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Updated on December 3, 2015

Bulimia is an eating disorder characterized by recurrent binge eating, followed by compensatory behaviours, referred to as "purging".

The word bulimia literally means “ox hunger”.  The word describes the bulimic person who feels a voracious appetite but who after feeding herself excessively does whatever she needs to get rid of the ingested food and with it, the feeling of guilt, fear of becoming fat and physical pain due to over eating.

Eating and Vomiting in history

Eating and vomiting are not new behaviours in our society.  They existed together since the antiquity.  It is recorded that during the time of the great Roman Emperors vomiting was an accepted behaviour during their parties and orgies.  It was such a common behaviour that there was an area called the “vomitorium”.  This was an area where people, usually guests to parties and orgies could go and get rid of the ingested food so they could go back to the party and continue to gorge themselves in all sorts of excesses.

Another culture who used purging as an accepted behaviour was the Egyptians who every month had a few days of fasting in order to keep healthy.

It is only during the XIX and the XX century that the crisis of bulimia and vomiting were labelled as hysteric crisis or psychological disorders. Only in the 1970s was Bulimia acknowledged as a real psychological problem, a problem within the eating disorders like anorexia.

Diagnosing Bulimia

Bulimia is very difficult to detect because sufferers are usually of normal weight, sometimes they are even overweight. The American Psychological Association uses the following criteria to diagnose bulimia.

  • Recurrent episodes of binge eating. That is, a lack of control over eating in a fixed period of time. This ends with the person eating more than what she or any other person would usually eat in a similar period of time.


  • A recurrent inappropriate compensatory behaviour to prevent weight gain, such as: self-induced vomiting; misuse of laxatives, diuretics, or other medications; also fasting and excessive exercise.


  • The bulimic episodes take place at least twice a week and over 3 months. People who have bulimic behaviours less than twice a week are not medically considered bulimics, but they still need help.


  • Self esteem is excessively influenced by the person’s weight.


Being diagnosed with bulimia does not explain the why or how a person became bulimic. Each case is individual. Treatment should take into account personal circumstances.

Types of Bulimia

There are basically two sub-types of Bulimia:


  • Purging: when the person self induces vomiting or any other means to evacuate the food ingested quickly.


  • Non-purging: when the person uses excessive exercise as a way of burning all the extra calories ingested.


Some people have both subtypes or alternate between the two behaviours. The people who purge appear more disturbed than those who don’t, they have a tendency to be more depressed and anxious and also to be unhappier with the way they look.


When does it start?

Generally the first bulimic behaviours take place during adolescence.

Effects Of Bulimia

Hair loss
Hair loss
severe caries
severe caries


Feeling up the stomach excessively and repetitive purging causes among many others:

  • Chronic gastric reflux after eating, constipation, diarrhoea, stomach cramps and flatulence among many other digestive troubles.

  • Low blood pressure, vertigo and a slow cardiac rhythm.

  • Anaemia

  • Dehydration caused by frequent vomiting and abuse of laxatives and diuretics.  This in turn causes a lack of sodium in the body leading to kidney failure. 

  • Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death.  Frequent vomiting disturbs the metabolism of potassium, an electrolyte that is responsible for muscular contraction.  The heart is a muscle, it if does not work properly because there is an imbalance of potassium in the body, the person risks death.  An imbalance of potassium also alters the kidneys and after years of vomiting and consuming laxatives, kidney failure can appear. 

  • Tearing or rupture of the oesophagus caused by repeated forced vomiting.

  • Oral trauma, in which repetitive insertion of fingers or other objects in the mouth to induce vomit, causes lacerations to the lining of the mouth or throat.

  • Pancreatitis
  • Peptic ulcers
  • Severe caries ('cavities') as the stomach acid lowers the pH of the oral environment making the teeth far more susceptible to demineralization.

  • Osteoporosis can settle after about two years of bulimic behaviour.  It can be reversible during adolescence but not during adulthood.

  • Loss of fertility.

  • Loss of hair and dry skin.

  • Anxiety, insomnia and depression.

What Causes Bulimia

Bulimia is related to deep psychological issues and feelings of lack of control over what one eats, when and how. Sufferers often use the destructive eating pattern to feel in control over their lives. After a while, bulimics find that they no longer have control over their binging and purging. The binging becomes an addiction that seems impossible to break.

Every one of two bulimics also suffers from depression and half of the bulimics suffer from anxiety. It is not rare either for bulimics to abuse alcohol and other drugs.


Recovery is very hard, and often, in the early stages of recovery, the patient will gain weight as they rehydrate and obtain electrolytes that they have lost during the purging process.

