Bulimia nervosa is an eating disorder that’s among the most common, but many people live with the condition in silence.

Bulimia is a serious eating disorder. It can affect people of all ages, races, genders, sexual orientations, religions, body shapes, and weights.

Although many people with bulimia hide their symptoms, you are not alone if you have bulimia. There are many others who are living with this condition.

Fast stats

  • Nearly 29 million people in the United States, or 9% of the total population, will have an eating disorder at some point in their lives.
  • Bulimia affects women five times more than men.
  • Around 1% of people in the United States will have bulimia at some point in their lives.
  • The median age of onset for bulimia is 18, but it may be as young as 12.
  • Black teenagers are 50% more likely to engage in bulimia-related behaviors.
  • Black, Indigenous, and People of Color are less likely to receive eating disorder diagnoses or treatment, but they are more likely to engage in bulimia-related behaviors than their white peers.
  • LGBTQIA+ people are more likely to have eating disorders than their heterosexual, cisgender peers.
  • Approximately 95% of people with bulimia have at least one other mental health condition.
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People with bulimia often have obsessive thoughts about food and eating. Many times these thoughts occupy the mind over any other thought. If you have bulimia, your day may be filled with anxiety about eating and finding ways to hide it from others.

Most of your day may be filled with trying not to think about food or attempting to control your urge to overeat, or binge eat.

In some cases, binge eating is not about hunger. Some people use binge eating as a way to cope with upsetting emotions and feelings. Eating may numb negative feelings and provide something else to focus on.

For other people, binge eating may be about control. For example, if you feel unable to control a situation, binge eating may offer a sense of power: You can control what you eat, when, and how much.

When you can control the urge to binge, you may feel a small sense of relief when the urge finally passes. But these urges are a constant cycle. They come back over and over again during the day, eventually becoming so intense that they’re hard to ignore.

When this happens, you may feel like the only way to quiet these intense feelings is to binge. It’s in the moments after bingeing that feelings of shame and guilt may overwhelm you.

After a binge, people with bulimia purge to manage these feelings of guilt and shame. Purging behaviors can include:

  • self-induced vomiting
  • use of laxatives or diuretics
  • fasting
  • excessive exercise

If you’re living with bulimia, this cycle of bingeing and purging repeats over and over, seeming like it won’t stop.

Dealing with these intense feelings and urges can be difficult, but they can be successfully managed. You can learn coping strategies to help you overcome these intense feelings and learn to eat and exercise in healthy ways again.

Over time, bulimia can affect every part of the body. The continuous cycle of bingeing and purging can cause damage to the organs, leading to complications affecting the gastrointestinal system, the heart, and more.

Some common complications include:

  • dizziness or feeling faint
  • damaged or inflamed esophagus
  • ulcers
  • feeling cold all the time
  • inflammation of the pancreas
  • trouble falling asleep
  • tooth decay
  • swelling of the jaw and cheeks
  • weak muscles
  • dry or brittle hair and nails
  • low blood pressure
  • constipation or acid reflux
  • irregular heartbeat
  • heart failure
  • kidney failure

Many of these complications don’t go away on their own and need treatment. If they remain untreated, they can become severe, even life threatening. For these reasons, a treatment plan that fits you is so important.

With the right support, you can reduce these complications and lower your chance of serious long-term health issues.

If you want to find out more about symptoms and complications of bulimia, look here.

According to the National Eating Disorders Association (NEDA), 95% of people with bulimia meet the criteria for one or more mental health conditions, and 64% fit the criteria for three or more mental health conditions.

Common coexisting conditions with bulimia include:

These coexisting conditions are so closely connected that it’s often unclear which condition developed first. Did the coexisting condition contribute to the bulimia, or did the bulimia contribute to the coexisting condition?

If you have a coexisting mental health condition, a healthcare professional will work with you to address all your mental health needs.

Anxiety

Anxiety disorders are the most common coexisting condition for people with eating disorders.

People with bulimia often have feelings of stress and worry about food and eating. Approximately 54 to 81% of people with bulimia also live with an anxiety disorder.

Generalized anxiety disorder and social anxiety disorder are two common anxiety disorders in people with bulimia.

Depression

The NEDA estimates that 36 to 50% of people with bulimia live with depression.

It’s not uncommon for people with an eating disorder and depression to only receive treatment for one of the conditions. While some receive therapy for the eating disorder only, others may be prescribed medications to treat the depression without being offered treatment for the eating disorder.

In many cases, symptoms of depression can interfere with treatment. For example, feelings of emptiness and hopelessness can make a person with bulimia less likely to participate in treatment, lacking the motivation and energy to continue.

Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is the most common type of anxiety disorder to coexist with an eating disorder. People with bulimia often have a preoccupation with food and eating as well as an obsession with body shape and weight.

This obsession can lead them to develop compulsive behaviors with food, weight, and eating. Nearly 33% of people with bulimia also live with OCD, estimates the NEDA. People with an eating disorder are more likely to develop OCD, too.

