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Eating Disorders: Bulimia Nervosa

What is it?

Bulimia is a disorder in which a person eats large amounts of food (“bingeing”) and then rids the body of that food before it can be absorbed (“purging”). A person who is bulimic purges either by vomiting or using laxatives or diuretics (water pills). Most people with eating disorders are girls; however, boys can suffer from these disorders as well. Many factors may be involved and are different for each person. Some factors include:

  • Feeling insecure
  • A distorted body image (feeling fat) and striving for the perfect body          
  • Extreme social pressures
  • Severe family problems            
  • Pressure from activities such as running, gymnastics, wrestling, or ballet
  • A history of sexual abuse         
  • A family history of depression or an eating disorder

What does it look like?

Bulimia usually develops between the ages of 15 and 24. A bulimic’s weight is usually within the range of what is normal for her size and height, but it tends to go up and down a lot because of all the binging and purging. She may be afraid to eat in restaurants or with other people because she cannot control the urges to binge or the urges to purge after eating normal amounts of food. People who develop bulimia often have a hard time dealing with and controlling impulses, stress, and anxiety. They are not happy with their body image and think they are overweight or fat. This leads them to start dieting, but then, in response to anxiety and other emotions, they give in to their impulses and cravings for food by bingeing.

During a binge, a person with bulimia may eat between 3,000 and 7,000 calories, often in less than a few hours. Depression, boredom, or anger often triggers a binge. Binges usually end when there is no more food to eat, when the stomach hurts so much from eating, or when something such as a phone call breaks the bulimic’s concentration on bingeing. After eating large amounts of food, the bulimic feels guilty and is afraid of gaining weight. Other factors that may lead to bulimia include depression, substance abuse, and childhood physical/sexual abuse. Bulimics may also change in other ways by:

  • Stealing food or hoarding it in strange places, such as under the bed or in closets.
  • Bingeing on foods with distinct colors in order to know when they are thrown up.
  • Spending a lot of time, energy, and money, because bulimia is a time consuming and expensive addiction.
  • Becoming very secretive about food, spending a lot of time thinking about and planning the next binge, and setting aside certain times to binge.

The following changes may be signs that a person has bulimia:

  • Weight goes up and down.                                     
  • Constant upset stomach, constipation, and sore throat may be present.
  • Menstrual periods become irregular.                       
  • Damage to vital organs, such as liver and kidneys, heart failure, and death can occur.
  • The face and throat look puffy and swollen.         
  • Dehydration due to loss of body fluids occurs.
  • Periods of dizziness and blackouts occur.
  • Teeth start to decay from contact with stomach acids during vomiting.

How do I treat it?

Then chance of successfully treating someone who has an eating disorder is much higher if the disorder is detected early and the person begins to get help. Treatment depends on many things, including the person’s willingness to cooperate, family and support structure, and the stage of the disorder. Successful treatment of eating disorders involves many health professionals who work together by treating a certain aspect of the disorder. A person with bulimia may need hospitalization to control the cycles of bingeing and purging to replace needed nutrients in the body. Counseling is necessary to help a person with an eating disorder understand how she uses food as a way of handling problems and feelings. It will help her improve her self-image (including body image) and develop independence so that she can take control of her life in positive ways. A mix of individual therapy and family therapy is usually most effective in treating eating disorders.


Information on this site is intended for Angel Kids Pediatrics patients only. Always consult your doctor before beginning, modifying, or discontinuing any treatment plan.

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