Bulimia Explained: Causes, Symptoms and Treatment

Bulimia nervosa, more commonly referred to simply as bulimia, is a common eating disorder that is considered to be less physically dangerous than anorexia.

Bulimia has some similarities to anorexia. Sufferers fear becoming fat, though they are usually normal weight and are sometimes even overweight. While those with anorexia will severely cut calorie, those with bulimia fall into what is sometimes called a ‘binge and purge’ cycle. They will binge on fattening food, such as cakes or ice cream. After bingeing, they feel guilty, which leads to feeling depressed. They respond to their depression by trying to purge those calories, by making themselves sick, using laxatives or diuretics, starving themselves, exercising excessively, or some combination of these. They can only sustain this for a little while before they are back to bingeing. Bulimia most commonly affects women in their 20s.

Causes of Bulimia

It’s not clear what exactly causes bulimia, but many sufferers also have very low self-esteem. It can be triggered by normal life stresses, such as family tensions, breakups, or sexual abuse. People who have a family history of bulimia are four times more likely to be sufferers themselves.

Dieting history can also be a factor. Those people that have had a history of failed dieting, can go on to develop bulimia. For some people, easy access to foods that you like to binge on can be a problem. For example, quick snack foods.

Recently, there have been increased calls for social media giants to help protect people from unnecessary exposure to diets, weight loss pills and fitness apps. In the UK a man called Daniel Magson has started to campaign to protect people with anorexia and bulimia who he feels are being targeted with dangerous dieting adverts on Facebook.


Symptoms of bulimia include:

  • Excessive laxative use
  • Vomiting after eating
  • Immediately using the bathroom after eating
  • Irregular or skipped periods
  • Swelling of the face or fingers (caused by frequent vomiting)
  • Mood swings
  • Depression
  • Stomach Ache
  • Bowel damage caused by excessive laxative use
  • Bingeing, or consuming large amounts of food quickly

People with bulimia often feel ashamed and will hide the behaviour at all cost.

The Cycle of Bulimia

Bulimia often becomes a vicious cycle that’s extremely difficult to break free from. It usually starts with a period of strict dieting or calorie restriction. When you drastically cut calories, your body responds by increasing hunger signals and cravings for high-calorie foods. This deprivation ultimately leads to a binge eating episode, where you rapidly consume a large amount of food in a short period of time.

During a binge, it’s common to feel out of control and unable to stop eating, even when uncomfortably full. Afterward, intense feelings of shame, guilt, and self-loathing set in. To cope with these negative emotions and undo the caloric effects of the binge, the sufferer then purges through vomiting, excessive exercise, laxative abuse, or other compensatory behaviors.

Purging provides a fleeting sense of relief, but the physical and emotional patterns of bulimia become deeply ingrained through this recurring binge-purge cycle. Over time, it creates an unhealthy preoccupation with food, weight, and body image that is hard to overcome without professional help.

Body Image and Bulimia

For many with bulimia, the constant pursuit of an idealized body weight or shape is a driving force behind the disorder. Our society places immense value on thinness and appearance, especially for women. Pervasive media images of supermodels and celebrities contribute to unrealistic beauty standards.

Low self-esteem and negative body image often lead to bulimic behaviors as a way to control weight and strive for perceived perfection. Unfortunately, those suffering rarely feel satisfied, which perpetuates the damaging cycle. The bingeing episodes reinforce feelings of failure, while purging provides only temporary relief.

Dismantling these deeply-rooted body image issues is a critical step in overcoming bulimia nervosa. Treatment often includes cognitive behavioral therapy to reframe negative self-talk and develop a more positive relationship with food and one’s body.

Male Bulimia on The Rise

While bulimia has historically affected more women than men, male cases are on the rise. Around 10-15% of those with bulimia or binge eating disorders are male. The widespread cultural emphasis on leanness and muscularity for men has contributed to an increase in eating disorders.

Male bulimics often go unnoticed or are hesitant to seek help due to societal pressures around masculinity. Many feel ashamed or embarrassed about having what’s perceived as a “woman’s disorder.” This lack of awareness and support can make recovery even more challenging for males struggling with bulimia.


Early diagnosis and treatment of bulimia is essential to avoiding long term damage, though there are no specific diagnostic tests. If you have symptoms of bulimia, your doctor may want to do blood tests to check for anemia or other signs of damage.


The primary goal of treatment is to get the person onto a normal eating schedule of three meals a day without purging. Counselling can help the sufferer get to the root of the behaviour, while antidepressants can help ease depression that may be contributing to the cycle.


Untreated bulimia can lead to disorders of the stomach, bowel, or kidneys due to laxative use. Frequent vomiting can cause damage to the esophagus and may even increase the risk of esophageal cancer. Stomach acid can also cause cavities, bad breath, sores in the mouth, sore throat, and damage to the stomach.


Your GP should be your first port of call if you or anybody close to you is affected by Bulimia. Support groups can also provide a listening ear and useful advice on coping with this disorder. For example, Beat is a leading UK charity dedicated to supporting individuals facing any kind of eating disorder or struggles with food, weight, and body image issues. Reaching out to understanding professionals and communities can make a huge difference in your recovery journey.

Photo “Bulimia Explained” by Anthony Cunningham for Zoom Health

Zoom Health is a leading UK supplier of Home Health Tests and Earplugs

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