Mental Health and Illness

Eating Disorders - Bulimia

Please note that the information provided on these websites is intended for educational purposes only and is not a substitute for medical advice. If you are experiencing difficulty with any symptoms listed here, please consult with a healthcare provider for proper diagnosis and treatment.

Bulimia Nervosa is a type of eating disorder characterized by recurrent episodes of binge eating (i.e., eating an excessive amount of food within a short period of time and feeling out of control while eating), followed by inappropriate compensatory behaviors (i.e., purging, fasting, or excessive exercise) to prevent weight gain.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides the following diagnostic criteria for bulimia nervosa:

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

F. The severity of the disorder is specified based on the frequency of inappropriate compensatory behaviors:

Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week.
Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per week.
Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per week.
Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.

It is important to note that the diagnosis of bulimia nervosa requires the presence of both binge eating and inappropriate compensatory behaviors, and that the severity of the disorder is based on the frequency of the inappropriate compensatory behaviors. A trained mental health professional should be consulted for an accurate diagnosis and treatment plan.

Treatment for Bulimia

Several psychological treatments have been shown to be effective in the treatment of bulimia nervosa, and the American Psychiatric Association recommends psychotherapy as the first-line treatment for this disorder. The following are some evidence-based psychological treatments for bulimia nervosa:

Cognitive Behavioral Therapy (CBT): CBT is a type of talk therapy that focuses on changing negative patterns of thinking and behaviors. In the case of bulimia nervosa, CBT typically involves helping the patient to identify and challenge the thoughts and beliefs that contribute to their disordered eating behavior. The therapist may also teach the patient strategies for coping with urges to binge and purge, and provide guidance on how to develop healthy eating habits.
Interpersonal Psychotherapy (IPT): IPT is a type of talk therapy that focuses on improving relationships with others. In the case of bulimia nervosa, IPT may involve working with the patient to improve their communication and interpersonal skills, as well as to develop a stronger support system. The therapist may also help the patient to identify and address any interpersonal issues that may be contributing to their disordered eating behavior.
Dialectical Behavior Therapy (DBT): DBT is a type of talk therapy that focuses on improving emotion regulation skills. In the case of bulimia nervosa, DBT may involve teaching the patient skills for managing intense emotions, such as mindfulness and distress tolerance. The therapist may also help the patient to develop more adaptive coping strategies for managing stress and negative emotions.
Family-Based Treatment (FBT): FBT is a type of therapy that involves the patient's family members in the treatment process. In the case of bulimia nervosa, FBT may involve working with the patient's family members to help them provide support and encouragement for the patient's recovery. The therapist may also help the family to develop more effective communication and problem-solving skills.
Acceptance and Commitment Therapy (ACT): ACT is a type of talk therapy that focuses on improving psychological flexibility. In the case of bulimia nervosa, ACT may involve helping the patient to identify their core values and develop strategies for living in accordance with those values, even in the face of difficult emotions and urges to binge and purge.

In addition to these evidence-based psychological treatments, some patients may also benefit from medications, such as antidepressants, which can help to reduce symptoms of anxiety and depression that may be contributing to their disordered eating behavior. It is important to work with a trained mental health professional to determine the most appropriate treatment plan for each individual patient.

Self-Help Strategies for Managing Bulimia

If a person is struggling with bulimia nervosa, there are several things they can do to help manage their symptoms and improve their overall well-being:

Seek professional help: The first and most important step a person can take is to seek professional help. A mental health professional can provide an accurate diagnosis and develop a treatment plan tailored to the individual's specific needs.
Educate yourself: Learning about the signs and symptoms of bulimia nervosa can help a person better understand their condition and how to manage it.
Keep a food diary: Keeping track of what and when you eat, as well as any binge and purge episodes, can help you identify patterns and triggers for your disordered eating behavior.
Identify and challenge negative thoughts: Negative thoughts and beliefs about oneself and food can contribute to disordered eating behavior. Identifying and challenging these thoughts can help a person develop a more positive and healthy mindset.
Develop healthy coping strategies: Finding healthy ways to cope with stress and negative emotions, such as exercise or meditation, can help reduce the likelihood of engaging in binge and purge behavior.
Develop a support system: Building a strong support system of friends, family, or support groups can provide encouragement and help a person stay motivated in their recovery.
Practice self-care: Engaging in self-care activities, such as getting enough sleep, practicing relaxation techniques, and engaging in activities that bring joy and fulfillment, can help a person reduce stress and improve their overall well-being.
Focus on long-term goals: Rather than focusing on short-term weight loss or appearance goals, focusing on long-term goals, such as overall health and wellness, can help a person maintain a healthy perspective on food and body image.
Avoid triggers: Avoiding triggers that may lead to binge and purge behavior, such as certain foods or stressful situations, can help a person better manage their symptoms.
Celebrate small victories: Celebrating small victories, such as making it through a meal without purging, can help a person stay motivated and feel proud of their progress.

Mental Health and Illness

Eating Disorders - Bulimia

Please note that the information provided on these websites is intended for educational purposes only and is not a substitute for medical advice. If you are experiencing difficulty with any symptoms listed here, please consult with a healthcare provider for proper diagnosis and treatment.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides the following diagnostic criteria for bulimia nervosa:

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.

A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

F. The severity of the disorder is specified based on the frequency of inappropriate compensatory behaviors:

Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week.

Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per week.

Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per week.

Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.

Treatment for Bulimia

Several psychological treatments have been shown to be effective in the treatment of bulimia nervosa, and the American Psychiatric Association recommends psychotherapy as the first-line treatment for this disorder. The following are some evidence-based psychological treatments for bulimia nervosa:

Self-Help Strategies for Managing Bulimia

If a person is struggling with bulimia nervosa, there are several things they can do to help manage their symptoms and improve their overall well-being:

Seek professional help: The first and most important step a person can take is to seek professional help. A mental health professional can provide an accurate diagnosis and develop a treatment plan tailored to the individual's specific needs.

Educate yourself: Learning about the signs and symptoms of bulimia nervosa can help a person better understand their condition and how to manage it.

Keep a food diary: Keeping track of what and when you eat, as well as any binge and purge episodes, can help you identify patterns and triggers for your disordered eating behavior.

Identify and challenge negative thoughts: Negative thoughts and beliefs about oneself and food can contribute to disordered eating behavior. Identifying and challenging these thoughts can help a person develop a more positive and healthy mindset.

Develop healthy coping strategies: Finding healthy ways to cope with stress and negative emotions, such as exercise or meditation, can help reduce the likelihood of engaging in binge and purge behavior.

Develop a support system: Building a strong support system of friends, family, or support groups can provide encouragement and help a person stay motivated in their recovery.

Practice self-care: Engaging in self-care activities, such as getting enough sleep, practicing relaxation techniques, and engaging in activities that bring joy and fulfillment, can help a person reduce stress and improve their overall well-being.

Focus on long-term goals: Rather than focusing on short-term weight loss or appearance goals, focusing on long-term goals, such as overall health and wellness, can help a person maintain a healthy perspective on food and body image.

Avoid triggers: Avoiding triggers that may lead to binge and purge behavior, such as certain foods or stressful situations, can help a person better manage their symptoms.

Celebrate small victories: Celebrating small victories, such as making it through a meal without purging, can help a person stay motivated and feel proud of their progress.