Bulimia nervosa is an eating disorder that involves a pattern of bingeing and purging. The person may eat a lot of food at once and then try to get rid of it by vomiting, using laxatives, or sometimes over-exercising.
People with bulimia are preoccupied with their weight and body image.
Many people with bulimia can stay at a normal weight, so they may be able to keep their condition secret for years. If not treated, bulimia can lead to problems from not getting enough nutrition. It can cause life-threatening complications.
People with bulimia may have the following signs and symptoms:
Bulimia nervosa is linked to depression and other mental disorders. It shares some symptoms with anorexia nervosa, another major eating disorder.
There is no single cause for bulimia. Multiple factors contribute to the development of this disorder, including:
These people are at higher risk for developing bulimia:
Often, people with bulimia are ashamed of their condition and do not ask for help for many years. If you have symptoms of bulimia, talk to your doctor as soon as possible.
People with bulimia may need a combination of treatment including:
It is important for the person with bulimia to be actively involved in their treatment. Studies show cognitive behavioral therapy is remarkably effective in treating bulimia.
Doctors often prescribe antidepressants for bulimia, usually those called selective serotonin reuptake inhibitors (SSRIs). They include:
Psychotherapy is a crucial part of bulimia treatment. Many people with bulimia have good results from cognitive behavioral therapy, which teaches you to replace negative thoughts and behaviors with healthy ones. Other psychotherapy approaches include interpersonal therapy, motivational enhancement therapy, and focal psychodynamic therapy. Family therapy is also an important component of recovery.
Mind-body and stress-reduction techniques, such as yoga, tai chi, and meditation may help you become more aware of your body and have a more positive body image.
Although there aren't any supplements that specifically treat bulimia, some may be good for your general health and well-being. Also, people with bulimia may fall short on some vitamins and minerals, which can affect their health. A better diet or taking supplements can help. Always tell your health care provider about any herbs and supplements you are thinking about using.
Follow these useful measures to overcome abnormal eating behaviors:
Follow these nutritional tips for maintaining overall health:
If you have nutritional deficiencies, the following may be helpful:
There are no herbs proven as effective for treatment of bulimia.
People with eating disorders may misuse herbs or herbal supplements marketed as weight loss products. These products have not been tested for their safety and may have dangerous side effects. Products containing ephedrine alkaloids (such as Ephedra-containing herbal supplements) have been banned by the FDA due to serious health effects (such as stroke, seizures, and worsening of heart and kidney disease). However, other ephedra-free supplements may have similar side effects, especially when combined with caffeine, which causes heart rhythm problems. You should discuss with your health care provider before starting any treatment.
There are no studies on using homeopathy to treat bulimia.
Studies have found that acupuncture can be helpful in treating addictive behaviors and anxiety in general. That may help people with bulimia who are in recovery. One study had positive results on the improvement of quality of life in patients with bulimia using acupuncture in addition to their medical treatment.
Physical therapy approaches, including massage, yoga, and relaxation techniques can be effective as adjunct treatments of bulimia nervosa.
Therapeutic massage can be an effective part of a bulimia treatment plan. In one study, 24 teen girls who got massage therapy for 5 weeks had better behavioral outcomes did better than a group of girls who didn't get massage and were less anxious and depressed than their counterparts.
Bright light therapy (BLT) is a non-invasive treatment approach typically used for seasonal affective disorder and other types of depressive conditions. Because many people with bulimia binge-eat at night, BLT has repeatedly been tested as a potential therapy. Several studies demonstrated that BLT is effective in improving eating behaviors and mood in patients with bulimia nervosa.
It's very common for people with bulimia to relapse after treatment. They may need long-term care.
Possible complications resulting from bingeing and purging include problems with the:
Women with bulimia may find pregnancy emotionally difficult because of the changes in their body shape. The mother's poor nutritional health can affect the baby. Women who have stopped having periods because of bulimia are unlikely to become pregnant.
People with suicidal thoughts or severe symptoms may need to be hospitalized.
Bulimia is usually a long-term disease. A health care provider will need to check the person's weight, exercise habits, and physical and mental health on an ongoing basis.
Beauchamp MT, Lundgren JD. A Ssystematic Rreview of Bbright Llight Ttherapy for Eeating Ddisorders. Prim Care Companion CNS Disord. 2016;18(5). PMID: 27835724 www.ncbi.nlm.nih.gov/pubmed/27835724.
Bozzatello P, Brignolo E, De Grandi E, Bellino S. Supplementation with omega-3 fatty acids in psychiatric disorders: a review of literature data. J Clin Med. 2016;5(8).pii: E67. PMID: 27472373 www.ncbi.nlm.nih.gov/pubmed/27472373.
Carei TR, Fyfe-Johnson AL, Breuner CC, Brown MA. Randomized controlled clinical trial of yoga in the treatment of eating disorders. J Adolesc Health. 2010;46(4):346-351. PMID: 20307823 www.ncbi.nlm.nih.gov/pubmed/20307823.
Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2017;119:128-136. PMID: 28179205 www.ncbi.nlm.nih.gov/pubmed/28179205.
Ferri, FF. Bulimia nervosa. In: Ferri FF, ed. Ferri's Clinical Advisor 2018. Philadelphia, PA: Elsevier Mosby; 2014: 225-226.e1.
Field T, Schanberg S, Kuhn C, et al. Bulimic adolescents benefit from massage therapy. Adolescence. 1998;33(131):555-563. PMID: 9831872 www.ncbi.nlm.nih.gov/pubmed/9831872.
Fogarty S, Harris D, Zaslawski C, McAinch AJ, Stojanovska L. Acupuncture as an adjunct therapy in the treatment of eating disorders: a randomised cross-over pilot study. Complement Ther Med. 2010;18(6):233-240. PMID: 21130359 www.ncbi.nlm.nih.gov/pubmed/21130359.
Fogarty S, Smith CA, Hay P. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eat Behav. 2016;21:179-188. PMID: 26970732 www.ncbi.nlm.nih.gov/pubmed/26970732.
Kowalska I, Karczewska-Kupczewska M, Straczkowski M, Rubin RT. Anorexia nervosa, bulimia nervosa, and other eating disorders. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 29.
Mason BL. Feeding systems and the gut microbiome: gut-brain interactions with relevance to psychiatric conditions. Psychosomatics. 2017;S0033-3182(17)30148-2. PMID: 28716445 www.ncbi.nlm.nih.gov/pubmed/28716445.
LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH: LexiComp; 2000:387-388.
Polnay A, James VA, Hodges L, Murray GD, Munro C, Lawrie SM. Group therapy for people with bulimia nervosa: systematic review and meta-analysis. Psychol Med. 2014;44(11):2241-2254. PMID: 24238470 www.ncbi.nlm.nih.gov/pubmed/24238470.
Sangvai D. Eating disorders in the primary care setting. Prim Care. 2016;43(2):301-312. PMID: 27262009 www.ncbi.nlm.nih.gov/pubmed/27262009.
Setnick J. Micronutrient deficiencies and supplementation in anorexia and bulimia nervosa: a review of literature. Nutr Clin Pract. 2010;25(2):137-142. PMID: 20413694 www.ncbi.nlm.nih.gov/pubmed/20413694.
Tanofsky-Kraff M. Eating disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Sauders; 2016:chap 219.
Vancampfort D, Vanderlinden J, De Hert M, et al. A systematic review of physical therapy interventions for patients with anorexia and bulemia nervosa. Disabil Rehabil. 2014;36(8):628-634. PMID: 23826882 www.ncbi.nlm.nih.gov/pubmed/23826882.
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.
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