Understanding Bulimia

Many people go through periods where they eat more or less than usual. If these episodes are extreme, distressing, or happen often, they may be a sign of bulimia nervosa. Bulimia is a type of eating disorder where you have episodes of binge-eating (eating large amounts of food in an uncontrolled way) and compensation (doing things to prevent weight gain such as vomiting or using laxatives). At some point in their lives, about 3 in every 100 women and 1 in every 100 men develop bulimia (van Eeden et al., 2021). Fortunately, psychological treatments like cognitive behavioral therapy (CBT) are very effective in overcoming bulimia.

This guide will help you to understand:

• What bulimia is
• Why bulimia might not get better by itself
• Treatments for bulimia

Our ‘Understanding…’ series is designed to support your clients:

• Scaffold knowledge. The guides are perfect during early stages of therapy to help your clients understand how their symptoms fit together and make sense.
• Reassure and encourage optimism. Many clients find it hugely reassuring to know there is a name for what they are experiencing, and that there are evidence-based psychological models and treatments specifically designed to help.
• De-mystify the therapy process. To increase your client’s knowledge of the therapy process and the ingredients that it is likely to involve. If you can help your clients to understand why an intervention is important (think exposure!) it can help encourage them to engage.
• Signposting. If you’re just seeing a client briefly for assessment, or you have a curious client who wants to know more, these resources can be a helpful part of guiding them to the right service.
• Waiting time not

• van Eeden, A. E., van Hoeken, D., & Hoek, H. W. (2021). Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 34, 515-524.
• Waller, G., & Sheffield, A. (2008). Causes of bulimic disorders. Psychiatry, 7, 152-155.
• Goncalves, S., Machado, B. C., Martins, C., Hoek, H. W., & Machado, P. P. (2016). Retrospective correlates for bulimia nervosa: A matched case-control study. European Eating Disorders Review, 24, 197-205.
• Slade, E., Keeney, E., Mavranezouli, I., Dias, S., Fou, L., Stockton, S., Saxon, L., Waller, G., Turner, H., Serpell, L., Fairburn, C. G., & Kendall, T. (2018). Treatments for bulimia nervosa: A network meta-analysis. Psychological Medicine, 48, 2629-2636.
• Bo-Linn, G. W., Santa Ana, C. A., Morawski, S. G., & Fordtran, J. S. (1983). Purging and calorie absorption in bulimic patients and normal women. Annals of Internal Medicine, 99, 14-17.
• Hay, P. (2013). A systematic review of evidence for