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Bulimia Nervosa

Contact us about in-person and virtual bulimia nervosa treatment options.

Bulimia nervosa is characterized by a distressing cycle of binge eating, followed by compensatory purging behaviors such as self-induced vomiting, misuse of laxatives, fasting, and excessive exercise. This relentless cycle can take a significant toll on the body and mind, leading to severe physical and emotional consequences.

At The Emily Program, we’re committed to helping you find freedom from the vicious cycles of bulimia nervosa. Our expert team personalizes your treatment plan, integrating comprehensive medical, nutritional, and therapeutic support to foster lasting change. We’ll be by your side every step of the way, empowering you with the tools you need for long-term healing.

Break free from the grip of bulimia nervosa and start reclaiming your life today.

The shame that accompanies bulimia nervosa

Bulimia nervosa often hides behind a facade of normalcy. As with all eating disorders, the outward appearances of those struggling rarely tell the full story. While people of any body size can suffer from any eating disorder, individuals with bulimia are less likely to experience weight-related symptoms. This makes the disorder particularly insidious, as it can remain concealed for years without recognition by friends, family, or even healthcare professionals. The recurrent episodes of binge eating followed by compensatory behaviors like purging, fasting, or misuse of laxatives are usually carried out in secrecy, adding to the burden of isolation. 

This isolation is compounded by intense feelings of shame and guilt that accompany the cycle of bingeing and purging. Many individuals with bulimia struggle internally with these emotions, often feeling that they are in a constant battle with themselves. Societal stigma and misconceptions about eating disorders magnify this shame, making it even harder for those affected to seek help. At The Emily Program, we recognize the deep-seated shame that often shadows bulimia nervosa and offer a supportive, non-judgmental space where healing begins with compassion and understanding, paving the way toward recovery and self-acceptance.

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Bulimia nervosa symptoms and warning signs

It’s not always easy to notice when you or a loved one are struggling with bulimia nervosa, but there are signs you can look out for. Common bulimia nervosa symptoms and warning signs include:

  • Eating objectively large quantities of food in a short period of time
  • Fasting or restricting food 
  • Evidence of binges, such as the disappearance of large amounts of food or hidden food wrappers or containers
  • Compensatory behaviors such as self-induced vomiting, fasting, or over-exercising
  • Leaving for the bathroom immediately after eating
  • Swollen cheeks from self-induced vomiting
  • Yellow, sensitive, slightly pointed teeth, often with receding gum lines
  • Skin sores or gray or brown skin spots
  • Broken blood vessels in the eyes
  • Excessive talk about weight
  • Dissatisfaction with body image, size, or shape
  • Misuse of diuretics, diet pills, or laxatives
  • Feeling out of control, depressed, or anxious
  • Withdrawal from family and friends

Do you think you or someone you know might have bulimia nervosa? Take our eating disorder assessment quiz.

If you or someone you know needs help with bulimia, reach out today.

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What are the physical effects and symptoms of bulimia nervosa?

Bulimia nervosa takes a severe toll on the entire body, causing a range of physical effects and symptoms. Dental issues are common due to frequent vomiting, leading to enamel erosion, cavities, and oral lesions. Gastrointestinal complications, such as acid reflux, esophageal inflammation, and potentially life-threatening esophageal tears, are also prevalent. The physical strain of bingeing and purging can cause throat soreness, chronic stomach pain, and severe dehydration.

The endocrine system can suffer, as well, with hormonal imbalances affecting metabolism and menstrual cycles, often leading to irregular periods. Bulimia nervosa can also disrupt the body’s electrolyte balance, increasing the risk of heart arrhythmias and heart failure. Individuals may experience muscle weakness, fainting, and bloodshot eyes due to the strain on the body from repeated purging. 

Furthermore, bulimia nervosa impacts the nervous system, leading to cognitive difficulties, obsessive thoughts about food and weight, and increased anxiety and depression. Socially, the intense preoccupation with body image and the secretive nature of the disorder can cause significant isolation, affecting relationships, academic pursuits, and career goals​.

