Bulimia (cont.)

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What causes bulimia?

As with anorexia nervosa, there is currently no definite known cause of bulimia. Because of the complexity of the disorder, researchers within the medical and psychological fields continue to explore its dynamics.

Bulimia is generally felt to begin with a dissatisfaction of the person's body. The individual may actually be underweight, but when the person looks in a mirror, they see a distorted image and feel heavier than they really are. At first, this distorted body image leads to dieting. As the body image in the mirror continues to be seen as larger than it actually is, the dieting escalates and can lead to bulimic practices.

In certain neurological or medical conditions, there can be disturbed eating behavior, but the essential psychological feature of bulimia, the extreme concern with body shape and weight, is not present. For example, overeating is a common feature in depression; however, these individuals do not engage in inappropriate weight-loss behaviors and are not overly concerned with body image and weight loss as is characteristic of the person with bulimia.

Organic causes for bulimia are being investigated. There is evidence that bulimia and other eating disorders may be related to abnormalities in levels of chemical messengers (neurotransmitters) within the brain, specifically the neurotransmitter serotonin. Other studies of people with bulimia have found alterations in metabolic rate, decreased perceptions of satiety, and abnormal neuroendocrine regulation (the process by which the nervous system interacts with production of hormones and hormone-like substances).

What are symptoms and signs that may suggest a person has bulimia?

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It is not always possible to tell whether a person has bulimia. Those affected may be overweight, underweight, or of normal body weight. However, some warning signs may be present, although these do not confirm the diagnosis of bulimia:

  • Going to the bathroom after every meal (to induce vomiting)
  • Compulsive or excessive exercising
  • Physical signs arising from excessive vomiting, such as swollen cheeks or jaws, broken blood vessels in the eyes, or teeth that appear clear due to damage to tooth enamel
  • Excessive preoccupation with body image or weight
Medically Reviewed by a Doctor on 1/28/2014

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