Bulimia nervosa is characterized by recurrent and frequent episodes of
eating unusually large amounts of food (e.g., binge-eating), and feeling
a lack of control over the eating. This binge-eating is followed by a
type of behavior that compensates for the binge, such as purging (e.g.,
vomiting, excessive use of laxatives or diuretics), fasting and/or
Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week.
Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.
Other symptoms may include:
As with anorexia, treatment for bulimia often involves a combination of
options and depends on the needs of the individual. To reduce or
eliminate binge and purge behavior, a patient may undergo nutritional
counseling and psychotherapy, especially cognitive behavioral therapy
(CBT), or be prescribed medication. Some antidepressants, such as
fluoxetine (Prozac), which is the only medication approved by the U.S.
Food and Drug Administration for treating bulimia, may help patients who
also have depression and/or anxiety. It also appears to help reduce
binge-eating and purging behavior, reduces the chance of relapse, and
improves eating attitudes.
CBT that has been tailored to treat bulimia also has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy may be individually oriented or group-based.