What is bulimia nervosa?

Bulimia nervosa is an eating disorder and mental health issue where a person regularly eats large amounts of foods in a short space of time (bingeing), then tries to get rid of the food and the calories they contain (purging). Purging can take be done in many ways, e.g. vomiting, taking laxatives or doing too much exercise.
Bulimia nervosa is often linked to low confidence and anxiety. As with other eating disorders, food is used as a way of dealing with emotional problems. Bulimia nervosa is thought to be more common than anorexia nervosa, but is just as serious. It has been estimated that 4 in 100 women experience bulimia nervosa at some point in their lives (Royal College of Psychiatrists August 2015). Recently there has been more awareness of eating disorders in men. This has meant that doctors have been better able to identify eating disorders in men. Although men are still more likely to be underdiagnosed, misdiagnosed and under-referred.
In anorexia nervosa, it was often hard to tell when restricting food turned into a full blown illness. However, people we spoke with who had bulimia nervosa could often remember the first few times that they had binged or purged. Looking back, people often connected bingeing and purging to certain events or ‘triggers’, often emotional. Purging often became a way of dealing with anxiety, upset, anger or even boredom. Typically people said that they would binge to ‘cover’ up negative feelings of anger or sadness. Guilty feelings resulted from eating too much, and purging was a way to try to get rid of the guilt. The cycle of bingeing and purging was damaging and could lead to feelings of guilt and shame.

Emily describes the cycle of bingeing and purging and the emotions that kept the cycle going.

Age at interview 21

Gender Female

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People often described bulimia nervosa as ‘habitual’, and as something that became a normal part of their lives. It soon took over and they described how the ‘binge & purge’ cycle controlled every aspect of their lives becoming ‘life-absorbing’. Sam said that maintaining bulimia nervosa was like ‘a full time job with overtime’. It would often get worse at particular times. People could binge several times a day, followed by weeks or months of not bingeing as frequently. Bulimia nervosa often goes unnoticed for a long time as it is not usually associated with dramatic weight loss, and people often hide it from others.

David’s bulimia nervosa started as a one off, making himself sick after eating a takeaway…

Age at interview 22

Gender Male

Age at diagnosis 19

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There are similarities and differences between the types of eating disorder but many of the thought patterns and feelings are similar. It could also be the case that two people who have been diagnosed with the same eating disorder might experience different symptoms. One person’s diagnosis could change over time from bulimia nervosa to anorexia nervosa, or vice versa. Many had experienced both restricting (limiting the amount of food eaten) and bingeing and purging. People often said they had found bulimia nervosa harder to deal with, because there were less services and help available but also because they found it emotionally harder. Also, it could be difficult for other people to realise that a person with bulimia was ill because they would expect them to be underweight. People felt that bulimia, particularly bingeing, showed a lack of control while restricting was often the result of needing to exercise control over their lives. They commonly described bulimia nervosa as a ‘disgusting’ condition and felt they were being ‘greedy’ and ‘overindulgent’.

When Rebekah was ill with anorexia nervosa there was much more help available than when she tried…

Age at interview 18

Gender Female

Age at diagnosis 16

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Zoe found it harder to cope with bulimia than anorexia. Restricting gave her a sense of control,…

Age at interview 23

Gender Female

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Different aspects of the experience of Bulimia nervosa have been covered across this section of the website.

What is anorexia nervosa?

Anorexia Nervosa is an eating disorder and mental health condition where the person will severely limit or 'restrict' the amount of food they have, for...