Bulimia is an illness in which a person binges on food or has regular episodes of overeating and feels a loss of control. The person then uses different methods -- such as vomiting or abusing laxatives -- to prevent weight gain.
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:
Forcing yourself to vomit
Using laxatives, enemas, or diuretics (water pills)
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 that other people can see include:
Suddenly eating large amounts of food or buying large amounts of food that disappear right away
Regularly going to the bathroom right after meals
Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics
Signs and tests
A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit.
A physical exam may also show:
Broken blood vessels in the eyes (from the strain of vomiting)
Pouch-like look to the cheeks
Rashes and pimples
Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit
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.
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Hay PPJ, Bacaltchuk J, Stefano S, Kashyap P. Psychological treatments for bulimia nervosa and binging. Cochrane Database Syst Rev. 2009;(4):CD000562.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.