Bulimia nervosa

Our relationship with food can be damaging such as getting into a cycle of eating too much food and then trying to undo the effects. Unhealthy habits can be bingeing followed by starving yourself, making yourself sick or using laxatives, thinking constantly of eating, eating in secret, having irresistible cravings for certain foods and thinking yourself fat. This is known as bulimia nervosa.

The causes of bulimia are multiple such as social pressures, wanting to control, family problems, depression, low self-esteem and emotional distress. But you can recover from your eating disorder and improve the quality of your life. Nightingale Hospital London can help you take that vital step to regain a healthy and happy life. Please call us about bulimia treatment.

Signs and symptoms of bulimia

You may find that you:

  • Worry more and more about your weight
  • Binge eat
  • Make yourself vomit and/or use laxatives to get rid of calories
  • Have irregular menstrual periods
  • Feel tired
  • Feel guilty
  • Stay a normal weight, in spite of your efforts to diet

When does it start?

Bulimia Nervosa often starts in the mid-teens. However, people don’t usually seek help for it until their early to mid-twenties because they are able to hide it, even though it affects their work and social life. People most often seek help when their life changes – the start of a new relationship or having to live with other people for the first time.

About 4 out of every 100 women suffers from bulimia at some time in their lives, rather fewer men.

How can bulimia affect you?

Psychological symptoms

  • Sleep badly
  • Find it difficult to concentrate or think clearly about anything other than food or calories
  • Feel depressed
  • Lose interest in other people
  • Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness)

Physical symptoms

  • Find it harder to eat because your stomach has shrunk
  • Feel tired, weak and cold as your body’s metabolism slows down
  • Become constipated
  • Not grow to your full height
  • Get brittle bones which break easily
  • Be unable to get pregnant
  • Damage your liver, particularly if you drink alcohol
  • In extreme cases, you may die. Anorexia Nervosa has the highest death rate of any psychological disorder.

If you vomit, you may:

  • Lose the enamel on your teeth (it is dissolved by the stomach acid in your vomit)
  • Get a puffy face (the salivary glands in your cheeks swell up)
  • Notice your heart beating irregularly – palpitations (vomiting disturbs the balance of salts in your blood)
  • Feel weak
  • Feel tired all the time
  • Damage your kidneys
  • Have epileptic fits
  • Be unable to get pregnant

If you use laxatives regularly, you may:

  • Have persistent stomach pain
  • Get swollen fingers
  • Find that you can’t go to the toilet any more without using laxatives (using laxatives can damage the muscles in your bowel)
  • Have huge weight swings. You lose lots of fluid when you purge, but take it all in again when you drink water afterwards (no calories are lost using laxatives)

Treatment for bulimia nervosa at Nightingale Hospital

We have the expertise in eating disorders to approach the support and treatment we offer adults and adolescents in a personal and flexible way to benefit you the most in your recovery. Bulimia nervosa treatments here in London can be as an outpatient, day patient or inpatient.

Based on current clinical evidence and put into practice by an experienced, multidisciplinary team of consultant psychiatrists, unit doctors, nurses, a dietician and specialist therapists, our approach to bulimia treatment at Nightingale Hospital London is tailored to the individual.


Through intensive psychological and emotional support in group therapy sessions and individual counselling and psychotherapy, you can understand underlying factors that have contributed to your bulimia and find strategies to overcome the eating disorder. Cognitive Behavioral Therapy can help you identify your negative thoughts and learn more positive emotional and behavioural responses to your beliefs about yourself and your eating. Family therapy can improve the way family members relate to each other and communicate and Occupational Therapy can support you practically in returning to a normal life away from your eating disorder.


It can be difficult adjusting to life eating disorders after an inpatient admission, so we offer a step-down programme to our eating disorders daycare, individual counselling and free aftercare groups post inpatient treatment to sustain motivation for living free from an eating disorder.

