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Bulimia nervosa is a serious eating disorder that affects many people throughout the UK. It’s usually characterised by episodes of binge eating, followed by purging behaviours.
Bulimia is a fairly common eating disorder in the UK. It’s estimated that around 1 in 50 people will experience it at some point in their lives. Bulimia tends to affect more women than men and often first develops during adolescence or early adulthood. However, it’s important to understand that it’s possible for this eating disorder to affect anyone, across different genders and age groups.
These eating disorder statistics offer some insight into the widespread impact of bulimia on people and their loved ones. Here, we’ll explore different bulimia treatment options available in the UK. These include evidence-based therapies, such as cognitive behavioural therapy (CBT) for bulimia, as well as the vital role of support groups in helping people to recover.
Symptoms of bulimia
The most common symptoms of bulimia nervosa are bingeing and purging. However, there are also a number of other symptoms to look out for.
Binge-purge cycles
Someone with bulimia will often go to great lengths to try to hide their bingeing and purging behaviours. Bingeing and purging can be defined as:
- Binge eating – this is when you eat excessively, even if you’re not hungry. Typically, during a binge eating episode, you might consume 3 or 4 times more food than you normally would. People tend to binge on foods that are considered to be unhealthy. This might include crisps, chocolate or other types of ‘junk food’. This behaviour is typically marked by feelings of guilt, shame or distress afterwards
- Purging – after binge eating, bulimia sufferers will often try to remove the calories they’ve consumed in order to try and maintain their body weight or shape. Purging behaviours include making yourself sick, exercising excessively or abusing laxatives, diuretics or enemas
The binge-purge cycles associated with bulimia can be triggered by hunger, stress, anxiety, tiredness, loneliness, or at times, for no reason at all.
Worryingly, people with bulimia may appear to have a stable or ‘normal’ weight, because the binge-purge cycles can balance this out. While you might have slight weight fluctuations, these don’t tend to be as extreme as in other eating disorders, such as anorexia or binge eating disorder (BED). Therefore, people with bulimia can appear to be a healthy weight, which can make this eating disorder very difficult to spot.
- Obsession with body image – you might have a preoccupation with your body weight and shape, leading to a distorted self-image. This is why you use purging behaviours to try and control your weight
- Obsession with food – you might find that you’re obsessed with food, dieting, calorie counting and meal planning. You may feel as though this is all you ever think about and that your life revolves around what you eat
- Extreme tastes – you might be very ‘all or nothing’ when it comes to eating, not just in terms of the amount you eat, but also in terms of the type of food you might eat. For example, you might only binge on food that’s either extra spicy or completely mild. Or if you’re eating steak, you might only settle for a prime fillet steak and won’t touch anything else. If these extremities and thresholds aren’t met, you might not consider it to be worth the binge cost
- Low self-esteem – feelings of low self-worth and being extremely self-critical are common in people with bulimia
- Mood swings – frequent mood swings, including feelings of depression, anxiety and irritability may be present
- Perfectionism – many people with bulimia are perfectionists and set unrealistically high standards for themselves. This is especially in relation to their appearance and eating patterns
- Social withdrawal – bulimia can lead you to isolate yourself from others and withdraw from social activities. This may be because you feel ashamed or anxious about your eating habits, and don’t want other people to find out
- Secretive behaviour – due to the shame and guilt associated with bulimia, you may engage in secretive behaviours to hide your condition. This might include hiding food and only purging when you’re alone. You might also plan time out for bingeing and purging, when you know you won’t be disturbed
- Denial – you might deny or downplay your eating disorder, even to yourself. This can make it challenging for you to reach out for the help you need
- Dental problems – frequent vomiting can lead to dental issues, including tooth decay, erosion of tooth enamel and gum problems
- Gastrointestinal issues – purging behaviours can also result in gastrointestinal problems, such as acid reflux, stomach ulcers and irritation of the oesophagus
- Dehydration – repeated purging through vomiting or using laxatives can lead to dehydration, which can have various health consequences
- Electrolyte imbalance – frequent laxative abuse and vomiting can also disrupt electrolyte balance in your body. This could potentially lead to heart irregularities and other serious complications
- Fatigue – the physical strain of bulimia, coupled with nutritional deficiencies, can lead to extreme fatigue and weakness
- Swollen salivary glands – frequent vomiting can cause your salivary glands to become swollen. This can lead to discomfort and puffiness in your cheeks
- Skin and hair problems – as a result of nutritional deficiencies, your skin may appear dry and develop a yellowish tint. Your hair and nails may become fragile and brittle
The symptoms of bulimia can significantly impact on your wellbeing and quality of life, both physically and psychologically. That’s why it’s essential to get professional help, in order to address these challenges and work towards recovery.
