What is bulimia nervosa?
Bulimia nervosa is an eating disorder where a person eats a larger amount of food than most people would eat over a short time, once a week or more for at least three months.
- Binge eating is a period of uncontrolled eating, when a large amount of food is eaten in a short period of time. It is often followed by the person feeling shame over their perceived lack of control.
- Purging is when a person with bulimia nervosa induces vomiting or uses laxatives or other pills to rid their body of the calories they consumed during their binge. Some people with bulimia nervosa will also go through periods of starvation or do excessive exercise to try to lose weight.
A person with bulimia nervosa worries about gaining weight, feels shameful about their binge eating and will engage in unhealthy or dangerous purging behaviours (e.g., vomiting, taking pills, dieting to extremes or doing too much exercise) to prevent weight gain.
People with bulimia nervosa may be thin, average weight, or overweight. In addition to bingeing and purging, someone with bulimia nervosa feels unhappy about their appearance and wants to lose weight. People with bulimia nervosa may not seek help on their own because they may be embarrassed by or ashamed of their eating patterns. However, with treatment, they can often get better. Bulimia nervosa is more common than anorexia nervosa. However, people with bulimia nervosa often do not seek help, as they may be embarrassed by or ashamed of their eating patterns. As a result, bulimia nervosa may go undiagnosed for some time.
What causes bulimia nervosa?
The exact causes of bulimia nervosa are unknown. Generally, bulimia nervosa results from a mix of social factors, stressful life events and genetics. Often, people who develop bulimia nervosa begin their illness with a period of attempted or actual weight loss.
Social factors
Peer pressure to fit in, dieting and the media's emphasis on being thin may all play a part in someone developing bulimia nervosa. Other factors include certain environments or activities such as involvement in a body-based sport such as gymnastics, which may put pressure on a child or teen to lose weight.
Stressful life events
A person may develop bulimia nervosa after experiencing stress or a trauma. The stress or trauma may cause them to feel a loss of control that is reflected in bingeing and purging.
Genetics
Having a relative who has been diagnosed with an eating disorder may be a risk factor for developing bulimia nervosa. Also, certain temperaments or personality traits, such as increased impulsivity, may make someone more likely to develop bulimia nervosa.
Who is affected by bulimia nervosa?
Bulimia nervosa typically begins between the ages of 14 and 22. It may often occur with an existing mental health condition such as depression or a substance use disorder. People with bulimia nervosa can be of any body weight, shape or size.
At SickKids
SickKids has an eating disorder program that treats children and teens who are struggling with symptoms of anorexia nervosa, bulimia nervosa and avoidant restrictive food intake disorder. For more information on our program visit: www.sickkids.ca/adolescentmedicine/eating-disorders-program
Further information
For more information on bulimia nervosa, please see the following pages:
Bulimia nervosa: Signs and symptoms
Bulimia nervosa: Medical complications
Bulimia nervosa: Treatment options
Bulimia nervosa: How to help your child at home
Please visit our teen mental health hub for teen-specific resources on bulimia nervosa.
Resources
NEDIC – National Eating Disorder Information Centre (Canada)
NEDA – National Eating Disorder Association (United States)
American Academy of Pediatrics – Eating Disorders in Children
BEAT – Beating Eating Disorders (United Kingdom)
Kelty Eating Disorders (Kelty Mental Health Resource Centre, BC Children's Hospital)
Children's Hospital of Eastern Ontario – Eating Disorders
Virtual care services for children:
Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support eating disorders, visit Boomerang Health powered by SickKids.