Bulimia nervosa (buh-LEE-me-ah nur-VOH-suh), often called bulimia, is a type of eating disorder. People with bulimia eat large amounts of food at one time, then try to get rid of the food or weight gain by throwing up, taking laxatives, fasting (not eating anything), or exercising a lot more than normal. Bulimia affects more girls and women than boys and men. Bulimia is a serious health problem, but people with bulimia can get better with treatment.
Bulimia nervosa, often called bulimia, is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise.
Women with bulimia eat a lot of food in a short amount of time and feel a lack of control over eating during this time (called binging). People with bulimia then try to prevent weight gain by getting rid of the food (called purging). Purging may be done by:
Women with bulimia may also try to prevent weight gain after binging by exercising a lot more than normal, eating very little or not at all (fasting), or taking pills to urinate often.
Women with bulimia usually have self-esteem that is closely linked to their body image.
Women with eating disorders, such as bulimia, anorexia, and binge eating disorder, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health.
Unlike women with anorexia, women with bulimia often have a normal weight. Unlike women with binge eating disorder, women with bulimia purge, or try to get rid of the food or weight after binging. Binging and purging are usually done in private. This can make it difficult to tell if a loved one has bulimia or another eating disorder.
It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment.
Bulimia affects more girls and younger women than older women. On average, women develop bulimia at 18 or 19.3 Teen girls between 15 and 19 and young women in their early 20s are most at risk. But eating disorders are happening more often in older women. In one recent study, 13% of American women over 50 had signs of an eating disorder.4
Someone with bulimia may be thin, overweight, or have a normal weight. It can be difficult to tell based on a person's weight whether someone has bulimia. This is because binging and purging is most often done in private. However, family or friends may see empty food wrappers in unexpected places or vomit in the home.
Over time, some symptoms of bulimia may include:5
Girls or women with bulimia may also have behavior changes such as:
People with bulimia often have other mental health problems, including depression, anxiety, or substance abuse.6
Researchers are not sure exactly what causes bulimia and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses.
Researchers are also studying unusual activity in the brain, such as changing levels of serotonin or other chemicals, to see how it may affect eating. Learn more about current research on bulimia.
Purging through vomiting or taking laxatives can prevent your body from getting the important nutrients it needs from food. Over time, bulimia can affect your body in the following ways:5,7,8
Long-term studies of 20 years or more show that women who had an eating disorder in the past usually reach and maintain a healthy weight after treatment.9
Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating, purging, or exercise behaviors. But doctors and nurses want to help you get better. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.
Your doctor may do blood or urine tests to rule out other possible causes of your symptoms. Your doctor may also do other tests to see whether you have any other health problems caused by bulimia. These tests may include kidney function tests or an electrocardiogram (ECG or EKG) to see if or how repeated binging and purging has affected your health.
Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better.
Treatment plans may include one or more of the following:6
Most girls and women do get better with treatment and are able to eat and exercise in healthy ways again.12 Some may get better after the first treatment. Others get well but may relapse and need treatment again.
Bulimia can cause problems getting pregnant and during pregnancy.
Repeated purging and binging can make your menstrual cycle irregular (your period comes some months but not others) or your period may stop for several months. Irregular or missing periods mean you may not ovulate, or release an egg from the ovary, every month. This can make it difficult to get pregnant.13 However, if you do not want to have children right now and you have sex, you should use birth control.
Bulimia can also cause problems during pregnancy. Bulimia raises your risk for:
Women who have recovered from bulimia and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy.
If you had an eating disorder in the past, it may take you a little longer to get pregnant (about six months to a year) compared to women who never had an eating disorder.17
Tell your doctor if you had an eating disorder in the past and are trying to become pregnant.
Maybe. Some medicines used to treat bulimia can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding.
Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter a medicine into the LactMed® database to find out if the medicine passes through breastmilk and any about possible side effects for your nursing baby.
For more information about bulimia, call the OWH Helpline at 800-994-9662 or contact the following organizations:
The Office on Women's Health is grateful for the additional reviews by:
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Page last updated: June 12, 2017.
Content last reviewed: June 26, 2016.