Bulimia treatment at Priory
Bulimia nervosa is a complex condition that needs tailored treatment approaches. There are a number of eating disorder treatment options available at Priory, and the choice of which is the most appropriate for you often depends on how severe your bulimia is.
Outpatient and inpatient treatment for bulimia
Outpatient and inpatient services are two primary avenues for treatment. Outpatient treatment allows you to receive care while continuing to live at home, maintaining your daily routines. This might be appropriate if you don’t need round-the-clock monitoring for your eating disorder.
In contrast, inpatient treatment involves more intensive care within a specialised facility. This could include a Priory hospital or our specialist eating disorder treatment centre, Life Works. This option is more appropriate for people who need 24-hour support to help them manage an eating disorder.
Therapy types for bulimia
Another approach to eating disorder treatment is therapy. Examples of this include:
- Cognitive behavioural therapy for bulimia nervosa (CBT-BN) – CBT-BN is a highly effective therapy for bulimia. It focuses on identifying and challenging distorted behaviours, thoughts and feelings related to food, body image and self-worth. CBT-BN also helps you to develop healthier coping strategies and break the binge-purge cycle
- Interpersonal therapy (IPT) – IPT address the interpersonal and emotional aspects of bulimia. It can help you to improve your relationships, communication skills and emotional regulation, which can help you to reduce your binge-purge behaviours
Support groups for bulimia
Support groups play a crucial role in bulimia treatment. These groups provide a safe and empathic space where you can share your experiences, challenges and successes. Connecting with others who understand the journey of recovery can also offer emotional support and motivation.
Support groups can be in-person or online, making them accessible to a wide range of people seeking help for bulimia. The eating disorder charity, Beat, offers a number of eating disorder support groups, including Dove, Kingfisher and The Nest.
Bulimia treatment FAQs
What causes bulimia?
Research shows there’s a number of factors that might cause someone to develop bulimia. These include genetics, gender, personality, general mental health and social and environmental influences.
Genetics
If you have a close relative such as a sibling or a parent who has an eating disorder, this makes it more likely that you’ll go on to develop an one yourself. This may be because of inheriting certain genes, and could also be because you may have been exposed to unhealthy eating habits from a young age, which have made these seem normal to you. Also, your family’s general attitude towards food could also make you more likely to suffer from an eating disorder such as bulimia.
Gender
Research shows that women and girls between the ages of 15 and 25 are more likely to develop bulimia than men and boys. However, it’s important to understand that eating disorders can affect anyone and are becoming more and more frequent in males. It’s estimated there are around 1.6 million people with an eating disorder in the UK, and approximately 25% of these are male.
Personality
Certain personality traits may also play a role in whether someone goes on to develop bulimia. You may be more likely to develop destructive eating behaviours if you:
- Have low self-esteem
- Have a fear of failure
- Have an eagerness to please other people
- Are a ‘perfectionist’
Mental health
If you already struggle with a mental health condition, this might make you more vulnerable to developing bulimia. Underlying mental health problems may include:
Society
In today’s society, we’re all faced with lots of different social pressures which can lead people to develop an unhealthy relationship with food. These social factors may include having hobbies or jobs where being thin is seen as the ideal (such as modelling, dancing or athletics), and pressure from the media to be thin (including celebrity airbrushing and pro-bulimia/pro-‘mia’ websites).
Environment
There are also a whole range of environmental influences that may lead to someone developing bulimia. These may include receiving criticism for your weight or eating habits, having a stressful school or work life, or experiencing something traumatic such as bereavement, or physical, sexual or emotional abuse.
Are young people treated for bulimia at Priory?
At Priory, we don’t just treat adults with bulimia; we can also provide expert, private bulimia treatment for patients who are under the age of 18 years.
More information on the eating disorder support that we offer for young people can be found on our private CAMHS page.
What if I'm in crisis?
Priory’s customer service team is available 24 hours a day, 7 days a week to ensure that people in crisis gain access to the best possible support, as quickly as possible.
