Bulimia: Symptoms, Types and Treatments

NOTE: Many people with bulimia also suffer from sleep problems. The best way to treat the sleep problems is to treat the bulimia. Talk to your doctor in the meantime about treating sleep problems caused by the eating disorder as you work on managing your bulimia.

When you discover that someone you know has bulimia, it can be hard to believe. Often, bulimics seem to be the envy of everyone they know. That is one reason why bulimia is so hard to recognize and treat in others.

Dangerous Symptoms

Although bulimia is often considered a teenage girl's affliction, baby boomers, young boys and grown men turn to bulimia to help them with their self-image. Symptoms of bulimia in either sex include:

·         Mood swings

·         Problems with teeth, cheek glands, and/or heartburn (see image)

·         Preoccupation with food, even if you never see them eat

·         Fears of getting fat

·         Use of the bathroom soon after meals

·         Irregular to no periods in women.

Types of Bulimia

We tend to think of bulimia as someone stuffing themselves with a refrigerator full of food and then throwing it all back up. There are actually different types of bulimia eating disorders which all showcase a person's self-hatred by their unhealthy relationship with food. Here are the three types of bulimia:

·         Anorexia bulimia: This is when someone alternates between anorexia (not eating) and bulimia.

·         Bulimia nervosa: This is the "usual", where the victim is obsessed about their looks and usually does not eat in public. They then binge eat and purge through vomiting or taking a lot of laxatives. This can go on for years until physical affects are eventually seen.

·         Pro Bulimia, Pro Ana or Pro-Mia: This is when a bulimic is in a state of denial about the damage they are doing to their health. They refuse to see bulimia as a problem, but instead call it a "lifestyle choice." As a consequence, they refuse treatment and resent being told they have a problem which could eventually kill them.

Treatment Options

You don't really need a doctor or therapist to diagnose bulimia (especially if you catch the bulimic in the acts of binging and purging), but a professional diagnosis can greatly help the patient face the problem. Any doctor or therapist should be able to diagnose bulimia.


There are many treatment options available, especially if there are any other issues like addiction or depression in addition to bulimia. The patient might not need to do all of them or do a combination in order to feel better about themselves and about food. Bulimia treatments include:

·         Therapy: This could be for the patient or for the whole family as ongoing treatment or an intense rehabilitation retreat.

·         Medication: Bulimia brings on secondary symptoms that need medical attention, such as loss of menstruation or getting tooth damage. The triyclic antidepressant Elavil (amitripyline) is often prescribed for bulimia. Other antidepressants are used when a patient cannot take amitripyline. Another promising drug is Topamax (topiramate.)

·         Support groups: This is essential for ongoing treatment, just to let the patient know they are not alone and don't have to fight alone. Social interaction is also helpful in breaking self-destructive thoughts and to think about something else other than when to binge and purge. You can find anorexia and bulimia support groups online as well as through your doctor or your Yellow Pages.

·         Hospitalization: This is for emergencies, such as collapse or a suicide attempt. Although it might seem drastic, it may serve as a needed wake-up call.

References:

eMedicine. “Bulimia.” Rebecca Barth, MD, et al. Oct. 8, 2010. 

Mayo Clinic. “Bulimia Nervosa.” 

National Alliance on Mental Illness. “Eating Disorders.” 

Image of teeth damaged from bulimia nervosa By Jeffrey Dorfman for Wikimedia Commons