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Bulimia bloat is not a medical term, but it is frequently used to describe the distended (swollen) belly that commonly occurs in people who are struggling with or in recovery from bulimia nervosa (BN).
Like most cases of bloating, the issue is usually the consequence of excess gas in the digestive tract, which can have a number of causes. Bloating related to BN can also be physically painful, and a potential psychological hazard, particularly for those in eating disorder recovery, as the discomfort and swollen stomach can evoke negative emotions around body image, food, and eating.
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But bulimia bloat is also one of the most easily treatable symptoms of BN, typically lasting for just a few weeks until eating patterns stabilize and the digestive system heals.
Bloating is one of the most common gastrointestinal (GI) effects associated with BN, often occurring among a suite of other GI issues, such as indigestion, feelings of fullness, and abdominal pain.1
Due to the disordered eating patterns involved in BN, there are a number of ways the condition can lead to bloating.
Bulimia nervosa is an eating disorder characterized by recurring cycles of binging and purging. These behaviors put a lot of strain on the GI tract and tend to disrupt the digestive process as a whole.
Frequent purging behaviors have been tied to delayed gastric emptying, a symptom that involves food staying in the stomach longer and taking longer to move through the rest of the digestive tract.5 When this happens, food has more time to ferment in the body, producing gas throughout the process which can lead to bloating.4 It may also contribute to the feelings of fullness that often accompany bloating.
Eating certain foods too quickly, as is frequently the case in binging episodes, has also been found to lead to bloating.8 And binging episodes have also been tied to highly palatable foods, including those which are artificially sweetened, which can also lead to bloating.15,16
Highly processed foods, such as those high in artificial sweeteners and carbohydrates, can lead to bloating, and these foods tend to be consumed during binge eating episodes.15,16 Foods high in salt—another common ingredient in highly processed foods—can also contribute to water retention, which can present as bloating.9
Processed food and food devoid of proper nutrients also lack the proper flora the digestive system needs to feed its army of helpful probiotics, or the microorganisms that promote digestion and gut health. Improper flora means unhealthy bacteria gain predominance and produce gas, which contributes to bulimia bloating.3
Bulimia nervosa can also have an impact on the pancreas, a gland that plays a pivotal role in the digestive process, primarily by producing digestive juices and other digestion-related hormones. Pancreatitis—or, the inflammation of the pancreas, which often leads to damage—has been connected to BN.6
Chronic pancreatitis can also work to develop exocrine pancreatic insufficiency (EPI), an issue that impacts the number of digestive enzymes the pancreas creates.7
Less enzymes make it more difficult to digest food, and when food cannot be broken down properly, the gut flora is disrupted, allowing unhelpful bacteria to spread, which produces large amounts of gas.2
Constipation is another common GI issue that occurs with bulimia nervosa and could also contribute to bloating.
The symptom could be tied to delayed gastric emptying involved in BN. In many cases, it becomes more of an issue when laxatives are used as a regular purging method.
While this class of drugs was developed to help people more easily move their bowels, the misuse of laxatives has been connected to constipation.2 Constipation can then, in turn, lead to bloating or the sensation of fullness or internal pressure in the abdomen.
When it comes to bloating, fiber can be a tricky issue. Fibrous foods can actually help reduce bloating in certain cases. But eating too much of these foods, or eating them too quickly, can also lead to bloating.8 And eating large volumes of food—and eating them quickly—are hallmarks of binge eating episodes.
Water retention, or edema, is common among people with BN, particularly after periods of food restriction or during periods of refeeding and recovery.9 This isn’t exactly the same thing as bloating, but it can produce similar effects, including a protruding stomach, discomfort, and tightness in the abdomen.
How does bulimia bloat differ from regular bloating?
Physiologically, "bulimia bloating" represents the same GI complications that occur in people who do not have the eating disorder.14 But it's the cause of these issues that generally separates bulimia bloat from regular bloating.
People without BN may also struggle with constipation, eat highly processed foods, have certain food allergies or sensitivities, and experience pancreas issues and all the other issues responsible for bloating. But ultimately, these problems don’t come from the same complications presented in BN and are, for the most part, a short-term issue for someone without bulimia nervosa.
Someone with BN is more likely to consistently struggle with these issues, as they can frequently arise from the disordered eating behaviors associated with the condition. And someone with BN is more likely to develop GI issues in general than someone without the condition.
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How to treat bulimia bloat and ease discomfort
Thankfully, treating bulimia bloat is relatively easy. It generally requires patience and a consistent diet more than anything.
Over time, the body naturally gets rid of excess gas in the digestive tract by burping or passing it out through the rectum. This can help alleviate bloating symptoms relatively quickly and effortlessly.
Some herbal teas can help jumpstart this natural process. Tea involving peppermint or lemon have been found particularly helpful for alleviating gas. And products with ginger can also help move along the digestive process and ease digestive discomfort in general.10,11,12,13
However, the best way to treat bulimia bloat is to address the bulimia nervosa itself. Stabilizing eating patterns and building an overall healthier diet and lifestyle helps alleviate or eliminate nearly all of the digestive distress BN can cause.
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If you or a loved one are struggling with bulimia nervosa, anorexia nervosa (AN), or another eating disorder, it's important to seek out help.
It's generally best to turn to medical professionals who specialize in eating disorders, to ensure all the underlying psychological issues driving the disorder are attended to, as well as the physical symptoms.
Your primary care doctor, therapist, or another trusted professional are a great place to start. They may be able to help you secure an official diagnosis or guide you through your next best steps.
You can also reach out to us at Within Health. Our team of multidisciplinary experts can help address the physical, psychological, and emotional aspects of a serious mental health condition like BN, personalizing a treatment plan that's right for you. And our unique program helps ensure you get that tailored help all without having to leave home.
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.
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