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What causes bulimia?

Bulimia is an eating disorder that is most commonly found among adolescent girls and young women; older women and men, however, can be also affected. It is typified by dissatisfaction with body shape and a desire to be thin that results in a frequent cycle of binge eating followed by purging.

Those suffering from bulimia are often aware that their eating habits are abnormal but feel powerless to do anything about it. They feel shame and guilt as a result of their behaviour. Effective treatment is available and identifying the cause of the problem is an important part of its success.

The causes of bulimia

Science has been unable to find any single cause for the onset of bulimia, and it is believed that a combination of factors is most probably involved. Factors thought to play a part include:

  • Psychological – as with many eating disorders, people with psychological or emotional problems appear to be more susceptible. Those with depression or anxiety disorders are at risk as are individuals with low self-esteem as well as perfectionists who cannot meet their own high expectations.
  • Genetic – those with a parent or sibling who suffers from bulimia or other eating disorder are at a higher risk of becoming bulimic than the general population. It is also thought that a deficiency of serotonin, a neurotransmitter in the brain that, among other things, affects appetite, may play a role.
  • Trauma – traumatic events like a history of abuse, an accident, the loss of a loved one, loss of a job or impending examinations create stress that can trigger bulimic behaviour.
  • Society – peer pressure and the perception fuelled by the media and fashion, cosmetics and entertainment industries that thin is attractive and healthy create a desire to be thin, especially among girls and younger women. Also, some activities like dancing and gymnastics require the participant to be slim, adding to the pressure. And, comments made about a young girl’s figure, even if spoken in jest by those closest to her, can be hurtful and trigger bulimia.
  • Drug abuse – while not necessarily a cause of bulimia, it is sometimes the case that bulimia sufferers have a history of drug abuse.

The effects of bulimia

Unlike that other common eating disorder, anorexia, bulimia does not necessarily result in severe emaciation and it is far less likely to have fatal consequences. It does, however, cause several potentially serious problems:

  • Tooth decay, gum disease and damage to the oesophagus can be caused by exposure to stomach acids resulting from frequent induced vomiting.
  • Bowel damage and digestive problems can result from overuse of laxatives.
    Menstrual periods may become irregular, cease altogether or, in the case of young girls, not start at all.
  • Major organs may fail. Dehydration can lead to kidney failure while bulimic behaviour can cause heart failure.
  • Given that bulimia sufferers are often psychologically and emotionally fragile, it is possible that they might become anxious or depressed (or that existing conditions might be exacerbated) or that they might turn to drugs or alcohol.


Although bulimia is a long term illness and some sufferers will exhibit symptoms for years even with treatment, bulimics can be helped so that they can live normal, happy lives. Bulimia treatment usually involves therapies like cognitive behavioural therapy, nutritional therapy and support groups. Sometimes anti-depressant drugs might also be included in cases where therapy alone is ineffective. Only in very severe cases is hospitalisation necessary.

The important point is that help is available and should be sought as soon as possible.

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