The Psychology Behind Bulimia



Bulimia nervosa is a severe mental health disorder that if left untreated can become life-threatening. It involves the intake of excessive amounts of food and then engaging in compensatory behaviors to counteract this intake. There can be purging bulimia where the person uses self-induced vomiting or laxatives, enemas or diuretics to rid the body of the food. In contrast, there can be non-purging bulimia where they use other compensatory methods such as strict dieting or engaging in excessive exercise. These two types of bulimia are not necessarily exclusive and often overlap. Despite this focus on food, truly bulimia is not about food, but anxiety. People experiencing bulimia are often worried about their weight or body shape. They are likely to have high expectations for themselves and a tendency to focus on their self-perceived flaws. As bulimia goes deeper than simply a concern about food or weight and is rather due to deeper seeded low self-esteem, it can be very difficult to recover from. However, with good support and the right treatment, it can certainly be overcome.

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Signs and Symptoms of Bulimia

Bulimia nervosa is not just an eating disorder but a grave psychological disorder that can become life-threatening under some circumstances. This eating disorder is typically characterized by recurring phases of binge eating and purging where the patient first stuffs as much food as possible and thereafter, retires to the bathroom to vomit out the food. The bulimic initially tries to refrain from bingeing as he is apprehensive of gaining weight, but is unable to control his cravings in the end.

Historically, across cultures, humans (and other animals) are known to engage in ritualized behaviors of  purging and regurgitation as methods of altering states of consciousness. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP

In order to compensate for having consumed too much, a patient of bulimia attempts to disgorge the excessive food through self-induced regurgitation through the use of diuretics, emetics, and laxatives. Many bulimics do intensive workouts, starve, and go through a rigorous dietary plan to burn the calories. Bulimia nervosa often takes a tremendous toll on the physical and mental health of the patients resulting in their suffering from heart attacks, hypertension, and damaged kidneys.

A great majority of bulimics often report symptoms of depression, and anxiety disorder and several other mental disorders.


Following are some of the most common symptoms of bulimia nervosa:

  • A round of bingeing where the patient consumes upwards of 2,000 calories of food at one sitting lasting for a short period
  • The bingeing is followed by spells of vomiting to disgorge the excess amount of food consumed or embarking on strenuous exercises, fasting or following rigorous dietary regimens in order to burn calories
  • Large scale misuse of laxatives, diuretics, and emetics with the ultimate aim of preventing weight gain. However, rampant abuse of such medications can prove to be fatalistic in the long run.
  • Torn between feelings of uncontrollable urge to eat on one hand and the attendant guilt that comes with overindulgence and the apprehension of putting on weight
  • Preoccupation with overeating, dieting, purging, and body weight keeps the bulimic from performing routine tasks and leading a normal life
  • Having a sense of worth oriented around weight and physique

Perhaps sociology could offer answers as to why these so-called ‘gurgitators’ would inhale everything from hot dogs to mayonnaise under the pressure of time and before live screaming audiences…of thousands. — Lawrence Rubin Ph.D, ABPP, LMHC, RPT-S

Besides the above prevalent and widespread symptoms, a bulimic may exhibit the following signs as well:

  • Stowing food items in the most unlikeliest of places, especially areas that the patient may be easily able to access without being found out
  • Prefers to eat alone rather than in the company of other people
  • Female bulimics may experience irregularity in their menstrual cycles
  • The patient might lose or gain considerable weight on a recurrent basis, and in a short time period
  • Conversations and discussions will mostly revolve around dieting, foods, figure, and body weight
  • Will appear ashen or pale owing to deficiency and/or imbalances of vital electrolytes including sodium, potassium, and calcium and loss of fluids owing to frequent purging leading to dehydration
  • Will be obsessed with workouts and overuse laxatives/diuretics


Physical signs and symptoms:

  • Flaky, dry, and wrinkled skin
  • Thin, dry and frizzy hair
  • Mouth ulcers and sores
  • Decaying teeth, tooth enamel, and bleeding gums
  • Inflamed salivary glands
  • Abdominal pain and cramps
  • Successive bouts of diarrhea and constipation
  • Heartburns
  • Dizziness
  • Feeling tired most of the time
  • Restlessness and anxiety owing to lack of sleep
  • Calluses or bite marks on knuckles resulting from frequent regurgitation brought upon by oneself
  • Wreaked by feelings of guilt, depression, and anxiety
  • Shoplifting
  • Substance abuse, alcoholism, and resorting to intake of banned medications or drugs

Ample research shows that people can be healthy and confident at a whole range of shapes and sizes. — Alexis Conason Psy.D.


Most of the common signs or symptoms associated with bulimia nervosa are not palpable, making it difficult to diagnose the eating disorder as the patients are fearful of expressing the same. Bulimics can go to extreme lengths to prove that they are perfectly normal and healthy. If you are a bulimic yourself or know somebody who may be suffering from the eating disorder, then you seek medical intervention right away.