Does bulimia cause weight loss? Will throwing up work?

Key Points

• Bulimia is an eating disorder that involves calorie restriction, followed by binge eating and purging through vomiting or other methods.
• The main goal of purging is to counteract the effects of overeating during a binge but throwing up after meals does not lead to weight loss.
• Living with bulimia can be incredibly hard, but recovery is possible with effective treatment.

Bulimia, or bulimia nervosa, is a serious eating disorder that can have severe and lasting health effects. It follows a cycle of strict dieting, binge eating, and purging. Purging involves vomiting or misusing laxatives to prevent the body from absorbing calories consumed during a binge.

Despite these behaviors, bulimia typically does not lead to weight loss. People with this disorder are mostly in a normal weight range; some are even overweight.

But why do people with bulimia self-induce vomiting after a binge? And why doesn't it work for weight loss? Plus, what happens to a person's health if bulimia is left untreated?

This article explores all this and more.

Can vomiting help you lose weight?

Vomiting, or throwing up, does not lead to weight loss. In fact, bulimia can even make people gain weight over time. This is because our bodies begin to digest food almost immediately after we begin eating.

If the foods eaten are high in sugar and highly processed, calories can be absorbed within minutes. Throwing up after a meal, even immediately, retains more than 50% of the calories consumed.

Another way that people with bulimia attempt to purge is through the use of laxatives or diuretics. However, any weight loss from this method is usually water loss, making it temporary and potentially leading to a host of other health issues.

Experienced Registered Dietitian Rita Faycurry, RD, says, "Learning that bulimia doesn’t cause weight loss is important. However, this information is not to nudge someone with an eating disorder to look for other harmful ways to lose weight. Ultimately, the goal is to build a healthy relationship with food and break free from all forms of disordered eating."

Why do people with bulimia throw up or self-induce vomiting?

Bulimia is an eating disorder marked by cycles of binging and purging. During a binge, a person eats a large amount of food in a short time. To compensate, they may force themselves to vomit or use laxatives and diuretics. Some may also turn to excessive exercise to burn off calories.

Binging often comes with feelings of losing control, as well as guilt, shame, and intense anxiety. Purging becomes a way to try to relieve this tension and "undo" the binge.

It's a vicious cycle that starts with the urge to diet or severely restrict calories between binge eating episodes. The calorie restriction, stress, and overwhelming emotions, combined with a negative body image, can trigger the next binge eating episode.

While binge eating may bring temporary feelings of relief and a false sense of control, constant binging and purging can have long-term health consequences.

Bulimia risks: Harmful effects of binge eating and purging

According to the National Eating Disorders Association (NEDA), bulimia nervosa is a life-threatening eating disorder that leads to health issues impacting the mind and body.

Physical health

• Electrolyte imbalances: Frequent vomiting can lead to severe imbalances such as hyponatremia or low sodium and hypokalemia or low potassium. This can lead to fatigue, dizziness, an irregular heartbeat, and seizures.
• Tooth erosion: Repeated purging brings stomach acid into contact with teeth, leading to enamel erosion, cavities, tooth decay, sensitivity to hot and cold foods, and gum disease. Additionally, vomiting stimulates saliva production, and repeated exposure to stomach acid causes the salivary glands to become inflamed and swollen, leading to puffy cheeks or "chipmunk cheeks."
• Throat issues: People with bulimia can develop a sore throat and mouth ulcers from stomach acid contact. In extreme conditions, cells in the esophagus may change their shape to resemble that of the stomach. This condition is known as Barrett's esophagus (BE). Throwing up frequently can lead to a tear in the food pipe called a Mallory-Weiss tear, resulting in blood in the vomit. If the tear is severe, it can lead to life-threatening bleeding.
• Cardiac issues: Bulimia can damage heart cells, leading to congestive heart failure, arrhythmias, and even sudden cardiac death.
• Hormonal imbalances: Females with bulimia often have low estrogen levels, and experience skipped or missed periods, increasing the risk of infertility.

Emotional health

Bulimia nervosa is associated with several mental health conditions and can significantly worsen emotional well-being.

Co-existing psychological disorders

The constant binging and purging and the secrecy surrounding eating disorders like bulimia can increase stress levels.

People with bulimia may also battle severe depression, obsessive-compulsive disorder (OCD), anxiety, impulsiveness, low self-esteem, and poor body image. Often, they may also have issues with addiction or substance use disorder.

Potential to lead to other eating disorders

According to Faycurry RD, "There is a risk that bulimia may morph into a different eating disorder. An example is when it becomes harder for someone with bulimia to purge in secret after meals. In this case, they may begin to restrict food intake to lose weight without purging, leading to anorexia nervosa. This is dangerous and can be a toxic disordered eating cycle of binge eating disorder, bulimia, and anorexia."

What causes bulimia nervosa?

The exact causes of bulimia nervosa are unknown, but several factors increase the risk of developing the disorder.

Genetics

According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), there is a 28%-83% risk of developing eating disorders if there is a family history.

Chemical imbalances

Eating disorders may also be linked to a chemical imbalance in the brain involving serotonin, the "happy hormone" primarily produced in the gut.

Some research indicates that females with diabetes may be at a higher risk of developing eating disorders. This may be due to fluctuating blood sugar levels. These shifts can affect appetite and mood, which might trigger the urge to binge.

Coping with trauma and negative emotions

Many who binge and purge use food as a way to cope with negative emotions, trauma, childhood neglect, and challenging transitions such as changing jobs or schools, going through puberty, or heartbreak.

Studies show that more than 50% of people with eating disorders also have post-traumatic stress disorder (PTSD). Research also suggests a strong link between bulimia and childhood sexual assault.

Social pressure related to weight

The social pressure to be "skinny" can trigger eating disorders. Kids bullied or shamed for their weight are especially vulnerable. Even indirect messages, like hearing loved ones praise others for being "thin," can have a lasting impact. Add constant ads promoting the "perfect" body, and the influence grows stronger.

At the same time, the food industry floods us with messages to "treat" ourselves with ultraprocessed foods. Packed with empty calories and lacking fiber, these foods are engineered to hijack brain chemicals and fuel binge eating.

Bulimia diagnosis

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) outlines the criteria for diagnosing bulimia as:

• Binge eating: eating large amounts of food in a short period of time (less than two hours) compared to what people usually eat in the same timeframe. During a binge, the person will report feeling a lack of control over their feeding habits.
• Compensatory behaviors: A binge followed by purging, laxative misuse, fasting, or excessive exercise to negate the effects of the binge.

Faycurry RD notes, "Binging and purging must take place at least once a week for 3 months to be considered bulimia nervosa."

If you suspect you or a loved one has bulimia, please visit a licensed healthcare provider who has experience with eating disorders. They are the only professionals authorized to diagnose bulimia.

Bulimia treatment and recovery

Like all eating disorders, bulimia can be overwhelming and wreak havoc on a person's mental and physical health. Many feel trapped in the restrict-binge-purge cycle and cannot imagine a life free from thoughts of food.

However, recovery is possible, and individuals can build a better relationship with food. The first step is to seek treatment from experts who specialize in eating disorders.

Find the best bulimia treatment near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.