Bulimia Nervosa

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.Body ImageThe following page includes discussions of body image, including starving oneself, binging and purging, exaggerated self-analysis, and body dysphoria. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Bulimia Nervosa**, commonly called just **Bulimia**, is an eating disorder characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting. One may set a very strict set of rules for themself about dieting, eating, or exercising. Individuals with bulimia are usually at a healthy weight, but they judge themselves harshly based on their view of their body shape and/or weight. They usually have self-esteem issues closely linked to their body image.

## Signs & Symptoms

* Being preoccupied with ones body shape and weight.
* Living in fear of gaining weight.
* Repeated episodes of eating abnormally large amounts of food in one sitting.
* Feeling a loss of control during bingeing.
* Forcing oneself to vomit or exercising too much to keep from gaining weight after bingeing.
* Using laxatives, diuretics or enemas after eating when they're not needed.
* Fasting.
* Using dietary supplements or herbal products excessively for weight loss.
* Appears uncomfortable eating around others.
* Develops food rituals.
* Skips meals or takes small portions of food at regular meals.
* Disappears after eating, often to the bathroom.
* Steals or hoards food in strange places.
* Drinks excessive amounts of water or non-caloric beverages.
* Uses excessive amounts of mouthwash, mints and gum.
* Hides body with baggy clothes.
* Maintains an excessive, rigid exercise regimen.
* Shows unusual swelling of the cheeks or jaw area.
* Has calluses on the back of hands and knuckles from self-induced vomiting.
* Teeth are discolored, stained.
* Withdraws from usual friends and activities.
* Looks bloated from fluid retention.
* Frequent checking in the mirror for perceived flaws in appearance.
* Extreme mood swings.

### Diagnosis

According to the DSM-5, the official diagnosis criteria for bulimia nervosa are:

* Recurrent episodes of binge eating.
	+ Eating, in a discrete period of time, an amount of food that is definitely larger than most individuals would eat during a similar period of time under similar circumstances.
	+ A sense of lack of control over eating during the episodes.
* Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics or other medications, fasting, or excessive exercise.
* The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
* Self-evaluation is unduly influenced by body shape and weight.
* The disturbance does not occur exclusively during episodes of anorexia nervosa.

## Causes

The exact cause of bulimia nervosa isn't known, but researchers think it may be a combination of genetics and learned behavior. If one has a relative that has or had an eating disorder, they are at a higher risk of developing one themselves.

Popular culture and the media put pressure on individuals to have a certain body type. These outside influences can affect ones body image and self-esteem. Feeling stressed, upset or out of control can all lead to bulimia.

Many individuals with bulimia nervosa also struggle with co-occuring conditions, such as:

* Self injury
* Substance abuse
* Impulsivity
* Diabulimia

## Health Risk

Bulimia can eventually lead to physical problems associated with not getting the right nutrients, vomiting a lot, or overusing laxatives.

* Feeling tired and weak.
* Dental problems.
* Bad breath, a sore throat, or tears in the lining of the throat.
* Irregular or absent periods.
* Dry skin and hair.
* Brittle fingernails.
* Swollen glands.
* Fits and muscle spasms.
* Heart, kidney or bowel problems, including permanent constipation.
* Bone problems.

## Known Individuals with Bulimia

### Princess Diana

Princess Diana recorded tapes for author Andrew Morton for his biography about her, the tapes saying, "The bulimia started the week after we got engaged and would take nearly a decade to overcome. My husband put his hand on my waistline and said: 'Oh, a bit chubby here, aren't we?' and that triggered off something in me..."

### Elton John

Elton John's 2019 biopic *Rocketman* depicted many of the challenges he faced through his life, one being his bulimia. He's been surviving for over 30 years since sobriety.

### Kesha

Kesha, in an interview with *Rolling Stone*, said, "I really just thought I wasn't supposed to eat food. And then if I ever did, I felt very ashamed, and I would make myself throw up because I'd think 'Oh, my god, I can't believe I actually did that horrible thing. I'm so ashamed of myself because I don't deserve to eat food.'" Throughout her career, her eating disorder worsened as the individuals around her would unknowingly enable her.

### Demi Lovato

Demi Lovato is very outspoken about their experiences with mental health, discussions about her bulimia are no different. "I still struggle. Daily. There are periods of time where I forget about my food struggles and other times it's all I think about."

### Lindsay Lohan

Lindsay Lohan opened up about her bulimia in a *Vanity Fair* magazine. She credited *Saturday Night Live* producer Lorne Michaels and head writer Tina Fey for her journey to recovery after staging an intervention, noticing how skinny she was getting.

### Lady Gaga

Lady Gaga opened up about her experience with bulimia after sharing photos in order to counter the harassment she got because of her gaining weight, captioning the photos with, "Bulimia and anorexia since I was 15."

## References

https://www.mayoclinic.org/diseases-conditions/bulimia/symptoms-causes/syc-20353615

https://www.nhs.uk/mental-health/conditions/bulimia/overview/

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia

https://my.clevelandclinic.org/health/diseases/9795-bulimia-nervosa

https://www.vogue.com/article/princess-diana-real-life-battle-with-bulimia

https://www.eatingdisorderhope.com/blog/impact-elton-johns-courageous-battle-eating-disorders

https://www.rollingstone.com/music/music-news/kesha-opens-up-about-her-eating-disorder-and-experience-in-rehab-189818/

https://www.self.com/story/demi-lovato-eating-disorder-recovery-daily-struggle

https://people.com/celebrity/lindsay-lohan-admits-bulimia-battle/

https://childmind.org/blog/lady-gaga-fights-bulimia-and-the-fat-police/