Read more about the physical effects and symptoms of bulimia nervosa.


30 million

individuals in the U.S. alone will struggle with an eating disorder

1 in 3

people with an eating disorder is male

50%

of people with eating disorders need a higher level of care to recover

18

is the average age of onset for bulimia


What causes bulimia nervosa?

Bulimia isn’t rooted in vanity or motivated by a desire for attention. Contrary to misconceptions, binge eating and purging do not reflect “a lack of control” over food and are not behaviors individuals can simply decide when to engage in and when to turn off.   

Bulimia, like all eating disorders, is a complex mental health disorder that emerges from a mix of biological, psychological, and social factors. Genetics provide the blueprint, but it’s how someone’s personality interacts with their environment that shapes their likelihood of developing an eating disorder.

  • Genetic and Biological Influences: Though it’s not a guarantee, having a family history of bulimia can increase the odds of development. Exposure to dieting and/or overeating may also contribute to the onset of bulimia nervosa. What’s more, the hormonal fluctuations experienced during puberty and menopause can affect both appetite and body image, potentially exacerbating existing vulnerabilities to developing eating disorders like bulimia. Highly heritable traits, such as hypersensitivity and impulsivity, can predispose someone to bulimia, as well.

  • Psychological Drivers: Bulimia nervosa is associated with greater levels of novelty seeking—a characteristic related to impulsive decision-making, greater risk-taking, and reward dependence. Higher harm avoidance is often found in people with bulimia, as well. This personality trait can present as tendencies toward difficult emotions such as excessive worrying, fear, and pessimism. High harm avoidance and impulsivity are associated with emotional regulation issues, which may increase vulnerability to substance use and self-harm—both of which commonly co-occur with bulimia.

  • Social and Environmental Pressures: Our culture’s obsession with appearance and unrealistic body standards is a major factor in the development and maintenance of bulimia nervosa. The constant bombardment of weight-based messagesin media, online, and in everyday interactionscreates pressure that can take a toll on self-esteem. Unresolved trauma or emotional distress can also play a role in driving bulimic behaviors, as bingeing and purging may offer a temporary escape from overwhelming emotions.

There’s not a definite answer to what causes an eating disorder, but that doesn’t make recovery any less possible. The multifaceted nature of bulimia underscores the importance of comprehensive, holistic treatment like that offered by The Emily Program.

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Bulimia nervosa treatments

The Emily Program offers a wide range of bulimia nervosa treatment options, including residential, partial hospitalization/intensive day (PHP/IDP), intensive outpatient (IOP), outpatient, and virtual programs for children, adolescents, and adults of all genders. Our flexible, individualized bulimia nervosa treatment options allow us to meet you wherever you are in your recovery journey, empowering you to reclaim your health and well-being at the level of support that’s right for you.

The initial focus of treatment for bulimia in our higher levels of care is medical and psychiatric stabilization. Our expert medical and psychiatric teams prioritize the safe cessation of bulimic behaviors. We provide personalized care to support your unique symptom presentation and any underlying mood disorders that often co-occur with bulimia, enhancing the effectiveness of treatment.

Our comprehensive bulimia treatment programs include individual, group, and family therapy, as well as nutritional counseling and education. Our evidence-based therapeutic interventions emphasize the importance of addressing your ingrained eating disorder behaviors and helping you develop healthy coping skills and strategies. You’ll learn to interrupt the cycle of bingeing and purging and cultivate balance and flexibility with food, setting the stage for recovery beyond treatment.

We recognize the integral role of family support in bulimia recovery. Our family-based bulimia treatment is designed to provide psychoeducation about the disorder and equip family members and communities of support with the tools and coping skills to support their loved one’s recovery journey. Family involvement is encouraged at all levels of care to promote healing within the family unit.

