Bulimia or bulimia nervosa is an eating disorder characterized by a tendency to regurgitate food that has been eaten. Bulimia is a dangerous and potentially life- threatening mental disorder .

Bulimia is generally experienced by adult women and adolescents who are dissatisfied with their body weight or shape. People with bulimia tend to take unhealthy ways to lose weight, namely by forcing food out, either by vomiting it or using laxatives.

Forced vomiting is the wrong way to lose weight. In order to keep your body weight and shape ideal, adopt a healthy diet, namely by eating balanced nutritious foods, eating small but frequent meals, and limiting snacks or intake high in saturated fat.

Causes of Bulimia

The main cause of bulimia is not known with certainty. However, there are several factors that are thought to trigger a person to develop bulimia, namely:

  • Hereditary factors
    If one of the nuclear family members (parents or siblings) suffers from or has a history of bulimia, then the risk of someone suffering from the same disorder will increase.
  • Emotional and psychological factors The
    risk of bulimia will be higher in someone who suffers from emotional and psychological disorders, such as depression, anxiety disorders, post-traumatic stress disorder ( PTSD ), and obsessive compulsive disorder ( OCD ) .
  • Bulimia's social environment factors
    can arise due to the influence of pressure and criticism from the people around them regarding eating habits, body shape, or weight.
  • Occupational factors
    Some types of work, such as models or athletes, require workers to maintain an ideal body weight. These demands can cause the worker to experience depression or bulimia.

Bulimia Symptoms

The initial symptom of bulimia is the habit of following a strict diet by not eating at all or only consuming certain foods in very small amounts.

This condition continues until the sufferer loses control and eats excessively, even though he is not hungry. This habit arises due to emotional disturbances, such as stress or depression.

This habit will make sufferers feel guilty, regret, and hate themselves. As a result, he attempts to expel all food in unnatural ways, such as using laxatives or forcing himself to vomit.

Other psychological symptoms that can appear in bulimia are:

  • Feeling afraid of fat
  • Having negative perceptions of their own weight and body shape
  • Tend to be aloof and withdraw from the social environment
  • Have low self-confidence and anxiety
  • Do not want to eat in public places or in front of other people

In addition, people with bulimia can also show physical symptoms, in the form of:

  • Body feels weak
  • Sore throat
  • Abdominal pain or flatulence
  • Swelling of the cheeks and jaw
  • Broken teeth and bad breath

When to see a doctor

Do not hesitate to see a child or family member to a psychiatrist if there are signs that are suspected to be symptoms of bulimia. Symptoms of bulimia are often seen by other people, because sufferers tend to be unaware that they are experiencing bulimia symptoms.

If you or a family member has problems with weight, you should consult a nutritionist . The nutritionist will provide information about the right and healthy way to gain ideal body weight . One way is to adopt a healthy diet.

Bulimia Diagnosis

To determine whether a person has bulimia or not, the doctor will ask questions to the patient and the patient's family. A person is said to have bulimia if he vomits his food once a week for at least 3 months.

The doctor will also check whether the patient's teeth are damaged or eroded due to exposure to the acid in the vomit. An eye examination may also be done to find out if there are broken blood vessels in the eye. This is because when vomiting, blood vessels will be tense and at risk of rupture.

In addition to examining the patient's teeth and eyes, the doctor will also examine the patient's hands. People with bulimia tend to have small sores and calluses on the top of the finger joints because they are often used to force themselves to vomit.

Not only a physical examination, blood and urine tests are also carried out to detect other conditions that can cause bulimia, and check the impact of bulimia on the body, such as dehydration or electrolyte disturbances . The doctor also does a heart echo to detect heart problems.

Bulimia Treatment

The main focus of bulimia treatment is treating mental disorders experienced by patients and improving eating patterns. This treatment effort involves the role of various parties, namely the family, psychiatrists, and nutritionists.

There are several treatment methods to treat bulimia, namely:


Psychotherapy or counseling aims to assist patients in rebuilding positive attitudes and thoughts about food and eating patterns. There are two types of psychotherapy that can be done, namely:

  • Cognitive behavioral
    therapy Cognitive behavioral therapy aims to help restore the patient's eating patterns, and change unhealthy behaviors to healthy ones, and negative mindsets to be positive.
  • Interpersonal
    therapy This therapy aims to help patients interact with other people, as well as improve the patient's ability to communicate and solve problems.


To relieve the symptoms experienced by the patient, the doctor will give fluoxetine . This drug is a type of antidepressant drug most often used to treat bulimia, but is not intended for patients under 18 years of age.

Fluoxetine can also relieve depression and anxiety disorders experienced by patients. During treatment with antidepressants, the doctor will periodically monitor the progress of the patient's condition and body reaction to the drug.

Nutrition counseling

Nutritional counseling aims to change eating patterns and mindset towards food, increasing nutrient intake in the body, and slowly increasing body weight.

If the symptoms of bulimia get worse or are accompanied by serious complications, then intensive treatment at the hospital is necessary. This step needs to be done to prevent fatal consequences from complications, such as suicide.

Bulimia treatment takes a long time. Support from friends, family and closest relatives is very important in the patient's healing process.

Bulimic Complications

Bulimia can cause malnutrition which can damage organ systems in the body. In addition, bulimia can cause the sufferer to become dehydrated due to too much fluid that comes out through vomiting.

Bulimia can also trigger serious complications and be fatal if not treated immediately. Some of the complications that can arise are:

  • Heart disease , such as arrhythmia or heart failure
  • Kidney failure
  • Mallory-Weiss syndrome , which is tearing of the inner wall of the esophagus due to too much vomiting
  • Depression or generalized anxiety disorder
  • Drug or alcohol abuse
  • There is an urge to commit suicide

People with bulimia who are pregnant are also at high risk of complications during pregnancy, such as miscarriage, premature birth , birth defects in the fetus, and postpartum depression .

Bulimia Prevention

Steps to prevent bulimia are not known with certainty until now. However, the role of family and friends can help steer the person with bulimia toward healthier behaviors. The way to do this is:

  • Increase self-confidence by motivating each other to always live a healthy life every day
  • Avoiding conversations that are related to the physical or that affect the patient's psychology, for example, his body is too thin or fat, and his face is not beautiful
  • Invite family members to always eat together
  • Prohibit diet in unhealthy ways, such as using laxatives or forcing oneself to vomit
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