Bulimia Nervosa

WHAT IS BULIMIA NERVOSA?

If you find yourself going through cycles of binge eating and purging, you may be experiencing Bulimia Nervosa.

Bulimia Nervosa can result in serious physical and psychological consequences that affect your health and happiness.

On this page, you can find out more about what it might feel like living with Bulimia Nervosa, and the symptoms and warning signs to look out for. You can also find out about the factors that might cause Bulimia Nervosa to develop, and how psychological and nutritional interventions can support you in your recovery.

Symptoms of Bulimia Nervosa

When trapped in the cycle of bulimia, you may experience some of the following symptoms:

  • Weight fluctuating as you swing between periods of overeating and restricting
  • A constant preoccupation with thoughts about food
  • A feeling of being out of control and fearful around food
  • Feeling ashamed and eating in secret
  • After bingeing, a strong desire to compensate through either laxatives, vomiting, exercise or further restriction
  • After purging, having a compelling urge to binge again – it can feel addictive
  • Unpleasant physical symptoms such as swollen cheeks, a sore throat, acid reflux or sensitive teeth
  • Feeling very critical and unhappy with your weight and body shape

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WHAT DOES HAVING BULIMIA NERVOSA FEEL LIKE?

Have you experienced any of these thoughts and feelings?

You struggle daily with low self-worth which is significantly influenced by your weight and body shape. This may have led you to controlling your food intake, or implementing strict dieting rules in an attempt to manage your weight. These rigid rules create feelings of deprivation and hunger, resulting in episodes of binge eating, The bingeing can feel out of control, as eating is fast and takes place in secret.

You temporarily allow yourself the freedom to eat all the foods that have been banned, these often being high in fat and sugar. After the momentary relief and enjoyment from eating, guilt and shame may quickly descend, as you compensate through purging, (vomiting, laxatives, diuretics) or non-purging compensatory mechanisms such as starvation or over-exercise.

Although initially, this cycle is often triggered by restrictive eating or dieting, it can rapidly becomes a coping strategy for emotional distress.

PSYCHOLOGICAL FACTORS IN BULIMIA NERVOSA

Several psychological, social and emotional factors can contribute to the development of Bulimia Nervosa.

WEIGHT CONFLICT & BODY IMAGE

Fear of weight gain combined with negative, often highly critical, judgements about body size and shape, are often at the core of bulimia. 

Comments by parents, teachers, siblings or our peer group growing up can all contribute to how we start to perceive our appearance and body image. 

Throw away comments about weight and shape, mixed with judgements and comparisons help to form what can often be a complex relationship between weight, appearance and body image.

Add to this negative social comparisons and the internalisation of societal beauty and body shape standards, strongly intensified by social media, and it helps us understand how individuals with bulimia often develop core beliefs that they are not good enough, the foundation of low self-worth.

This weight conflict mixed with poor body image can trigger a desire to lose weight, and in turn an unhelpful pattern of restriction and compulsive eating.

Purging becomes a way of ‘getting rid’ of feared excess calories that have been consumed.

Purging often leads to malnutrition, which in turn affects our brain and cognition. This can skew our body image perception and trigger more unhelpful thinking, disordered eating patterns and worsen our body image and our view of ourselves.

SHAME

Binge-purge cycles are repetitive patterns of behaviour that drive bulimia nervosa, and can often trigger cycles of shame and guilt.

After bingeing, we may feel overwhelmed with shame and disgust, and the momentary relief that we felt from our stress and emotions while bingeing is gone.

Bingeing and purging can activate our critical inner voice, leading to intense feelings of shame. Sadly these feelings are often too overwhelming, and may trigger yet more bingeing and purging. 

This desire to reduce emotional distress, and the false psychological and emotional relief that purging brings, reinforces bulimia.

Feeling shame, we may isolate ourselves from the people around us, as we believe they will judge us negatively. This often makes bulimia something that must be hidden, a factor that can often strengthen the grip of bulimia in your life.

STRESSFUL EMOTIONS

Feeling overwhelmed by negative emotions, such as anxiety, stress and sadness, can lead us to turn to food for comfort.

Overeating can help us feel numb, and help us escape from emotions that we fear, that seem too strong or intense. We may associate binge eating and purging with feeling calm and happy, and this can make us feel addicted to the binge-purge cycle and the relief it provides.

With weight conflict, negative core beliefs and poor body image at the heart of bulimia, feelings of shame, disgust and worthlessness can activate anxiety.

We may believe that purging will make us feel better, but these unhelpful thoughts and behaviours can maintain our experience of anxiety, and keep us feeling trapped and stuck in the cycle of bulimia.

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Warning Signs of Bulimia Nervosa

You may be concerned about a friend or loved one. Here are some warning signs that may suggest they are struggling with bulimia:

  • Evidence of binge eating include the disappearance of large amounts of food in short periods of time, and the existence of wrappers and containers indicating the consumption of large amounts of food
  • Evidence of purging behaviours include frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
  • Excessive, rigid exercise regimen – despite weather, fatigue, illness or injury – the need to ‘burn off’ calories taken in
  • Unusual swelling of the cheeks or jaw area
  • Calluses on the back of the hands and knuckles from self-induced vomiting
  • Discolouration or staining of the teeth
  • Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions
  • Withdrawal from usual friends and activities
  • In general, behaviours and attitudes indicating that weight loss, dieting and control of food are becoming primary concerns

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BULIMIA NERVOSA TREATMENT

Our experienced team of therapists can work with you to explore your relationship with food, your beliefs and emotions that maintain binging and purging, and support you in finding new and healthy ways to move forwards.

Psychotherapy sessions might include:

  • Exploring the root causes that led to your bulimia
  • Exploring your body image and helping you restructure how you think and feel about your body
  • Uncovering thoughts, beliefs and assumptions that are keeping you stuck in your bulimia cycle, and helping you create new ways of interpreting situations and feelings
  • Helping you name, feel and manage emotions without the need to use food or purging to cut them off
  • Working with you to break eating habits and create new behaviours in your life around food
  • Supporting you in improving your self-worth and self-confidence, as you develop more positive self-beliefs that shape your concept of who you are
  • Helping you build a toolkit of strategies to keep you on track and help you cope with life stressors

It may be important to receive a combination of psychological and nutritional support to help you improve your physical and mental health.

Our integrated package, Rebalance, combines 6 psychotherapy sessions and 4 dietitian sessions to help you calm your chaotic eating patterns, and support you in moving towards bulimia recovery.

Bulimia eating patterns can lead to extreme imbalances in your biochemistry. Nutritional support may be important to help you balance your brain and blood chemistry to help you feel healthier and happier. 

By improving your physical symptoms and targeting the underlying psychological factors that are maintaining your experience of bulimia, we can support you in finding a healthier balance in your mind and body.

Learn more about Bulimia Nervosa