What Are the Real Facts about Bulimia?

Content Overview

What are the facts about bulimia?

These are just a few key facts everyone should know about bulimia:

  • A cycle of binges and purges characterizes this disease.
  • More women have bulimia than men, but men can get bulimia, too.
  • Suicidal thoughts are common among people with bulimia.
  • This eating disorder can be treated.
  • Without treatment, bulimia can cause death.

Bulimia is classified as a serious mental health disorder and recognized in the definitive guide for clinicians, the Diagnostic and Statistical Manuel of Mental Disorders – 5.
The main hallmark of bulimia is bingeing. During a binge, a person will typically consume a large volume of high-calorie foods in a short period of time (usually in one sitting and up to 3,000 calories or more).

People report that they feel out of control and cannot stop themselves during a binge. After a binge, feelings of guilt or shame typically set in, and individuals feel great remorse for the behavior. At this point, individuals engage in compensatory behaviors – purging activities – to rid their bodies of the calories consumed. Purging can take different forms, including self-induced vomiting, starvation for a limited period of time, over-exercising, and/or using laxatives or enemas.

Bulimia Statistics

A review of some of the statistics related to bulimia can provide helpful, concise insight into the many risks associated with this disorder.

Surveys show a rate of approximately 1.5 percent of the US female population and 0.5 percent of the male population has experienced bulimia in their lifetimes. These percentages translate to 4.7 million females and 1.5 million males. Although bulimia primarily affects adolescents and young adults, there are reports of this disorder occurring in a person as young as 6 years old as well as senior citizens.

Among men, research shows that bisexual and gay men are at greatest risk of experiencing bulimia compared to men who identify as heterosexual. Athleticism can put males at an increased risk for bulimia. The risk is especially high for men who participate in sports that have a preference for lean body types or fixed weight requirements, such as wrestling and boxing.

There is an increased risk of suicide among individuals who have bulimia. In fact, suicide is the number one leading cause of death among people who struggle with bulimia.

One research study reviewed the cause of death across death certificates in the US for the study’s given time window and found a mortality rate of 3.9 percent for bulimia. The rate of fatalities that involved bulimia, or that were caused by this disorder, is likely to be higher because coroners may list an associated condition as the cause of death, such as cardiac arrest.

Despite public awareness on the many hazards associated with bulimia and the imminent need for help, it is estimated that only one in 10 people with bulimia will receive treatment. Relapse occurs in 30-50 percent of cases; however, relapse is considered to be part of the recovery process and should not be considered a sign that recovery is not possible.

Treatment for bulimia is readily available across the country. Research and client feedback show that treatment can be effective at managing this disorder and stopping the binge-and-purge cycle. In addition, treatment can help to reverse some, if not all, of the health effects that arise as a result of the disorder.

Health Risks

It is critical to understand that bulimia is a serious mental health disorder, and it can have health consequences that range from mild to severe. A consideration of some of the health risks associated with bulimia can help awaken a person to the reality this disorder’s severity.

As the National Eating Disorders Association (NEDA) notes, the following health complications can arise from bulimia:

  • Imbalance of electrolytes leading to heartbeat irregularity that can, in turn, cause heart failure or death
  • A gastric rupture during bingeing episodes
  • Due to an ongoing practice of self-induced vomiting, inflammation or rupture of the esophagus
  • Chronic bowel problems, including constipation or irregularity (a specific risk when laxatives are abused)
  • Risk of pancreatitis and peptic ulcers
  • Tooth decay/stomach acid staining of teeth due to persistent vomiting episodes
Bulimia can also cause mental health problems that only exacerbate this condition and further diminish the level of life satisfaction. Individuals who face bulimia often also exhibit symptoms of anxiety, depression, and obsessive-compulsive disorders (OCD).

As hiding bulimic practices is frequently part of living with this eating disorder, living a “dual-life,” so to speak, can be particularly stressful.

This disorder involves feelings of wanting to be perfect while at the same time perceiving oneself to be flawed on the outside and inside. Bulimia is often a way for a person to attempt to manage emotional pain, but it only makes matters worse. In this way, a person’s emotional pain is not addressed, but further fueled by the bulimic practices, and the response may be to ramp up obsessive thoughts and compulsive behaviors. From this internal viewpoint, it is understandable how the cycle of bulimia can become more deeply entrenched in a person’s life over time.

Getting Help

It is most advisable for bulimia treatment to occur in a structured rehab program. The main treatment approaches for bulimia are medications and therapy.


While there is no cure for bulimia, the U.S. Food and Drug Administration has approved a medication for the treatment of this disorder, fluoxetine (brand name Prozac).

In those with moderate to severe bulimia, fluoxetine has been shown to reduce the desire to self-induce vomit as well as the number of bingeing episodes.

The prescription medications sertraline (brand name Zoloft) and paroxetine (brand name Paxil) may be used off-label to relieve depression in people with bulimia. These drugs may also help those suffering from bulimia to feel less obsessive about their weight and food intake. In addition to these medications, attending medical professionals may prescribe different medications for health conditions related to bulimia during treatment.

Cognitive Behavioral Therapy (CBT) has been shown to be effective for the treatment of bulimia. In the umbrella category of therapy, there are at least 200 schools or theories. CBT, true to its name, blends the schools of behavioral therapy and cognitive therapy. CBT can address the unhealthy thoughts underlying bulimia as well as bingeing and/or purging behaviors. According to research, CBT is particularly helpful in addressing clients who manifest underlying perfectionism, low self-esteem, or relationship difficulties in an eating disorder.

CBT treatment begins with a collaborative session between the therapist and client in which the therapist asks a range of questions to evaluate the severity and components of the bulimia. Treatment sessions progress at regular intervals. Primary goals of this phase are for the recovering client to embrace treatment, engage in it, commit to it, and begin eating regularly. In an effort for clients to forego compulsively weighing themselves, weekly weigh-ins with professionals are often suggested.

CBT, which can continue for several more weeks or months, will provide clients with education about what happens to the body during bulimia. Sessions help recovering individuals to recognize destructive bulimia practices and make changes, which in turn can cause their thinking regarding these practices to shift.

At the cognitive level, a CBT therapist will work with a recovering person to bring to light the self-critical thoughts that helped to trigger an initiation into bulimia as well as perpetuate the disorder. In specific, sessions will typically center on the recovering person’s overvaluation of physical features like shape and weight, feelings such as the self-perception of being “fat,” and the harmful desire to achieve physical perfection.

To the extent that it is beneficial to recovery, supportive loved ones may be invited to participate in therapy. Part of the reason for potentially bringing in loved ones is to deepen everyone’s commitment to healing and help to ensure that the recovering person will receive appropriate support after program graduation. Families and loved ones are often instrumental in the recovery process, and therapy helps to ensure loved ones can be as constructive and helpful as possible.


After graduation from a structured treatment program for bulimia, the recovering person is strongly encouraged to engage a host of supportive services, including mutual support groups. The fellowship Anorexics and Bulimics Anonymous follows the 12-Step model laid out by its founding organization, Alcoholics Anonymous.

Meeting availability is dependent on locale, but the fellowship welcomes recovering individuals to start a new chapter if one is not already available in their area. To ensure ABA is accessible to those who need it, aside from brick-and-mortar meetings, phone meetings or Skype meetings may be available. Many individuals who are in long-term recovery from bulimia credit their support networks, including recovery groups, with playing instrumental roles in the healing process.

Disclaimer: AAC facilities do not treat bulimia. Those in need can find comprehensive care via programs that are dedicated to treating this serious disorder.

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