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Causes of Bulimia Nervosa

Comprehensive look at causes of bulimia nervosa. Learn about 8 different bulimia causes putting you or loved one at risk for developing bulimia nervosa.

What are the causes of bulimia? Why is bulimia so common in North America?

In the United States about 1 million men and 7 million women suffer from an eating disorder, and the lifetime prevalence of bulimia in women is 1% - 3%. (See bulimia statistics) Many causes of bulimia are suspected but it is clear that eating disorders are linked to a cultural obsession with thinness and beauty. The causes of bulimia nervosa include factors that are biological, genetic, cultural, environmental and psychological.

Biological Causes of Bulimia

There are several parts of the body thought to contribute to eating behaviors including the hypothalamic-pituitary-adrenal axis (HPA). This system originates in several areas of the brain and is responsible for releasing neurotransmitters (chemical messengers) that regulate stress, mood and appetite. Of particular importance to eating disorders is the chemical messenger serotonin which is thought to be related to well-being, anxiety and appetite. A deficiency in serotonin is thought to be one of the causes of bulimia development1 and may be why selective serotonin reuptake inhibitors (SSRIs) are sometimes used for bulimia treatment.

Genetic Causes

No specific gene has been linked to bulimia, but it is known that a family history of eating disorders increases the child's risk of developing an eating disorder 2 - 20 times that of the general population. Studies also show that twins have a tendency to share specific eating disorders, including bulimia. At this time, areas on two chromosomes appear to be one of the causes of bulimia nervosa and anorexia but scientists are doubtful that a single gene will ever be found. Instead, it is likely that a number of genes contribute to an overall susceptibility to bulimia.2

Risk Factors

The risk factors for bulimia center on physical, behavioral and psychological traits. Bulimia nervosa appears almost entirely in women with only 2% - 8% of cases being male. Bulimia has a median onset of age 18. Bulimic women tend to be of normal weight or slightly overweight. Bulimia is also common among people with type I diabetes.

It is thought that five personality traits put a person at the highest risk for bulimia or anorexia:

  • Obsessive
  • Perfectionist
  • Anxious
  • Novelty-seeking
  • Impulsive

Last Updated: 14 May 2016
Reviewed by Harry Croft, MD

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