Bulimia Nervosa

Bulimia Nervosa is a serious mental health illness that may affect anyone (any gender, age or background).

According to Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition – DSM-5 criteria, an individual suffering Bulimia Nervosa presents the following features:

  • Recurrent episodes of binging

Binging episode is characterised by eating in a short period of time (less than 2 hours) an amount of food that is definitely larger than what most individuals would eat in similar period of time and under similar circumstances. A sense of lack of control over eating must also be present to consider an episode as binging.

  •  Recurrent inappropriate compensatory behaviour

In order to prevent weight gain, an individual engages in compensatory behaviours such as: vomiting, misuse of laxatives, diuretics (or other medications), fasting or excessive exercising.

(The binge eating and inappropriate compensatory behaviour both occur at least once a week for 3 months)

  •  Self- evaluation is influenced by body shape and weight

Excessive emphasis on body shape or weight typically determines self- esteem.

People suffering from eating disorders tend to use their eating habits and behaviours to cope with emotional distress, and often have an abnormal or unrealistic fear of food, calories and being fat. Because of this fear, people with bulimia nervosa tend to restrict their food intake.

This results in periods of excessive eating and loss of control (binge eating), after which they compensate, which may be done by making themselves vomit or using laxatives (purging).

They purge themselves because they fear that the binging will cause them to gain weight, and usually feel guilty and ashamed of their behaviour.

This is why these behaviours associated with bulimia are usually done in secret.

Such binge-purge cycles can be triggered by hunger or stress, or are a way to cope with emotional anxiety.

Recent studies suggest that as many as 8% of women have bulimia at some stage in their life.

The condition can occur at any age, but mainly affects women aged between 16 and 40 (on average, it starts around the age of 18 or 19).

Approximately 25% of bulimia sufferers are male and we know this number may be higher due to the number of boys and men whom do not seek support from health and other statutory services, and also influences available through sports and fitness and across the media portraying the stereotypical male physique.

Sufferers of bulimia can and do develop serious physical health issues alongside dealing with the anxiety and depression factors associated with this high risk mental health condition. 

Many of the physical problems are similar to those of anorexia sufferers. Please see below for health hazards of certain behaviours associated with bulimia.

Vomiting and laxatives

  • Dental problems caused by constant vomiting, since the stomach acid passing the teeth erodes the enamel
  • Water and salt imbalance can affect your heart, kidney and brain
  • Potassium levels can become very low and affect the electrical activity of the heart and brain leading to heart attacks and fits
  • Swollen facial glands
  • Severe dehydration can lead to kidney failure and stones
  • Laxatives can damage the bowel and stop it from working normally, this can lead to constipation and lots of wind. These effects can be irreversible
  • Straining due to use of laxatives can result in piles and prolapse (where your bowel leaves the body)

Over Exercise See Compulsive Exercise for more information

  • Dangerously low sugar levels can lead to coma and death
  • Bones are thin so can easily break
  • Muscles and joints can be damaged from increased strain
  • Destroys muscle and shape as your body eats its own flesh

Diet Pills and Diuretics

Diuretics (water tablets) cause dehydration and salt imbalance and damage the circulation and kidneys in a similar way to laxatives and vomiting.

Slimming drugs and appetite suppressants used to control appetite and prevent binges may work in the short term but can cause irritability, anxiety attacks, depression, paranoia, constipation, blurred vision and in some cases, psychosis or death.

  • Diet pills taken to excess can cause the body to become overactive and excitable
  • Difficulties in sleeping
  • Heart palpitations and permanent cardiovascular damage
  • You become on edge and jumpy
  • The mind becomes overactive and you become suspicious and agitated
  • Eventually, seizures or fits may develop. In those with epilepsy, appetite suppressants will substantially increase the risk of seizure

Other types of Bulimia – Diabulimia

Diabulimia  is a serious mental health and life- threatening illness.

According to Diabetics UK, Diabulimia is an eating disorder that affects people who are Type 1 Diabetics.

It refers to an individual who reduces their insulin intake in order to lose weight.

Some signs to look for

  • Typically within the normal weight or overweight range
  • Fear of putting on weight
  • Being critical about body shape and weight
  • Mood changes
  • Preoccupation with food
  • Behaving secretly
  • Bloating or tummy pain
  • A sore throat from being sick
  • Eating a lot of food very fast
  • Going to the bathroom after eating,
  • Erosion on teeth, painful and bleeding gums

‘Bulimia is a vicious cycle. It took away my confidence and I’ve been very absorbed in a binge- purge behaviours. This took over my life and made it difficult to do the things that everybody my age was doing’.


We are grateful to Sarah Cooke for creating this helpful support guide which she created as part of her university degree underlined with a wealth of academic references and evidence:  Bulimia Support Guide References

Sarah has created this support guide for young people aged 13 to 17 year olds whether worried about their own eating habits, and is also a helpful for anyone who may be worried about someone you might know showing signs of bulimia and binge eating disorders.

Bulimia Support – Are you worried about your eating habits or someone you know

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