Specialist Treatment for Eating Disorders at The London Centre

Bulimia Nervosa

What is Bulimia?

Bulimia nervosa is an eating disorder in which people binge eat at least once a week for three months, engage in compensatory behaviours to try and prevent weight gain, and judge themselves based on their weight and/or shape. Bingeing is when one eats a large amount of food (family bag of crisps / large bar of chocolate / loaf of bread) in a short space of time, whilst experiencing a sense of loss of control (feeling unable to stop). The compensation can take a number of forms: purging (vomiting / taking laxatives) or dieting/skipping meals/exercising in an attempt to compensate for the binge. When people use dieting or exercise to compensate for bingeing, it is called “non-purging bulimia nervosa”. Sometimes people experience a sense of loss of control over eating, despite not eating a large amount of food. This may be “subjective binge eating” which can still cause of a lot of distress and requires treatment - although this is more likely to fall under the diagnosis of OSFED (Other Specified Feeding or Eating Disorder).

 

 

what maintains bulimia?

Those struggling with bulimia are often trapped in a highly distressing cycle of unhealthy eating behaviours, with both physiological factors (hunger) and psychological factors (stress, guilt, shame or low mood) feeding into the bingeing. Because of the compensatory behaviours, people with bulimia nervosa are typically in the healthy weight range, although frequent large binges can cause weight gain. However, as with other eating disorders, people with bulimia are likely to experience high levels of body dissatisfaction and often have a strong desire to lose weight. Bulimia nervosa can also be associated with depression, low self-esteem, binge-drinking or self-harm.

 

 

What Treatment is best?

Effective treatment for bulimia nervosa needs to target both the physiological and emotional triggers, as well as the underlying causes. Cognitive Behavioural Therapy is known to be the most effective treatment for bulimia nervosa and so is most commonly recommended by our clinicians. Other helpful treatments could include Family Based Therapy (especially for children or adolescents) or DBT.