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Bulimia Nervosa (Part 2)

What causes bulimia?

Researchers are not sure exactly what causes bulimia and other eating disorders; they are finding that a complex combination of genetic, biological, behavioral, psychological, and social factors may be the cause. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses. Researchers are also studying unusual activity in the brain, such as changing levels of serotonin or other chemicals, to see how it may affect eating.

How does bulimia affect a woman's health?

Purging through vomiting or taking laxatives can prevent your body from getting the important nutrients it needs from food. Over time, bulimia can affect your body in the following ways:

  • Stomach damage from overeating
  • Electrolyte imbalance (having levels of sodium, potassium, or other minerals that are too high or too low, which can lead to heart attack or heart failure)
  • Ulcers and other damage to your throat from vomiting
  • Irregular periods or not having periods, which can cause problems getting pregnant
  • Tooth decay from vomiting
  • Dehydration
  • Problems having bowel movements or damage to the intestines from laxative abuse

Long-term studies of 20 years or more show that women who had an eating disorder in the past usually reach and maintain a healthy weight after treatment.

How is bulimia diagnosed?

Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating, purging, or exercise behaviors. However, doctors and nurses want to help you get better. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.

Your doctor may do blood or urine tests to rule out other possible causes of your symptoms. Your doctor may also do other tests to see whether you have any other health problems caused by bulimia. These tests may include kidney function tests or an electrocardiogram (ECG or EKG) to see if or how repeated binging and purging has affected your health.

U.S. Department of Health and Human Services (DHHS), Office on Women's Health (OWH). (Updated 2025, September 18). Bulimia nervosa. Retrieved March 12, 2026, from https://womenshealth.gov

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