Bulimia Nervosa Therapy

What is Bulimia Nervosa?

Bulimia nervosa (commonly referred to as bulimia) is an eating disorder. Many know it by the bingeing (overeating) and purging (throwing up, laxative use, over-exercising) behaviors associated with the condition. People who suffer from bulimia will regularly find themselves trapped in an uncontrollable cycle. This includes eating lots of food in a short amount of time. That’s followed by finding ways to offset the caloric intake in a quick, if not dangerous, way. That’s why it’s vital to seek out bulimia nervosa therapy.

Bulimia Nervosa Therapy: What’s Behind the Eating Disorder?

bulimia nervosa therapy

Alt text: A woman thinking about binge eating and seeking out bulimia nervosa treatment.

Bulimia is linked to self-esteem issues. This can include interpersonal rejection sensitivity and fear of being alone. People suffering from bulimia may also find themselves dealing with other co-occurring issues. A few to watch out for are depression, anxiety, OCD, Borderline Personality Disorder (BPD), or bipolar disorder.

The severity of the binge-purge episodes can also vary from weekly to daily. Many people who suffer from bulimia maintain a normal body weight and can therefore appear “healthy” while hiding the condition easily. 

The most widely known purging behavior is vomiting. However, these behaviors can also include excessive exercise and the misuse of laxatives and diuretics (water pills). There’s quick efforts to lose calories consumed during a purging episode. In order to meet the diagnostic criteria for bulimia, the person suffering from episodes has to have the behaviors at least once a week for a period of three months.

Also, people may not meet this exact criteria, but still engage in these behaviors. They may still meet criteria for an eating disorder. For example, Other Specified Feeding or Eating Disorder (OSFED), and should seek out help from a medical provider. 
If you’re in prolonged periods where you feel like you can’t control what you eat and you purge, you’re not alone. Help is available. Talk to a specialist today.

Bulimia Warning Signs and Symptoms Include:

  • Eating large amounts of food in a short period of time (binging)
  • Feeling out of control while eating
  • Purging behaviors to get rid of calories or compensate for binging behaviors, such as:
    • Self-induced vomiting
    • Misusing laxatives or diuretics (water pills)
    • Fasting or skipping meals
    • Excessive exercise
  • Preoccupation with body shape, weight, or appearance
  • Spending lots of time thinking about food, calories, or eating
  • Secrecy around eating behaviors or going to the bathroom after meals
  • Puffy face or cheeks
  • Anxiety or distress around eating
  • Mood swings, irritability, or depression
  • Low self-esteem and sensitivity to interpersonal rejection
  • Feeling guilt, shame, or secrecy about eating behaviors

How do we Treat Bulimia Nervosa at EDRS?

Due to common views on what a person with an eating disorder looks like, people who struggle with bulimia often go unnoticed. This can even be the case with those who are closest to them because they appear to have a “normal” body size. For the most part, those who reach out for help have been in their food routines and rituals for a long time. Their ingrained behaviors can require expert support to overcome.

If you believe you have an eating disorder, consider bulimia nervosa therapy. Our admissions team will work with you to assess the episodes. You can learn more about the driving factors and motivations. As with anorexia, medical stability must be established before psychological work can continue. Also, due to the purging episodes and health risks, our admissions team will coordinate with a Primary Care Physician (PCP). This can help to ensure that electrolyte monitoring has begun. Clients suffering from bulimia can deteriorate quickly. That’s why medical monitoring is essential. 

Bulimia Nervosa Therapy and Treatment Options

Once a client with bulimia has come into our care, nutrition therapy is recommended alongside psychotherapy. A meal plan allows clients to learn how to eat properly and retrains their bodies and nervous systems. Fullness cues help to maintain healthy eating patterns during recovery. 

EDRS is part of a larger behavioral health healing ecosystem. There are many options and ways to maximize your bulimia recovery. That’s why it’s best to find care options that are specific to your needs and schedule. Depending on what you may need, you can start with a more traditional outpatient route of weekly therapy and meal support. You may also find yourself in a more devoted, yet flexible treatment option: our intensive outpatient program (IOP).

Therapy for people suffering from bulimia has proven to be effective treatment. For many clients, Dialectical Behavior Therapy (DBT) psychotherapy has been successful with impulse control and emotion regulation issues. These skills can help with controlling and stopping the binge-purge cycle. However, no two clients are the same, and our clinicians recognize this with a highly personalized approach.

If you think you might be ready for bulimia nervosa therapy, we are here to help. We have an experienced team ready to guide you through the next steps – call today. 

Helpful Screening Questions for Bulimia Nervosa

  • Do you find yourself eating large amounts of food, larger than what most people would consume? 
    • If yes: consider the details and the nature of food you are eating, if you’re unsure of what is a large amount of food, you can always reach out to our admissions team.
  • Do you ever feel that your eating is out of control?
  • Do you think about behaviors to get rid of the food you just ate? For example, self-induced vomiting, laxatives, fasting, or exercise, and do you do this after eating?
  • Do you find that you spend your time worrying about your body shape and weight? Does it affect your day and your mood?

If you have answered yes to any of these questions, contact our admissions team today for a full assessment. Help is available and you’re not alone.