Family support groups

Those nearest to the sufferer often blame themselves, going through a range of emotions from despair, depression and guilt to anger and frustration, leaving them exhausted and having difficulty coping, as well as feeling powerless in how to deal with the situation.

Research has shown that the involvement of families in the treatment process greatly increases the prospects of a person’s recovery.

Recent family support group feedback

  • “It was good to meet up with other people who understand the complexities of caring for a loved one with an eating disorder. The group was well-led. Joanna is very knowledgeable and took the time to listen to everyone even though there were many needs and peoples at different stages of the journey.”
  • “We cannot thank you enough for the education and advice this group has offered and the chance to discuss our questions with yourself and other careers of loved ones. We would be grateful if we could attend future Zoom meetings. We have started to read the advised book and already this is becoming of great help. Thank you again, Joanna.”

Bulimia specialists at Nightingale Hospital

Nightingale Hospital London has a number of consultant psychiatrists and therapists that can help you through your bulimia. It is vital you find an eating disorder specialist that you can trust and work with on your recovery. If you cannot find the information you need on bulimia specialists and bulimia treatment programmes we would welcome your call so you feel secure in the decisions you make.

Our team is led by:

  • Nightingale Hospital Lead Consultant for Eating Disorders, Consultant Psychiatrist Dr Helen Murphy
  • Nightingale Hospital Lead Therapist for Eating Disorders, Dr Joanna Silver

Please contact us confidentially on 020 7535 7700 24 hours a day.

Do I have bulimia? How can I help myself?

  • Do you make yourself sick because you’re uncomfortably full?
  • Do you worry that you’ve lost control over how much you eat?
  • Have you recently lost more than 6 kilograms in three months?
  • Do you believe you’re fat when others say you’re thin?
  • Would you say that food dominates your life?

If you answer ‘yes’ to two or more of these questions, you may have a problem with your eating. We encourage you to get in touch with us to discuss this further.

Eating disorder treatment telephone consultation

We offer a free telephone consultation to determine if eating disorder treatment would be right for you, or a loved one. Complete the form below and a member of our expert eating disorders team will be in touch to arrange an appointment.

Helping yourself

  • Bulimia can sometimes be tackled using a self-help manual with some guidance from a therapist.


  • Stick to regular mealtimes – breakfast, lunch and dinner. If your weight is very low, have morning, afternoon and nighttime snacks.
  • Try to think of one small step you could take towards a healthier way of eating. If you can’t face eating breakfast, try sitting at the table for a few minutes at breakfast time and just drinking a glass of water. When you have got used to doing this, have just a little to eat, even half a slice of toast – but do it every day.
  • Keep a diary of what you eat, when you eat it and what your thoughts and feelings have been every day. You can use this to see if there are connections between how you feel, what you are thinking about, and how you eat.
  • Try to be honest about what you are or are not eating, both with yourself and with other people.
  • Remind yourself that you don’t always have to be achieving things – let yourself off the hook sometimes.
  • Remind yourself that, if you lose more weight, you will feel more anxious and depressed.
  • Make two lists – one of what your eating disorder has given you, one of what you have lost through it. A self-help book can help you with this.
  • Try to be kind to your body, don’t punish it.
  • Make sure you know what a reasonable weight is for you and that you understand why.
  • Read stories of other people’s experiences of recovery. You can find these in self-help books or on the internet.
  • Think about joining a self-help group. Your GP may be able to recommend one, or you can contact Beat.


  • Don’t weigh yourself more than once a week.
  • Don’t spend time checking your body and looking at yourself in the mirror. Nobody is perfect. The longer you look at yourself, the more likely you are to find something you don’t like. Constant checking can make the most attractive person unhappy with the way they look.
  • Don’t cut yourself off from family and friends. You may want to because they think you are too thin, but they can be a lifeline.
  • Avoid websites that encourage you to lose weight and stay at very low body weight. They encourage you to damage your health, but won’t do anything to help when you fall ill.


“When you have a problem and you drink, take drugs or gamble, the problem won’t go away. Stay and tackle the problem”