
Bulimia Nervosa is an eating disorder characterized by a cycle of binge eating and purging. People with bulimia nervosa eat much more than most people in a limited period of time and then engage in unhealthy behaviors to prevent weight gain, such as forced vomiting, the use of laxatives, diuretics, or excessive exercise. They are usually of a healthy weight but have self-esteem issues closely linked to their body image. Treatment for bulimia nervosa includes psychotherapy, nutritional counseling, medication, and support groups.
| Characteristics | Values |
|---|---|
| Weight | People with bulimia nervosa are usually at a healthy weight |
| Self-esteem | People with bulimia nervosa have self-esteem issues closely linked to their body image |
| Binge eating | People with bulimia nervosa eat large amounts of food in a limited period of time |
| Purging | Purging may involve making yourself throw up (vomiting) or taking laxatives, diuretics, or diet pills |
| Hiding food | People with bulimia nervosa often hide their eating and purging from others |
| Exercise | Excessive exercising is common among people with bulimia nervosa |
| Treatment | Treatment for bulimia nervosa includes psychotherapy, nutritional counseling, medication, and support groups |
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What You'll Learn

Purging
Bulimia Nervosa is an eating disorder that is characterised by uncontrolled episodes of overeating, known as bingeing, followed by purging. People with bulimia nervosa are usually of a healthy weight, but they judge themselves harshly based on their body shape and weight. They often have self-esteem issues closely linked to their body image.
- Self-induced vomiting: This involves forcing oneself to throw up after eating.
- Misuse of laxatives: Laxatives are medications that speed up the movement of food through the body.
- Misuse of diuretics (water pills): Diuretics increase urine production and are meant to treat medical conditions such as high blood pressure or oedema. However, people with bulimia may misuse them to try to reduce water weight.
- Excessive exercise: Some people with bulimia may engage in excessive exercise to try to burn off calories and prevent weight gain after bingeing.
- Fasting: This involves eating very little or not at all for a period after a binge.
The purging behaviours associated with bulimia nervosa can have serious health consequences. They can lead to malnutrition, which can affect almost every organ system in the body. Some potential complications include heart and kidney problems, an inflamed oesophagus, and dental issues.
Treatment for bulimia nervosa typically involves a combination of individual and family therapy, nutritional counselling, and medication. Early detection and treatment are crucial for a successful recovery.
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Laxatives and diuretics
Bulimia nervosa is an eating disorder characterised by a cycle of binge eating and purging. Purging may involve making oneself throw up or taking laxatives. Laxatives are medications that speed up the movement of food through the body. People with bulimia nervosa may also misuse diuretics, or water pills, which are another form of purging.
Laxatives are commonly misused by patients with eating disorders, particularly those with bulimia nervosa. Patients with anorexia nervosa may also misuse laxatives, especially those with the binge-purge subtype. Laxatives are used to induce diarrhoea to feel thinner, lighter, or "empty". They are also used to prevent the absorption of calories to lose weight or to avoid weight gain after binge eating. However, it is important to note that laxatives are not an effective means of losing weight. The effect on nutrient absorption is minimal, with only about a 12% reduction in calories with the use of laxatives.
Stimulant laxatives are typically used by individuals with eating disorders to stimulate the muscles of the gut to produce a bowel movement. Initially, an individual with an eating disorder might use laxatives to treat constipation or other gastrointestinal complications caused by low food intake and dehydration. However, over time, the misuse of laxatives can lead to a variety of issues, including dependency on these medications and complications that affect entire organ systems. Laxative abuse is frequently considered an addiction-like behaviour, and individuals can become both psychologically and physiologically dependent on them.
The most common consequence of laxative abuse is dehydration. Diarrhoea, a common side effect of laxative misuse, causes significant water loss, which can pose a great health risk. Symptoms of dehydration include dizziness, weakness, confusion, and fainting. Prolonged dehydration can even lead to death. Laxatives not only impact the absorption of water but also crucial electrolytes such as sodium and potassium. Electrolytes are necessary to maintain nerve and muscle function throughout the body. By depleting electrolytes, an imbalance occurs in the body, which can lead to shock, cerebral edema (swelling in the brain), seizures, and coma.
