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Bulimia: Teen Version



  • Bulimia is an eating disorder that causes you to binge, and then purge, cut back on eating, or exercise too much to make up for binging.
  • Treatment involves learning healthy eating habits, therapy, and possibly hospitalization if your condition is severe and life threatening.
  • If you can’t appreciate yourself for who you are, not what you look like, or what you weigh, get professional help.


What is bulimia?

Bulimia is an eating disorder that causes you to binge, which means you eat large amounts of food in a short time without being able to stop. The amount of food you eat is much more than most people would eat at one time. You may then purge, which is getting rid of the food by making yourself vomit or using laxatives, water pills or enemas. You may fast by not eating at all for a period of time, cut back on eating, or exercise too much to make up for binging.

Most people with bulimia have a normal or above normal weight but feel they cannot control their eating. Once a binge starts, you may feel as if you can’t stop eating.

Although the disorder can affect men, most people with bulimia are young women. If you are pregnant, eating disorders can affect your health and your baby’s development.

What is the cause?

The exact cause of bulimia is not known. It may be caused by a mix of physical, mental, and social factors, and traits that are inherited from parents. It may be related to problems with the chemicals in the brain that control mood and appetite.

You may be at risk of developing bulimia if you:

  • Have a family history of bulimia or other eating disorders
  • Have a family or personal history of obesity
  • Have a family or personal history of depression, bipolar disorder, anxiety disorders, or obsessive-compulsive personality disorder
  • Have a history of physical or sexual abuse

What are the symptoms?

In addition to binging and purging, the signs and symptoms of bulimia include:

  • Strict dieting, trying fad diets, or going long periods without eating between binges
  • Ritualistic eating such as never eating in front of other people
  • Exercising too much
  • Having heartburn, throat pain, damaged teeth, or swollen cheeks caused by the stomach acid in your vomit
  • Having scratches or scars on the back of your hands caused by using your fingers in your throat to make yourself vomit
  • Feeling weak, depressed, or guilty after binge eating
  • Constantly thinking about food, being thin, and feeling that your weight is tied to self-esteem

Bulimia may cause other health problems including:

  • For females, if your weight gets very low, you may not have monthly periods. Hormone changes result from low weight and low levels of body fat. This can happen if you exercise a lot also.
  • For males, low amount of the hormone testosterone
  • Weakening of your bones called osteoporosis
  • Low amount of red blood cells called anemia
  • An imbalance of minerals called electrolytes in your body
  • Heart and blood vessel problems such as low blood pressure, abnormal heart rhythms, and heart failure
  • Kidney and bowel problems
  • Death

The risk of suicide is much greater if you have bulimia.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will ask about your eating habits and other behaviors. You may have blood tests, X-rays, or other tests.

How is it treated?

Bulimia does not go away or get better on its own. Treatment involves learning healthy eating habits, getting to and keeping a healthy weight, and learning to think about weight differently. Your healthcare provider may suggest that you meet with a dietitian to create a healthy meal plan. You may need therapy to help you change how you think about yourself and food.

Cognitive behavior therapy (CBT) is a good way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns even after you stop going to therapy. It can help you learn to manage stress and improve self-esteem.

Family therapy may be helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.

Your healthcare provider may prescribe medicine to help reduce constant thoughts about food. Medicine may be prescribed if you have anxiety or depression.

You may need to go for treatment every day or be hospitalized if your condition is severe and life threatening.

If you have bulimia, you may think constantly about weight and food for many years. Even after you reach a healthy weight, you may need to continue treatment for many months. Being under a lot of stress can cause the symptoms to get worse. The earlier you seek treatment, the more successful it is likely to be.

How can I take care of myself?

  • Get support. Talk with family and friends. Join a support group in your area.
  • Learn to manage stress. Ask for help at home and school or work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
  • Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a variety of healthy foods. Limit caffeine. If you smoke or use e-cigarettes, try to quit. Avoid alcohol and drugs. Do not overuse laxatives, diuretics, or diet pills. These can have serious effects on your health. Stay physically active only as advised by your provider.
  • Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the prescription and nonprescription medicines, natural remedies, vitamins, and supplements you take. Take all medicines as directed by your provider or therapist. Take mineral and vitamin supplements only as advised by your healthcare provider.
  • Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. See your healthcare provider regularly to have your weight, blood pressure, heart rate, and temperature checked.

Get emergency care if you or a loved one has thoughts of suicide or self-harm, violence, or harming others.

What can be done to help prevent bulimia?

  • Learn all you can about bulimia. Don’t let what you see online, on TV, or in magazines affect your self-esteem. Question advertisements or articles that make you feel bad about your body shape or size. Are they are trying to sell you something? Is what they say and show true? Or, have the pictures been air-brushed or computer generated to make the person look so perfect?
  • Remember to eat a variety of foods in healthy amounts. No single food is always bad or always good.
  • Try to accept your body’s unique shape and size. Also avoid judging other people based on their weight or shape. It is much more important to be healthy than to be skinny.
  • Learn to like yourself for who you are, not what you look like, or what you weigh. Treat yourself with respect. Choose to value yourself based on goals, accomplishments, talents, and character.
  • If you think someone has an eating disorder, talk with that person. Gently but firmly encourage the person to seek professional help.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2021-12-07
Last reviewed: 2021-02-25
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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