What is bulimia nervosa?

A person with bulimia nervosa binges on food regularly and feels a loss of control. Binging involves eating large amounts of high-calorie foods over a short period. When the binge starts it is extremely difficult to stop. Some patients say they consume the food so fast that they hardly taste it.

During an episode of binging the individual may consume up to 3,000 calories – in some cases much more.

The binge is followed by a feeling of guilt and shame, which leads to compensatory actions, such as self-induced vomiting, over-exercising, not eating, and overusing diuretics, enemas or laxatives.

According to Boston Children’s Hosptial2, 1% to 5% of adolescents and 1.1% to 4.2% of females in the U.S. are believed to have bulimia nervosa.

The National Health Service3, UK, says that up to 8% of females probably have had or will have bulimia nervosa at some time in their lives.

As with anorexia nervosa and other eating disorders, people with bulimia often use their eating behaviors and habits as a means of coping with emotional stress, and typically have an irrational fear of becoming fat, calories and food.

What are the causes of bulimia nervosa?
Scientists and experts are not sure what the exact causes of bulimia nervosa are. They all agree that it is a result of a combination of environmental and genetic factors.

Genetics – the National Alliance on Mental Illness4 (NAMI) says that individuals with a family history of eating disorders have a higher risk of developing bulimia nervosa.

The American Psychiatric Association5 says that although evidence points to heredity as a contributory factor in eating disorders risk, many people with no prior family history are also afflicted.

Being bullied – children who have been bullied at school are more likely to develop bulimia compared to other kids.

Victims of abuse – incidences of bulimia are higher among people who have been sexually and/or physically abused.

Traumatic/stressful life events – bereavement, divorce, leaving home and other stressful life events are believed to be possible triggers for bulimia nervosa.

Having mental health problems – bulimia is frequently associated with other psychological problems, such as personality disorders, PTSD (post-traumatic stress disorder), anxiety disorders, OCD (obsessive-compulsive disorder) and depression.

Cultural factors – some people believe that susceptible individuals, especially young females, who are exposed to Western media photographs of slim and beautiful women become more vulnerable to developing eating disorders. Studies have so far provided conflicting results.

One study found that up to 40% of fashion models may be suffering from an eating disorder.

Hormones – the onset of eating disorders in most cases coincides with puberty, a period in life when people become more aware of their own bodies and experience major hormonal changes. Several experts suggest that hormonal changes may be linked.

Scientists at the Karolinska Institute in Sweden found that up to 30% of females with bulimia nervosa may be suffering from an imbalance of sex hormones.

Low self-esteem – after successful treatment many patients say they had had a low opinion of themselves and saw their bulimic behaviors as a way of enhancing their self-worth.

Competitive sports – in an article in the Asian Journal of Sports Medicine6, Dr. Alan Currie explains that there is strong and consistent evidence that eating disorders are common in sports, especially weight-sensitive ones such as jumping events, endurance sports and esthetic sports. He concluded “In many sports prevention, screening and support programs have been developed for a variety of medical conditions or sports-related injuries. Similar programs should be developed for eating disorders.”