Bulimia—Easy to Read

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What is bulimia?
What causes it?
What are signs of bulimia?
What happens to someone who has bulimia?
Can someone with bulimia get better?
Can women who had bulimia in the past still get pregnant?
Does bulimia hurt a baby when the mother is pregnant?
What should I do if I think someone I know has bulimia?

See also...

• Anorexia
• Binge Eating Disorder

What is bulimia?

Bulimia (buh-LEE -me-ah) nervosa, typically called bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (called bingeing) and then tries to prevent weight gain by purging. Purging might be done in these ways:

• making oneself throw up
• taking laxatives, pills, or liquids that increase how fast food moves through your body and leads to a bowel movement (BM)

A person with bulimia may also use these ways to prevent weight gain:

• exercising a lot
• eating very little or not at all
• taking pills to pass urine

What causes it?

Bulimia is more than just a problem with food. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. While there is no single known cause of bulimia, many things may have a role in its development:

• Biology. There are studies being done to look at many genes, hormones, and chemicals in the brain that may have an effect on the development of, and recovery from, bulimia.
• Culture. Some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.
• Personal feelings. Someone with bulimia may feel badly about herself, feel helpless, and hate the way she looks.
• Stressful events or life changes. Things like starting a new school or job, being teased, or traumatic events like rape can lead to the onset of bulimia.
• Families. The attitude of parents about appearance and diet affects their kids. Also, a person is more likely to develop bulimia if a mother or sister has it.

What are signs of bulimia?

People with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disorder. However, someone with bulimia may have these signs:

Uses extreme measures to lose weight

• uses diet pills, or takes pills to urinate or have a bowel movement (BM)
• goes to the bathroom all the time after she eats (to throw up)
• exercises a lot, even during bad weather, tiredness, sickness, or injury

Shows signs of throwing up

• swelling of the cheeks or jaw area
• cuts and calluses on the back of the hands and knuckles
• teeth that look clear

Acts differently

• is depressed
• doesn't see friends or participate in activities as much

What happens to someone who has bulimia?

Bulimia can be very harmful to the body. Look at the picture to find out how bulimia affects your health.

click here for a text version of this diagram

Can someone with bulimia get better?

Yes, a person with bulimia can get better. Different types of therapy have worked to help people with bulimia. This may include individual, group, and family therapy. A class of medicines, also used for depression, like Zoloft, has been effective when used with therapy. These medicines change the way certain chemicals work in the brain.

Can women who had bulimia in the past still get pregnant?

Bulimia can cause problems with a woman’s period. She may not get it every 4 weeks or it may stop. But researchers don't think this affects a woman's chances of getting pregnant after she recovers.

Does bulimia hurt a baby when the mother is pregnant?

If a woman with active bulimia gets pregnant, these problems may result:

• miscarriage
• high blood pressure in the mother
• baby isn’t born alive
• low birth weight
• low Apgar score, which are tests done after birth to make sure the baby is healthy
• during the delivery, they baby tries to come out with feet or buttocks first
• birth by C-section
• baby is born early
• depression after the baby is born

What should I do if I think someone I know has bulimia?

If you know someone with bulimia, you can help. Follow these steps from the National Eating Disorders Association:

1. Set a time to talk. Set aside a time to privately talk about your concerns with your friend. Be open and honest. Make sure you talk in a place away from distractions.
2. Tell your friend about your concerns. Tell your friend about specific times when you were worried about her eating or exercise behaviors. Explain that you think these things may show a problem that needs professional help.
3. Ask your friend talk about these concerns. She could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment.
4. Avoid conflicts or a battle of the wills with your friend. If your friend doesn’t admit to a problem, repeat your feelings and the reasons for them. Be a supportive listener.
5. Don’t place shame, blame, or guilton your friend. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements like, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
6. Avoid giving simple solutions. Don’t say, "If you'd just stop, then everything would be fine!"
7. Express your continued support. Remind your friend that you care and want her to be healthy and happy.

For more information

You can find out more about bulimia by contacting the National Women's Health Information Center (NWHIC) at 800-994-WOMAN or the following organizations.

National Institute of Mental Health (NIMH), NIH, HHS
Phone:(866) 615-6464
Internet Address: http://www.nimh.nih.gov

National Mental Health Information Center, SAMHSA, HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org

Academy for Eating Disorders (AED)
Phone: (703) 556-9222
Internet Address: http://www.aedweb.org

Eating Disorder Referral and Information Center
Phone: (858) 792-7463
Internet Address: http://www.edreferral.com

Harvard Eating Disorders Center (HEDC)
Phone: (617) 236-7766
Internet Address: http://www.hedc.org

National Eating Disorders Association (NEDA)
Phone: (800) 931-2237
Internet Address: http://www.nationaleatingdisorders.org

This FAQ was reviewed by Barbara E. Wolfe, PhD, RN, CS, FAAN, Assistant Professor of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School.

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August 2004