Bulimia Nervosa and the Myth of the Perfect Body

As one of the most well-known kinds of eating disorder, bulimia nervosa affects over 5 million men and women in the United States alone. Although the stereotype holds that only women have the disorder, almost 25 percent of cases are observed in men. Another stereotype surrounding bulimia nervosa is the misconception that it’s primarily about food. 

On the contrary – bulimia nervosa’s notorious cycle of binge eating sessions followed by purging is a behavioral symptom, not the cause.

Many factors combine to cause bulimia nervosa in the (mostly) young men and women it commonly afflicts. There are genetic factors; people whose parents had bulimia nervosa are much more likely to develop the disorder themselves. Similarly, there are biological factors. Women and girls predominate the diagnosis of bulimia nervosa. However, psychological and psychiatric factors are the best indicators of a burgeoning case of bulimia nervosa.

Body Image and Self-Esteem

So, bulimia nervosa isn’t really about food. What’s it all about, then?  

In short, it’s about being dissatisfied with one’s body, especially one’s weight.  

Most people feel negative about their bodies at some point in their lives. Body image is a central part of how we see ourselves, how we interact with others, and how attractive we feel. In most forms of eating disorder, the individual suffers from a not only negative but flawed body image. Regardless of their actual weight or body shape, they tend to perceive themselves as “fat” or “overweight.”

This results in disordered eating patterns that are designed to force weight loss, such as the self-starvation that accompanies anorexia nervosa. With bulimia nervosa, the defining behavioral symptom is a cycle of binge eating episodes, in which a person will eat a large amount of food in a short period, and then purge those calories through a variety of means. The most common method is self-induced vomiting, but abuse of laxatives and diuretics, excessive exercise, and abusing diet pills are also frequently observed.

In striving to lose weight (even if they are dangerously underweight in reality), people with bulimia nervosa are really striving to improve their self-image.

Perfectionism and Reaching for Unattainable Goals

Disordered body image leading to a case of bulimia nervosa is often fueled by perfectionism. Perfectionism, in a clinical sense, isn’t the laudable trait many people assume it to be. Rather than a barista trying to make the perfect cup of coffee, for example, or a lawyer making an airtight closing argument, clinical perfectionism often leads to chronic self-esteem issues. 

All too often, maladaptive perfectionism leads people to chase unattainable goals. In cases of bulimia nervosa, the individual is trying to achieve the “perfect body.” Despite the methods used to attain this kind of “perfection” being potentially harmful, with health consequences such as heart disease, malnutrition, and eroded teeth, people with bulimia nervosa will continue to lose weight. 

Perfectionism also inspires negative feelings and exacerbates symptoms of depression. Since the goal of a “perfect” (skinny) body is not reachable or healthy, people with bulimia nervosa might feel like failures, inspiring more negative self-esteem issues and furthering the cycle.  

Add to this the presentation of “the perfect body” in films, TV, advertising, and even social media, there are constant assaults on their self-esteem. When caught in a cycle of shame about binging and purging (a common feeling for people with bulimia to have), and seeing what society presents as perfection, a feeling of hopelessness can set in. While their relationships with food are disordered, the root cause is more often than not driven by a sense that their body is flawed, and an overwhelming compulsion to somehow “fix” those flaws.

The Perfect Body Isn’t Attainable. Peace of Mind Is.

Bulimia nervosa treatment can be very effective, although it’s never a “quick fix.” Months and often years of therapy are normally required. However, it can result in a full recovery if the underlying causes are properly addressed. One way to do so is to promote the concept of HAES, “Healthy At Every Size,” which helps people with flawed body image and perfectionism embrace their natural body shape and size and learn to accept themselves as they are. If you or a loved one is struggling with bulimia nervosa or a distorted body image, don’t wait. Reach out for help and get started on a happier, healthier life.


With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment  – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.