What is bulimia?

Bulimia Nervosa

Bulimia is characterized by two main behaviors- binging and purging. Purging is an attempt to rid the body of calories. Many people associate vomiting with bulimia, and in fact this is one of the more common forms that purging can take. Those who purge through vomiting often do it immediately after a binge, but sometimes a significant amount of time can lapse between binging and purging.

What many people don’t know is that purging can also take other forms - some people may exercise excessively, fast for a period of time, or take diuretics or laxatives. For some people purging may feel like a “necessary evil” in order to relieve guilt about binging, but others find the sense of relief and emptiness that they gain from purging a motivation in itself.

Another part of the diagnosis is that a person’s “self-evaluation is unduly influenced by body shape and weight”. For someone with any eating disorder, weight gain is associated with a terrible spiral of guilt, shame, and unworthiness. It can be difficult to understand from the outside why somebody would be so preoccupied with their body shape and size, but it is enough to know that your partner’s weight likely symbolizes much more to them. A person must also be able to maintain a minimum healthy weight in order to qualify for the bulimia diagnosis (although the person may not see their weight as healthy), or else anorexia, binge-purge type, would be a more appropriate label. According to the National Association of Anorexia Nervosa and Associated Disorders, 1.5% of American women will suffer from bulimia at some point in their lifetimes.



Bulimia is an eating disorder characterized by obsession over weight and tendency to eat food and then get rid of it in some manner.

Bulimia is an eating disorder characterized by obsession over weight and tendency to eat food and then get rid of it in some manner.

Common Behaviors Associated with Purging/Bulimia:

  • Anger, irritability and/or anxiety if unable to purge after binging
  • Excusing oneself to the bathroom immediately after eating
  • Running the shower or faucet while in the bathroom
  • Spending an unusual amount of time in the bathroom
  • Returning with watery, red eyes after suspected purging
  • Spending hours at the gym
  • Exercising even when injured
  • Fasting or dieting in order to compensate for food eaten
  • Hiding boxes of laxatives, diuretics, or enemas
  • Obsessing over weight, body shape or size

Is it Anxiety or Just Stress?

There is a tendency to explain away symptoms of anxiety by attributing difficulty functioning to work stress, travel stress and family stress.  Generally speaking, "stress" is external and passes when the situation passes.  For example, work stress should be expected to typically abate around the end of the work day.

Anxiety is an internal experience, an emotional reaction to both external and internal life events.  This distinction is murky because stress also engenders anxiety, but it is important.  Let's go back to work stress:  you have a deadline, the phone is ringing off the hook, and you can never tell what mood your boss will be in (as an aside, unpredictability and uncertainty are the two greatest predictors of stress).

That is stress.  But ruminating over the possibility of getting fired, feeling like you aren't good enough, and being unable to "turn off" work worries at the end of the day are closer to anxiety.  Stress is about things, anxiety is about you.

Some other symptoms of anxiety include:

  • Difficulty sleeping
  • Disturbing dreams
  • Irritability
  • Fatigue
  • Stomach aches
  • Muscle tension
  • Clenched jaw, sometimes with tongue "glued" to the top of the mouth
  • Tinnitus (ringing in the ears)
  • Racing thoughts
  • Thoughts that seem to "bounce" from topic to topic
  • Difficulty getting certain thoughts "out of your head"
  • Difficulty concentrating

Anxiety, once it is understood as a separate problem from stress, is extremely treatable.  While stress can be ameliorated through external actions such as meditation and moderate exercise, anxiety requires a different approach and it is usually helpful to consult a professional.  A good therapist can help you to understand where your anxiety is really coming from and address the issue at its root to help you learn to approach stressful situations differently.  


anxiety or stress

Mental Health Awareness Week

It is Mental Health Awareness Week, a week chosen by the National Alliance on Mental Illness to promotes awareness about mental health.  Some important issues affecting mental health are listed below; please click each link for more information.

Anxiety:  feeling worried, tense, and irritable much of the time

Depression:  feeling lethargic, worthless, or down much of the time

Post Traumatic Stress Disorder:  feeling hypervigilant, numb, &/or suffering flashbacks in response to a discrete trauma

Complex Post Traumatic Stress Disorder:  feeling chronically hypervigilant, impulsive, numb or empty in response to repeated trauma such as emotional or physical neglect or abuse

Eating Disorders:  being preoccupied with food and weight, patterns of not eating enough, eating too much, or oscillating between the two

Panick Attacks/Panic Disorder:  sudden periods of acute, very intense anxiety

Screening instruments for these and other mental health issues can be found here.

But let's not forget the other important piece of mental wellness.  It's not just about being free of a diagnosable mental health condition (especially as there is a great deal of controversy surrounding our current diagnostic system).  

It's about being well:  Cultivating peace of mind, enhancing vitality, creating satisfying and meaningful relationships with others and yourself.  It's about being able to work, love and play.  Being free from fear and constant self-recrimination.  Being comfortable in your skin.  Feeling free.

Everybody has a mind, and mental health is about everybody.