Unlike anorexia nervosa, people with bulimia nervosa usually maintain a normal weight. Some bulimics may even appear to be slightly overweight. Interestingly, bulimics share many of the same intense worries and idiosyncrasies about their weight and appearance as those with anorexia.
People with bulimia attempt to control their weight by binge-eating and then engaging in inappropriate behaviors to rid their body of the food they consumed. They may use forced vomiting, laxatives, diuretics, fasting, excessive exercise or a combination of these behaviors to maintain or lose weight. The bingeing and purging cycle can occur several times a week or several times a day. Many of these activities are usually hidden and done in secret because the person often feels disgusted or ashamed of their behavior.
Many people with bulimia are aware that their eating behaviors are out of their control. During a binge period, they will each much more food than is typical for a normal meal or snack. They often will eat until they are uncomfortable or in pain and then begin to purge the food from their bodies.
The cause of bulimia is not known, but like anorexia, genetics and environmental factors are cited as potential factors. People with a first-degree relative – a sibling or a parent – who has an eating disorder are more likely to develop an eating disorder as well. Psychological and emotional problems such as low self-esteem, perfectionism, impulsive behavior, depression, anxiety disorders or obsessive-compulsive disorder can contribute to the development of disorders like bulimia. Traumatic life events may also be contributing factors. Peer pressure and media images that equate thinness with beauty may also fuel an unrealistic desire to be thin. Often times they have a distorted self image of their weight and body size, perceiving them selves to appear significantly larger or heavier than what they actually look like.
Like anorexia, bulimia is a serious medical condition that requires professional treatment. To begin, steps must be taken to interrupt the lifestyle of purging behaviors and excessive exercise to ensure that the person receives adequate nutrition. Certain types of psychotherapy and psychiatric medications can be effective, but treatment plans must be tailored to the individual needs of the affected person, and closely provided by or supervised by a licensed professional.