EATING DISORDER SERIES pt. 2: Bulimia

We are continuing our series this week and focusing on Bulimia Nervosa. In this episode you will learn the symptoms, common findings on physical exam, risk factors, criteria to diagnose and treatment options as well as secret tips! If you want to listen to our episode now you can do so by CLICKING HERE.


♡ What is Bulimia?

  • Bulimia is an eating disorder marked by recurrent episodes of binge eating accompanied by compensatory behaviors. These people will feel out of control while eating large amounts of food in a specific period of time. After doing so they will try to get rid of all of the extra calories by a variety of methods (purging, exercising, restricting behaviors and or laxative use). This becomes a repetitive cycle that can affect you mentally and physically like many of the other eating disorders.

Note: all of these behaviors need to affect your day to day life in order to be classified as a disorder!

♡ Causes?

  • Genetics, environment, peer pressure, emotional health

♡ Risk Factors?

  • Age (teens and early 20s)

  • Gender (females are more likely affected than males)

Note: In males this condition may be underdiagnosed since they are less likely to get help.
  • Other risk factors include:

- Family history (higher risk for those with first degree relatives who suffer from anorexia)

- Dieting

- Stress or major life changes

- Specific vocations and activities


i.e.: Athletes: like gymnasts, runners, wrestlers and dancers


Individuals who have jobs or hobbies that require rapid weight gain or weight loss and those who need to be a particularly “thin” body type are at higher risk. This includes: bodybuilders or ballerinas.

♡ Symptoms?

  • Loss of control during the episodes of eating large amounts of food at one time

  • Recurrent episodes with compensation by vomiting, excessive exercise, restrictive eating, and or laxative use

  • Low self esteem

  • Feelings of being out of control

  • Guilt, shame and even withdrawal from family and friends

♡ Physical Exam?

  • Weight is often normal or slightly above ideal body weight (unlike in anorexia nervosa)

  • Parotid gland enlargement may be noted

  • Dental cavities

  • In some people you may see the Russell sign (i.e.: calluses on the hand from inducing vomiting)

♡ Complications?

  • Cavities, GERD, electrolyte abnormalities, arrhythmias (due to electrolyte abnormalities), metabolic alkalosis and heart failure

♡ Diagnosis?

  • To meet the criteria for diagnosis these episodes must occur once a week for at least for 3 months

  • You will also obtain labs similar to other eating disorders including but not limited to, a BMP and an EKG

  • Must differentiate bulimia from anorexia and binge eating disorder

♡ Treatment?

  • Therapy: CBT

  • Pharmacologic: SSRIs

  • SSRIs are particularly useful in those who have a co occurring illness (i.e.: anxiety or depression) or in those who don’t respond to CBT alone


♡ Secret Tips

  • Seek help

  • Be aware of what you or someone next to you may be going through

  • If needed always get a second opinion

  • Eat well balanced meals

That's all for this week, don't forget to leave us feedback, rate, review, subscribe and send in your questions so we can continue to improve as well as, provide you high quality content.


Disclaimer: The Content on our podcast/website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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