Bulimia Risk Groups

There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, modelling, dance, cheerleading, running, horse riding, acting, and figure skating.

When can we say that a person has bad eating habits and when can we say that the person is bulimic?

Our society encourages slimness, therefore it has become common for young women to spend hours exercising and dieting to achieve the perfect body. How can we distinguish the perturbed eating behaviour? Usually, there is something to worry about if:

1. The person eats with anxiety or guilt. Eating is not enjoyable but a source of shame and anxiety.

2. Eating causes ill sensations. The person feels pain, bloated or nauseous after eating.

3. The person only eats a very strict or very rigid diet. Her eating is very stereotyped.

4. Eating is very irregular; the person does not follow a schema of three meals a day. The person prefers to do something else to avoid eating and losing control over the amount eaten.

5. The person goes from very restrictive eating to extreme over eating. Feeding behaviour becomes unstable.

6. Feeding habits reflect the emotional state of the person, like someone eating because she is sad, lonely or anxious.

7. Feeding is modified by weight. The person weights herself and plans her eating for the day according to her weight and her objectives.

8. Inadequate physical activity. That is, exercising excessively with the whole objective of burning calories. The person isolates herself to dedicate all her free time to exercise.


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    • Sun-Girl profile image

      Sun-Girl 6 years ago from Nigeria

      Wonderful lecture you shared in here which i enjoyed and learnt a lot from.

    • susanmarion profile image

      susanmarion 7 years ago from Bunnell

      Great information. I just wrote a hub about my past experience with this problem. It has been 22 years since I had that problem. It was a red flag. I was pretty messed up in my thinking. It has been 22 years of self evaluation and well worth the trip. There are way too many girls and women with this problem when it can be stopped.

    • febriedethan profile image

      febriedethan 8 years ago from Indonesia

      I think it will be great if people with Bulimia may share their problem each other under a group like care group. Of course there will be a psychiatrist to control the group. I think what a bulimic person needs is our understanding and caring. Very informative and great hub Princessa..:)

    • Princessa profile image

      Wendy Iturrizaga 8 years ago from France

      prasetio30 : I don't agree, I don't think that bulimia affects only the rich and famous. Bulimia can affect anyone, regardless of their age, sex and socio-economical status.

    • prasetio30 profile image

      prasetio30 8 years ago from malang-indonesia

      I think bulimia could happen when someone want to diet. but to over diet with bad effect for the body.Bad habbit, we should concern about this in our environment. we still remember about Princess Diana case. mabe it happen in rich or famous people. do you agree with me?

    • nancydodds1 profile image

      nancydodds1 9 years ago from Houston, Texas

      Nice hub! Very interesting.

    • Princessa profile image

      Wendy Iturrizaga 9 years ago from France

      BkCreative :Bulimia comes from a Greek word, "bous" meaning ox + "limos" meaning hunger. Most girls do not realize how dangerous it is until they start lossing their hair, their periods or their teeth!

      Patty: elementary school children abusing prescription diet pills? That is absolutely shocking! I see in here girls as young as 7 are already worrying about their diets and exercising to avoid putting on weight, but what you say is amazing!

      Thanks for sharing that information.

      Denise: I have not seen that film, but you made me curious now. I'll check it out.

      pariprashneno : Thanks for the comment. The Holiday season is a very difficult time for people with eating disorders. But it is also the best time for friends and family to spot if someone is having trouble.

    • pariprashneno profile image

      pariprashneno 9 years ago from Kolkata, India

      A good reading with the daily life necessary info - simply sweet and spontaneous! Another gems from Princessa,

    • denise mohan profile image

      denise mohan 9 years ago from California

      Princessa-been reading your material and I am engorged with information, sweet. Thnx for sharing so much of your knowledge with us. The vomitorium reminded me of the masabatorium. Remember "Running with Scisors"!

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      I have heard about vomitoriums as well and it makes me cringe. Our city has a history of elementary school children abusing prescription diet pills as far back as 1960 in an attempt to be super slim.

      This is all horrible for anyone that suffers from the disorder and for their families and friends. In Dayton OH, an eating disorders clinic opened in the 1970s or early 80s and seems to have helped a number of people.

    • BkCreative profile image

      BkCreative 9 years ago from Brooklyn, New York City

      Bulimia means 'ox hunger' - I had no idea. But I do know it's a common problem here in the US. In my youth I knew young women to do this but I think they got it under control eventually as the side effects were so evident as you listed, the hair falling out, the teeth.

      I do remember reading about 'vomitoriums' - excess at its best - or worst.

      Thanks for this informative, thought-provoking (and shocking) article.