Many exercise excessively to burn calories. Bulimics, like anorexics, fear weight gain but lack the iron-clad control required by strict diets. After giving in to cravings for food, they feel guilty and panicky. Then they try to get rid of the calories they have eaten. When bulimics don't binge, they usually diet, making themselves hungry for sweet, starchy, and fatty foods.
Prolonged hunger turns into powerful cravings that often lead to a binge.
Many binges are triggered by hunger plus anxiety, emotional distress, and problems in relationships. Concerned about how they look and what others think of them, they commit themselves to stern discipline and dieting. The time they spend binging may be the only time they spend on themselves. Even though many bulimics appear independent and successful, they lack self-confidence and feel inadequate. For them, pleasing others and gaining approval are more important than pleasing themselves.