Bulimia Nervosa: Breaking The Binge-purge Eating Disorder Cycle

Bulimia is an eating disorder that consists of periods of excessive overeating (binge) followed by purging. Binge eating occurs in several different eating disorders, for instance Binge Eating Disorder, however Bulimia Nervosa differs from binge eating disorder in that bulimia is followed by a method of purging.

Most are familiar with Bulimia as a binge-purge cycle, however vomiting is not the only method of “purging.” It is not uncommon for people with bulimia to attempt to manage or offset their food consumption with excessive exercise, laxatives, restricting or a combination of these methods as an alternative to purging.  Another scary form of purging for those who also suffer from Type 1 Diabetes is to manipulate insulin levels in order to manage weight, a terrifying and life-threatening tactic!

Bulimia nervosa typically follows a cycle of food restriction, binge and purge.  Here’s a little more about these two cycles:

Restriction:   Restriction or deprivation is an important element of the dangerous binge-purge cycle. This is because dieting, food restriction or the threat of starvation triggers us to binge eat. It is the result of starvation dating back to our ancestors. it was our body’s normal response to starvation.

Binge:  Individuals with binge eating disorder and bulimia tend to hide their excessive food intake. As we discussed on a previous blog article, it is important to note that a “binge” episode is not clearly defined by caloric intake;  some professionals may describe it as the consumption of an unusual amount of food intake in one sitting or within a 2 hour time period.  However in order to meet the diagnostic criteria for a true eating disorder, the binge episodes go beyond the amount of calories or food items consumed; the binge episodes are distressing and those suffering from this disorder often say they feel a lack of control. In an article on PsychCentral, Dr. Toby Goldsmith explains, “once a binge begins, it is very difficult to interrupt.” It is not uncommon for people to describe being lost in a “trance” during their binge episodes. Binge episodes can be planned or unplanned and these episodes are typically accompanied by mood changes before, during and after.

While there are a variety of individual triggers that may lead to a binge episode, some of the more common triggers are:

  • uncomfortable mood states
  • interpersonal stress
  • disrupted hunger/fullness cues (often stemming from dietary restriction)
  • negative feelings related to body image

Purge:  Following a binge, it isn’t uncommon for people suffering from bulimia nervosa to feel immense guilt or shame. In some cases, even if the type or quantity of food is what most would consider normal, a person with and eating disorder may attach guilt or shame to certain food choices.  This often leads to purging, which can be done by using laxatives, exercise, vomiting or diuretics, each of which carry significant dangers when misused.

After a binge, many report that purging brings back a momentary feeling of control to their lives. Some individuals have described the act of purging as momentarily euphoric, distracting them from the real issues at hand. Bulimia has also been compared to drug addiction because of the the temporary release of endorphins, or feel-good hormones.


Managing weight through these methods has incredibly detrimental effects on the body. Frequent binge/purge cycles can place incredible stress on the body. The stress of this cycle can lead to

  • arrhythmia
  • electrolyte imbalance
  • heart attack
  • inflammation, tears or rupture of the esophagus
  • gastroparesis or chronic gastric reflux.
  • mouth sores
  • degradation of the gums and teeth
  • puffy cheeks or jaws come from swollen salivary glands
  • damage to the kidneys
  • damage to the intestines can cause bloating, diarrhea, or constipation
  • anemia
  • ruptured vessels in the eyes due to the force of vomiting

It is very important to know that these health issues do not always disappear once you have overcome the illness; conditions such as gastroparesis can last for years after the cessation of binge-purge behaviors and the damage to the gastrointestinal system can last for a lifetime.

It is important to understand bulimia nervosa is more than just about food; it is about overwhelming emotions, and feelings of lack of control over the sufferer’s life. This sense of lack of control triggers the binge-purge cycle which is difficult to stop without professional help.  The good news?  There is help available!

Sabrina Landa is a clinical intern who offers counseling services here at Empowerment Treatment & Counseling Center while she completes her Masters degree in Professional Counseling at Grand Canyon University.

If you or someone you know needs help, talk with your health care provider or give us a call!  We have a caring staff of seasoned therapists in our Phoenix/Glendale, Arizona offices who have experience in helping people heal from the past, find meaning and joy in the present, and embrace hope for the future.  (623) 810-1663


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