Bulimia Nervosa: Symptoms, Health Consequences, and Treatment Options
What Is Bulimia Nervosa?
A serious eating disorder characterized by recurrent binge eating (large amount in short time, sense of loss of control) followed by compensatory behaviors to prevent weight gain:
- Self-induced vomiting
- Laxative/diuretic/enema misuse
- Fasting
- Excessive exercise
Weight Is Not Diagnostic
Individuals with bulimia can be underweight, normal weight, or overweight. The disorder is defined by behaviors and psychology, not BMI.
Health Consequences
- Electrolyte imbalances (hypokalemia, hypochloremia) → arrhythmias, cardiac arrest.
- Dental erosion from gastric acid.
- Esophagitis, tears (Mallory-Weiss), gastric rupture.
- GI motility disorders, constipation, rectal prolapse.
- Renal impairment from dehydration/laxatives.
- Hormonal disruption (amenorrhea, infertility).
- Osteoporosis.
- Psychiatric comorbidity: Depression, anxiety, substance use, self-harm, suicide risk.
Treatment
Multidisciplinary, evidence-based:
- CBT-E (Enhanced Cognitive Behavioral Therapy): Gold standard.
- Antidepressants: Fluoxetine (SSRI) approved for bulimia; reduces binge/purge.
- Nutritional counseling: Normalize eating, address deficiencies.
- Medical monitoring: Electrolytes, cardiac, dental.
- Family-based therapy for adolescents.
Recovery Is Possible
Early intervention improves outcomes. Many achieve full remission. Relapse prevention is key.
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