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Bulimia is an illness in which a person binges on food or has regular episodes of overeating and feels a loss of control. The affected person then uses various methods -- such as vomiting or laxative abuse -- to prevent weight gain.
Many (but not all) people with bulimia also have anorexia nervosa.
Bulimia nervosa; Binge-purge behavior; Eating disorder - bulimia
Many more women than men have bulimia. The disorder is most common in adolescent girls and young women. The affected person is usually aware that her eating pattern is abnormal and may feel fear or guilt with the binge-purge episodes.
The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.
In bulimia, eating binges may occur as often as several times a day for many months.
People with bulimia often eat large amounts of high-calorie foods, usually in secret. People can feel a lack of control over their eating during these episodes.
Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:
Purging often brings a sense of relief.
People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder.
Symptoms can include:
A physical examination may also show:
People with bulimia rarely have to go to the hospital, unless:
Most often, a stepped approach is used for patients with bulimia. The treatment approach depends on how severe the bulimia is, and the person's response to treatments:
Patients may drop out of programs if they have unrealistic hopes of being "cured" by therapy alone. Before a program begins, the following should be made clear:
Self-help groups like Overeaters Anonymous may help some people with bulimia. The American Anorexia/Bulimia Association is a source of information about this disorder.
Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment.
People with fewer medical complications of bulimia, and those who are willing and able to take part in therapy have a better chance of recovery.
Bulimia can be dangerous. It may lead to serious medical complications over time. For example, vomiting over and over again puts stomach acid in the esophagus (the tube from the mouth to the stomach), which can permanently damage this area.
Possible complications include:
Call for an appointment with your health care provider if you (or your child) have symptoms of an eating disorder.
American Psychiatric Association. Treatment of patients with eating disorders, 3rd ed. American Psychiatric Association. Am J Psychiatry. 2006 Jul;163(7 Suppl):4-54.
Hall MN, Friedman RJ 2nd, Leach L. Treatment of bulimia nervosa. Am Fam Physician. 2008 Jun 1;77(11):1588, 1592.
Sim LA, McAlpine DE, Grothe KB, Himes SM, Cockerill RG, Clark MM. Identification and treatment of eating disorders in the primary care setting. Mayo Clin Proc. 2010;85(8):746-751.
Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet. 2010;375(9714):583-593.