Munson Health
Bulimia Nervosa

Back to Document

by Wood D



Risk Factors

Factors that increase your chance of developing bulimia include:


Behavioral symptoms include:
Physical symptoms include:
  • Abdominal pain and heartburn
  • Menstrual problems
  • Swollen cheeks and jaw
  • Sore throat
  • Swollen salivary glands (in the mouth and throat)
  • Bloating
  • Stained or chipped teeth (due to contact with stomach acid)
  • Cuts or scars on back of hands (from scraping skin on teeth during forced vomiting)
Bulimia may lead to other problems, including:
  • Dental and throat problems from stomach acid that rises during vomiting
  • Changes in body chemistry and fluids due to vomiting and abuse of laxatives or water pills
Symptoms of these complications include:
  • Dizziness
  • Feeling faint
  • Thirst
  • Muscle cramps
  • Weakness
  • Constipation
  • Irregular heartbeat
  • Heart problems, including sudden death
People with bulimia have a high incidence of psychiatric conditions, including:
  • Depression (often with rapid and wide swings in mood)
  • Anxiety and panic disorder
  • Drug and alcohol abuse or dependence


The doctor will ask about:
  • Your medical and psychological history
  • The amount of food you eat
  • The ways you to try to rid your body of food
The doctor will also do a physical exam. Your teeth will be checked for signs of erosion.
Tests may include:
Heart EKG
Bulimia can lead to severe heart problems.
Copyright © Nucleus Medical Media, Inc.
A mental health professional may also perform a psychiatric exam and/or psychological tests.


The goals of treatment are:
  • To stop binging and purging
  • To focus self-esteem away from body weight and shape
Treatments include:

Nutritional Support

You may be referred to a registered dietitian. A dietitian can teach you how to follow a healthy diet and create reasonable weight and calorie goals.


Cognitive-behavioral therapy (CBT) can be very effective, especially when combined with medicine.
Other therapies may be less effective, but can help you to:
  • Gain insight into the problem
  • Recognize what triggers binging and purging
  • Develop new coping skills
  • Learn and practice stress-management techniques
  • Talk about feelings
  • Develop a more appropriate idea of thinness
  • Develop healthier attitudes about eating
  • Learn to eat regularly to reduce the urge to binge


Antidepressant drugs, particularly selective serotonin reuptake inhibitors (SSRIs), have proven effective in helping to reduce binging and purging.


Bulimia Nervosa Resource Guide for Family and Friends

National Association of Anorexia Nervosa and Associated Disorders

National Eating Disorders Association



Bulimia Anorexia Nervosa Association

Canadian Mental Health Association



Bulimia. EBSCO DynaMed website. Available at: . Updated July 17, 2012. Accessed August 28, 2012.

Bulimia nervosa fact sheet. Women's website. Available at: . Updated June 15, 2009. Accessed August 28, 2012.

Eating disorders. National Institute of Mental Health website. Available at: . Accessed August 28, 2012.


Revision Information