Bulimia nervosa is an eating disorder that involves concerns about body shape and size. Unlike anorexia nervosa, bulimia doesn’t have the primary feature of starvation but instead is characterized by cycles of binging and compensating. A binge occurs when an excessive amount of food is consumed, and the person experiences a loss of control over their eating. To compensate for a binge, people with bulimia may purge (vomit), exercise excessively or go without food for a period. For someone to be diagnosed with bulimia, they must exhibit these behaviors at least once a week over three months.
Bulimia is a complex psychological disorder that is commonly linked to other emotional problems and perceived pressure to adhere to social standards of beauty. This eating disorder is also linked to certain personality traits, such as neuroticism or perfectionism.
The experience of bulimia can be highly distressing to the affected individual and their loved ones. Understandably, bulimia is associated with lower quality of life. Bulimia statistics suggest that bulimia can often go unnoticed, and people with this eating disorder may be slower to receive treatment.
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Prevalence of Bulimia
In a survey of American adults, the prevalence of bulimia in the United States was 0.28%, though it is thought to be much higher in high-risk groups, with rates as high as 1.6% in adolescent females. Bulimia is more common in women, with an estimated 1–4% of women in the United States having experienced the disorder.
Bulimia is more common in certain groups. Typically, these groups tend to be exposed to pressure or expectations surrounding body types, such as young women or elite athletes. For example, research has shown that athletes, such as swimmers or gymnasts, feel greater pressure related to weight and appearance. The related body dissatisfaction is linked with symptoms of bulimia.
Rates of bulimia can also vary by demographic factors, and evidence suggests that bulimia is:
- More common in Western countries
- More frequently diagnosed in white women
- More common in homosexual than heterosexual men
Age of Onset
The typical age of onset of eating disorders tends to be between 10 and 20 years old. Increases in body dissatisfaction during the teenage years may be due to the natural physical changes that take place during this time, as well as the internalization of social beauty standards.
Bulimia and Co-Occurring Health Conditions
Although bulimia has a genetic component, some of the psychological or social risk factors for bulimia are common to other mental health conditions. For example, bulimia frequently co-occurs with depression and anxiety, which can be linked to suicidal ideation or self-harm. Impulsivity also plays a role in binging and purging and may be a shared symptom with other impulse disorders such as kleptomania.
Bulimia often stems from feelings of extreme body dissatisfaction or low self-esteem. In addition to taking part in the binge/purge cycle, people with bulimia may cope with these feelings through alcohol or substance abuse.
Whether in isolation or combination with other disorders, the health risks of bulimia are multiple. From a mental health perspective, people with bulimia score lower on emotional well-being and social functioning. Bulimia is linked to many physical conditions, several of which are linked directly to bulimic behaviors. These can include ulcers, chronic headaches, severe dehydration and gum disease.
Bulimia Suicide Risk
Suicide attempts are much more common among people with bulimia than in the general public. This risk can be further increased when a person is experiencing both bulimia and depression. Suicidal tendencies in bulimia can stem from feelings of inadequacy and low-self esteem. Suicidal ideation may not be easily identified in people who do not have other comorbid conditions, and therefore, may be overlooked in bulimia treatment.
Bulimia nervosa prognosis can vary from person to person. The average episode duration of bulimia has been reported at 6.5 years. Though the road to recovery can be challenging, the 5-year clinical recovery rate has been reported at 55.0%.
Statistics on Bulimia Treatment and Recovery
There are different options for the treatment of bulimia, and people experiencing the disorder may choose one or multiple options. Treatments can include:
- Cognitive behavioral therapy
- Self-help strategies
- Medication, such as selective serotonin reuptake inhibitors
Possible comorbidities, like depression or anxiety, should also be considered in the development of a treatment strategy for bulimia. If you or a loved one is experiencing symptoms of bulimia and co-occurring substance use disorder, contact The Recovery Village today to discuss our comprehensive treatment options.
Lavender J.M. et al. “Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature.” Clin Psychol Rev, 2015. Accessed May 5, 2019.
Hail L. and Le Grange D. “Bulimia nervosa in adolescents: prevalence and treatment challenges.” Adolesc Health Med Ther, 2018. Accessed May 5, 2019.
Bardone-Cone, A. M., et al. “Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status.” Behav Res Ther, 2006. Accessed May 5, 2019.
Ágh, T., et al. “A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder.” Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 2016. Accessed May 5, 2019.
Udo, T. and Grilo C. M.. “Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults.” Biol Psychiatry, 2018. Accessed May 5, 2019.
Smink, F. R. E., et al.. “Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates.” Curr Psychiatry Rep, 2012. Accessed May 5, 2019.
Bodell L.P. et al.. “Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa.” J Psychiatr Res, 2013. Accessed May 5, 2019.
Martinsen, M. and Sundgot-Borgen, J. “Higher Prevalence of Eating Disorders among Adolescent Elite Athletes than Controls.” Medicine & Science in Sports & Exercise, 2012. Accessed May 5, 2019.
Anderson, C. M., et al. “Psychosocial correlates of bulimic symptoms among NCAA division-I female collegiate gymnasts and swimmers/divers.” J Sport Exerc Psychol, 2011. Accessed May 5, 2019.
Latzer, Y. et al. “Understanding eating disorders: Integrating culture, psychology and biology.” 2010. Accessed May 5, 2019.
Weissman, R.S. and Bulik, C. “Risk factors for eating disorders.” American Psychologist, 2007. Accessed May 5, 2019.
Nagl, M. et al. “Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults.” European Child & Adolescent Psychiatry, 2016. Accessed May 5, 2019.
Zapolski T.C. et al. “Borderline Personality Disorder, Bulimia Nervosa, Antisocial Personality Disorder, ADHD, Substance Use: Common Threads, Common Treatment Needs, and the Nature of Impulsivity.” Indep Pract. 2010. Accessed May 5, 2019.
Kessler R.C. et al. “The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys.” Biol Psychiatry, 2013. Accessed May 5, 2019.
Mayo Clinic. “Bulimia nervosa.” May 10, 2018. Accessed May 5, 2019. https://www.mayoclinic.org/diseases-conditions/bulimia/symptoms-causes/syc-20353615
Bodell L.P. et al. “Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa.” J Psychiatr Res. 2013. Accessed May 5, 2019.
Pisetsky E.M. et al. “Depression and Personality Traits Associated With Emotion Dysregulation: Correlates of Suicide Attempts in Women with Bulimia Nervosa.” Eur Eat Disord Rev, 2015. Accessed May 5, 2019.
Keski-Rahkonen, A., et al. “Incidence and outcomes of bulimia nervosa: a nationwide population-based study.” Psychol Med, 2009. Accessed May 5, 2019.
Herpertz S. et al. “The diagnosis and treatment of eating disorders.” Dtsch Arztebl Int, 2011. Accessed May 5, 2019.
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