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Bulimia nervosa (BN) is an eating disorder characterized by a recurrent cycle of binging and purging or other compensatory behaviors. It’s a potentially life-threatening illness often accompanied by mental health disorders such as depression and anxiety disorders. Understanding bulimia facts and statistics can help break the stigma around eating disorders and encourage more individuals to seek help.
Bulimia nervosa appears statically uncommon; however, it is considered a public health concern as BN and other eating disorders are often under-treated. Many eating disorders co-occur with other psychopathology and medical professionals may view the signs of an eating disorder as a result of another condition.1
Women are 5x more likely to develop bulimia.
The average age of onset for bulimia is eighteen, with an overall prevalence of 0.3%. Broken down by gender, bulimia develops in 1.5% of women and 0.5% of men, making it five times more common to develop in women.1,2
Bulimia statistics in minority populations
While further research is needed to understand how bulimia affects sexual and gender minorities, studies indicate that the lifetime prevalence of bulimia in sexual minority adults is 1.3%, which is higher compared to cisgender heterosexual adults.3
Furthermore, the lifetime prevalence of bulimia in transgender men and transgender women is reported to be 3.2% and 2.9%, respectively which is significantly higher than in the cisgender population.3 Body dissatisfaction (gender dysphoria is known to increase body dissatisfaction) may be a core contributing factor to eating disorder development, in transgender individuals.3
Minority stress and discrimination may also contribute to the higher levels of disordered eating behaviors in sexual and gender minority behaviors.
Additional research on eating disorders among LGBTQ+ populations shows:4
Gay and bisexual boys are significantly more likely to have engaged in purging behaviors to control their weight in the last 30 days.
Gay, lesbian, and bisexual teens are at higher risk of binging and purging than their heterosexual peers.
Gay males are seven percent more likely to report binging and twelve times more likely to report purging than heterosexual males.
These bulimia facts and statistics recognize a need for further research into the specific eating disorder risk factors and intervention strategies for sexual and gender minorities. Plus, training and better education in the treatment of eating disorders beyond the gender binary will be essential in addressing the disparity in eating disorder prevalence.
Bulimia facts: Causes of Bulimia
Medical professionals are unsure of the exact cause of bulimia, but it’s believed genetics and environment play a role in someone’s development of bulimia. Examples of risk factors include:5
Traumatic life experiences
Physiological influence
A family history of eating disorders
Exposure to an environment focused on body size and dieting
LGBTQ+ people may experience additional unique factors that play a role in eating disorder development, including but not limited to:4
Fear of rejection or experiences of rejection.
Being a victim of discrimination or bullying due to one’s sexual orientation and/or gender identity.
Internalized negative beliefs about oneself due to their sexual orientation or gender identity.
Conflict between one’s biological sex and gender identity
Perception that one doesn’t meet the body ideals and body shape within some LGBTQ+ cultures and communities.
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Bulimia nervosa mortality rates
Eating disorders have the highest mortality rate of any mental illness, including a higher risk of suicide. Previous studies showed that mortality rates were low for bulimia nervosa despite medical complications associated with the condition. However, more recent research finds a 3.9% mortality rate for bulimia compared to the 4% rate for anorexia nervosa. The highest mortality rate (2.3%) is between 20-30.5
Cardiac arrest is the most common cause of death among those with bulimia. The habitual purging of bulimia can cause an imbalance in electrolytes, which are minerals in the blood responsible for maintaining vital bodily functions, including regulation of the heart’s rhythm. When the body has an electrolyte imbalance, it can cause an irregular cardiac rhythm and disrupt other important functions of the heart. Other causes of mortality related to bulimia include choking during self-induced vomiting, esophagus or stomach rupture, kidney failure, and suicide.
There is no set time for bulimia recovery. It varies from person to person and is dependent on numerous factors. You may find yourself feeling in a more comfortable place in your recovery journey within a few months, while for others it may take years for a person to repair their relationship with food and themselves.
Bulimia relapse
It’s also important to remember that eating disorder treatment is not a linear process. Relapses into disordered eating behaviors are not uncommon, particularly in the first year of recovery.6
A study from the American Journal of Psychiatry indicates that 31% of those with bulimia relapse within the first two years of recovery with the majority of relapses occurring in just the first six months of treatment.9
Weight and body image distortions and co-occurring mental health conditions are both correlated with a risk of eating disorder relapse for people with bulimia. Additionally, those with more frequent self-induced vomiting are also at an increased risk of relapse.9 Other relapse risk factors include low self-esteem, limited social relationships, and low motivation for recovery.
Relapse can happen to anyone, but typically it’s more common in adolescents and those who don’t receive treatment for co-occurring mental health conditions.
So, if you relapse during your recovery journey, know that you’re not alone. Relapses are part and parcel of the recovery process that often provide valuable insights to your care team by identifying new skills to work on, helping to boost your confidence and enrich your recovery.
Get treatment for bulimia nervosa
Seeking help early on can significantly increase a person’s chances of a full recovery and decrease the risk of relapse. It takes courage to start the healing process, but the key is finding trusted and compassionate experts, including mental health professionals, for guidance. The team at Within Health understands the complexity of bulimia and provides evidence-based treatments personalized to fit each individual.
Reach out to the admission team at Within Health to start healing from bulimia.
Personalized treatment for bulimia—at home
Receive treatment for bulimia from the comfort of your own home. Attend therapy sessions online, manage your schedule from an easy-to-use app, and get meals delivered to your door.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Hetman, I., Klomek, A.B., Goldzweig, G., Hadas, A., Horwitz, M., & Fennig, S. (2017.) Percentage from target weight (PFTW) predicts re-hospitalization in adolescent anorexia nervosa. Israel Journal of Psychiatry, 54(3), 28-34.