Bulimia Nervosa: Causes & Symptoms

By: Dr. Sonia Lal Gupta and Dr. Sameer Gupta

Not many people in today’s society are aware of the devastating reality of ‘eating disorders’. They are often perceived as being self-inflicted and attention seeking behavior. However, the reality of these disorders is much grimmer than one would anticipate. Eating Disorders are serious and complicated mental disorders that can be potentially life-threatening. In fact, it was found that more people die from eating disorders than from any other mental illness. One such dangerous eating disorder is ‘Bulimia nervosa’.

What is Bulimia nervosa?

Bulimia nervosa (generally referred as bulimia) is an eating disorder which is characterized by a vicious cycle of binging on food and purging. The person suffering from this illness often experience episodes of eating excess amounts of food followed by compensatory behavior like misusing laxatives, vomiting or exercising to excess, in order to prevent weight gain. This binge-and-purge cycle has a damaging effect on the digestive system and can result in life-threatening complications.


There is a general misconception that bulimia and other eating disorders are limited to negative body image and desire to be thin. But this is not the case. There are several psychological and cultural factors or a combination of them that play important role in development of these disorders:

  • Anxiety & stress
  • Depression
  • Societal Pressure
  • History of abuse
  • Poor self-esteem
  • Genetic

Warning Signs and Symptoms:

A person suffering from Bulimia nervosa may or may not experience extreme change in body weight. Thus, Bulimia can often go undetected for a long period of time as you can’t tell whether a person has an eating disorder just by looking at their appearance.

An individual with Bulimia nervosa shows physical, psychological and behavioral symptoms:


  • Frequent weight fluctuations
  • Swollen cheeks and jaw and sore throat caused by vomiting.
  • Inflamed esophagus
  • Bad breath
  • Bloating
  • Broken blood vessels within eyes
  • Chronic dehydration
  • Disturbance in Menstrual Cycle in females
  • Fatigue and dizziness


  • Having distorted image of their body shape and weight
  • Living in fear of gaining weight
  • Having low self-esteem and showing extreme body dissatisfaction.
  • Feeling that they can't control their eating behavior.


  • Frequent trips to bathroom after having meal
  • Misuse of laxatives, enemas, appetite suppressants or diuretics
  • Avoiding meals with other people and eating in secrecy
  • Self-harm
  • Alcohol and drug abuse
  • Excessive exercising
  • Alternating between overeating and fasting.
  • Anti-social behavior and mood changes.

Effects of Bulimia on body:

The constant pattern of eating and purging is destructive for the body. Bulimia nervosa not only has devastating effects on digestive system but also contributes to other health complications. Here are some severe health problems caused by this eating disorder:

  • Electrolyte imbalance leading to heartburns and heart failure
  • Tooth decay and inflammation of food pipe because of frequent vomiting
  • Gastric rupture
  • Stomach and intestinal ulcers
  • Irregular bowel movements
  • Anemia
  • Low blood pressure
  • Headaches
  • Death

This is a serious condition and if someone you know suffers from Bulimia, they should get medical help right away.

Dr. Sameer Gupta FACC, FSCAI, Diplomate, National Board of Echocardiography (USA)
Dr. Gupta, awarded the status of “Extraordinary Ability and Achievement” by the United States Government in 2013, is a highly skilled cardiologist specializing in Interventional cardiovascular and peripheral procedures. A native of New Delhi, Dr Gupta spent 10 years in USA to accumulate knowledge, experience & awards returning to India to deliver world-class health care to his country and serve its people.
Dr. Sonia Lal Gupta, MBBS, Diplomate of American Board of Psychiatry and Neurology
Sonia Lal Gupta MD is a highly qualified Board Certified Neurologist. After completing her MBBS from Government Medical College Patiala, she pursued Neurology at New York Medical College. She graduated in 2011 becoming one of the youngest neurologists in the world at the age of 27.

Image: Loss of enamel from the inside of the upper teeth as a result of bulimia. Source/Author: Own work / James Heilman, MD. Date: 12 April 2015. Access the original Image information here: https://commons.wikimedia.org/wiki/File:BulemiaEnamalLoss.JPG