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is an eating disorder. You eat a large amount of food in a short period of time. This is called binging. You then vomit, use laxatives, starve, or exercise for hours to prevent weight gain. This is called purging. You do this at least 1 time each week for several months.
Common signs and symptoms:
- Not being able to stop eating, usually secretly or when you are alone
- Worrying that you are fat even if your weight is healthy or too low, or your weight goes up and down often
- Often being bloated and having constipation or diarrhea
- A sore throat and tooth decay caused by vomiting
- A puffy face and throat, dehydration, or thinning hair
- Calluses or cuts on your knuckles if you use your hand to make yourself vomit
- In girls, monthly periods that are irregular or stop completely
- Feeling cold all the time, or tired, weak, dizzy, or lightheaded
- Being moody and depressed, believing self-worth is tied to weight, or talking about food and weight all the time
Call 911 for any of the following:
- You want to harm or kill yourself.
- You have pain when you swallow, or severe pain in your chest or abdomen.
- Your heart is beating very fast or fluttering, or you feel dizzy or faint.
Seek care immediately if:
- Your muscles feel weak, and you have pain and stiffness.
- You cannot stop vomiting.
- You vomit blood or see blood in your bowel movements.
Contact your healthcare provider if:
- You are constipated.
- You have tingling in your hands or feet.
- You have pain in your teeth, mouth, or gums.
- You have new pain in your abdomen.
- Your monthly period is very light or has stopped completely.
- You are planning to get pregnant and need to develop a safe eating plan.
- You have questions or concerns about your condition or care.
Follow up with your healthcare provider as directed:
You may need blood tests to make sure treatment is working. Write down your questions so you remember to ask them during your visits.
You may need any of the following:
- Antidepressants called SSRIs are usually used to treat bulimia. You may need this medicine even if you are not depressed. An SSRI gives your brain more of a chemical called serotonin. Serotonin may help you focus on other things and think less about weight and food.
- Anticonvulsants may help control your mood swings and decrease aggression or irritability.
- Antinausea medicine may be given to calm your stomach and prevent vomiting.
- Vitamin or mineral supplements may be needed if your nutrient levels are low because of bulimia.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Manage bulimia nervosa:
- Go to counseling sessions. Counseling is an important part of treatment for bulimia. You may work with healthcare providers alone or in a group. Group counseling is a way for to talk with others who have bulimia. Counseling may center on helping you replace negative thoughts with positive thoughts. Family sessions can help everyone in the family understand bulimia and what to do to help you.
- Work with your dietitian. Others in your family may also meet with the dietitian. Together you will develop a healthy meal plan. It is important to eat 3 to 5 structured meals a day to reduce the urge to binge. You might need to learn how to prepare healthy food. You might also need to relearn what it feels like to be hungry and full. You may be asked to keep a food diary and bring it to future visits.
- Care for your mouth. Brush your teeth or rinse with fluoride mouthwash or baking soda after vomiting. This will help prevent tooth damage. Use toothpaste made for sensitive teeth if your tooth enamel has been damaged by vomiting. Suck on tart candies to help with swollen glands in your mouth.
- Manage stress. Stress may increase your risk for a relapse. Take a break and rest for 30 minutes every day. Try different ways to reduce stress, such as yoga, meditation, journaling, or spiritual development.
- Be patient. Recovery from bulimia is a process that takes time. You may have a binging and purging episode after a long period of healthy eating. This is common. Work with family members and healthcare providers to get back on track with healthy eating and healthy exercise. Try not to be angry with yourself for the episode. It might help to talk about your feelings with someone you trust.
- Focus on a healthy self-esteem. Think about everything you like about yourself. For example, you may be a talented artist, or you may write well. Focus on those skills or talents instead of on appearance. Ask others not to comment on your weight or shape. Your healthcare provider can tell you healthy weight ranges for your age and height. It may take time before you are comfortable knowing your weight or seeing your weight as healthy. Remember your goals to build a healthy self-esteem. Be patient with yourself as you change your thinking.
- Have regular family meals. This can help change your thinking by preventing you from eating alone. Focus on spending time with others. Do not focus on your food choices. For example, do not worry that you should take a larger portion or another helping. It may take time before you are ready to eat like others at the table.
- Spend time doing things you enjoy. Make family time about being together, not about meals. Try to go to places other than restaurants, movies, and other places that feature food.
For support and more information:
- National Institute of Mental Health (NIMH), Public Information & Communication Branch
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda , MD 20892-9663
Phone: 1- 301 - 443-4513
Phone: 1- 866 - 615-6464
Web Address: http://www.nimh.nih.gov/
- The National Women's Health Information Center
8270 Willow Oaks Corporate Drive
Fairfax , VA 22031
Phone: 1- 800 - 994-9662
Web Address: http://www.womenshealth.gov
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.