When you think of an eating disorder, you might imagine someone who’s very thin and struggles to maintain their weight. But eating disorders are more complex than that. One such eating disorder is bulimia, which is characterized by cycles of binge eating and then purging, according to the National Eating Disorders Association. While dieting and weight loss is a major concern of those with bulimia, weight gain can actually be a common side effect.
Bulimia nervosa, often just referred to as bulimia, is a serious and dangerous eating disorder, notes the National Eating Disorders Association. Those with bulimia often eat more than most people in one sitting or feel a lack of control over how much they eat. This is followed by behaviors to try to undo the effects of how much they’ve eaten, such as vomiting, excessive exercise, fasting, or misusing laxatives.
Signs that a loved one may be experiencing bulimia can include secrecy about eating, rotating between binge eating and fasting, disappearing to the bathroom after eating a meal, the smell of vomit, discolored teeth, persistent weight fluctuations, and excessive exercise (via HelpGuide). Risk factors include poor self-esteem and body image, a history of trauma and abuse, and going through stressful life transitions.
If you need help with an eating disorder, or know someone who does, help is available. Visit the National Eating Disorders Association website or contact NEDA’s Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).
A pattern of eating that can cause weight gain
It’s common that those with bulimia will actually gain weight, which is typically the opposite of the intended outcome, according to Psychology Today. A 2024 study published in the International Journal of Eating Disorders found that roughly 60% of participants gained weight, gaining an average of 40 pounds in three years.
This is most likely due to the binge-restrict cycle. When you lose so much weight that you reach underweight levels, your body can respond to this danger of starvation by cueing you to eat more. Those with bulimia may then binge eat, become worried about how much they’ve eaten, and then purge or restrict. This could not only mean that they gain the weight lost back, but they could eventually gain more than they weighed previously. Some experts believe that this possibility of weight gain could be used as a tool to motivate people to recover.
Typical treatment for bulimia involves both psychotherapy and antidepressant medication, according to the Mayo Clinic. Effective psychotherapy modalities include cognitive behavior therapy (CBT) and family therapy. The Food and Drug Administration (FDA) has only approved Prozac, a selective serotonin reuptake inhibitor, to treat bulimia. Other strategies like nutrition education, constructing healthy relationships, and learning ways to cope with stress can also be helpful.
