Bulimia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Bulimia?
A psychiatrist (a mental health doctor) or a psychologist often leads care. They work with a dietitian, a food and nutrition expert. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is bulimia?
Bulimia, also called bulimia nervosa, is an eating disorder. A person has regular episodes of eating a very large amount of food. This is called bingeing. During a binge, the person feels a loss of control. Afterward, they act to keep from gaining weight, such as vomiting or using laxatives. This is called purging.
Many people with bulimia stay at a normal weight, so others may not notice the illness. Eating disorders are not a choice. With treatment, people can recover. The disorder is most common in teen girls and young women. It affects both sexes.
Symptoms
Signs of bulimia are:
- Eating large amounts of food, often in secret, with lost control.
- Purging by vomiting, laxatives, enemas, or water pills (diuretics).
- Excessive exercise or fasting.
- Sore throat. Swollen salivary glands in the neck and jaw.
- Worn tooth enamel and decaying teeth.
- Small cuts or calluses on the knuckles. These come from forcing vomiting.
Others may notice large amounts of food that vanish fast, or bathroom visits right after meals. Low blood potassium can also happen. This salt imbalance may lead to dangerous heart rhythm problems.
Causes and who gets it
The exact cause is unknown. Genetic, psychological, family, and social factors may all play a role. Bulimia is likely due to more than one factor. Women get bulimia far more often than men. It most often starts in adolescence.
How doctors diagnose it
Doctors diagnose bulimia from a careful interview about eating and purging habits. Under the DSM-5, the mental health manual used for diagnosis, episodes must happen at least once a week for three months. Doctors check height, weight, and vital signs. They also examine the skin, mouth, and belly. Blood tests can show low potassium, dehydration, or other problems. In severe cases, doctors may do an ECG, a recording of the heart's electrical signals.
Treatment
The main goal is to stop the binge and purge cycle. Cognitive behavioral therapy (CBT), a type of talk therapy that works on thoughts and habits about food, can effectively treat bulimia.
Fluoxetine is the only medicine the FDA has approved specifically for bulimia. It is an SSRI, a type of antidepressant. Talk therapy combined with an SSRI may help when talk therapy alone does not work. Nutritional counseling is part of most treatment plans. Most people are treated as outpatients. Severe cases may need a partial hospital program or an inpatient stay.
When to see a doctor
Talk to a doctor or mental health professional as soon as you or your child shows signs of an eating disorder. In some cases, eating disorders can be life-threatening. Call 911 for fainting, chest pain, trouble breathing, vomiting blood, or confusion. People with bulimia have a high risk for suicidal thoughts and attempts. If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can refer you to a mental health professional and can monitor your overall well-being during treatment.
Common questions
Can bulimia be cured?
Most patients who have bulimia nervosa will recover from the condition, and eating disorders can be treated successfully. But it is a long-term illness, and relapse is common. Many people still have some symptoms even with treatment. Early care improves the chances of recovery.
What is the difference between bulimia and anorexia?
Both are eating disorders. A diagnosis of anorexia nervosa requires low body weight. Bulimia does not. People with bulimia are often at a normal weight. Some people have both conditions.
What health problems can bulimia cause?
Repeated vomiting can wear down tooth enamel and cause dental cavities. It can also tear the esophagus, the tube that moves food to the stomach. Vomiting and overuse of enemas or laxatives can cause dehydration and low blood potassium. Low potassium may lead to dangerous heart rhythm problems.
How can I help someone with bulimia?
Encourage them to see a health care provider and stay with them through treatment. A person's family can play a key part in treatment. If they are in danger of hurting themselves, call or text 988 right away.
Sources
- MedlinePlus - Bulimia
- National Institute of Mental Health - Eating Disorders: What You Need to Know
- NCBI Bookshelf - Bulimia Nervosa
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