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The first step in getting treatment for bulimia nervosa is to reach out and schedule an assessment. No referral is needed. Give us a call at 1-888-364-5977 or complete an online form. We’re available seven days a week to answer your questions and help you get started on the path to recovery from bulimia.

Recovery from bulimia begins here.
Get started today.

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Additional resources about bulimia

Eating disorders like anorexia nervosa are still widely misunderstood. That’s why we provide a variety of resources to help navigate these complex illnesses. Check out these resources for information about bulimia and eating disorders in general:


Frequently asked questions about bulimia nervosa

What is the first step for getting bulimia help?

If you think you or someone you know may be experiencing bulimia, reach out to The Emily Program for a free eating disorder assessment. You can simply call us at 888-364-5977 or fill out our online form and we’ll reach out to you — no referral needed. In this first phone call, one of our compassionate admissions specialists will listen to your concerns, answer any questions you may have, and set up an intake assessment. 

During your initial assessment, an Intake Therapist will ask you about your relationship with food and body image, evaluate your unique needs, review your benefit information, and determine a treatment plan (if needed) that’s right for you. 

On your start date, you’ll be welcomed to treatment at The Emily Program in person or virtually. You’ll attend orientation, get to know your treatment team, and begin your journey to healing.

How long will I be in treatment for bulimia?

Just like eating disorders themselves, every recovery experience is different. Due to this, the length of treatment is not universal. You will work with your multidisciplinary care team to determine the level of care that’s right for you: residential, partial hospitalization/intensive day (PHP/IDP), intensive outpatient (IOP), or outpatient, and you and your team will reevaluate as your needs change. We are with you through every step of the process.

What is the Emily Program’s approach to bulimia treatment?

Treatment for bulimia and all eating disorder diagnoses must be holistic. At The Emily Program, we are committed to compassionate, whole-person care because we know it results in a more successful and longer-lasting recovery. With knowledge of the complex nature of bulimia treatment, we provide care to people of all ages and genders, helping them reach true healing. 

Bulimia affects people both physically and mentally. That is why The Emily Program provides a team of multidisciplinary experts to treat your illness, including medical providers, psychologists, dietitians, psychiatrists, yoga instructors, and more. Our wide variety of experts can aid you in all aspects of your healing journey. 

Treatment for bulimia at The Emily Program focuses on establishing regular, balanced eating patterns, treating medical complications associated with purging, and helping you build a better relationship with food and your body. If you are experiencing any co-occurring conditions — such as anxiety, PTSD, bipolar disorder, depression, and/or substance use disorder —we will treat that condition alongside your eating disorder. We understand that true healing can only occur if every aspect of your mental and physical health is considered.  

Here at The Emily Program, we want to walk beside you every step of your bulimia recovery journey — that is why we offer a continuum of care. From residential to outpatient and everything in between, we have a level of care that can fit your needs. Recovery is nonlinear, and you may need to move between the levels of care during your treatment journey. When transitioning to a new treatment level, you can continue the momentum of your recovery in a comfortable, familiar setting with a team who knows you. We’re there with you at every stage. 

The mission of The Emily Program is to provide expert, individualized care to as many people as possible. We envision a future where everyone with bulimia can have a peaceful relationship with food and body image.

How should I talk to my child about my concerns?

The possibility of your child struggling with bulimia can trigger a wave of emotions – fear, confusion, maybe even helplessness. These feelings are common and completely valid. Please remember that your child’s eating disorder is not a reflection of your parenting. Bulimia is a complex and multifaceted illness, stemming from a combination of biological, psychological, and social factors beyond your control. 

While you may not have been able to prevent your child’s eating disorder, you can be a powerful force for healing. Opening up about your concerns, no matter how difficult, is a vital starting point first step in getting your child the help they need. 

Here are some essential tips for navigating the conversation with your child, specifically for adolescents ages 12 and older. For younger children, please seek guidance from a pediatrician, primary care physician, or therapist.

