Bulimia Nervosa

Bulimia Nervosa


Bulimia Nervosa (BN) consists of both binge eating episodes and repeated compensatory behaviors (e.g., purging) to prevent weight gain. Binge eating episodes involve eating, in a discrete period of time (e.g., around 2 hours), an amount of food that is definitely larger than what most people would eat, along with a sense of lack of control over eating. Compensatory behaviors often follow binge episodes and can consist of self-induced vomiting, laxative or diuretic use, fasting, or excessive exercise.

Individuals suffering from BN are very concerned with their body’s shape and weight, and they are usually at normal weight or overweight. About 1-4% of women and .5% of men suffer from BN. Patients with diabetes mellitus who are suffering from BN may omit or diminish insulin to reduce metabolism of food.

Signs of Bulimia Nervosa can also include:
  • dieting behaviors and preoccupation with eating and food
  • repetitive or obsessive behaviors related to body shape and weight
  • frequently weighing oneself
  • frequent changes in weight (loss or gain)
  • spending more money than usual on food
  • hiding food and food wrappers throughout the house
  • skipping meals
  • feelings of shame, self-loathing, or guilt, particularly after eating
  • eating in private or avoiding meals with other people
  • excessive time spent exercising and/or exercising very intensely
  • frequent trips to the bathroom after eating
  • feeling bloated or constipated
  • fainting or dizziness
  • tiredness, fatigue
  • feeling bloated or constipated
  • depression, anxiety, or irritability
  • body checking behaviors (e.g., pinching or measuring body parts)
  • frequently evaluating oneself in the mirror, or avoiding looking at oneself in the mirror

The gold standard, most effective treatment for BN is Cognitive-Behavioral Therapy for Eating Disorders (CBT-E). CBT-E targets the thoughts, behaviors, and emotions that contribute to and maintain BN. Your therapist will help implement a regular pattern of eating that will prevent you from getting too hungry and then binge eating. You will also learn to identify and address triggers that lead to binge eating and purging, to tolerate the urges to binge and purge without having to act on them, and to manage intense emotions in ways that don’t involve binge eating and purging. Urges to binge and engage in compensatory behaviors become weaker over time the less you engage in them. Your therapist will also work with you to challenge thoughts and eliminate behaviors that contribute to a negative body image. If applicable, co-occurring anxiety and depressive disorders are also addressed.

National Eating Disorders Association
Academy for Eating Disorders