Etiology: biological
The exact cause of bulimia nervosa is unknown.
Research suggests that inherited biological and genetic
factors contribute.
Research has also focused on abnormalities in the structure
or activity of the hypothalamus, structure responsible for
regulating eating behaviors.
 Studies suggest that the hypothalamus of bulimics may not
trigger a normal satiation (feeling full or finished) response
The binge behavior of bulimics may also be a response to
low serotonin levels in the brain.
Etiology: cognitive
The perception of one’s body size is
 The idea of an oversized, or fat, body.
Ideas of dichotomous thinking leads to extreme
forms (All or nothing).
Faulty beliefs lead to a distorted schemas.
Negative emotions lead to a faulty interpretation of
the self.
Etiology: sociocultural
Film stars represent an ideal that people compare
themselves to, so they establish standards for how we
should look.
People constantly compare themselves to other people and
their self-esteem is affected by this.
Women are more likely than men or children to be the target
for the media propaganda that promotes thinness.
Schemas and social standards that are set in todays current
society leads to the impossible and unattainable idea of a
pleasant and aesthetic figure.
Eating uncontrollably followed by purging
Vomiting or abusing laxatives or diuretics in an attempt to
lose weight
Using the bathroom frequently after meals
Excessive exercising
Preoccupation with body weight
Dental problems
Sore throat
Feeling out of control
Swollen glands in neck and face
Heartburn, indigestion, bloating
Irregular periods
Weakness, exhaustion, bloodshot eyes
Almost 50% of people with eating disorders meet the criteria
for depression.
Up to 24 million people of all ages and genders suffer from
an eating disorder (anorexia, bulimia and binge eating
disorder) in the U.S.
An estimated 10-15% of people with anorexia or bulimia are
Among gay men, nearly 14% appeared to suffer from bulimia
and over 20% appeared to be anorexic.
An estimated 1.1 to 4.2 percent of women have bulimia
nervosa in their lifetime.
Among the criteria for a diagnosis of bulimia in the
Diagnostic and Statistical Manual of Mental Disorders
IV (DSM-IV) are:
 Repeated episodes of binge eating, including eating an
abnormally large amount of food and feeling a lack of control
over your eating.
Recurrent inappropriate compensatory behavior in order to
prevent weight gain, such as self-induced vomiting; misuse
of laxatives, diuretics, enemas, or other medications; fasting;
or excessive exercise.
These behaviors occur at least twice a week for at least
three months.
Self esteem is overly influenced by body shape and weight.
The eating disorder behavior doesn't occur during periods of
Cultural factors
Particularly in modern Westernized countries, models, the
media and dieting fads currently influence women and girls
to be as thin as possible.
Sociologists studying the development of eating disorders
across time have noted that the ideals of beauty have
changed and that thinness wasn't always considered
In 1999, a study was published about the effects of exposing a
culture to Western television for the first time. Prior to the
television viewing, the people of Fiji believed that the ideal body
was plump, round, and soft. Interviews after 38 months of
exposure to Westernized shows suggested a sharp decrease in
self-esteem and an increase in symptoms of eating disorders in
teenage girls.
Gender differences
Far more common in women than men.
 Still apparent in men.
Men are more likely to have a greater
factor in binge eating, as women are more
likely to have a greater factor in the
immediate and excessive loss of weight.
Treatment approaches
Bulimia treatment requires the consideration of the physical
as well as the psychological needs of the person. Treatment
may include psychological counseling and medications such
as antidepressants or other drugs. In many cases, treatment
is undertaken by a team of medical, nutritional, and mental
health professionals. The ideal outcome of treatment is to
restore physical health and normal eating patterns.
Stress (sociocultural):
Bodily Factors (biological):
The imposing view of the
perfect body by the media and
faulty schemas created.
1. Different levels of serotonin.
2. Damaged or altered
Constitutional (biological)
Psychiatric Outcome
(Bulimia Nervosa)
Cognitive Factors:
Inherited Factors (Biological):
Genetics determine weight and
diet of the individual.
Striegel-Moore, Ruth H., Lisa
R. Silberstein, and Judith
Rodin. (1986)
1. Perception of one’s body size is
2. Negative emotions.
3. Faulty beliefs leading to faulty
Agras, W. Stewart, (2000)