What is Bulimia Nervosa?
Bulimia nervosa is an eating disorder that’s characterized by cycles of binge eating followed by purging. What does this really mean? Essentially, someone with bulimia will eat a large amount of food (think 2-3x the amount of food as someone who is in the same situation), in a short period of time. It must be characterized by eating well beyond the feelings of fullness and usually the person feels like they can’t stop even when they want to stop. After said type of episode, it is quickly followed by intense feelings of guilt, shame, or fear of gaining weight. Those feelings flood through you and then lead to purging. Purging can have various forms, most commonly vomiting or overexercising. Purging can also happen via laxatives, diet pills, diuretics or even fasting in an attempt to “make up for” the binge.
The binge-purge cycle can feel overwhelming and makes the person feel out of control.
Often, people with bulimia feel stuck in this pattern. At the start of the binge, the person will experience some form of temporary relief from obsessive thoughts about food & body image. They will also feel relief from any uncomfortable emotion that was present before those obsessive thoughts began. Thus providing relief from two significantly challenging sets of thoughts and emotions.
What’s important to understand is that bulimia doesn’t always look the way you might expect. People with bulimia, just like the majority of eating disorders, can be at any weight, shape, or body size. They contribute to those around them. They achieve milestones & successes just as their friends & family do who do not have eating disorders. The likelihood that someone in your life or that several people in your life struggle from an eating disorder is very high.
The Physical and Emotional Impact of Bulimia
On a physical level, bulimia can have serious consequences. The repeated cycle of binging and purging takes a toll on the body. Frequent vomiting can erode tooth enamel, cause throat damage, and lead to electrolyte imbalances that can be life-threatening. Overuse of laxatives can harm the digestive system, while excessive exercise can cause injury or extreme fatigue.
But beyond the physical effects, the emotional toll is significant. It can leave you feeling trapped, isolated, and out of control. Many people with bulimia feel like they are living in secrecy, constantly worried that someone will find out what’s going on. All individuals with eating disorders, fear being judged for their bodies & their behaviors. They have a very strong inner critic that dishes out self-criticism in a rapid-fire manner. They can look very confident at times but are suffering silently in self-judgment & fearing judgment from others all day long.
What is Anorexia Nervosa (Binge-Purge Type)?
Now, let’s talk about anorexia nervosa, particularly the binge-purge subtype, which shares some similarities with bulimia but is distinct in key ways. Anorexia nervosa is primarily known for the extreme restriction of food intake, leading to significant malnutrition and weight loss. But in the binge-purge type of anorexia, there is also a pattern of binge eating followed by purging, much like with bulimia.
However, the main difference between anorexia nervosa binge-purge type and bulimia nervosa lies in the person’s weight and overall relationship with food. With anorexia, the person usually maintains a low body weight for what is considered healthy for their age and height. The primary goal is weight loss and refusal to maintain an appropriate weight. The binge episodes, while they do occur, are often smaller amounts of food, and they may not involve the same feeling of being “out of control.” Anorexia has an “over-control” or highly rigid energy, even within the context of the binge. The amount of food may not reach the full criteria of binge but has the compulsive push behind it as with bulimia.
In contrast, people with bulimia nervosa may be at a weight or size that is normal for the person’s body history & genetic makeup, be that large or small. The focus of bulimia is more on managing the distress of binge eating through purging, rather than the constant refusal to maintain an appropriate weight. However, body image distress & fear of weight is a key feature for those with bulimia nervosa.
How Does It Feel to Have Bulimia vs. Anorexia (Binge-Purge Type)?
If you’re reading this and some of these behaviors sound familiar, you might be wondering which disorder you identify with, or whether you’re struggling with disordered eating at all. It’s important to remember that eating disorders exist on a spectrum, and the labels we use (like bulimia or anorexia) are there to help identify patterns, but they don’t define you.
If you have bulimia, you might feel like food is both a comfort and a source of guilt. The binge episodes can feel uncontrollable like you’re eating faster than you can think, and the purging may bring a brief sense of relief. But afterward, that relief is often replaced by shame and regret. You might feel like you’re constantly swinging between these extremes—eating too much and then punishing yourself for it.
On the other hand, if you have anorexia binge-purge type, you might experience a similar cycle of binging and purging, but it is often within the context of extreme restriction and an intense fear of gaining weight. The binge episodes might be smaller, and your primary focus may still be on restricting your food intake, keeping your body weight dangerously low.
Bulimia Nervosa Vs. Atypical Anorexia, binging purging type
These two disorders will look more similar in nature in that their commonality is that weight, shape, and size are devoid of being underweight according to the medical standards that utilize the BMI. The nuances between the two disorders are tied to the intention behind the behaviors, emotional triggers for the behaviors, and the type of nutritional deficits in each type of eating disorder. In short, it is best to have an eating disorder therapist & dietician help you understand which diagnosis best fits your current struggles when you begin treatment. To your treatment team, all eating disorders are taken seriously, and not one is less severe than the other. Often clients are really anxious to disclose binging or purging in any form because they fear being misunderstood or judged for the behaviors. This is often because self-judgment or shame is so high and that restriction or exercise is often culturally rewarded and happens in plain sight, where binging and or purging often carry more secrecy and happen in private.
The Emotional Experience
Whether you’re dealing with bulimia or anorexia binge-purge type, the emotional struggles are real and valid. Both disorders are often driven by feelings of inadequacy, anxiety, or and to feel like some part of your life feels predictable.
It’s also not uncommon to feel like you’re not “sick enough” to seek help. Maybe you’ve told yourself, “I’m not ________ enough to have an eating disorder,” or “I can stop anytime I want.” But the truth is, eating disorders don’t have to look a certain way to be harmful. If your relationship with food is causing you distress, if you feel trapped in a cycle of binging and purging, or if you’re constantly consumed with thoughts about your body and weight, those are signs that something is wrong.
Seeking Help: It’s Never Too Early Nor Too Late
If you’re struggling with bulimia or anorexia binge-purge type or any other type of food or body image difficulty, know that you are not alone, and you are not beyond help. These disorders can feel isolating, but many people have found recovery through reaching out for support. Whether you turn to a therapist, a doctor, or even a trusted friend, the first step is acknowledging that you don’t have to do this alone.
Start Working with An Eating Disorder Therapist in Provo, UT
Your emotions and your behaviors do not define you, even if you feel like they are consuming you. You can find peace again. You can find a connection again, and you can feel like yourself again.
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