home care, nutritional counselling, and sometimes medication. Cognitive-behavioural therapy (CBT) has shown effectiveness in treating bulimia by helping individuals identify and modify unhealthy thought behaviours and patterns related to food and body image. Nutritional counselling aims to establish a balanced eating routine, gradually normalising eating habits and promoting a healthier relationship with food.

Given the complex nature of eating disorders, particularly bulimia nervosa, it’s important to tailor treatment approaches to each individual’s unique needs. Sometimes, people with bulimia may transition to another eating disorder, such as anorexia nervosa. Close weight and physical health monitoring is essential, even if the individual appears to be at a “normal” weight. At Nurseline Community Services, we support people with bulimia with a holistic and outcome-based approach that combines therapeutic techniques, regular check-ins and personalised guidance from healthcare professionals to address the physical and mental components of eating disorders, promoting recovery with positive results.


Treating bulimia with psychotherapy involves a structured and comprehensive approach to address the underlying psychological factors contributing to the disorder. Cognitive-behavioural therapy is a widely utilised psychotherapeutic approach where individuals learn to identify and challenge negative thought patterns related to body image, self-esteem, and eating behaviours. Dialectical behaviour therapy (DBT) incorporates mindfulness techniques to regulate emotions and enhance self-acceptance. A solid therapeutic alliance between the individual and therapist is cultivated throughout psychotherapy, providing a safe space for exploration, expression, and gradual change. The collaborative nature of psychotherapy equips individuals with the tools and insights needed to achieve sustainable recovery and improved overall well-being.


The treatment of bulimia nervosa often incorporates medications as part of a progressive approach. Initially, healthcare providers may assess the need for medication to address specific symptoms or underlying factors contributing to the disorder. Prescription of selective medicines may be considered to regulate mood and reduce binge-eating episodes. These medications are introduced gradually, allowing close monitoring of their effects and adjustments as needed. Alongside therapeutic interventions, medicine can play a role in alleviating the distress associated with bulimia and facilitating sustained progress on the path to recovery.

Person-Centred Approach with Home Care

The focus is on fostering a supportive and empathetic environment where the person actively participates in their recovery journey. Creating a collaborative atmosphere, promoting self-awareness and sustainable behaviour change are some of the key factors why home care gives positive outcomes. Family and social support are integral components, enhancing the person’s well-being within the comfort of their home. This holistic approach prioritises the person’s autonomy and values, leading to a more effective and fulfilling recovery from bulimia nervosa.

Nutritional Therapy

Treating bulimia nervosa through nutritional therapy involves a specialised approach to restoring a healthy relationship with food. Collaborating with a registered dietitian or nutritionist, the treatment addresses disordered eating patterns promotes balanced meals, and establishes regular eating habits. Nutritional education empowers individuals to make informed choices, dispelling myths and misconceptions. Meal planning, portion control, and mindful eating techniques enhance awareness of hunger and fullness cues.

Complications From Bulimia

Complications stemming from bulimia are multifaceted and can have severe physical and mental health importance. The recurrent cycle of bingeing and purging takes a toll on the body’s digestive system, potentially resulting in electrolyte imbalances, dehydration, and damage to vital organs such as the heart and kidneys. Chronic purging can lead to tooth enamel erosion, causing dental problems, and disrupt the natural balance of gut microorganisms, impacting gastrointestinal health. Beyond the physical realm, bulimia can cause existing psychological issues to become more challenging, intensifying feelings of shame, guilt, and self-loathing.

Individuals with bulimia may experience social isolation and poor relationships due to the secretive nature of their behaviours. As the eating disorder progresses, it can further erode self-esteem, perpetuating a distressing cycle of negative emotions and harmful behaviours. Timely intervention and comprehensive treatment, encompassing medical, nutritional, and psychological support, are crucial in addressing complications associated with bulimia.

Can Bulimia Cause Cancer?

While there is no direct causal link between bulimia and cancer, it is essential to approach this topic with a mindful perspective that acknowledges the potential impact of long-term disordered eating on overall health.

Experiencing behaviours, such as recurrent episodes of binge eating followed by purging, can lead to physiological complications. Prolonged purging, for instance, may disrupt the body’s natural balance and potentially contribute to inflammation, which has been implicated in the development of various conditions, including cancer. However, it is crucial to recognise that cancer is a multifactorial disease influenced by diverse genetic, environmental, and lifestyle factors.

Living With Bulimia

Living with bulimia can be an emotional and physical rollercoaster, marked by the relentless cycle of secretive binge eating and subsequent purging behaviours. The constant preoccupation with body image and weight, coupled with the physical toll of purging, affects mental and physical well-being, making everyday life a complex maze of emotions and challenges.

Even though it is a challenging journey that calls for progressive and mindful approaches to foster healing and well-being, those navigating this path find themselves engaged in continuous self-discovery and growth as they seek to liberate themselves from the grip of disordered eating patterns. Amid the complexities of living with bulimia, a progressive mindset becomes an essential companion. Progress is not linear; therefore, embracing the transformation with patience and persistence is necessary.

How Nurseline Community Services Supports People Struggling With Bulimia

Nurseline Community Services supports people with bulimia nervosa with a Fast Response team that compassionately aids during crisis situations. With a commitment to person-centred care and outcome-based approaches, Nurseline Community Services extends a helping hand to guide individuals toward recovery and healing. Our rapid response team is equipped with the expertise to provide tailored assistance that addresses the unique needs and circumstances of each individual, fostering a path toward physical and emotional well-being.

If you need immediate support, don’t hesitate to contact Nurseline Community Services’ offices in Bristol, Birmingham and Gloucester. We deliver our services across the UK and are the first port of call for de-escalating crisis situations.