Medical Complications of Bulimia Nervosa

  • A sore throat that is chronically inflamed
  • Tooth decay from exposure to stomach acids after their enamel wears off
  • Gastroesophageal reflux disorder, caused by constant vomiting
  • Intestinal issues caused by irritation from laxative abuse
  • A puffy or swollen face and cheeks
  • Severe dehydration from the purging of fluids
  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure
  • Salivary glands below the jaw and in the neck become swollen
  • Kidney problems caused by the use of diuretics, or water pills
  • Calluses on hands and knuckles (Russell’s Sign)
  • Chronic or irregular bowel movements and constipation as a result of laxative abuse

Due to the health issues with purging behaviors, medical complications for bulimia can be severe. If you believe that you have bulimia with physical disruptions and imbalances, it’s critical that you seek help from a professional. We are here to answer your questions. Call today.

Prevalence of Bulimia Nervosa (NIMH)

  • The overall prevalence of bulimia nervosa in adults was 0.3%.
  • The prevalence of bulimia nervosa was five times higher among females (0.5%) than males (0.1%).
  • Typical age of onset: Late teens to early 20s

Unlike anorexia, bulimia typically onsets later in life. While women are more likely to have bulimia than men, the disorder, like many others, does not discriminate. Anyone can suffer from bulimia regardless of gender, race, age, body type, or sexual orientation. Due to many people with bulimia maintaining a “normal” body weight, it can be easier to hide. If you suspect you or someone you know has bulimia it’s important to reach out to a professional and seek help. Call to speak with someone in admissions today. 

Psychological and Co-Occurring Factors

  • Mood disorders: Depression, anxiety, bipolar disorder
  • Substance use disorders: Alcohol or drug misuse
  • Personality traits: Perfectionism, impulsivity
  • Trauma history: Childhood abuse, neglect, or other adverse experiences
  • Body image disturbances: Preoccupation with weight, shape, or eating

Bulimia can come with co-occurring factors and is highly linked to BPD. One of the most common personality traits with the disorder is their impulsive nature. In therapy, DBT is used to confront these impulses and teach emotion regulation. Our therapists are trained in a variety of modalities and expertises. This helps to address all psychological factors at play within a bulimia diagnosis. Informed, holistic, and caring help is available. Reach out to admissions to learn more about what healing could like for you or someone you know. 

Bulimia Nervosa Risk Factors

  • Genetic/biological: Family history of eating disorders or mood disorders
  • Sociocultural: Pressure to be thin, media influence, and dieting culture
  • Environmental/psychological: Trauma, stress, low self-esteem, and perfectionism
  • Adolescent/young adult age: Peak onset often in late teens to early 20s

There are a variety of risk factors associated with bulimia. The condition is often associated with low self-esteem and perfectionism. Societal pressures of thinness and other environmental factors can trigger a bulimic episode. If you believe that you or someone you know may have bulimia, it’s important to reach out to a professional for help. Call today.

Glossary of Terms

Binge Eating: Consuming a large amount of food in a short period of time, often accompanied by a sense of loss of control.

Calluses / Russell’s Sign: Hardened skin or marks on the hands or knuckles caused by repeated contact with teeth during self-induced vomiting.

Co-Occurring Disorders: Mental health or medical conditions that happen alongside bulimia, such as depression, anxiety, or bipolar disorder.

Compensatory Behaviors: Actions taken to offset calorie intake after bingeing, including vomiting, laxatives, diuretics, fasting, or excessive exercise.

DBT (Dialectical Behavior Therapy): A form of psychotherapy that helps with emotion regulation, impulse control, and coping skills.

Digestive Issues: Problems such as acid reflux, constipation, bloating, and sore throat often result from purging behaviors.

Electrolyte Imbalance: Abnormal levels of minerals in the blood (like potassium, sodium, or chloride) that can affect the heart, muscles, and nervous system.

Esophagitis / Esophagus Problems: Inflammation or tears in the esophagus caused by repeated vomiting.

Food Rituals / Food Routines: Repetitive behaviors or habits around eating that may reinforce an eating disorder.

Impulsivity: Acting on urges without fully considering consequences, often linked to binge-purge cycles.

IOP (Intensive Outpatient Program): A structured therapy program that provides more frequent care than standard outpatient treatment while allowing clients to live at home.

Laxatives: Medications or substances used to stimulate bowel movements, sometimes misused to purge calories.

Purging: Attempting to eliminate food or calories through vomiting, laxatives, diuretics, or excessive exercise.

Self-Esteem Issues: Low confidence or negative self-image, which can contribute to the development or maintenance of bulimia.

Trauma History: Experiences of abuse, neglect, or other adverse events that can influence mental health and risk for eating disorders.

Weight/Body Image Disturbances: Excessive focus on body shape, size, or weight, often influencing eating behaviors.

Questions about any of these terms, or what can be considered a purging behavior? Contact our admissions team today to learn more. 

Research and Support for People Struggling with Bulimia:

Sources:

Bulimia nervosa therapy is possible and has proven successful with meal planning and therapeutic support. However, early intervention is critical. Click here to call admissions. We’re here to help.

 

woman sitting on boat dock.

Ready to start your recovery journey?

We have had tremendous success with helping clients gain control of their lives and tackling their eating disorders head-on. 

Our clinical intake coordinators can confidentially learn more about your respective situation and work with you to assess your needs and the best path forward. 

We look forward to helping you on your path to better health and recovery.

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