What is bulimia?

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What is bulimia?

Bulimia nervosa (BN) is an eating disorder that involves binge eating and purging. It effects approximately 1% of young women and 0.1% of young men and co-morbid disorders, such as mood disorders, anxiety and substance abuse are common.

So how do you get diagnosed with bulimia?

To be diagnosed with bulimia nervosa one would fit the following criteria:

Recurrent episodes of binge eating, which is eating within a distinct period of time, typically 2 hours, an amount of food that is larger than most people would eat under similar circumstances, and feeling out of control over the eating during that time.

To prevent weight gain there are recurrent use of inappropriate compensatory measures, such as self-induced vomiting; misuse of laxatives; diuretics, or other medications; fasting; or excessive exercise.

The binge eating and inappropriate compensatory measures take place, on average, 1x/week for 3 months and self-evaluation is unduly influenced by body weight and size.

What is the treatment?

Treatment for all eating disorders can take place in various levels of care: outpatient therapy, inpatient, residential, partial hospitalization, and intensive outpatient. The level of severity determines which level of care a person will necessitate.

Cognitive behavioral therapy and dialectical behavior therapy are the most common evidence based treatments for BN. A major part of treatment is learning to sit with emotions, even the uncomfortable ones, without using binging or purging to numb out. Becoming adept at riding out uncomfortable emotions, or being able to change the ones that are changeable, can lead to significant breakthroughs., Bulimia is difficult to treat and approximately 30-50% of people will relapse.

The effects of purging

Bulimia can be very dangerous. Frequent binge/purge episodes put your body through the ringer and can lead to arrhythmia, heart palpitations, heart attacks, or death. Repeated purging can lead to electrolyte imbalances. The two most common are hypokalemia and metabolic alkalosis. Hypokalemia is caused by low potassium levels and can be life-threatening. Metabolic alkalosis is harder to explain, but basically your blood is made up of acids and bases and this type of alkalosis is caused when either there is a significant increase in base or decrease in acid. If not treated metabolic alkalosis can lead to shock and coma.

If you are in the Vancouver, WA or Portland, OR areas and would like to talk to a counselor specializing in eating disorders about bulimia, please call me at 360-284-7008 or click the button below to fill out the online form.

Information retrieved from the National Eating Disorder Association (NEDA), 2016), the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, 2013, and HealthLine.


Tamara Werner

Tamara Werner is a counselor, author, speaker, and activist. Her private practice, Get Centered Counseling in Vancouver WA, helps women with food and body issues learn to love themselves, their body, their life, and their relationships. Her life’s work is steeped in personal experience, having fifteen years in recovery for anorexia, in addition to being a breast cancer survivor. An up and coming force in the counseling community, Tamara has been published in a textbook called Treatment Strategies for Substance and Process Addictions, and has sat on a panel at the American Counseling Association Conference, where she spoke to her peers on strategies and tools to use with clients struggling with eating disorders. Having a deep, personal understanding of what it takes to recover from this condition, she seeks to be an example to those she treats, to let them know that recovery is possible.