Commonly Asked Questions: Bulimia Nervosa

What is It?

Bulimia nervosa is an eating disorder. People with this disorder often eat in "binges" and then try to eliminate the food from their system by making themselves vomit, using laxatives, dieting or exercising excessively, and other techniques.

Sometimes people confuse bulimia nervosa with anorexia nervosa. Unlike people with anorexia, people with bulimia stay at an average or above-average weight for their height. While people with anorexia may binge-eat from time to time, they tend to exercise, diet, or eliminate food from their system so frequently that their body weight is dangerously low.

Approximately nine out of ten people diagnosed with bulimia are female. Most are diagnosed in their late teens or early- to mid-twenties. Like anorexia, bulimia is seen mostly in the cultures of North America, Europe and parts of the South Pacific.

What are the Symptoms?

If you are wondering whether someone you know may have bulimia, here are some critical characteristics to look for:

Frequent Binge Eating

Binge eating means eating a much larger amount of food than normal (usually thousands of calories) over a short period of time (usually less than two hours). Eating a large meal during a holiday or celebration, or snacking all day are not considered eating binges.

People with bulimia often binge on sugary foods with a lot of calories, such as chocolate, cookies, cake, or ice cream. However, they can also binge on other types of foods such as fried chicken, hamburgers, or pizza.

People diagnosed with bulimia often say that they feel as though they are "losing control" when they binge-eat. They have a feeling that they can't stop eating, even when it causes them physical pain or upsets them emotionally.

Drastic Attempts to Prevent Gaining Weight

People with bulimia often try to prevent gaining weight through two basic patterns.

• Purging Patterns -- These individuals regularly attempt to eliminate food from their system by making themselves vomit, using medicines that make them urinate frequently (diuretics), or misusing laxatives or enemas. Approximately 80 to 90 percent of people who are treated for bulimia regularly attempt to make themselves vomit. It appears that vomiting helps them calm their worries about gaining weight and relieves the physical discomfort of overeating.

   

• Non-purging Patterns -- These individuals try to limit any weight gain by going on "crash" or starvation diets and/or exercising excessively. Like people who attempt to purge their food, these individuals are trying to correct for their binge-eating.

   

Many people with bulimia don't fit neatly into one category or another. They may combine vomiting with crash diets or the use of laxatives with exercising three times a day.

Frequent Binge-Eating and Inappropriate Attempts to Keep Weight Down

People who have eaten or exercised a lot more than usual over the past few weeks don't necessarily have bulimia. Bulimia is a lasting condition. It is generally accepted that people must be binging and compensating at least twice a week for three months before the diagnosis of bulimia nervosa can be considered.