What is Bulimia Nervosa

Bulimia Nervosa is an eating disorder which is characterized by a cycle of binge eating followed by purging to try and rid the body of unwanted calories. The bingeing of bulimia is accompanied by purging in an attempt to compensate for the compulsion to eat. To try to control weight someone with bulimia will often purge, most commonly by vomiting or laxative abuse.

Bingeing and purging

Bingeing sometimes starts as an attempt to cope with emotional difficulties or to ease tension, but this can rapidly get out of control. The food eaten during bingeing is often high in calories, things like carbohydrates and fat. Some people with bulimia resort to eating things like uncooked pasta, partially defrosted frozen food or condiments, or retrieve and eat previously discarded food as the compulsion to eat becomes overwhelming.

As the bulimic starts to feel full, feelings of guilt and shame start to take hold which is what leads to purging as a way of getting rid of the food, as well as the feelings of guilt and shame. It is not uncommon for people to eat two, three or even four times a normal amount of food in one go and a binge is different for all individuals. For one person a binge may range from 1000 to 10000 calories, for another, one cookie may be considered a binge.

Having binged, some people describe a feeling of emotional relief and the physical symptoms such as light-headedness appear to block out feelings. However, this cycle can only shut out the inner pain and unhappiness for a brief time before the emotional distress returns.

Purging and Non Purging type bulimia

Having binged, the bulimia sufferer attempts to rid their bodies of the food consumed, leading to purging or some other form of weight control.

Purging type bulimia involves the physical expelling of food and calories from the body. For example, self-induced vomiting, laxative and diuretic abuse, and the misuse of enemas are all purging type bulimic behaviours.

Non-purging type bulimia involves inappropriate and extreme compensatory behaviours but the sufferer has not engaged in self-induced vomiting or laxative, diuretic and enema abuse. Typical non-purging type behaviours include fasting and excessive exercise.

The frequency of these bulimic cycles will vary from person to person. Some people suffer from an episode every few months whereas those more severely affected may binge and purge several times a day. Some people vomit automatically after they have eaten any food. Others will eat socially but may be bulimic in private. It is possible that some bulimics do not regard their illness as a problem, but others despair and fear the vicious and uncontrollable cycle they are trapped in.

What causes bulimia?

As with other eating disorders, there is no pre-determined cause of bulimia and the reasons for the onset of the disorder may vary from person to person. It is common for sufferers of anorexia to progress to bulimia. The concept of trying to keep control is not as strong with bulimia as anorexia (although there are still some elements of it). Bulimia is a much more spontaneous illness and because of this suicide attempts are more common among bulimics.