0.6% of the US adult population over the course of a lifetime
Adolescents and young adult women
About 80% of bulimia patients are female
Medically, bulimia is defined as recurrent episodes of binge eating—the rapid intake of unusually
large amounts of food—an average of twice a week for at least 3 months Although bulimia literally
means “the hunger of an ox,” the majority of those with bulimia do not have excessive appetites
Instead, their tendency to overeat compulsively seems to arise from psychological problems, possibly
due to abnormal brain chemistry or a hormonal imbalance
Despite their overeating, most of them are of normal weight They compensate for overeating by
strict dieting and excessive exercise, or by purging through self-induced vomiting or abuse of
laxatives or enemas
Repeated purging can have serious consequences, including nutritional deficiencies and an
imbalance of sodium and potassium, leading to fatigue, fainting, and palpitations Acids in vomit can
damage tooth enamel and the lining of the esophagus Laxative abuse can irritate the large intestine,
cause rectal bleeding, or disrupt normal bowel function, leading to chronic constipation when the
laxatives are discontinued One of the most severe consequences, however, may be an increased
occurrence of depression and suicide
Nutrition Connection
Like all eating disorders, bulimia can be difficult to treat and usually requires a team approach
involving nutrition education, medication, and psychotherapy Along with addressing psychological
issues, some nutritional issues can be addressed with these guidelines, under the guidance of a
dietitian or a physician
Treat nutritional deficiencies This is especially important if the body’s potassium reserves have
been depleted by vomiting or laxative abuse High-potassium foods, such as fruits (both fresh and
dried), especially bananas, and vegetables usually restore the mineral; if not, a supplement may be
needed
Emphasize foods high in protein and starches This diet should include these foods while
excluding favorite binge foods until the bulimia is under control; then those foods can be reintroduced
in small quantities At this stage of treatment, the person with bulimia learns how to give himself or
herself permission to eat desirable foods in reasonable quantities, in order to reduce the feelings of
deprivation and intense hunger that often lead to loss of control in eating
Add high-fiber foods Those with bulimia who abuse laxatives may need a high-fiber diet to
overcome constipation Whole grain cereals and breads, fresh fruits and vegetables, such as berries,
apples, and pears, and adequate fluids can help restore normal bowel function
Beyond the Diet
A complete medical checkup is the only way to be absolutely certain of a diagnosis of bulimia Once
certain, a doctor can offer guidance on the following:
Journal Nutritional education typically begins with asking the person with bulimia to keep a diary
to help pinpoint circumstances that contribute to binging A nutrition counselor may also give the
person an eating plan that minimizes the number of decisions that must be made about what and when
to eat
Treat depression Because chronic clinical depression often accompanies bulimia, treatment
usually includes giving antidepressant drugs like fluoxetine (Prozac), which also suppresses appetite,
and sertraline (Zoloft)
Look at alternative therapies Meditation, guided imagery, and progressive relaxation routines
can help those with bulimia become less obsessive about weight and their eating habits
Practice patience Don’t expect instant success; treatment often takes 3 years or longer, and even
then, relapses are common