Bulimia Nervosa



The cause is not known. It may be due to a mix of genes and the environment.

Risk Factors

Bulimia is more common in young women. Other things that may raise the risk are:

  • Low self-esteem
  • Feelings of helplessness
  • Wanting to be perfect
  • Fear of gaining weight
  • Not being happy with weight and size
  • Pressure to be thin
  • Having other family members with the same problems
  • Emotional stress
  • Prior obesity or anorexia
  • Having other mental health problems, such as depression or anxiety
  • Substance use disorder
  • A way of life that highlights being thin as ideal



People with bulimia have a healthy weight. But, their habits are not healthy. Bulimia may cause:

  • Eating of large amounts of food at one time
  • Feeling like eating is not in one's control
  • Forced vomiting
  • Taking of laxatives, enemas, diuretics, or diet pills
  • Too much exercise
  • Mood swings
  • Problems with impulse control
  • Misuse of alcohol or other substances

Physical problems may be:

  • Belly pain
  • Heartburn
  • Menstrual problems
  • Swollen cheeks and jaw
  • Sore throat
  • Swollen glands in the mouth and throat
  • Bloating
  • Stained or chipped teeth—because of contact with stomach acid
  • Cuts or scars on back of hands—from scraping skin on teeth during forced vomiting


The doctor will ask about symptoms, past health, and eating habits. A physical and mental health exam will be done. Other tests may be:

  • Blood tests to look for electrolyte imbalances
  • ECG to check heart function
Heart EKG
Bulimia can lead to severe heart problems.
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The goal of treatment is to develop healthy habits and thought patterns. Treatment can include a combination of:

  • Nutrition counseling and support
  • Mental health counseling methods, such as individual or group cognitive-behavioral therapy
  • Vitamins and minerals
  • Antidepressants along with therapy


There are no known guidelines to prevent bulimia.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.