Bulimia or bulimia nervosa is an eating disorder characterized by a tendency to regurgitate food that has been eaten. The eating disorder is a dangerous and potentially life-threatening mental disorder.

Bulimia can be experienced by anyone, especially adult women and teenagers, who feel dissatisfied with their weight or body shape. People with this eating disorder tend to use unhealthy ways to lose weight, namely by forcibly removing food, either by vomiting or using laxatives.

bulimia nervosa eating disorders

Forced vomiting of food is wrong. To maintain ideal body weight and shape, you are encouraged to adopt a healthy diet, namely by eating balanced nutrition, eating small but frequent portions, and limiting snacks and a high intake of saturated fat.

Causes of Bulimia

The main cause of bulimia is not known with certainty. However, several factors are thought to trigger a person to develop bulimia, namely:

1. Hereditary factors

If one member of the nuclear family (parents or siblings) suffers or has a history of bulimia, then a person’s risk for suffering from the same disorder will increase.

2. Emotional and psychological factors

The risk of developing bulimia is higher if a person experiences emotional and psychological disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

3. Social environmental factors

Bulimia can arise from the influence of pressure and criticism from people around you about your eating habits, body shape, or weight.

4. Occupational factors

Some types of work require workers to maintain ideal body weight, such as models or athletes. These demands can cause the worker to experience depression or bulimia.

Symptoms of Bulimia

The initial symptom of someone suffering from bulimia is the habit of following a strict diet by not eating at all or only eating certain foods in very small amounts.

This condition continues until the sufferer loses control and eats excessively, even though he does not feel hungry. This habit arises because of emotional problems, such as stress or depression.

The sufferer will feel guilty, regretful, and self-loathing, forcing his body to expel all food in an unnatural way, such as using laxatives or forcing himself to vomit.

Other psychological symptoms that can appear are:

  • Feeling afraid of fat.
  • Always think negatively about your own body weight and shape.
  • Tendency to be alone and withdraw from the social environment.
  • Low self-esteem and anxiety.
  • Do not want to eat in public places or in front of other people.

In addition, people with this disorders can also show physical symptoms, such as:

  • Body feels weak.
  • Sore throat.
  • Stomach pain or bloating.
  • Swelling in the cheeks and jaw.
  • Broken teeth and bad breath.

Bulimia Diagnosis

A person is said to have bulimia if they experience vomiting symptoms once a week for at least three months. To determine whether a person has a disorder or not, the doctor will ask questions to the patient and the patient’s family.

The doctor will also perform a physical examination, such as checking for damaged or eroded teeth due to exposure to acid in the vomit. An eye exam may also be done to see if any of the eye’s blood vessels have burst. When you vomit, the blood vessels will tense up and risk rupturing.

In addition to examining the patient’s teeth and eyes, the doctor will also examine the patient’s hands. People with bulimia tend to have small sores and calluses on the top of the finger joints because they are often used to force themselves to vomit.

Not only a physical examination, blood and urine tests are also carried out to detect other conditions that can cause bulimia and examine the impact of bulimia on the body, such as dehydration or electrolyte disturbances. Doctors also perform heart echoes to detect heart problems.

Bulimia Treatment

The main focus of treatment for bulimia is treating mental disorders experienced by sufferers and improving diet. This treatment effort involves the role of various parties, namely families, psychiatrists, and nutritionists. There are several treatment methods to treat bulimia, namely:


Psychotherapy or counselling aims to help people with bulimia rebuild positive attitudes and thoughts about food and eating patterns. Two types of psychotherapy can be done, namely:

1. Cognitive behavioural therapy

Cognitive-behavioural therapy is used to help restore the patient’s eating patterns, as well as change unhealthy behaviours into healthy ones and negative thinking patterns into positive ones.

2. Interpersonal therapy

This therapy aims to assist patients in interacting with others, as well as improve the patient’s ability to communicate and solve problems.


To relieve the symptoms experienced by people with bulimia, doctors will give fluoxetine. This drug is a type of antidepressant drug that is most often used to treat bulimia but is not intended for people under the age of 18 years.

Fluoxetine can also relieve depression and anxiety disorders experienced by sufferers. During treatment with antidepressants, the doctor will regularly monitor the progress of the patient’s condition and body reaction to the drug.

Nutrition counselling

Nutrition counselling aims to change eating patterns and mindsets towards food, increase nutrient intake in the body, and increase body weight slowly.

If the symptoms of bulimia get worse or are accompanied by serious complications, special treatment in the hospital needs to be done. This step needs to be taken to prevent the fatal consequences of complications, such as suicide.

Treatment of bulimia takes a long time. Support and motivation from family, friends and closest relatives are very important in the healing process of sufferers.

Complications of Bulimia

man with bulimia nervosa
photo created

Bulimia can cause malnutrition which can damage organ systems in the body. In addition, this disorder can cause the sufferer to become dehydrated due to too much fluid that comes out through vomiting.

Bulimia can also lead to complications that are serious and even fatal if not treated immediately. Some of the complications that can arise are:

  • Heart diseases, such as arrhythmia or heart failure
  • Kidney failure
  • Mallory-Weiss syndrome, which is tearing of the inner wall of the esophagus due to too much vomiting
  • Depression or generalized anxiety disorder
  • Drug or alcohol abuse
  • There is an urge to commit suicide

People with bulimia who are pregnant are also at high risk of complications during pregnancy, such as miscarriage, premature birth, birth defects in the fetus, and postpartum depression.

Bulimia Prevention

The steps to prevent bulimia are not known with certainty until now. However, the role of family and friends can help steer people with bulimia toward healthier behaviours. Ways that can be done are:

  • Increase self-confidence by giving each other motivation to always live healthy every day.
  • Avoiding conversations related to the physical or psychologically affecting the sufferer, for example, his body is too thin or fat, and his face is not beautiful.
  • Invite family members to always eat with the family. – Prohibit diets in unhealthy ways, such as using laxatives or forcing yourself to vomit.