Diuretics are also commonly misused by patients with eating disorders, especially those with bulimia nervosa and the binge-purge subtype of anorexia nervosa. Diuretics are used to produce more urine to help eliminate water and achieve a lower body weight. Just like laxatives, diuretics can also cause dehydration due to fluid losses. This fluid loss causes an increase in certain hormones in the body, including aldosterone, which can contribute to edema formation. Additionally, the increased water loss from diuretics can lead to hyponatremia, which is a dangerous drop in serum sodium levels.
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Binge eating
Binges often involve eating large amounts of food in a short period, eating faster than normal, and continuing to eat until uncomfortably full, even when not feeling hungry. People with BED may eat in secret and choose foods they would usually avoid. Unlike bulimia, those with BED do not compensate for binges by vomiting, taking laxatives, or exercising excessively.
Treatment for BED typically involves a multidisciplinary team, including a doctor, dietitian, and therapist. Treatment options include nutritional counselling, psychotherapy, and medication. Cognitive-behavioural therapy (CBT) is a common form of individual counselling, focusing on changing thoughts and behaviours associated with binge eating. It teaches techniques for developing a healthy relationship with food and weight and managing difficult situations. Nutritional counselling involves learning healthier ways to eat and can help individuals reach and maintain a healthy weight.
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Weight maintenance
Bulimia nervosa (BN) is a mental health condition and eating disorder that can be life-threatening. People with bulimia nervosa usually maintain a normal weight and engage in a cycle of binge eating and purging. Binge eating involves consuming an unusually large amount of food in a short period, and purging involves getting rid of the food by vomiting, taking laxatives, or excessive exercise. Other characteristics of bulimia nervosa may include the misuse of water pills (diuretics) or diet pills, frequent visits to the bathroom, particularly after meals, preoccupation with body image, intense fear of weight gain, and depression, anxiety, or substance abuse.
To safely manage weight during bulimia recovery, it is important to practice intuitive eating and pay attention to how your body feels when engaging in movement. Eating is considered disordered when it interferes with daily functioning, causes psychological distress, and results in fluctuating weight. Mindful exercise that integrates mind and body, such as yoga or tai chi, can be beneficial. This type of exercise focuses on non-judgmental inward focus instead of compulsively targeting heart rate and includes criteria such as being meditative/contemplative, focusing on the present instead of being goal-oriented, and breathwork to regulate the nervous system.
In terms of nutritional counselling, individuals in recovery from bulimia can work with a registered dietitian or counsellor to develop healthier eating patterns. This may include learning about intuitive eating, which can help individuals make peace with food and honour their body's hunger and fullness cues. It is important to note that dieting is generally not recommended during recovery, as it can trigger disordered eating behaviours and negatively impact an individual's relationship with food. Instead, the focus should be on nourishing the body and promoting a healthy mindset around food and movement.
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Nutritional counselling
The treatment of bulimia nervosa often involves a team of specialists, including dietitians, mental health professionals, and other medical specialists. This interdisciplinary approach is crucial for understanding the complexities of eating disorders, which are influenced by a combination of genetic, developmental, and psychological factors.
In summary, nutritional counselling is a vital aspect of treating bulimia nervosa, helping individuals recover from the disorder and heal their relationship with food. It is a collaborative and tailored process that addresses both physical and mental health needs.
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Frequently asked questions
Bulimia Nervosa is an eating disorder characterised by binging and purging. People with bulimia often eat large amounts of food in a limited period of time and then try to get rid of the food or calories by purging.
Purging involves making yourself throw up or taking laxatives, diuretics, or engaging in excessive exercise to compensate for calories consumed.
Treatment for bulimia includes psychotherapy, nutritional counselling, medication, and support groups. Antidepressants such as Selective Serotonin Reuptake Inhibitors can help reduce the frequency of binge eating and vomiting.
People with bulimia may be thin, average weight, or overweight. They may hide their eating and purging behaviour from others. Warning signs include empty food wrappers and laxative packaging.
People with anorexia are usually underweight and engage in self-starvation, extreme diets, and excessive exercise to lose weight. They have an intense fear of weight gain and a distorted body image. In contrast, people with bulimia may be a healthy weight and engage in a cycle of binging and purging.

































