Bulimia

Among eating disorders, bulimia is one of the most common types. This condition is always rooted in psychological causes, but it is also classified as a mental illness. That is why bulimia requires timely intervention by specialists — and now we will talk about what makes this disorder so dangerous.

Symptoms and Manifestations of the Disorder, Its Consequences

Bulimia is one of the most common eating disorders, characterized by a paradoxical combination of the desire to have a perfect body and constant overeating. Consuming an unrealistically large amount of food leads to self-disgust and triggers forced purging of the food — by inducing vomiting or through other methods. Bulimia is a form of mental disorder.

There are three main symptoms that clearly indicate the presence of the disorder:

1. Regular episodes of overeating.
2. Intentional purging of the digestive tract after eating.
3. An excessive preoccupation with body weight, viewing it as the primary factor in one’s self-esteem.

Bulimia is more difficult to detect than anorexia, as a person’s weight often remains within the normal range. The most common form is nervous bulimia, which may be caused by disorders of the central nervous system, the endocrine system, or certain mental illnesses.

Bulimia may be a constant condition or occur in episodes. A common example is nighttime binge eating followed by purging.

People suffering from bulimia often say they can’t overcome this “habit.” It’s not as simple as it seems, because those with bulimia frequently experience painful hunger, weakness, and abdominal discomfort. They quite literally cannot resist the urge to eat on their own. Although bulimia is caused by psychological issues, it often leads to additional disorders — such as depression, neurosis, or neurasthenia. Many people with bulimia also develop hidden alcohol dependency or are generally more prone to forming various types of addictions.

Bulimia poses a serious risk to physical health, though the mortality rate is lower than that of anorexia. People with bulimia are particularly drawn to high-calorie, so-called “junk” foods that rapidly harm the body. Common comorbid conditions include: tooth decay and other oral diseases, gastrointestinal problems — including intestinal bloating and distension, constipation, dysfunction of internal organs (such as the pancreas, liver, and kidneys), endocrine and metabolic disorders, and skin issues. Frequent purging can lead to hoarseness, esophageal mucosal tears, and bad breath. In women, amenorrhea or irregular menstrual cycles are common.

Who Is at Risk and What Causes Bulimia

Among those suffering from bulimia, not everyone seeks help — many can live with the disorder for years. People often feel ashamed to talk about their condition, and it is nearly impossible to detect the illness based on appearance alone. Close observers might notice unusual amounts of food being purchased for personal use, frequent and large meals, or long stays in the bathroom after eating. However, these signs are usually noticeable only when living together with the person.

Women are more likely to suffer from bulimia than men. The main risk group includes girls and young women aged 13 to 35. Moreover, the number of people with mild forms of bulimia is increasing — and many can live that way for decades. Among patients who seek medical help for eating disorders, more than half are diagnosed with bulimia.

Why is this disorder so widespread? Of course, there isn’t a single defining cause. Both psychological and social factors play a role. Let’s start with the fact that today’s obsession with having a perfect body is extremely strong — especially among young women. Unfortunately, the beauty standards they follow are often far from realistic or healthy.

Very often, women strive for unattainable ideals and choose unrealistic methods to reach them. For example, many turn to fasting or extreme diets. Inevitably, hunger takes over, leading to binge eating — which not only cancels out the effects of the diet but also promotes weight gain. To many, the idea seems tempting: eat as much as you want, then immediately get rid of it in the bathroom.

The problem is that these binge-eating episodes are beyond the person’s control. Many describe the experience as “being in a fog,” and when awareness returns, they are overwhelmed by self-disgust, shame, guilt, and fear over losing control. These feelings can be so intense that a person cuts off all social contact, trying to keep this terrible secret hidden from others. This creates a deep internal conflict: they purge to maintain physical attractiveness, yet isolate themselves from relationships — especially with the opposite sex — out of shame. Such contradiction leads to profound dissatisfaction with life and often becomes a direct path to neurosis.

For people with bulimia, body weight becomes the main factor shaping their self-esteem. Every 200 grams on the scale feels like a tragedy. Where does this obsessive idea come from? Many are influenced by societal pressure, while for others the roots lie in upbringing or deep psychological trauma — including experiences from childhood. Some parents unknowingly instill a negative attitude in their children toward people with excess weight, encouraging ridicule of body fat. As a result, even the thought of gaining weight can trigger panic. And once that happens, the person instantly feels worthless — as if life is over. At that point, any measure seems justified, as long as it prevents being “fat.”

A psychological trauma can trigger episodes of binge eating. “Eating away” one’s worries is a common coping mechanism — and when it’s combined with an internal ban on gaining weight, bulimia may develop. Low self-esteem is a core issue for people suffering from bulimia. Their self-image is too fragile and distorted to support healthy adaptation to life. A sensitive nervous system, high levels of anxiety, and low self-confidence create a predisposition to eating disorders. As the illness progresses, people often become secretive, possessive, irritable, and even envious. At the same time, they struggle with an ongoing inner conflict and a deeply suppressed emotional state.

How Bulimia Is Treated

Bulimia is treatable! This is the most important thing every person suffering from this disorder should know. Many people with bulimia believe that nothing can help them and blame themselves for being weak or lacking willpower. In reality, willpower alone is often not enough — professional help is essential. Treatment usually involves a dietitian, a psychotherapist, and sometimes a psychiatrist. Hospitalization is typically not required, although in severe cases it may be necessary.

Psychotherapy usually provides lasting results, but there is a significant risk of relapse. Bulimia is most commonly treated using cognitive-behavioral therapy (CBT). Antidepressants are often included in the treatment plan — and they can be genuinely helpful. It is also crucial to address damage done to internal organs during the illness and to restore the person’s health after prolonged dehydration.

Recovery from bulimia is a long journey. You must be prepared for slow progress — sometimes so gradual that it feels invisible. But the reward for patience is a return to a healthy, fulfilling life. Don’t give up on yourself or convince yourself that your case is hopeless. Bulimia can be overcome — and you deserve to win this fight.

Anna BUNYAK – Psychologist

First published: 2017
Updated in 2025 to reflect current guidelines and recent scientific research