Bulimia is an eating disorder that involves a pattern of compulsive binge-eating and purging behaviors. Binge eating occurs when a large amount of food is consumed in a short period. The food eaten while binging is often high in calories or unhealthy, so someone may feel guilty and try to rid their body of the extra calories and fat by purging. This cycle is what defines bulimia.

People living with bulimia may induce vomiting, exercise excessively, fast or use laxatives or diuretics to compensate for the binge eating. These compensatory behaviors often occur in secret, which can impede the identification of the disorder. People living with bulimia are typically of a healthy weight and body mass index, but they have perceptions that they are overweight. The false perceptions encourage their unhealthy eating pattern to continue.

Bulimia is categorized as a mental health disorder in The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). It’s a lifelong disorder that should be addressed by professional treatment. Even after treatment, managing the disorder can be challenging. Treatment for bulimia should begin when someone recognizes that they have the disorder.

Discover If You Have Bulimia

Occasionally overeating doesn’t necessarily mean you have an eating disorder. According to the DSM-5, bulimia is characterized as a pattern of binging and purging behaviors that exist for three months. There are lists of symptoms and self-assessments that can help you determine if you, or someone you know, live with bulimia.

Not only is recognizing the symptoms of bulimia in yourself important, it’s also important to be able to identify mental and physical signs of bulimia in others since the disorder is often hidden by those who have it and thus difficult to observe and diagnose.

Some mental symptoms of bulimia include:

  • Feeling shame
  • Experiencing low self-esteem
  • Having a distorted view of personal appearance
  • Being overly preoccupied with food and dieting
  • Desiring social isolation

Physical signs of bulimia include:

  • Bloating
  • Diarrhea
  • Constipation
  • Acid reflux
  • Heartburn
  • Stomach pain
  • Dental issues

If any of these symptoms are observed, the person should see a physician to be potentially diagnosed with bulimia. If bulimia is diagnosed, treatment will likely be the next step. If bulimia goes untreated, it can result in serious health problems or death.

Identifying Bulimia Triggers

In treatment for bulimia, patients can participate in different types of therapy that can teach them coping mechanisms and skills to manage triggers they might experience throughout their life. Managing bulimia is a lifelong process, so treatment can prepare you for triggers that may occur.  

Triggers for behavior related to bulimia may vary among patients, but the most commonly reported triggers include:

  • Stress and anxiety
  • Boredom
  • Childhood habits
  • Childhood trauma
  • Social eating
  • Parties or gatherings

Once you identify what triggers urge engagement in bulimic behaviors, you can also identify coping mechanisms to combat your initial reactions. Some ways to avoid triggers include:

  • Meal prepping
  • Replacing unhealthy snacks with healthy ones
  • Placing healthy foods in the front of the refrigerator for easy access
  • Portioning food to prevent overeating

How to Seek Help for Bulimia

If you think you or someone you know lives with bulimia, treatment is the best option to avoid serious health issues or death. Treatment for bulimia typically involves therapy and nutrition counseling as well as medications for patients who have a co-occurring mental health condition or substance use disorder. More than half of patients who have bulimia also have anxiety, and 1 in 10 people with bulimia have a substance use disorder. It’s critical to patients’ recovery that both disorders are treated at the same time to determine triggers and avoid setbacks.

After Treatment: How to Overcome Bulimia

There is no cure for bulimia, but receiving treatment can help people better manage the symptoms and behavior of the disorder. The goal of treatment is to change the behaviors and perceptions of patients.

Some tips to overcome bulimia and remain in recovery include:

  1. Focus on therapy. It’s important to remember what you were taught during therapy sessions because you can continue to use those skills in recovery. A study by the American Psychological Association found that a significant number of patients who participated in at least 20 weeks of therapy stopped their bulimia-related behaviors.
  2. Follow a sleep schedule. A lack of sleep can be a trigger for bulimic behaviors, so it’s important to get enough sleep to ensure that you don’t experience fatigue.
  3. Eat when you’re hungry and stop eating when you get full. As bulimia progresses, signals from the body are often lost or unrecognized. During therapy, you’ll relearn how to recognize when your body is hungry and when it’s full.
  4. Avoid diets. Being focused on dieting and food could be a trigger for bulimic behavior. Instead, focus on a healthy, balanced relationship with food.
  5. Plan ahead. If you know you’ll be in a situation that can be triggering for your bulimia, plan accordingly by meal prepping or surrounding yourself with a support network.
  6. Find joy beyond food. People with eating disorders often engage in overeating because it provides a surge of dopamine. When in recovery, it’s important for patients to find a hobby or activity that doesn’t involve food so they can still experience happiness from another source.

DeAngelis, Tori. “Promising treatments for anorexia and bulimia.” American Psychological Association, March 2002. Accessed February 26, 2019.