Before the conversation 

Educate yourself: Bulimia nervosa, like all eating disorders, is a complex mental illness, not a choice. It goes far deeper than food or weight, and is rooted deeply in underlying emotional struggles. As a springboard for learning more about bulimia and related conditions, we recommend exploring our Eating Disorders We Treat and Eating Disorder Facts pages.

Choose the right time and place: When addressing concerns about your child’s eating habits, setting the stage for a productive conversation is key. Choose a quiet, private space where you won’t be interrupted. To create a safe space for open communication, consider keeping this conversation between a few trusted individuals. Your child may feel more comfortable expressing themselves with fewer people involved. 

You might be inclined to immediately confront your adolescent when you’ve discovered that they are engaging in harmful eating disorder behaviors. It’s best to wait until you’re both calm and collected, however. There’s a greater chance of your child feeling heard, understood, and willing to open up when emotions aren’t running high, leading to a more productive conversation.

Prepare for a range of reactions: Understand that responses can vary widely. Your child might dismiss your concerns, justify their behaviors, or feel seen and heard. Stay patient and open no matter their response, and remember that this is the start of ongoing dialogue.

During the conversation 

Your child needs to know you understand the seriousness of the situation. While they might not be ready to accept help right away, you can continue to communicate your concern. Emphasize that you care about them as a whole person — not just their appearance or eating habits — and that you want to connect them with resources to help them.

Use “I” language to describe specific behaviors or changes in their energy, focus, and joy you’ve noticed. Here are some conversation starters you might use if you’re concerned that your child may have bulimia:

  • “I’ve noticed you seem to excuse yourself from the table right after meals lately.”
  • “I remember how much fun you used to have with exercise. It seems like it’s become more stressful recently.”
  • “I see you looking at yourself in the mirror quite a bit these days.”
  • “I have noticed that large amounts of food are sometimes gone.”
  • “I’ve missed having you at our usual lunches.” 
  • “I’ve noticed you’ve been wearing looser clothes lately.” 

Be sure your observations are followed by expressions of concern and an invitation for your child to share their thoughts and feelings. Here are some ways to follow up:

  • “I care about you so much, and I’m here no matter what.”
  • “Can we talk about what’s been going on?”
  • “Is there anything I mentioned that sparked any emotions or questions for you?”
  • “Did anything I say click with your experience?”

If your child isn’t ready to talk, let them know you can give them space to think but plan to check back in soon—ideally in the next couple of days. It’s important to follow up, even if your child seems to downplay what’s going on. Stand by what you said but do it with care. Remind them how important they are to you and consider offering different ways to talk about it later, such as text, email, or in person, after they’ve had some time to reflect.

Remember, the goal is to let your child know they’re not alone and that you’re there to support them through their struggles with compassion and understanding. The journey requires patience and persistence, but with open communication and professional support, your child can navigate through this challenging time. Visit the For Families section of our website for more tips on supporting a loved one struggle with an eating disorder.

I am concerned my child will not participate in the intake appointment, but I know they need help. How will you handle this?

The first steps toward eating disorder recovery often feel overwhelming. We get that. That’s why our team of seasoned professionals is specially trained to navigate these challenges with unmatched sensitivity and care. 

During the intake process, we prioritize creating a welcoming and non-judgmental environment to help reduce any anxiety and resistance your child may feel. Our trained intake therapists are prepared to meet them exactly where they are, both emotionally and in their willingness to accept support.  

We’re also here to help you reinforce a healing environment at home, with resources specifically designed for families facing eating disorders. Recognizing the bravery it takes for you and your child to start this journey, we’re here to make the entire family feel supported every step of the way.

Are there recommended support groups, websites, or books to help me make sense of what I’m experiencing?

Eating disorders can often cause feelings of powerlessness, fear, and overwhelm — but you don’t have to face it alone. At The Emily Program, we offer a variety of tools and resources to help you on your road to recovery. 

