Bulimia – Causes, Symptoms & Treatment


Bulimia (Bulimia nervosa) is an addiction to eating and vomiting and is therefore one of the eating disorders. Unlike with anorexia  , people with bulimia hardly look like they are suffering from an eating disorder, since they are usually of normal weight. Typical signs are high-calorie foods, vomiting , tooth decay and a lack of self-esteem .

What is bulimia?

Bulimia (Bulimia nervosa) is derived from the Greek and actually means “ox hunger”. In psychological and general parlance, however, bulimia is synonymous with binge eating. This involves eating excessively (cravings), but vomiting again for fear of gaining weight .

In advanced cases of bulimia, eating continues after vomiting and the cycle begins again. In the meantime, however, there are also subtypes of bulimia in which there is no vomiting, but too much sport to train away what has been eaten (sport bulimia) or to discharge it with various means.


The causes of food cravings in bulimia have deep psychological reasons, while vomiting in bulimia can be linked to the ideal of beauty. Possible reasons for bulimia can be trauma experiences that the person concerned could not process mentally. This includes fear of loss, abuse, rape, neglect and/or other physical and psychological violence.

Bulimia is often accompanied by codependency. This is also referred to as relationship addiction and includes the unconditional care of a close person in the environment. For example, alcoholic or drug addicted parents, siblings or closest friends.

In addition, there is the fear of gaining weight , which may be due to the beauty ideal of the media and the general public. However, many people suffering from bulimia also work in jobs where a good figure is important (e.g. model industry). However, bulimia is not tied to a job.

Symptoms, Ailments & Signs

Most people affected by bulimia are of normal weight. In line with the normal healthy population, they are sometimes overweight or underweight. In this respect, bulimia is not expressed in the external appearance of those affected. Rather, the disease is characterized by more or less regular binge eating, which can occur several times a day or even every few days. The perceived control over eating behavior decreases. Large amounts of food and fast eating play a role in binge eating.

The clinical picture of bulimia is defined by the fact that those affected try to compensate for their eating habits. Self-induced vomiting is particularly common in this regard. But doing a lot of sport, initiating extreme diets and using laxatives and emetics also appear to be good measures for those affected. Combinations of these measures also occur.

Cravings are further promoted during the course of the disease by the fact that the countermeasures taken against eating put a strain on the body’s energy balance. In this respect, a vicious circle of binge eating and wasting countermeasures is initiated.

Possible late effects affect the teeth and esophagus (due to stomach acid), the stomach, the metabolism and intestines (due to laxatives) and much more. Head, neck and back pain are particularly common and non-specific symptoms that are common in people with bulimia.

The disease often occurs around the age of 17 or 18 and is occasionally linked to a history of anorexia. The list of possible psychological comorbidities is long and includes, for example, substance abuse, feelings of inferiority and impulse control disorders .


Bulimia is a serious illness that must be treated by a doctor or psychologist. It is not uncommon for patients to be admitted to a clinic for treatment so that they can no longer harm themselves. If bulimia is not treated properly, it can cause serious damage to the body and, in the worst case, lead to death.

As a rule, there are various symptoms and complications associated with bulimia. The affected person often shows aggressive behavior and social isolation. There is also depression and feelings of inferiority, which are not further aggravated by social exclusion.

Not infrequently, bulimia occurs with the abuse of alcohol and other drugs and leads to the use of medications that cause vomiting. These drugs are harmful to the body in high amounts and cause problems with the stomach. The teeth are permanently damaged by the rising gastric acid and must be replaced with crowns.

Treatment takes place primarily on the psychological level. In addition, there is the treatment of the physical symptoms, since the body has to get used to a normal food intake again. As a rule, the treatment of bulimia is successful, but does not rule out the possibility that the affected person will contract the disease again.

When should you go to the doctor?

If you have bulimia, you definitely need medical attention. In the worst case, the disease can lead to death. In serious cases, those affected must be treated in a closed clinic. In most cases, the patients themselves do not admit the illness, so that it is mainly parents and friends who have to initiate the treatment and diagnosis.

A doctor must be consulted if the sufferer loses a lot of weight in a short period of time. Persistent vomiting or reduced self-esteem can also indicate the disease. Likewise, patients often suffer from tooth decay and eat high-calorie food. In addition, a doctor should be consulted if bulimia causes psychological and social problems.

In acute emergencies, an ambulance must be called. Comprehensive treatment of bulimia should be carried out in a clinic. However, those affected have to admit they have the disease. Treatment in self-help groups is also possible.

