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Bulimia nervosa

• Treatment
• More information on bulimia nervosa

Bulimia nervosa, or bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (bingeing) and then tries to get rid of the calories by purging. Purging might be done in these ways:

• Making oneself throw up
• Taking laxatives (pills or liquids that increase how fast food moves through your body and leads to a bowel movement)

A person with bulimia may also use these ways to prevent weight gain:

• Exercising a lot (more than normal)
• Restricting her eating or not eating at all (like going without food for a day)
• Taking diuretics (pills that make you urinate)

Bulimia is more than just a problem with food. It's a way of using food to feel in control of other feelings that may seem overwhelming. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and to ease stress and anxiety.

Unlike anorexia, when people are severely underweight, people with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disease. However, someone with bulimia may have these signs:

• Thinks about food a lot
• Binges (normally in secret)
• Throws up after bingeing
• Uses laxatives, diet pills, or diuretics to control weight
• Is depressed
• Is unhappy and/or thinks a lot about her body shape and weight
• Eats large amounts of food quickly
• Goes to the bathroom all the time after she eats (to throw up)
• Exercises a lot, even during bad weather, fatigue, illness, or injury
• Unusual swelling of the cheeks or jaw area
• Cuts and calluses on the back of the hands and knuckles from making herself throw up
• White enamel of teeth wears away making teeth look clear
• Doesn't see friends or participate in activities as much
• Has rules about food — has "good" foods and "bad" foods

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Treatment

Someone with bulimia can get better. A health care team of doctors, nutritionists, and therapists will help the patient recover. They will help the person learn healthy eating patterns and cope with their thoughts and feelings. Treatment for bulimia uses a combination of options. Whether or not the treatment works depends on the patient.

To stop a person from binging and purging, a doctor may recommend the patient:

• Receive nutritional advice and psychotherapy, especially cognitive behavioral therapy (CBT)
• Be prescribed medicine

CBT is a form of psychotherapy that focuses on the important role of thinking in how we feel and what we do. CBT that has been tailored to treat bulimia has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy for a person with bulimia may be one-on-one with a therapist or group-based.

Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration (FDA) for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes. ("Relapse" means to get sick again, after feeling well for a while.)

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More information on bulimia nervosa

Read more from womenshealth.gov

• Bulimia Nervosa Fact Sheet — This fact sheet answers common questions about bulimia nervosa, including its causes, warning signs, complications, and available treatment options.
  http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.cfm

Explore other publications and websites

• A Brief Overview of Therapies Used in the Treatment of Eating Disorders (Copyright © National Association of Anorexia Nervosa and Associated Disorders) — Psychotherapy can be an effective way of treating eating disorders. This fact sheet provides an overview of each type of psychotherapy commonly used in the treatment of anorexia nervosa and other eating disorders.
  http://www.anad.org/get-information/information-about-treatment/
• ANAD Eating Disorder Support Groups (Copyright © ANAD) — If you have an eating disorder, this web page will help you locate a support group in your area.
  http://www.anad.org/?s=ANAD+Eating+Disorder+Support+Groups
• Bulimia — This web page describes the symptoms, treatments, and prognosis of eating disorder Bulimia and offers contact information for support groups.
  http://www.nlm.nih.gov/medlineplus/ency/article/000341.htm
• Bulimia Nervosa Resource Guide for Family and Friends (Copyright © ECRI Institute) — This website provides a one-stop comprehensive resource on bulimia nervosa for anyone who wants to understand the disorder and how to support a family member or friend with bulimia nervosa.
  http://www.bulimiaguide.org/
• Bulimia Nervosa: Checklists and Tip Charts (Copyright © Bulimia Nervosa Resource Guide) — this web page provides information about every aspect of treating bulimia nervosa: recommended questions to ask your doctor, guidance for insurance issues, ways for friends and family to be supportive, and more.
  http://www.bulimiaguide.org/index/category.aspx?lid=464
• Bulimia Nervosa: Signs, Symptoms, Treatment, and Help (Copyright © Helpguide.org) — This page outlines the basic information about the eating disorder bulimia and explains how to get help.
  http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm
• Eating Disorders — This detailed booklet describes symptoms, causes, and treatments of eating disorders. It also includes information on getting help and coping.
  http://www.nimh.nih.gov/health/publications/eating-disorders/summary.shtml
• Eating Disorders & Pregnancy: Some Facts About the Risks (Copyright © National Eating Disorder Association) — This publication discusses the risks of having an eating disorder during pregnancy, including an explanation of how it can affect both the baby and the mother. It also provides information on what to do if you become pregnant while already struggling with an eating disorder.
  http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/Pregnant.pdf
• How to Afford Appropriate Treatment for an Eating Disorder: A Guide for Patients & Their Families (Copyright © National Eating Disorder Association) — This publication provides detailed information about health insurance, where to find help for eating disorders, and where to get financial assistance for treatment.
  http://www.nationaleatingdisorders.org/uploads/file/information-resources/Eating%20Disorders%20Survival%20Guide%20revised%2012_21_2008.pdf

Connect with other organizations

• Academy for Eating Disorders
  http://www.aedweb.org//AM/Template.cfm?Section=Home
• American Dietetic Association
  http://www.eatright.org/default.aspx
• Bulimia Nervosa Resource Guide
  http://www.bulimiaguide.org/
• Families Empowered and Supporting Treatment of Eating Disorders (FEAST)
  http://feast-ed.org/feast.html
• National Eating Disorders Association
  http://www.nationaleatingdisorders.org/
• National Institute of Mental Health, NIH, HHS
  http://www.nimh.nih.gov
• National Mental Health Consumers' Self-Help Clearinghouse
  http://www.mhselfhelp.org/
• Nutrition.gov
  http://www.nutrition.gov/
• Weight-Control Information Network
  http://win.niddk.nih.gov/index.htm

Content last updated March 29, 2010.

Resources last updated March 29, 2010.

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