There are many factors that could play a role in developing bulimia, but exact causes are unknown. Some possible contributors include a chemical imbalance in the brain that affects behavior, as well as emotional health, social values, genetics, environment, and other issues, including perfectionism.

Life events that are stressful can also trigger bulimia — such events can include moving, the death of a loved one, divorce, or even a traumatic event that may have taken place years before (a history of experiencing bullying or physical abuse, sexual abuse or rape, or emotional abuse).

Social values can reflect unhealthy attitudes about weight and body perception (particularly among young women). A person with low self esteem and negative body image may take extreme measures to uphold the standard they have created for themselves, which may include severe diet restrictions, as well as bingeing and purging.

Eating disorders can run in families. Genetics can play a role in how prone a person is to developing one. Certain gene mutations, particularly variations in the gene for serotonin may be a strong predictor of whether someone suffers from this disease. Serotonin plays an important role in impulse control and appetite regulation.

A person may go on a diet in an effort to build self-esteem and have more control over their life. However, taken to an extreme, severe dieting may result in bingeing. Purging becomes part of the process due to feeling guilt about bingeing. Once the bingeing/purging cycle has been established, it is difficult to break.