Bulimia Nervosa

Bulimia Nervosa is a painful and exhausting cycle—one that often unfolds in secret and leaves people feeling trapped. It involves episodes of eating large quantities of food in a short span of time (often within minutes or hours), followed by attempts to “undo” the eating through behaviors like vomiting, fasting, excessive exercise, or misuse of medications. While the behaviors may seem like an effort to manage weight, they’re more often rooted in deeper emotional struggles: anxiety, shame, a need for control, or a desperate attempt to quiet inner chaos.

Bulimia can lead to serious medical and psychological complications—including electrolyte imbalances, heart issues, anxiety, depression, and in extreme cases, death. But healing is possible. And it doesn’t require shame or willpower—it requires understanding, support, and a new way of relating to the parts of yourself that feel stuck in this cycle.

A client I’ll call “Talia” once said: “The bingeing felt like I was trying to fill a hole I couldn’t see. And the purging felt like trying to erase myself afterward. It was all so loud in my head—I couldn’t tell which voice to believe.”

In our work together, we used tools from Internal Family Systems (IFS) to identify and gently connect with the parts of her that binged, purged, criticized, and protected. Through Acceptance and Commitment Therapy (ACT), Talia also began clarifying her values—what truly mattered to her beneath the noise—and learning how to take actions that aligned with those values, even when uncomfortable feelings arose.

The DSM-5 outlines the following criteria for Bulimia Nervosa:

• Recurrent episodes of binge eating, involving:

  • Eating an amount of food in a discrete period (e.g., within 2 hours) that is larger than most people would eat under similar circumstances

  • A sense of lack of control during the episode

• Recurrent compensatory behaviors to prevent weight gain, such as vomiting, laxative misuse, fasting, or excessive exercise

• These binge-purge episodes occur at least once a week for three months

• Self-worth is overly influenced by body shape and weight

• The behaviors are not limited to episodes of anorexia nervosa

Bulimia often emerges in response to a perfect storm of emotional pain, social pressure, and unspoken inner beliefs. If this feels familiar, know that there's a reason for your suffering—and also a path forward. Therapy offers a safe and steady space to explore what’s beneath the surface, build awareness without shame, and develop new ways to relate to food, your body, and yourself with compassion.

Recovery isn’t about becoming someone different. It’s about reclaiming who you are beneath the struggle—and allowing that self to lead.