Bulimia

Many people with bulimia try to control eating with strict rules or long gaps without food. This leaves the body and mind very hungry, which makes a binge more likely.

Stress and feeling out of control may play a role in bulimia. Food can become a way to cope with painful feelings for a short while.

During a binge, a person eats a large amount of food in a short time and feels they have lost control. It often happens alone and in secret.

Strong guilt, shame and secrecy around eating are common. These feelings are painful, and they push the urge to “undo” what happened.

After a binge, a person may try to get rid of the food or make up for it, for example by making themselves sick, not eating for a long time or exercising too much. These do not undo a binge, and they can seriously harm the body.

People with bulimia may be at an average weight or in a larger body. Fewer than 6% of people with any eating disorder are medically “underweight”.

Guilt and secrecy about eating are common signs of bulimia. Many people fear others will be disgusted or angry if they find out.

Healthcare workers have seen it many times before. You will not shock them, and they want to help.

Men make up as many as 1 in 4 people with eating disorders. Women are up to five times more likely to be diagnosed than men, and men often don’t see their symptoms as a problem.

People of color have similar rates of eating disorders to white people, but are about half as likely to be diagnosed. LGBTQ+ young people are about three times as likely to have an eating disorder.

Mood changes are a common sign of bulimia. Tiredness and poor sleep can make feelings even harder to handle.

A strong focus on weight and body shape, and a fear of gaining weight, are part of bulimia. Self-worth can feel like it rises and falls with how you see your body.

Feeling unable to control eating is one of the main signs of bulimia. It can be frightening and exhausting.

Secrecy can make people feel cut off, even when they are surrounded by others. Support groups and peer mentors can help people feel understood.

Having a close relative with an eating disorder raises the risk. Researchers think genes and learned behaviours work together.

People with anxiety or depression are at higher risk of bulimia. Research shared by ANAD found girls with ADHD are 5.6 times more likely to have bulimia.

Most teens with bulimia also have another mental health condition. Treating both together helps.

Pressure from media and cultural ideas about the “right” body may play a role in bulimia.

Stress, big changes and feeling out of control may play a part. Food can become a way to cope when life feels too much.

In sports where weight matters, research shared by ANAD found that most athletes, both men and women, reported unhealthy ways of trying to control their weight.

Talking therapy for bulimia often starts with a self-help workbook or online course. You may work through it on your own or with a therapist.

Cognitive behavioral therapy (CBT) is a main treatment for bulimia. It looks at the thoughts, feelings and patterns that keep the cycle going, and builds new ways to cope.

If you are under 18, your family may be involved in your talking therapy. Research suggests family-based treatment can improve outcomes for teens.

A registered dietitian can help with eating patterns and nutrition. Regular, steady eating helps break the cycle of restricting and bingeing.

Support groups can be a helpful addition to other care. Hearing from others who understand can ease shame and loneliness.

A hospital stay may be needed if there are serious health problems, or a risk of self-harm or suicide.

Try this

1. Choose a calm, private moment, not around a meal.
2. Say you care and have been worried.
3. Talk about how they seem, not their size or what they eat.
4. Listen, and let them share at their own pace.
5. Encourage them to see their doctor, and offer to go with them.

They may feel deeply ashamed, deny it or get upset. Try not to take it personally, and keep inviting them to things.

• Comments on weight, shape or looks
• Criticising or lecturing
• Checking the bathroom or watching every bite
• Simple fixes like “Just stop”
• Talking about diets or “good” and “bad” foods

• Calling the ANAD helpline together
• Finding a provider through ANAD’s free treatment directory
• Going with them to appointments
• Planning relaxing things to do together after meals

Recovery takes time, with good days and bad days. Supporting someone can be tiring and worrying.

• Get your own support or counseling
• Join a group for families and friends
• Keep up your own sleep, meals and hobbies