Bulimia: What are its causes, symptoms, consequences and treatment?

Bulimia: What are its causes, symptoms, consequences and treatment?
Photo source: Getty images

Bulimia is an eating disorder. It mostly affects girls and women aged 15-30 years. The word has a Latin Greek origin and means wolf hunger. It is characterized by bouts of overeating and subsequent disease weight control. They achieve this by vomiting, but also by other mechanisms.


Bulimia is also referred to as mental bulimia , technically  Bulimia nervosa . This disorder is classified as an eating disorder. And known anorexia also belongs to this group.

Eating disorders are diseases of civilization.

One suffers from the morbid notion that one must look slim and live healthy. Limits or otherwise excessively reduces weight. Behind this disorder is usually another psychological disorder, such as severe stress, traumatic experience, often divorced parents. 

Young people in particular suffer from eating disorders. With the predominance of girls, up to 10 times more often than boys. The highest incidence is during puberty and adolescence, ie from 13 to 18 years of age. With bulimia, it is typically between the ages of 17 and 18. Bulimia is reported to affect approximately 1-3% of women during this period.

The estimate is only approximate, as it is very difficult to identify this disorder. Many young girls have learned to disguise bulimia perfectly. Whether in front of your friends or family. They sometimes manage to hide their problem for years.

What is bulimia?

Bulimia is an eating disorder that has a paroxysmal, episodic nature. And the period of excessive food intake alternates with the effort to maintain your calorie intake and the desired figure. The period of overeating can be alternated by inappropriate starvation. In addition to disease starvation, other mechanisms also help. For example, Bulimk uses the following to control its weight:

  • vomiting after eating
  • starvation period
  • excessive to dangerous physical activity
  • laxatives
  • diuretics, ie substances that help urinate

A person with bulimia suffers from a disease-controlled control of food intake, ie calories. He tries diets to maintain his body weight and proportions. However, the bodyweight of a bulimic is average or slightly above the BMI (body mass index) index. Which does not physically differentiate him from other people and helps him to conceal the disorder.

TIP:  Information about BMI is given in the article about overweight.

Bulimia is also associated with other mental disorders. Such as low self-esteem, anxiety, emotional instability and long-term stress. But also nervousness, frustration or loneliness. And even for these mental problems, bulimia deepens.

Bulimia has been considered a separate disorder since 1979. Its form has been known since ancient Rome. When the Lukul feast was celebrated with overeating and subsequent relaxation of the stomach for further food intake. And from other people, not secretly.

Burger, as a sign of overeating in bulimia
The period of overeating alternates with starvation. Photo source: Getty Images

Bulimik tries to banish his bad mental state by overeating. Subsequently, he develops remorse, induces vomiting or engages in other calorie-lowering practices. Both of these mechanisms, as well as overeating and vomiting, help alleviate anxiety and tension in the short term. However, in the long run they have no effect.

The main features of bulimia assessment include:

  • sick food treatment, irresistible cravings and overeating attacks
  • trying to suppress the effects of overeating by vomiting, starvation or laxatives
  • fear of overweight and obesity

Bulimia is divided into two types:

  • purgative, ie cleansing, when the bulimic cleanses the food by vomiting, laxatives or diuretics
  • non-surgical type, it is not cleansing, but uses starvation, excessive physical activity for regulation


The causes of bulimia are multifactorial. And this means that social, physical and psychological factors are involved in its outbreak. Social means that it arises from the influence of social belief that a person must be slim in order to be healthy and happy. As a result, a sick effort arises.

Bulimia and morbid beliefs about a healthy diet, woman, anorexia, vegetables
Social effect - slim figure, healthy diet = health and success. Photo source: Getty Images

Television, fashion magazines, modeling have a great social effect. Girls in adolescence are compared with models, bowls, actresses. Multimedia is, therefore, a strong factor. However, it is stated that this is mostly a secondary effect. The main role is played by psychological and genetic predisposition.

Biological effects include:

  • genetic predisposition, heredity
  • individual bodily preconditions
  • hormonal disorders 

Nature, and therefore mainly a psychological factor, contributes to the onset of bulimia. Nowadays, it is known that bulimia also arises on the basis of another mental disorder. In addition to anxiety or depression. But also as a result of disproportionate mental strain, unfulfilled expectations, as a result of severe stress.

The predisposition is unstable nature, insufficient parental care, ie neglect. But also abuse. The family incidence of obesity and childhood obesity or parental alcoholism have a negative effect. It can also be caused by a stressful life event, a divorce of parents and another unpleasant traumatic experience.


Bulimia is mostly hidden from the outside world. But one of its main features is the characteristic period of overeating, which is followed by the induction of vomiting. In addition to vomiting, another method may be involved in weight control. Examples include laxative abuse, diuretics, excessive to dangerous physical activity and starvation.

The evaluation criterion states that these stages should last at least twice during one week for three months. Overeating attacks can last from a few minutes to hours, usually 2 hours. The frequency during the month is individual. In some cases, three times a month to several times a day.

Periods of excessive food intake are preceded by anxiety or depression. Overeating will suppress this mental difficulty. After a stage of excessive food intake, a phase of remorse begins. And again, the bad mental state deepens.

