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Bulimia Nervosa

What is bulimia nervosa? — Bulimia nervosa is an eating disorder in which people have episodes of overeating (called "binges"). After overeating, people then use unhealthy behaviors to rid their bodies of the food and avoid gaining weight (called "purges").
Bulimia nervosa is more common in women than men. It usually begins in the teen or early adult years.
Many people with bulimia nervosa are a normal weight for their height. Because their weight appears normal, other people might not know that they have an eating disorder. But it's important for people to get treatment, because bulimia nervosa can cause serious problems.
What are the symptoms of bulimia nervosa? — People with bulimia nervosa:
Binge at least once a week for 3 months or longer – During binges, people eat a much larger amount of food than normal. When they overeat, they usually feel out of control, guilty, afraid, or ashamed.
Purge or exercise after they eat – To avoid gaining weight after overeating, people:
•Make themselves vomit
•Exercise too much
•Use medicines to make themselves vomit, urinate, or have bowel movements
Judge themselves based on their weight and body shape – They feel good about themselves if they are thin and feel bad about themselves when they think they are overweight.
Is there a test for bulimia nervosa? — No. There is no test. But your doctor or nurse should be able to tell if you have it by doing an exam and talking with you about your eating habits, behaviors, and thoughts.
Your doctor or nurse will do tests to check your health, because bulimia nervosa can lead to many health problems. You will probably have:
Blood tests
Urine tests
An electrocardiogram (also called an "ECG") – This test measures the electrical activity in your heart and records your heart rate and rhythm (figure 1).
What problems can bulimia nervosa cause? — Bulimia nervosa can cause different kinds of health problems. That's because people vomit too often or use certain medicines too much. These health problems can include:
Dehydration – This is when the body loses too much water. It can make people feel thirsty, tired, dizzy, or confused, and have dark yellow urine.
Feeling very tired
Irregular menstrual periods (in women)
Belly pain, bloating, and trouble having bowel movements
Damage to the esophagus (the tube that connects the mouth to the stomach)
Damage to the teeth, gums, or cheeks
Problems with the heart, kidney, and glands
People with bulimia nervosa can also have:
Depression – This is when people feel very sad, empty, or hopeless most of the time, or do not enjoy the things that usually make them happy. In addition, people can have trouble with their sleep, appetite, energy, memory, or concentration. Some depressed people think about hurting themselves. If you are thinking of hurting yourself, call your doctor or nurse right away or go to the hospital.
Anxiety – This is when people worry a lot or think about certain things over and over.
Alcohol or drug abuse
How is bulimia nervosa treated? — Treatment for bulimia nervosa involves:
Psychotherapy – Psychotherapy involves meeting with a therapist to talk about your feelings, thoughts, and life. Different kinds of psychotherapy can be helpful, including:
•Working one-on-one with a therapist
•Group therapy – You can join a group for people with eating disorders.
•Family therapy – You and your family can work with a therapist.
Medicines – Some medicines that treat depression can also help treat bulimia nervosa.
A healthy eating plan – You can work with a dietitian (food expert) to make a healthy eating plan. If you are underweight or overweight, the dietitian can make a meal plan to help you get to a healthy weight.
Most people with bulimia nervosa can be treated at home, but some need to be treated in the hospital. It depends on the person's weight, symptoms, and health problems. Treatment for bulimia nervosa can be hard work, and it can take a long time. A complete recovery can take years.
What happens after treatment? — Many people get better with treatment. But people with bulimia nervosa often "relapse." This is when their symptoms and unhealthy eating patterns return.
To help prevent a relapse, you can follow your treatment plan and keep talking to your therapist. If you start to have symptoms again, let your family, therapist, or doctor know as soon as possible so that you can get help.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16566 Version 7.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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