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Health Issues

What is bulimia?

Bulimia is an eating disorder that is harmful to a person's physical and mental health. People with bulimia eat large amounts of food in a short time (binge). Guilt and fear then cause them to get rid of the food (purge) by vomiting or other means such as overexercising.

People with bulimia have a difficult time controlling their eating behavior. They may be afraid to eat in public or with other people because they are afraid they won't be able to control their urges to binge and purge. Their fear may cause them to avoid being around people. They also may

  • Become very secretive about eating food.
  • Spend a lot of time thinking about and planning the next binge, set aside certain times to binge and purge, or avoid social activities to binge and purge.
  • Steal food or hide it in strange places, like under the bed or in closets.
  • Binge on foods with distinct colors to know when the food is later thrown up.
  • Exercise to "purge" their bodies of food consumed.

People with bulimia often suffer from other problems as well, such as

  • Depression and thoughts of suicide
  • Substance abuse

Bingeing and Purging

During a binge, people with bulimia eat large amounts of food, often in less than a few hours. Eating during a binge is almost mindless. They eat without paying attention to what the food tastes like or if they are hungry or full. Binges usually end when there is no more food to eat, their stomachs hurt from eating, or something such as a phone call breaks their concentration on bingeing.

After bingeing, people with bulimia feel guilty and are afraid of gaining weight. To ease their guilt and fear, they purge the food from their bodies by vomiting or other means. They also may turn to extreme exercise or strict dieting. This period of "control" lasts until the next binge, and then the cycle starts again.

Bulimia becomes an attempt to control 2 very strong impulses—the desire to eat and the desire to be thin.

Effects of bulimia

Bulimia can cause serious damage to the body. For example,

  • Teeth start to decay from contact with stomach acids during vomiting.
  • Weight goes up and down.
  • Menstrual periods become irregular or stop.
  • The face and throat look puffy and swollen.
  • Periods of dizziness and blackouts occur.
  • Dehydration caused by loss of body fluids occurs (treatment in a hospital may be needed).
  • Constant upset stomach, constipation, and sore throat may be present.
  • Damage to vital organs such as the liver and kidneys, heart problems, and death can occur.


The earlier an eating disorder is recognized, the higher the chances are of treatment working. Treatment depends on many things, including the person's willingness to make changes, family support, and the stage of the eating disorder.

Successful treatment of eating disorders involves a team approach. The team includes many health care professionals working together, each treating a certain aspect of the disorder. Treatment should begin with a visit to a pediatrician to see how the eating disorder has affected the body. If the effects are severe, the person may need medical treatment or even need to be hospitalized.

People with bulimia also may need to be hospitalized to treat medical complications, replace needed nutrients in the body, or stop the cycle of bingeing and purging.

Counseling is an important part of treatment. Counseling helps people with eating disorders understand how they use food as a way to deal with problems and feelings. It helps them improve their self-images and develop the confidence to take control of their lives. Family therapy usually is needed to help family members understand the problem, how to be encouraging and supportive, and how to help manage the symptoms. Nutrition counseling with a registered dietitian also is recommended to assist patients and families in returning to healthy eating habits.

Living with an eating disorder is very hard on teens and their families! The wear and tear on the body is tremendous. Without help, a person with an eating disorder can have serious health problems, become very sick, and even die. However, with treatment, a person can get well and go on to lead a healthy life.


Last Updated
Eating Disorders: Anorexia and Bulimia (Copyright © 2005 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.