Bulimia Nervosa is characterised by recurrent binge‐eating episodes followed by compensatory behaviours such as self‐induced vomiting, misuse of laxatives, diuretics, fasting and over exercising.
A bingeing episode involves consuming a large amount of food in a short period of time, whilst also experiencing a loss of personal control and intense feelings of guilt.

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Bulimia Nervosa

Provided by The Butterfly Foundation

We have partnered with The Butterfly Foundation to bring you the best factsheet information we can on this topic. The Butterfly Foundation provides support for Australians for suffer from eating disorders and negative body issues and their carers.

Bulimia Nervosa is characterised by recurrent binge‐eating episodes followed by compensatory behaviours such as self‐induced vomiting, misuse of laxatives, diuretics, fasting and over exercising. A bingeing episode involves consuming a large amount of food in a short period of time, whilst also experiencing a loss of personal control and intense feelings of guilt.


Bulimia Nervosa is characterised by the following symptoms:

  • Eating in a discrete period of time an amount of food that is larger than most people would eat during a similar period of time and under similar circumstances
  • A sense of lack of control over eating during the episode ie. A feeling of not being able to stop eating or control what or how much is being eaten
  • Recurrent inappropriate compensator behavior in order to prevent weight gain, such as self‐induced vomiting, misuse of laxatives, fasting, or excessive exercise
  • The binge eating and inappropriate compensatory behaviors occur on average at least twice a week for 3 months
  • The person’s evaluation of themselves is unduly influenced by their body shape and weight.

There are two sub types of Bulimia:

Purging Type

The person regularly engages in self‐induced vomiting or other forms of purging

Nonpurging Type

The person uses other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self‐induced vomiting or the misuse of laxatives, diuretics, or enemas.

People with bulimia nervosa are typically within a healthy weight range, or are slightly under or overweight. This makes it impossible to tell if someone has bulimia nervosa simply by looking at them.

Physical Warning Signs

  • Broadening of the jaw line due to swollen salivary glands
  • Discoloration of teeth Calluses on the back of the hands and knuckles from self induced vomiting
  • Frequent weight changes

Bulimia affects 5 in 100 people in
Australia. It is common for people
with bulimia to keep their disorder hidden for as long as 8‐10 years.

Behavioural Warning Signs

  • Excessive exercise routine
  • Disappearance of large amounts of food or the existence of large quantities of wrappers and containers
  • Using the bathroom frequently after meals
  • Signs or smell of vomiting and the presence of wrappers or packages of laxatives or diuretics
  • Shoplifting food or spending large amounts of money on food.
  • Food missing from the house
  • Reacting to emotional stress by overeating

Psychological Warning Signs

  • Low self esteem
  • Obsession about food, weight and shape
  • Distortion of body weight
  • Depression, anxiety and irritability
  • Feeling deeply out of control
  • Withdrawal from friends and family
  • Insomnia and lethargy
  • Substance abuse or self injury
  • Feeling guilty or ashamed after eating
  • Overly judgmental of themselves and/or others
  • Difficulty expressing emotion through language Fear of criticism
  • Uncontrollable urges to eat large amounts


  • Fluid and electrolyte disturbance
  • Significant and permanent loss of dental enamel resulting in chipped teeth
  • Clammy hands and tremors
  • Anxiety and heart palpitations
  • Risk of osteoporosis
  • Puffy skin under the eyes
  • Menstrual irregularities or cessation of periods
  • Inflammation and possible rupture of the esophagus from frequent vomiting
  • Chronic irregular bowel movements and constipation due to laxative abuse

Where to go for help

It is important that if you believe you or someone you know has an eating disorder to seek professional assistance immediately.

It can be scary to make this first step, however the earlier help is sought, the quicker the road to recovery.

If you require a referral to a general practitioner or other health practitioner practicing in the eating disorder field please contact The Butterfly Foundation for a confidential referral.

The The Butterfly Foundation offers telephone and email support for those with eating disorders and their family and friends. This confidential and supportive counselling service is available on
(02) 9412 4499 or 

Treatment Options

Visit our information page on Treatment Options for Eating Disorders for more information including a factsheet and videos.

Tips for Recovery

Recovering from an eating disorder means different things to different people. Recovery is a process, like a journey, and it has many stages. For some people recovery can be the abstinence of behaviours and thoughts that have kept them unwell. For others, it has a focus on integrating back into regular life.

