Bulimia

Bulimia is an eating disorder in which a person has regular episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over eating. The person then uses different ways, such as vomiting or laxatives (purging), to prevent weight gain.

Many people with bulimia also have anorexia nervosa .

Anorexia nervosa

Anorexia is an eating disorder that causes people lose more weight than is considered healthy for their age and height. People with this disorder may...

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Causes

Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or guilt with the binge-purge episodes.

The exact cause of bulimia is unknown. Genetic, psychological, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.

Symptoms

With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating.

Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

• Forcing oneself to vomit
• Excessive exercise
• 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:

• Spending a lot of time exercising
• 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

Exams 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.

Cavities

Dental cavities are holes (or structural damage) in the teeth.

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Gingivitis

Gingivitis is inflammation of the gums.

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A physical exam may also show:

• Broken blood vessels in the eyes (from the strain of vomiting)
• Dry mouth
• 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

Blood tests may show an electrolyte imbalance (such as low potassium level ) or dehydration .

Low potassium level

Low potassium level is a condition in which the amount of potassium in the blood is lower than normal. The medical name of this condition is hypokal...

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Dehydration

Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...

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Treatment

People with bulimia rarely have to go to the hospital, unless they:

• Have anorexia
• Have major depression

  Major depression

  Depression is feeling sad, blue, unhappy, or down in the dumps. Most people feel this way once in a while. Major depression is a mood disorder. It...

  

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• Need medicines to help them stop purging

Most often, a stepped approach is used to treat bulimia. Treatment depends on how severe the bulimia is, and the person's response to treatments:

• Support groups may be helpful for mild bulimia without other health problems.
• Counseling, such as talk therapy and nutritional therapy are the first treatments for bulimia that does not respond to support groups.
• Medicines that also treat depression, known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. Combining talk therapy with SSRIs may help, if talk therapy alone does not work.

People may drop out of programs if they have unrealistic hopes of being "cured" by therapy alone. Before a program begins, people should know that:

• Different therapies will likely be needed to manage this disorder.
• It is common for bulimia to return (relapse), and this is no cause for despair.
• The process is painful, and the person and their family will need to work hard.

Support Groups

The stress of illness can be eased by joining a support group . Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

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 willing and able to take part in therapy have a better chance of recovery.

Possible Complications

Bulimia can be dangerous. It may lead to serious health problems over time. For example, vomiting over and over can cause:

• Stomach acid in the esophagus (the tube that moves food from the mouth to the stomach). This can lead to permanent damage of this area.
• Tears in the esophagus
• Dental cavities
• Swelling of the throat

Vomiting and overuse of enemas or laxatives can lead to:

• Your body not having as much water and fluid as it should
• Low level of potassium in the blood, which may lead to dangerous heart rhythm problems

  Low level of potassium

  Low potassium level is a condition in which the amount of potassium in the blood is lower than normal. The medical name of this condition is hypokal...

  

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  Heart rhythm problems

  An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...

  

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• Hard stools or constipation

  Constipation

  Constipation in infants and children occurs when they have hard stools or have problems passing stools.  A child may have pain while passing stools o...

  

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• Hemorrhoids

  Hemorrhoids

  Hemorrhoids are swollen veins in the anus or lower part of the rectum.

  

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• Damage of the pancreas

  Damage of the pancreas

  Pancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or improve, gets worse over time, and lead...

  

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When to Contact a Medical Professional

Call for an appointment with your health care provider if you or your child has symptoms of an eating disorder.