Sick cravings for food can lead to criminal behavior and theft in the event of financial problems. Psychological manifestations of bulimia nervosa include other difficulties such as:

A woman in the refrigerator as a sign of overeating at bulimia
Bulimik suffers from a morbid craving for food. Photo source: Getty Images
  • depression
  • anxiety
  • self-harm
  • suicidal thoughts and tendencies
  • desire for slenderness
  • distorted view of weight and figure
  • morbid interest in weight, calories
  • reduction diets
  • selection of individual foods
  • loss of interests, favorite activities
  • disinterest in relationships, friends, family, avoiding them
  • solitary way of life
  • concentration disorders
  • reduced mental condition
  • uncritical behavior
  • reduced self-confidence, distrust
  • nervousness, emotional lability
  • feelings of shame
  • fatigue

Of course, as with anorexia, bulimia affects the body. They arise as a result of starvation, vomiting, but also dehydration. This is accompanied by a reduced level of minerals and trace elements.

Physical difficulties resulting from bulimia:

  • frequent vomiting
  • weight fluctuation
  • excessive to harmful physical activity
  • dehydration and disturbance of the internal environment 
    • hypochloraemia
    • hypokalaemia
    • alkalosis
  • heart rate problems, arrhythmias, low blood pressure
  • shortness of breath
  • risk of inhalation vomiting, pneumonia
  • stomach ache
  • bloated belly
  • esophageal rupture
  • menstrual disorders
  • potency disorders
  • strata libido
  • infertility
  • damage to tooth enamel, yellow teeth, tooth decay
  • gum damage
  • enlargement of the parotid glands
  • growth slowdown
  • muscle involvement, muscle weakness, weakness
  • bone disease, bone thinning
  • brittle nails
  • poor hair condition and thinning, hair loss
  • dry skin
  • cracked oral corners
  • abrasions on the hands, especially on the hooks - Russell's marks
  • overall weakness

TIP:  Information on the indoor environment failure is given in the article on acidification.


Bulimia is assessed on the basis of a criterion that determines that episodes of overeating last for three months, with a frequency of at least 2 times a week. He consumes an excessive amount of food in a short period of time.

Diagnosing an eating disorder is difficult. She is also aggravated by the fact that especially a child patient often downplays (simplifies) or obscures difficulties. Otherwise, limited food intake may be to blame for abdominal pain or other problems.

Although bulimia is an eating disorder, it is preceded by another mental disorder. Therefore, it is important in diagnosis to determine this primary psychological cause. Especially if it is a depressive disorder and associated self-harm or the risk of suicidal tendencies.

The history itself plays a role in the diagnosis. Data from family members and loved ones are also important. They may first notice the child's developmental lag, loss of interest, sad mood, tightness, avoid eating, throw away the tenth, and frequent going to the toilet may be one sign.

As episodes of overeating, alternating periods of reduction diets, laboratory blood tests are also important. This reveals variations in the indoor environment and other difficulties. Diagnostic indicators can also be fluctuations in body weight and visible changes,  for example on the skin or hair.

Subsequently, if complications are already associated, other examinations according to physical difficulties. Of course, differential diagnosis is also important to reveal that it is a disease other than an eating disorder. In this case, examinations such as USG, X-ray, CT, ECG may be helpful.


We should look for the trigger of the disease in a biological, social or psychological factor. These prevent eating disorders. The onset of difficulties also depends, of course, on personal assumptions.

Bulimia - a woman lying on the ground, weight, body weight, anxiety
Depression, anxiety, dissatisfaction with weight. Photo source: Getty Images

Initially, a period of anxiety or depression occurs. The affected person compensates for this bad mental state with an episode of overeating. The act of eating an excessive amount of food and, consequently, vomiting and vomiting has a dampening effect on mental difficulties.

The excess of food received is alternated by a period of remorse, dissatisfaction with calories and a relentless problem with one's own figure. This causes further deterioration of the mental condition. This vicious circle continues around and it is difficult to get out of it.

Mental restlessness is also caused by other factors. These include, for example, hiding from family and friends, the stress of revelation. The sufferer is becoming more and more skilled in hiding his problem. Other symptoms are associated, such as loss of interest, a solitary way of life, emotional states, but I am tired. Man selects and accepts only a certain type of food.

With a long-term problem, physical difficulties begin to occur. In children, we can observe the lagging behind of physical and mental development, growth retardation, muscle weakness. The skin is dry, the hair is brittle and falls out to a greater extent.

Dehydration, a disorder of the internal environment, is serious, which can lead to cardiovascular problems. Low blood pressure, risk of cardiac arrhythmias or shortness of breath. Repeated vomiting can cause sore throats and is a risk for aspiration, ie inhalation of vomit into the airways, which in turn causes aggressive pneumonia.

Frequent vomiting results in damage to the enamel, and thus increased susceptibility to tooth decay. Teeth turn yellow, stomach contents are also harmful to the gums, which usually results in periodontitis.

How it is treated: Bulimia

Bulimia treatment has both physical and mental aspects

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How does bulimia progress?

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Interesting resources

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  • Flett GL, Newby J, Hewitt PL, Persaud C (September 2011). "Perfectionistic Automatic Thoughts, Trait Perfectionism, and Bulimic Automatic Thoughts in Young Women". Journal of Rational-Emotive & Cognitive-Behavior Therapy29 (3): 192–206