Post-traumatic stress disorder (PTSD)

Research suggests a connection between PTSD, trauma, and eating disorders.

A 2012 study found that the number of men and women participants who had an eating disorder was higher in those who experienced trauma and PTSD than in those who had not. The study found that about one-third of women participants with bulimia experienced PTSD at some point in their lives.

People with bulimia may use bingeing and purging as a way to manage PTSD symptoms or as a coping tool to deal with unresolved trauma.

Finding the right treatment plan that works for you will take some work. Every person with an eating disorder is different. What works for you may not work for someone else, and vice versa.

There may be a little trial and error before you find the right path that fits you and your lifestyle. That’s OK.

If you have health insurance, a good place to start is with your insurance provider or family doctor. They’ll be able to refer you to a specialist who can provide you with an in-depth evaluation and recommendations for treatment.

Telehealth or online therapy might also be available options if you don’t have insurance. You can find information about online therapy and mental health support services by visiting:

Support for bulimia will often involve finding a team of health professionals that may include:

  • a licensed counselor or psychologist
  • registered dietitian
  • physician
  • psychiatrist
  • other doctors, like a cardiologist or gastroenterologist

Bulimia is a treatable mental health condition that trained medical professionals are well equipped to handle in a judgment-free environment. To treat bulimia, therapists and doctors will often take a multifaceted approach to ensure the best outcome.

Treatment may involve:

  • Medical treatment for any health issues or complications as a result of bulimia.
  • Nutritional counseling to help you learn new ways of eating.
  • Therapy to give you tools and strategies to cope with the emotional and psychological issues that may be contributing to bulimia.
  • Inpatient care may be needed if you require a higher level of support and care.
  • Support programs give you round-the-clock support to help with your recovery.

Your healthcare team will work with you to develop a plan that works for you and your goals. When choosing your team, try to find professionals who are knowledgeable and understand eating disorders.

You can find out more about treatment for bulimia here.

Don’t have insurance?

If you or a loved one need help finding treatment near you, you can call the NEDA hotline at 800-931-2237. Support staff can help you find the information you need.

Need immediate help? Text “NEDA” to 741741 to connect with the Crisis Text Line.

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Recovery for bulimia is a long-term, continuous process.

Like other eating disorders, bulimia revolves around food and eating, which is difficult to avoid as it’s needed for survival.

Treatment for bulimia typically involves strategies to help you:

  • build a healthy relationship with food and exercise
  • address any underlying medical or mental health issues
  • challenge any unhealthy eating behaviors and thoughts

For some people, treatment helps the first time, while others may experience a relapse and need treatment again. Treatment will also help reduce the possibility of a relapse.

Many people with bulimia find that continued support and help from a therapist or other healthcare professional allows for treatment adjustments when needed and ongoing care.

While you’re recovering from bulimia, consider adding these self-care strategies to your day to day.

Try yoga

Yoga may help reduce stress and clear your mind of negative thoughts and feelings.

Yoga involves slow movements that help you become more aware of how your body moves. It promotes mindfulness and self-compassion, and it can both empower and improve your recovery.

A 2016 study found that yoga in combination with outpatient eating disorder treatment can help lower:

  • anxiety
  • depression
  • concerns with body image

Practice mindfulness meditation

Mindfulness-based interventions, such as meditation, can help treat stress and anxiety.

Mindfulness meditation is focused on training you to stay present in the moment while focusing on deep breathing or a mantra.

A 2020 review of nine studies found that people with an eating disorder who practiced mindfulness meditation reduced emotional eating, binge eating, and concerns with body weight and shape.

Find a new hobby

Consider finding new ways to channel your energy when the urge to binge gets too high.

Expressive or creative art therapy can help people with an eating disorder use art, drama, storytelling, movement, filmmaking, and music to promote healing and recovery. Art therapy, like mindfulness-based interventions, teaches you how to stay in the moment to explore the reasons behind your eating disorder and help you learn how to accept yourself in the present.

Gardening is another hobby that can help promote recovery and healing. Working with plants may improve mood and lower anxiety.

If you have an eating disorder, being involved from seed to harvest may give you a different perspective on food and eating, too.

Build a good support system

A strong support system is key to your recovery and healing. Parents, partners, or friends can help encourage healthy eating and offer an ear when you need it.

Because bulimia is often a private condition, it can seem lonely for some people. You may feel alone, but remember that you’re not. You can find help and support through the NEDA support page, which can connect you with forums, local and virtual support groups, recovery mentors, and more.

Bulimia is a serious condition. But the good news is that it’s treatable, and people do recover.

With the right support and professional care, you can find recovery and healing. Treatment often involves a combination of therapy, medication, and support groups.

If you have bulimia, consider talking with a healthcare professional. They will be able to refer you to an eating disorder specialist who can provide an in-depth evaluation and get you started on a treatment plan.

Your treatment plan will depend on your goals and will be tailored to fit you and your lifestyle.