Non-purging bulimia is a type of eating disorder in which a person uses a form of “compensatory” behavior, such as exercise, to counteract periods of binge eating.
Bulimia is a type of eating disorder. In the classic presentation, a person consumes a large amount of food in one sitting and then purges it through self-induced vomiting or the use of diuretics or laxatives.
Non-purging bulimia is a different presentation of the same condition. Instead of using a method to remove the food from their body, a person will engage in another behavior meant to “compensate” for overeating. This may include excessive exercise or skipping meals.
This article reviews what non-purging bulimia is and how it differs from purging bulimia. It also explores symptoms, methods, dangers, and more.
Non-purging bulimia is one type of bulimia nervosa, an eating disorder associated with episodes of overeating followed by guilt and a desire to “correct” the overconsumption.
Doctors refer to actions a person performs to try to undo the effects of binge eating as “compensatory behaviors.” In non-purging bulimia, these may include:
- excessive exercise
- meal adjustments
- the use of stimulants
Periods of overeating often occur in private. They are associated with a feeling of being out of control. A person may stop eating once the food runs out, they get interrupted, or stomach discomfort occurs.
For a doctor to diagnose bulimia, a person needs to have experienced at least two episodes of overeating per week for a minimum of 3 months.
Bulimia can occur in anyone. However, people assigned female at birth have a
Non-purging and purging bulimia are two types of the same condition. Overeating that is difficult to manage occurs in both types.
The two forms differ in terms of the compensatory behaviors a person performs after overeating. In purging bulimia, a person induces vomiting or takes medications, such as diuretics or laxatives, to try to get rid of the excessive food intake from their body.
In non-purging bulimia, the person chooses to use stimulants, change their meals, or engage in excessive exercise to counteract episodes of overeating.
Experts
Help is available
Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.
Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.
For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).
Many other resources are also available, including:
- The National Association of Anorexia Nervosa and Associated Disorders
- F.E.A.S.T., which provides support and educational resources to friends and family who want to help someone living with an eating disorder
Non-purging bulimia can cause several symptoms.
People living with bulimia often have a moderate weight. However, they
- fear gaining weight
- express intense unhappiness with their body’s shape and size
- seem desperate to lose weight
A person may also develop rules about food, such as assigning “good” and “bad” foods. They may also experience a depressed mood.
Physical signs and symptoms of non-purging bulimia
- low blood pressure
- swelling of the parotid gland, the salivary gland just in front of the ears
- dry skin
- edema or swelling of the limbs
- hair loss
- nosebleeds
A person may also develop an irregular menstrual cycle that can include missed periods, or the cycle may cease altogether.
Compensatory behaviors to counteract episodes of overeating in non-purging bulimia can include the use of stimulant medications, meal adjustments, or exercise.
Stimulant medications
Stimulant medications can alter a person’s appetite. Stimulants can include medications, such as Ritalin, illegal drugs, such as cocaine, or over-the-counter (OTC) supplements, such as caffeine pills.
A 2019 study estimates that as many as 50% of people with an eating disorder develop a substance use disorder. Commonly misused stimulants and other substances among people with eating disorders include:
- laxatives
- diuretics
- cocaine
- amphetamines
- alcohol
- emetics
- heroin
According to the same study, researchers are unclear about the exact relationship between substance misuse and eating disorders. However, they note that a person who develops either condition has a higher chance of developing the other.
Meal adjustment
A person with non-purging bulimia may adjust their meals to compensate for an episode of overeating. This can include:
- fasting
- skipping meals
- eating significantly smaller meals
Exercise
Excessive exercise
Bulimia can cause several potential issues with a person’s health, even if they maintain a moderate weight.
A person’s weight may fluctuate as they attempt to manage it through various methods, such as excessive exercise or changes in eating habits.
Experts typically focus their assessment of bulimia complications on those that can occur due to frequent vomiting in purging bulimia, which:
is associated with several complications related to the esophagus, teeth, and other aspects of the digestive system- can increase the risk of heart-related complications, such as heart attack or potentially sudden death, due to an imbalance of electrolytes associated with frequent vomiting
- increases the risk of esophageal cancer and other digestive issues
A possible complication of non-purging bulimia may be an increased risk of type 2 diabetes. This can occur if a person develops insulin resistance or experiences weight gain due to an excessive calorie intake.
A person with non-purging bulimia may also develop or already be living with other mental health conditions, such as anxiety. These may require additional treatment.
There are also
With treatment, many people with non-purging bulimia can recover.
The
The primary treatment attempts to stop the overeating behavior. Secondary treatment goals may include treating any other comorbid conditions or complications associated with bulimia.
Healthcare or mental health professionals may recommend the use of selective serotonin reuptake inhibitors (SSRIs), such as:
A doctor may also recommend using therapies, such as cognitive behavior therapy (CBT). Some people may find that they prefer group therapy sessions or find them more helpful due to the support members can provide each other.
In many cases, a comprehensive, flexible treatment plan is helpful for treating non-purging bulimia.
A person living with non-purging bulimia may want to seek out support from groups, mental health professionals, or other healthcare professionals.
People can use this tool from the National Eating Disorders Association (NEDA) to find support, including in-person and online support groups.
For a national listing of local treatment options, a person can check the NEDA’s map of resources.
If someone is already working with a mental health professional for a different reason but also has concerns about bulimia, they can bring these up during a treatment session. Their doctor or practitioner may be able to provide direct support or recommend additional therapies.
People with non-purging bulimia do not induce vomiting. Instead, they may use exercise, stimulants, or extreme changes to their diet to “compensate” for an overeating episode.
A person living with bulimia may exhibit signs such as an obsession with weight management or perceiving foods as “good” or “bad.” They may also have some fluctuations in weight.
Complications associated with non-purging bulimia may differ from those linked with purging. However, some may be the same in both types, such as an increased risk of developing type 2 diabetes. Both also lead to an increased mortality risk.
Treatment may involve a combination of medication and therapy. A person may find that support groups provide further help during and after treatment.
If an individual is experiencing symptoms of non-purging bulimia, it is important that they contact a healthcare or mental health professional.