Eating Disorders: Bulimia

by Nelly Uhlenkott on April 16, 2011

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This is part 3 of a 4 part series about eating disorders.

What is bulimia?

Bulimia involves going on massive eating binges and compensating for the binges to avoid gaining weight. People with bulimia feel completely out of control during their binges and feel ashamed of their eating behaviour and lack of self-discipline around food.

There are two types of bulimia: purging and non-purging. People with the purging type “get rid” of (purge) the food they’ve eaten by forcing themselves to vomit or by using things like laxatives, diuretics, or enemas. In the non-purging type of bulimia, people fast or exercise excessively to make up for their binges. Most people with bulimia have the purging type.

People with bulimia usually think their success or popularity depends on being a certain weight and shape and struggle to achieve their image of the ideal body. Many people with bulimia suffered from anorexia first.

What happens when you have bulimia?

People with bulimia usually stay within 10% of their healthy weight, making it harder to recognise than anorexia at first glance. It’s common for people with bulimia to hide their disorder for 8-10 years before they tell others about their struggle or seek out help. The binging and compensating behaviours take a serious toll both emotionally and physically, especially when it goes on for so long.

Bulimia and anxiety disorders often go hand-in-hand. About 80% of people with bulimia have had an anxiety disorder at some point in their lives. Depression is also common, affecting more than half of people with bulimia. Many bulimia sufferers have attempted suicide one or more times. Substance abuse issues are also common among people with bulimia.

People with bulimia who vomit frequently develop several other medical issues. Their faces may start to look swollen, and their stomach acid quickly wears down their tooth enamel, leading to major dental problems. Bodily fluids known as electrolytes also become imbalanced by repeated vomiting. That delicate balance of electrolytes is crucial to good health. If an electrolyte imbalance goes untreated, it can lead to life-threatening medical problems, including irregular or disrupted heartbeats, seizures, and kidney failure. Luckily, as soon as someone with bulimia returns to healthy eating habits their electrolyte balance returns to normal. For people with bulimia who frequently put their fingers down their throats to start vomiting, they can also develop hard callouses on the backs of their fingers where their fingers have scraped against their teeth.

People with bulimia who use laxatives to compensate for the food they’ve eaten can develop severe constipation or even permanent colon damage.

How bulimia is diagnosed?

Are these signs true for you or someone you care about?

  1. Recurring episodes of binge eating. Episodes of binge eating include two things:
  2. Eating a lot more food in a certain period of time than most people would in the same situation.
  3. Feeling like you’ve lost control over eating during the episode (feeling like you can’t stop eating, or you can’t control what or how much you’re eating)
  4. Repeatedly using inappropriate behaviour to make up for the food you’ve eaten in order to keep yourself from gaining weight (vomiting; using laxatives, diuretics, or other medications; fasting; or exercising excessively).
  5. Binge eating and the behaviours to make up for it both happen at least twice a week (on average) for three months or more.
  6. You self-evaluation is very influenced by your body shape and weight.
  7. The behaviours don’t happen only during episodes of anorexia.


People with bulimia tend to seek out treatment on their own much more than people with anorexia. The great news is that treatment for bulimia can make a huge difference to people’s lives. 70% of people who have had treatment for bulimia say that they’ve improved significantly.

As with other eating disorders, recovery from bulimia usually includes both medical treatment and counselling support. Recovery is difficult. Having the support of a caring counsellor can provide a lot of help with the emotional and psychological hurdles, including the depression and anxiety that often accompanies bulimia.

The team at Paul the Counsellor works sensitively and supportively with people who have eating disorders to aid them in their recovery. If  you think you have an eating disorder and live in Melbourne and would like counselling please contact us for assistance.

0458 090 687
253 Lonsdale St, Melbourne VIC 3000

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