What is Bulimia?

Bulimia nervosa, often simply called bulimia, is an eating disorder characterized by a cycle of binge eating and purging. A diagnosis of bulimia is based on:

• Eating an abnormally large amount of food in a discrete period of time (e.g., within any 2-hour period)
• A sense of lack of control over one’s eating during the episode, such as feeling that one cannot stop eating or control what or how much one is eating.
• Recurrent compensatory behaviors to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
• The binge eating and compensatory behaviors both occur, on average, at least once a week for 3 months.
• The individual’s self-worth is unduly influenced by body shape and weight.
• The behavior does not occur exclusively during episodes of anorexia nervosa.

What are treatments for Bulimia?

Cognitive-behavioral therapy (CBT) is considered the first-line treatment for bulimia. Effective treatment is based on strict adherence to detailed guided treatments that include 18-20 sessions over 5 to 6 months. CBT aims to interrupt the patient’s behavioral cycle of binging and dieting, and correct dysfunctional thoughts about food, weight, body image, and overall self-concept.

Antidepressant medications have also proven helpful in treating bulimia to reduce binge eating and purging.

Epidemiology

Bulimia is more prevalent than anorexia. Estimates of bulimia range from 1 to 4 percent in young women. As with anorexia, bulimia is more common in women than in men, but its onset is often later in adolescence than that of anorexia. The onset may also occur in early adulthood. Approximately 20 percent of college women experience transient bulimic symptoms at some point during their college years. In the United States, bulimia may be more prevalent among Hispanics and blacks than non-Hispanic whites.

Social Factors

Individuals with bulimia, as with those with anorexia, tend to be high achievers and to respond to societal pressures to be slender. As with anorexia patients, many patients with bulimia are depressed and have increased familial depression. The families of patients with bulimia, however, are generally less close with more conflict than the families of those with anorexia. Patients with bulimia describe their parents as neglectful and rejecting.