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What is Bulimia? Print E-mail
Written by Amanda Wattson, MD   
Monday, 05 October 2009
Bulimia is a chronic eating disorder. It is characterized by periods of eating and then trying to avoid weight gain.
What is going on in the body?

Individuals with bulimia secretly eat large amounts of food in a short period. This is called binge eating. They then try to avoid weight gain. They may do this by one of the following methods:
- fasting
- inducing vomiting
- using laxatives to have bowel movements
- taking diuretics, or water pills

What are the causes and risks of the condition?

Bulimia is thought to be a result of social, psychological, and biological factors. Genetics may contribute. Mood disorders are more common in family members of those who develop bulimia.

Social factors play a major role. Some societies emphasize thinness. Family problems, self-esteem, and identity conflicts are also factors. Bulimia is most common in females in adolescence or young adulthood.

What are the treatments for the condition?

A team approach to treatment is most effective. This includes:
- aggressive medical management
- nutritional rehabilitation and counseling
- individual, group, and family psychotherapy
- cognitive behavioral therapy

Bulimia may be treated in the hospital, or on an outpatient basis. The person's weight, cardiac status, and overall health influence the treatment choice. Some people become so malnourished that they need to be fed through tubes to stay alive. They will have strict rules about eating and weight management.

A combination of cognitive behavioral therapy and family therapy are often effective.
- Cognitive therapy helps individuals identify and question the reality of their beliefs about eating and weight.
- Behavioral therapy is designed to help change the behaviors that keep the illness going.
- Family therapy helps family members learn about the illness. They learn what they can do to help their loved ones recover. Sometimes, family problems need to be addressed before recovery can begin.

Medications are rarely used to treat bulimia. If the person has significant depression, antidepressants may be used.
What are the side effects of the treatments?

If antidepressants are used, they may cause drowsiness, dry mouth, and constipation.
What happens after treatment for the disease?

Psychotherapy usually continues for at least one year after treatment starts. Some individuals may need 5-6 years of therapy. People who recover from bulimia need to be aware that this illness can recur.

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