Recovering from an eating disorder takes some time and considerable effort. It is vital that you be patient and kind to yourself throughout your entire recovery process. You may find sometimes that you feel like you are not getting anywhere or moving quickly enough through your recovery. At times like this it is important to ‘hang in there’ and keep believing that full recovery is possible.

It is rare for anyone’s journey to recovery to happen in a linear way. There are often twists, turns and bumps along the way.

Listed below are some tips to help you in your recovery process:

Take Time Out

Try to do something nurturing and positive for yourself at least once a week. This is an important part of self care.

Reach Out for Support

You are not alone. Reach out to family, friends or community supports like Butterfly Foundation who can help you in times of need. Visit our treatment options information page for various options.

Reasons for Change

Remind yourself whenever possible of your reasons for change. You are deciding to move on from life without an eating disorder being present. This is a bold decision and deserves praise.

Values and Beliefs

Examine your values and beliefs and how your eating disorder may have detracted from you living your best life. This can be a powerful reminder as to why you are on a recovery path.

Triggers and Relapse

Relapse can occur in the process of recovering from an eating disorder and is actually quite common. It is important to not see this as a failure in any way. It is simply a part of the journey and a sign you may need extra professional support at that time.

Every person has different triggers and it’s important that you know yours. Often people with eating disorders find it difficult at times of change, high stress, and when feeling emotionally vulnerable.

Explore your triggers and put a plan into place if you feel that the eating disorder is coming back into your life. Reaching out for support to understand your triggers better can also help greatly.

Explore your Interests

Often when you are suffering from an eating disorder, your whole world becomes entrenched with thoughts about eating and associated behaviours. During recovery, take time to look at the enjoyed interests that you held before your eating disorder came into place, or that you might like to explore now. Did you enjoy playing the piano or would you like to learn a musical instrument? Are you a creative person that is missing an outlet for this side of yourself? By participating in these activities it will help you to refind your interests, find new ones and give you time out from your eating disorder.


Do not hide your feelings and emotions away. Allow yourself to feel. This can be a daunting task to do but can help you fight your eating disorder by being real and genuine. Work to sit with difficult feelings in a safe environment and this will help them to move on quicker. If you find the process of allowing your true feelings to surface to be very difficult, seek support from your treatment provider or a trusted family member or friend.

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One Response to “Bulimia Nervosa”

  1. Lhilowlhi says:

    Thank you very much RW for posting this. I am in rervceoy from an eating disorder. Believe me it is quite possible to eat that few calories, even fewer. I overexercise and have been for years, especially running. My body has maintained a normal weight on very few calories, running 2 consecutive hours a day, and purging. There are also times I have exercised less and eaten a little bit more and weighed 10-20 lbs less. One’s body will do whatever it can to survive. There are horrible complications from eating disorders. Eating disorders are a viscous cycle. It is always I just want to lose a few more lbs or I am just going to run another mile. Eating disorders aren’t about wanting to look thin. They are bad coping mechanisms. It is best to seek medical attention. There is definately help out there and the sooner that one gets help, the more successful rervceoy/treatment is. There are psychiatrists who specialize in EDs, nutritionists, social workers/psychologists, and many other medical professionals that work with ED patients to ensure rervceoy. Recovery doesn’t happen in a few week hospital stay either. It is an ongoing process that is much more difficult than running any race. If anyone knows someone that they think may have an ED, whether it is related to exercise and running or not, give that person your love and support. Encourage them to seek help. There are really some great resources on the internet on how to start seeking help. Ff someone is afraid to even approach their MD there are other people to approach. I am a Registered Nurse and I was afraid of saying it to my doctor. Many people with EDs are actually a normal weight not the stereotypical skeleton. ANAD is a great resource. Psychiatrists or your primary care physician are a great place to start. They can make sure that your medical needs are also being met. Even tell the nurse in your doctors office if you don’t feel comfortable bringing it up to him/her. Speaking from experience, let the person know that you care, are worried about their health/well-being. And DO NOT encourage eating disordered behaviors!!!! Many people will praise people who overexercise for their stamina and ability to exercise/run. It is sickening. They will praise their weight loss. This validates their eating disorder. I am glad that this girl asked this question. RW does an awesome job in all of their articles. Whether it be an article on just running performance or nutrition, it encourages PROPER behaviors and nutrients. I absolutely love this site. I see other fitness magazine related sites promote drastic low-cal diets and other inappropriate diets and exercise. RW is amazingly wonderful! Thank you for posting this so others can see that eating disorders are real, other there, and yes a problem for many runners.

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