Bulimia (cont.)

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is bulimia?
• What causes bulimia?
• How is bulimia diagnosed?
• What are signs that may suggest a person has bulimia?
• What medical complications and long-term effects can bulimia have?
• How is bulimia treated?
• Bulimia At A Glance
• Patient Comments: Bulimia - Describe Your Experience
• Patient Comments: Bulimia - Treatment
• Find a local Psychiatrist in your town
• Bulimia Index

As with anorexia, 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).