Eating Disorder Recovery

Bulimia

What is Bulimia?

Bulimia is a serious eating disorder characterised by frequent episodes of binge eating, followed by purging behaviours such as vomiting, fasting, laxative misuse or excessive exercise.

Binges involve eating a lot of food over a short period of time and is accompanied by a sense of having lost control over eating. People with bulimia may experience overwhelming feelings of guilt, shame, and distress related to their pattern of eating, body image, and weight.

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Frequently eat large amounts of food?

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Feel you’ve totally lost control of your eating at these times?

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Eat until you feel uncomfortably full or even in pain?

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Make yourself vomit, take laxatives, fast or excessively exercise after a binge to compensate for the food eaten?

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Find yourself thinking about food or eating all the time?

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Fear gaining weight?

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Feel awful, guilty or ashamed after a binge?

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Hate how your body looks or how much you weigh?

Causes of Bulimia

The causes of bulimia will be specific to the person and we recommend a specialist assessment to understand what is keeping the eating disorder going. 

The research evidence indicates that there are several factors that can make someone more vulnerable to developing bulimia. These factors include biological factors (e.g., having someone in your family who has had an eating disorder), psychological factors (e.g., low self-esteem, high levels of self-criticism, and poor body image), and social factors (e.g., history of trauma or abuse, bullying, life transitions, cultural messages regarding weight and weight stigma). 

There are also four well understood causes of binge eating: 

  1. Emotional links: we know that people with bulimia are more likely to struggle with feelings of anxiety and depression. Often people binge eat to cope with overwhelming negative emotions. Whilst people might feel better in the moment, afterwards they almost always feel worse.

     

  2. Under-eating: people with bulimia usually worry about their weight and have poor body image. Often people try to strictly diet to tackle these worries but find themselves eating out of control by the afternoon or evening.

     

  3. Food rules: Often linked with dieting, some people try to avoid certain types of food (carbohydrates, surgery foods, “junk” foods). If someone ends up eating a small amount of these foods they often find this can trigger a binge as they feel they’ve already messed up or failed to stick to the diet rule.

     

  4. Alcohol or drugs: we know that people are more vulnerable to binge-eating if they have been drinking or taking recreational drugs. This is because our ability to control our impulses are reduced.

Treatment for Bulimia

After an initial assessment your psychologist will put together an initial understanding of what has caused and maintained the eating disorder. They will then discuss with you the best treatment approach. 

Cognitive behaviour therapy for bulimia has the strongest evidence base. CBT will help you to address both the emotional and the physical causes of the binge-purge cycle and help you build a better understanding of the links between how you manage your emotions and food. Sessions usually start with a period of stabilising eating patterns, focussing on addressing worries about food and body weight. Sessions then move on to addressing the emotional links with binge-eating, body image and finishes with a plan to stay well. Depending on the person, sessions may also include other aspects (e.g., low self-esteem, perfectionism, emotion regulation). Usually 10-30 sessions are needed to successfully treat bulimia, the specific number of sessions needed will be discussed after the assessment session. Psychologists are trained in a number of therapy models, this means that we can integrate different approaches to create a personalised treatment plan designed for you. Compassion focused therapy is often very helpful, particularly for people who struggle with high levels of self-criticism

If you’re interested in learning more about our therapy services for bulimia, we invite you to book a 15-minute consultation to find out if we are a good fit.

We often talk about people being not ready to recovery from anorexia. We don’t always acknowledge that people with bulimia sometimes also feel conflicted about recovery. If you’re not sure whether you’re ready to recover, take a look a this post on 5 steps to help you move forward