How is bulimia different from anorexia nervosa?

Both disorders are characterized by an overwhelming drive for thinness and a disturbance in eating behavior. The main difference between diagnoses is that anorexia nervosa is a syndrome of self-starvation involving significant weight loss of 15 percent or more of ideal body weight, whereas patients with bulimia nervosa are, by definition, at normal weight or above.

Bulimia is characterized by a cycle of dieting, binge-eating and compensatory purging behavior to prevent weight gain. Purging behavior includes vomiting, diuretic or laxative abuse. When underweight individuals with anorexia nervosa also engage in bingeing and purging behavior the diagnosis of anorexia nervosa supersedes that of bulimia.

Excessive exercise aimed at weight loss or at preventing weight gain is common in both anorexia nervosa and in bulimia.

How can bulimia nervosa be treated effectively?

The best psychological treatment for bulimia nervosa is cognitive-behavioral therapy. This includes monitoring one’s own feelings, thoughts, and behaviors related to the eating disorder. Therapy focuses on normalizing eating behavior and identifying environmental triggers as well as irrational feelings and thoughts that tend to happen just prior to bingeing or purging. Patients are taught to recognize irrational beliefs about their weight and self-esteem. Antidepressants may be prescribed due to their effectiveness in decreasing bingeing and purging behaviors in bulimia. Most uncomplicated cases of bulimia nervosa can be treated on an outpatient basis although inpatient treatment is occasionally indicated.

What can happen to a woman who suffers from bulimia if she gets pregnant?

The following complications may occur during pregnancy:

  • High blood pressure
  • Depression
  • Miscarriage
  • Premature birth
  • Low birth weight

I’ve noticed behavior that I believe may indicate an eating disorder, but I’m not sure if it is (e.g., sometimes vomiting after meals)?

Vomiting, even only after some meals, indicates an unhealthy body image and an unhealthy relationship with food. While it’s not necessarily indicative of an eating disorder, it is important to express your concern over their behavior.

Are there other health complications one might experience if they have bulimia?

Yes — and some of these may be life threatening. Severe tooth decay and gum disease is one side effect. Repeated vomiting is damaging to teeth, due to toxic stomach acids which can erode the enamel and damage the gums. Repeated purging can also cause dehydration, which can eventually lead to kidney failure, as well as other health complications. Those with bulimia may also suffer from heart and digestive problems. There are also many mental health side effects, including anxiety, depression, and even suicide.

How does a person know if they require inpatient treatment?


If you suffer from an eating disorder and find you continue to have symptoms, or they have worsened despite attempts at outpatient treatment, please follow up with your physician immediately regarding inpatient treatment. You will be referred to a psychiatrist where your history and symptoms will be reviewed and you may require further medical testing. It is helpful to attend a consultation with a close family member or significant other, since we believe family support and involvement is very important when you are struggling with an eating disorder. The doctor will also be interested in any medical or psychiatric problems you may have besides an eating disorder.