Bulimia nervosa: what is it, diagnosis, treatment

One kind of eating disorder is called bulimia nervosa. It is quite a serious pathology of a psychogenic nature, provoking negative consequences up to fatal outcome. About how to diagnose and treat the disease to prevent a terrible outcome, you will learn from the article.


  1. What is bulimia.
  2. Triggers.
  3. Diagnosis.
  4. Treatment.
  5. Prognosis.

What is bulimia

Bulimia nervosa is the most common eating disorder. It is three times more common in the home than anorexia. The disease is gender-specific, with up to 90% of patients being women. Signs of the pathology need to know to avoid a fatal outcome. The debut of the disease occurs between the ages of 15 and 24. As a rule, those whose professional activity depends on their appearance and health are at risk: ballerinas, gymnasts, runners, dancers, actresses, models.

It is important for them not to be overweight, because their careers depend on it. And teenagers and young girls become victims of family attitudes toward their appearance, when any extra pounds are criticized. The disease is provoked by the opinion of classmates, fellow students, and the media, which promote certain standards of the ideal figure.

In essence, bulimia nervosa is gluttony. A person who suffers from a constant desire to eat something is delirious about food, his thoughts are only about it: he is not able to study or work. The sick person may even steal food, get it out of the garbage. As long as he eats, he has no inner tension.

He feels comfortable, but after overeating there is a feeling of remorse and guilt, a fear of gaining extra pounds. Then everything possible is used to prevent the phantom weight gain: artificial vomiting, laxatives, diuretics, enemas, fat burners. An empty stomach brings relief and soothing.

The patient begins to exhaust himself with physical effort, and such exercise is compulsive, he forces himself to do it. The bulimic believes that sports will help him get rid of extra calories and enable him to eat more.

This behavior cannot lead to anything good a priori, except a loss of attractiveness and impaired health:

  • increased acidity provokes erosive and ulcerative processes in the digestive system, spoiling the teeth;
  • acid-alkaline imbalance is formed;
  • arrhythmias occur;
  • tissue demineralization occurs;
  • trauma to the esophagus;
  • salivation is activated; salivary glands increase in size;
  • and a pastosity of the face;
  • liver and kidney function is disturbed;
  • diseases of various genesis appear;
  • mental disorders;
  • women’s menstrual cycle malfunctions;
  • cramps occur;
  • the skin dries out due to dehydration;
  • bone density decreases;
  • hair loss;
  • the person feels chills all the time.

Very often precedes bulimia is anorexia, when the patient deliberately restricts himself in eating, that is, starving. The goal is the ideal weight and shape. At the same time the person actually has a perfectly normal weight. Starvation constantly returns the patient’s thoughts to food, there is a nervous breakdown, loss of control over himself and consuming food in huge quantities.

In each episode of bulimia, there is a chance of more than 6,000 kcal, whereas 2,000 is enough. Some experts say that neurogenic anorexia and bulimia are two sides of the same coin, linked together by affinity for leptin. One might call it two stages of the same disease or a vicious circle: first the fear of being obese, then pathological thoughts about food, and again the return of the fear of being overweight.

This suggests that bulimia nervosa can be classified either as a root cause, a nosology in its own right, or as a secondary symptom of anorexia.


Impulsive gluttony occurs under the influence of stressful situations. Bulimics binge on resentments and worries. Criticism from others and loved ones, the desire for perfection, the desire to become the owner of ideal forms – these are the psychological reasons that cause the disorder. But there are also physiological triggers.

These are: fluctuations of the hormonal background, metabolic pathologies, organic damage to the cerebral structures that control eating behavior. It is necessary to understand that any type of disorder is a collective, complex concept, one closely related to the other. Therefore, any disorder provoked by the desire to have a perfect figure and weight, which is correlated with food intake, is considered to be multi-causal. Everything matters here: biological factors, cultural habits, genetics, traditions, psychological and physiological aspects.


It is not at all easy to recognize the pathology. No person is burning with the desire to share such a problem with others. The patient carefully hides the discomfort and does not realize how much he harms himself, trying to achieve the goal – weight loss. However, signs of pathology can still be noticed, especially to family members. Urgent measures are needed if a loved one suddenly begins to eat a lot, but does it alone, and afterwards – hides in the toilet. He does not change his weight, but he looks worse day by day. The habit of eating at night appears, and in the morning – it causes negative emotions, anxiety, the patient is nervous, looks depressed, exhausted.

You need to sound the alarm if your loved one:

  • is obsessed with striving to have perfect shapes;
  • dissatisfied with his body, his weight;
  • has low self-esteem;
  • eats quickly and a lot to the point of nausea;
  • often sits on diets, which alternate with episodes of real gluttony;
  • abuses laxatives and diuretics;
  • artificially induces vomiting after meals;
  • carries around a supply of fast food, for a quick snack at any moment;
  • exercises to the point of exhaustion;
  • constantly experiences depression, weakness, sudden change of mood;
  • is immersed in himself and against communication with others;
  • complains about the condition of the digestive system, skin, and frequent tonsillitis.

It is necessary to understand and remember that an eating disorder is quite a serious pathology that requires attention.


Therapeutic measures are taken by a psychiatrist (medications) and a psychotherapist (techniques). The goal of condition correction is to teach the patient not to binge on stress, but to control his or her emotions, to avoid situations that lead to overeating, and to eat normally. Further, thoughts are instilled in the patient’s mind that while our body is important, there are other more significant values. Therapy is carried out individually and in groups. A combination of the efforts of the psychotherapist and psychiatrist with the dietitian is obligatory. In neglected stages, a therapist and other narrow specialists, up to and including intensive care specialists, are involved.

We emphasize that the correction of an eating disorder is a complicated and long-term task. It is not solved by a click of a button. Nor can you cope with bulimia of a nervous nature on your own. The correct correction tactic is the prerogative of professionals. First of all, the patient should be aware of the problem, sometimes already at this stage the disease recedes. But this is more a rarity than a rule, so the intervention of a specialist is required.

There is another nuance: it is better not to bring yourself to the point where the process becomes irreversible and seek medical help as soon as possible.


Bulimia nervosa can be corrected in 80% of cases. On the other hand, it should be said that the increased attention to food and weight remains, but without fanaticism. The difficulty in correction is that patients suffering from overeating, do not want to admit their problem, hide it, harm themselves. The task of loved ones is to gently push the person to a doctor’s consultation.

The following can help in this:

  • communicate clearly the full extent of the danger of the patient’s condition;
  • be patient, even if they are aggressive (who would like their secret to be out in the open?);
  • convince the patient that your goal is to help, not to humiliate;
  • talk to the patient on an emotional level;
  • promise to keep the secret;
  • reassure them that the result will definitely be positive;
  • do not blame or chastise them for their gluttony.

The prognosis for correction of the condition is favorable if measures are taken in time, but in neglected cases there is a risk of lethal outcome due to irreversible changes in internal organs.


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