Bulimia - What is it?

Key points for people with bulimia

• More than 3 people in 100 have an eating problem like bulimia at some point in their life.[2] [3]
• It's very hard for people with bulimia to ask for help, so they often keep their illness secret for years.[4]
• Symptoms vary from one person to another. If your symptoms don't fit the exact definition for bulimia, you still may have an eating disorder. Treatments for bulimia can also help people with other eating disorders.
• If you get treatment, you have a good chance of getting better.[5] [6] [7] And the earlier you seek help, the better that chance will be.[1]
• Even if you've had bulimia for a long time, getting treatment can help you eat in a healthy way again.

If you have bulimia, you might also have had another eating disorder called anorexia. People who have anorexia sometimes get bulimia. These two diseases are closely linked. To learn more, see Other eating disorders.

Healthy eating

If you eat in a healthy way, you eat when you're hungry and stop when you're full. Most of us tend to eat three meals a day with perhaps a couple of snacks in between.

Eating is also usually a pleasure. When we meet up with family and friends, we often eat together. It's something most people look forward to and enjoy.

What goes wrong?

If you have bulimia, you worry about food and your body shape far more than most people do. You are horrified by the thought of being or getting fat. You think all the time about how you look and how much you weigh.

These feelings lead to irregular, unhealthy eating habits like the ones listed below.

• You think about food all the time. You count calories, plan what you'll eat and worry about meals.
• Sometimes you lose control and binge, eating large amounts at one time, in secret.
• Afterwards you might try to get rid of the calories you've just eaten by purging (throwing up or using laxatives or water pills).
• Or you might try to avoid putting on weight by not eating for a long time or by exercising obsessively.
• Vomiting or using laxatives can make your stomach feel empty, which might make you feel calm for a little while. But these feelings don't last long.
• It's the same with exercise. If you exercise obsessively to lose weight, you might feel good (or less bad) for a while, but only until the next time you lose control and binge.
• If you don't eat for a long time, you might get so hungry that when you do start to eat, you can't stop.
• You have to work hard to keep your eating habits secret. This leaves you little time for work, study or friends.[8]

Bulimia is a real illness, not a phase or a fad. It belongs to a group of illnesses called eating disorders. Bulimia can seriously damage your health. Also, if you have it you are more likely to get depressed than other people, and you are more likely to drink alcohol heavily.[9] [10] [11]

It's not easy to tell if someone has bulimia. People with the disease tend to be normal weight or near normal weight. If you're afraid that someone close to you has bulimia, it can be hard to decide what to do. For ideas on how to help, you might want to read Worried someone close to you might have bulimia?

Why me?

We're not sure what causes bulimia or any eating disorder. We have some ideas, but no proof yet for any of them. Below is a list of some things that seem to go along with bulimia. We think that when someone gets bulimia, it's probably because of a combination of these things:

• Fear of being fat
• Body image
• Western culture
• Emotional problems
• An imbalance of chemicals in the brain
• Genes and family history.

We know that some people are more likely to get bulimia than others. Doctors call things that make you more likely to get a disease risk factors. See Risk factors for bulimia to learn more.