When you begin receiving care with us, you will receive educational materials on your bulimia diagnosis and eating disorders in general so that you can start your recovery journey informed and empowered.

In addition, we create blog posts and host the Peace Meal podcast to spread knowledge, share stories of recovery, and keep you up to date on the current happenings at The Emily Program.

Websites:

National Alliance for Eating Disorders – Offering referrals, education, and comprehensive support for individuals with all types of eating disorders, this national non-profit organization prioritizes accessibility and inclusivity. The Alliance hosts complimentary therapist-led virtual support groups (e.g., pro-recovery, larger bodied individuals, and LGBTQ+ groups) and provides an interactive national database for locating eating disorder care. www.allianceforeatingdisorders.com

In addition, The National Alliance for Eating Disorders offers a therapist-led virtual support group for Friends & Family at no cost. Feel free to join and participate however much you want to — it’s also okay just to listen! www.allianceforeatingdisorders.com/eating-disorder-support-groups-and-programs

F.E.A.S.T. – Families Empowered and Supporting Treatment for Eating Disorders – F.E.A.S.T. is a global community that empowers the families of people experiencing eating disorders through education and supportive resources. www.feast-ed.org

National Eating Disorders Association (NEDA) – Devoted to preventing eating disorders, offering treatment referrals, and enhancing education on eating disorders, weight, and body image, the National Eating Disorders Association (NEDA) is a leading non-profit organization. www.nationaleatingdisorders.org

ANAD (National Association of Anorexia Nervosa and Associated Disorders) – This national non-profit organization offers complimentary peer support services to those suffering with eating disorders. anad.org

Project HEAL – A national non-profit organization that prioritizes equitable access to treatment for individuals in need of eating disorder treatment.  www.theprojectheal.org

Books:

When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating
By Lauren Muhlheim, PsyD

Overcoming Binge Eating: The Proven Program to Learn Why You Binge and How You Can Stop – 2nd Edition
By Dr. Christopher G. Fairburn

Help Your Teenager Beat an Eating Disorder – 2nd Edition
By James Lock, MD, PhD, Daniel Le Grange, PhD

How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach to Rebuilding a Healthy Relationship with Food
By Casey Crosbie, RD, CEDRD, CSSD, Wendy Sterling, MS, RD, CSSD, CEDRD-S

Autism and Eating Disorders in Teens
By Fiona Fisher Bullivant, Sharleen Woods, MSc, PgDip, RD

Skills-based Caring for a Loved One with an Eating Disorder: The New Maudsley Method – 2nd Edition
By Janet Treasure, OBE, PhD, FRCP, FRCPsych, Grainne Smith, Anna Crane, PhD

Survive FBT (Family Based Treatment): Skills Manual for Parents Undertaking Family Based Treatment (FBT) for Child and Adolescent Anorexia Nervosa
By Maria Ganci

Off the C.U.F.F.: A Parent Skills Book for the Management of Disordered Eating
By Dr. Nancy L. Zucker, PhD

Throwing Starfish Across the Sea: A Pocket-Sized Care Package for the Parents of Someone with an Eating Disorder
By Laura Collins Lyster-Mensh, MS, Charlotte Bevan

Brave Girl Eating: A Family’s Struggle with Anorexia
By Harriet Brown

Telling ED No!: And Other Practical Tools to Conquer Your Eating Disorder and Find Freedom
By Cheryl Kerrigan, PNP, Thom Rutledge, LCSW

Life Without ED – 10th Edition: How One Woman Declared Independence from Her Eating Disorder and How You Can Too
By Jenni Schaefer

Goodbye ED, Hello Me: Recover from Your Eating Disorder and Fall in Love with Life
By Jenni Schaefer


Check out our Eating Disorder Books and Resources for Families pages for further recommendations.


Ask for help. You are not alone. Begin your journey to recovery today.

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