Treatment & Therapy

Bulimia is a disease that can only be treated with the help of a doctor who specializes in bulimia. This doctor is usually a therapist or psychologist. The treatment of bulimia can usually only begin as soon as the person concerned realizes that they need help.

After that, a week-long psychosomatic spa stay is the best foundation for finding your way back to a healthy life. In this therapy, an attempt is made to find out the causes of bulimia in order to then work through them. Those suffering from bulimia must learn to use alternative options instead of overeating.

A person with bulimia will need to watch his eating habits throughout his life, just like a sober alcoholic needs to stay away from alcohol. However, the bulimic has the disadvantage here that he has to eat to survive and cannot live abstinently.

Dealing with food correctly is just as important a point in bulimia therapy as various methods of dealing with the causes. After the intensive therapy, outpatient, regular talk therapy must be continued in order to be able to cope with everyday life and to learn to deal with relapses without falling back into bulimia.

Outlook & Forecast

The eating disorder can be cured with the right therapy and substantial patient cooperation. About half of all patients achieve freedom from symptoms after a course of several years. In about 30%, only a partial improvement in the clinical picture is observed and 20% of all patients show no healing of the existing symptoms.

The earlier the disease is diagnosed, the better the overall chance of recovery. At the same time, the age of the patient at the start of treatment plays an important role in the prognosis. Younger teenage patients have a significantly better chance of recovery than adults.

With the use of a therapy, the chances of recovery are significantly better than without the help of a doctor or therapist. Despite receiving medical care, many patients often experience one or more relapses during the recovery process. Young patients in particular are affected. In addition, there is a risk that the disease will become chronic and persist for many years.

At the same time, the probability of the outbreak of a secondary disease increases. Patients with bulimia often experience depression , obsessive -compulsive disorder , addiction, or impulse control disorders. Patients who also suffer from borderline disease have a significantly poorer prognosis. They have a significantly increased suicide rate and the likelihood of alcohol abuse.


Preventing bulimia is very difficult because the causes of bulimia are usually established subconsciously. Before the sufferer realizes that he is stuck in a bulimic thought spiral, he is usually no longer able to recognize for himself that he needs help. Good self-reflection and a healthy self-esteem are important in order to be able to prevent it.

Like all addictions, bulimia is the expression of mental suffering that has not been processed. Anyone who has experienced bad things should therefore always seek therapeutic help, even if they think they do not need it. Becoming aware of this is essential for survival, because bulimia, like other addictions, can be fatal.


As a rule, intensive follow-up care is necessary for bulimia. Especially after inpatient therapy, it is advisable to visit an outpatient psychotherapist and continue the treatment. This can help those affected to find their way back into everyday life and prevent any relapses. Visiting self-help groups can also be helpful in most cases.

In most clinics, the individual aftercare concepts are agreed upon in consultation with the attending physicians before discharge. Patients should strictly follow such instructions. In some serious cases, those affected can move to special supervised residential groups for former bulimia patients after inpatient therapy for the period of aftercare.

In addition, many medical facilities offer the option of online aftercare for patients with eating disorders. Outpatient psychotherapy is particularly recommended for those affected who have not previously been treated in a clinic. This should be continued in any case, even if those affected perceive a significant improvement in the disease. Family members and relatives should be involved in the process throughout the entire period of aftercare. If a relapse occurs, patients should always consult a doctor.

You can do that yourself

Bulimia is a serious eating disorder that can cause significant physical and psychological damage if not recognized early and treated professionally. You should therefore definitely refrain from self-therapy. However, those affected can help to support the recovery process.

The earlier the disease is detected, the lower the risk that those affected will suffer long-term damage. Therefore, a doctor should be consulted at the first sign of binge eating. In addition to drug treatment, patients should definitely make use of accompanying psychotherapy .

If the attending physician does not suggest this himself, the therapy must be actively demanded by those affected. In particular , cognitive behavioral therapies are very often successful in bulimia.

It is also important that those affected are not ashamed of their illness and at least inform their social circle such as parents, roommates and, if necessary, colleagues or the supervisor about their illness. Many patients also benefit from joining a self-help group or talking to other sufferers in online forums for bulimics.

A bulimia diary is also recommended. Such records can help to keep track of eating behavior and identify the triggers of the disease. Binge attacks, which mainly occur at night, can also be controlled by consumer behavior. Instead of storing groceries for the whole week, you should only buy what you need every day.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.