Bulimia nervosa: an increasingly widespread problem

The sooner the disorder is diagnosed, the more likely the treatment will be successful.

Bulimia or bulimia nervosa is an eating and psychological disorder characterized by the adoption of certain eating behaviors, such as binge eating and purging. 

That is, patients, consume a large amount of food in very short periods of time and then purge, in order not to gain weight.

The purge (which can be done through self-induced vomiting or the use of diuretics or laxatives) is done by the regret that is experienced just after the binge.

According to the MSD Manual, patients with bulimia tend to be less introverted than patients with anorexia. 

On the other hand, they are also more likely to have impulsive behaviors, such as alcohol and other substances. And in the psycho-emotional field it clarifies:

“Anxiety (eg, in relation to weight and / or social situations) and anxiety disorders may be more frequent among these patients.”

Then, impulsive behaviors, feelings of guilt and loss of control are characteristic of this eating disorder.

Causes of bulimia nervosa

More than exact causes, there is the talk of a series of factors (both organic and psychological) that influence the development of this eating disorder.

The main factors to mention are low self-esteem, beauty stereotypes, and other social pressures. These, in conjunction with problems in the family environment, for example, can trigger bulimia.

Researchers have not yet found an exact cause of an organic type that allows shedding light on the subject.

However, hormonal activity, serotonin levels, and other endogenous chemicals continue to be investigated. 

The objective of these studies is to see how they affect eating habits.

bulimia nervosa symptoms

Unlike what is usually thought, the person with bulimia does not always have to be thin. There are patients with bulimia who also suffer from overweight and patients with bulimia who have a normal weight.

Therefore, it can be difficult to tell if a person has bulimia with their reference weight. This is because binge eating usually tries to do alone, without anyone noticing.

Over time, some symptoms of bulimia can be:

  • Swelling in the area of ​​the cheeks or jaw.
  • Calluses or scrapes on the knuckles, for using the fingers to cause vomiting.
  • Teeth that look transparent instead of white. In addition, they are increasingly sensitive and increases the risk of caries.
  • Broken blood vessels in the eyes.
  • Acid reflux, constipation, and other gastrointestinal problems.
  • Severe dehydration.

Patients who have this disorder may also manifest changes in behavior. For example, it is very typical that just after eating they want to go to the bathroom in order to vomit the food ingested. Other symptoms and behavior characteristic of these people are:

  • Exercise a lot
  • Being grumpy, sad.
  • Express frequently that they feel useless.
  • Stop doing activities you used to enjoy.
  • Having trouble expressing your anger or feelings in general.

It is very common for these people to suffer from other mental health problems associated with their eating disorders. Some of them may be depression, anxiety or substance abuse disorder.

Bulimia nervosa treatment

Bulimia is a disorder that must be addressed from several points, in order to help the patient. Therefore, cognitive behavioral therapy, interpersonal psychotherapy, and selective serotonin reuptake inhibitors ( SSRIs ) are used.

The combination of psychotherapy with antidepressants may be the most effective treatment to overcome this disorder. 

The treatment usually consists of a team approach that includes the patient himself, his family, the primary care physician, a mental health professional, and a nutritionist.

Different types of treatments available today for the treatment of bulimia are explained below.


Psychotherapy involves talking about the problem with a mental health professional. Different studies indicate that the following types of psychotherapy help improve the symptoms of bulimia nervosa:

  • Interpersonal psychotherapy
  • Cognitive Behavioral Therapy
  • Family-based treatment.

Pharmacological therapy for bulimia nervosa

The antidepressants can help relieve the symptoms of bulimia nervosa when they are used in conjunction with psychotherapy. The only antidepressant specifically approved by the FDA to treat bulimia is fluoxetine.

It is a selective serotonin reuptake inhibitor drug that may be helpful, even if the patient is not depressed.

If you have symptoms of bulimia or think that someone close to you can experience them, we recommend you go to a mental health specialist.

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