Bulimia nervosa and binge eating disorder (BED) are separate eating disorders. But they’re often compared because they both involve binge eating.
A person with bulimia will “purge” — often through vomiting or laxatives — after a binge. But this doesn’t always occur with BED.
Eating disorders can seriously affect a person’s mental and physical well-being. But recovery is possible with professional help.
Bulimia nervosa (also called bulimia) and binge eating disorder (BED) are two different eating disorders. But they share some common symptoms. Both conditions can involve an unhealthy cycle of binging and purging. In severe cases, these behaviors can be life-threatening.
Binging is when a person consumes an unusually large amount of food in a short period of time. It often leads to physical and emotional discomfort, a loss of control, and shame. Purging is when a person uses laxatives, vomiting, or overexercising to compensate for binge eating.
Binging and purging can harm your physical and mental health. Whether due to bulimia or BED, know that supports are available that can help you manage these behaviors. Learning more about what bulimia and BED have in common and what sets them apart can help ensure you get the right treatment for your needs.
How bulimia and binge eating are similar
Bulimia and BED are linked in several ways. Both conditions can lead to [1]:
A cycle of binge eating
Increased impairment over time (without treatment)
Intense emotional distress, often around weight and appearance
Feelings of shame, embarrassment, or guilt
Eating in secret
Restricted or unhealthy eating habits
Greater risk of co-occurring mental health concerns, like depression or anxiety disorders
Severe physical health problems
These similarities can make it hard to tell the difference between bulimia and BED. So if you’re concerned that you or someone you care about may have one of these conditions, it’s important to seek a formal evaluation. A medical or mental health professional can provide an assessment so that you receive an accurate diagnosis.
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How symptoms differ
The main differences between bulimia and BED are what happens before [2] and after [3] a binging episode. A person with bulimia may be more likely to binge (and then purge) after restricting their eating or losing weight. But for a person with BED, binges can occur more variably. They might be a way to numb emotional discomfort [4], deal with stress, or feel pleasure, if only temporarily. Afterward, a person with BED won’t necessarily engage in purging behaviors.
However, with bulimia, there’s always a cycle of compensatory behaviors following a binge. Self-induced vomiting is one of the most common means of purging. But it isn’t the only one. People with nonpurging bulimia may engage in alternative purging behaviors [3]. These include things like overexercising or fasting.
Can you have both bulimia and binge eating disorder?
Technically, you can have both bulimia and BED, but not at the same time. This is because of the purging distinction.
Both conditions are characterized by a cycle of emotional distress, binge eating, and physical health concerns. But unhealthy eating patterns can fluctuate throughout a person’s life. For example, someone with BED may binge eat for years without ever purging. But once they begin engaging in compensatory behavior following a binge, their condition may evolve into bulimia.
What treatment looks like for bulimia or binge eating disorder
Whether you’re living with bulimia or BED, know that recovery is possible with the right support. Eating disorder treatment can take place in a variety of settings, depending on a person’s needs. This can include outpatient therapy, inpatient treatment, or hospitalization.
These are the most common supports for BED or bulimia:
Therapy
Cognitive behavioral therapy (CBT) and interpersonal therapy have shown the most promise for treating both BED and bulimia [5].
Experts suggest treating eating disorders with a stepped care model [6]: starting with basic medical care or self-management strategies before accessing higher levels of care like therapy or inpatient treatment (if appropriate). For someone with bulimia or BED, this might mean working with a primary care provider, attending a support group, or learning evidence-based individual coping strategies before stepping “up” into other treatments.
Medication
A few different types of medication are approved for treating bulimia or BED. If you’re interested in this option, you’ll need a prescription from your doctor or a psychiatrist — ideally one who specializes in eating disorders.
Your provider can talk to you about the pros and cons of eating disorder medication. They can tell you about potential side effects, how long it might take to start working, and answer any other questions you may have about this approach.
Support groups
Eating disorder support groups can also be an important part of your treatment journey. Research shows that clinician-led support groups can help reduce eating disorder symptoms, even when they’re conducted online [7].
Connecting with others who understand what you’re going through can help you feel supported and less alone. Seeing that other people struggle with similar issues can help lessen the shame and isolation that often accompany eating disorders. In support groups, you can learn how others cope with their eating challenges as well as share personal insights that might help others.
When people understand that bingeing and purging are signs of distress rather than personal failure, treatment becomes less scary and more effective. With the right support, many clients are able to break these cycles and build a healthier relationship with food and their bodies.
Brandy Chalmers, LPC
Clinical reviewer
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Bulimia nervosa and BED are two different eating disorders. They have some similarities, like binge eating. But bulimia also involves purging, typically through self-induced vomiting or laxatives. These post-binge behaviors aren’t always present with BED. These conditions are serious and require professional support. Recovery is possible with treatments like therapy, medication, and support groups.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan https://psychiatryonline.org/doi/10.1176/appi.focus.20240001
- Differences between binge eating disorder and nonpurging bulimia nervosa https://pubmed.ncbi.nlm.nih.gov/10065398/
- A Preliminary Examination of a Nonpurging Compensatory Eating Disorder https://pmc.ncbi.nlm.nih.gov/articles/PMC3947431/
- Binge Eating Disorder https://my.clevelandclinic.org/health/diseases/17652-binge-eating-disorder
- Psychological Treatments for Eating Disorders https://pmc.ncbi.nlm.nih.gov/articles/PMC4096990/#S19
- Models of care for eating disorders: findings from a rapid review https://link.springer.com/article/10.1186/s40337-022-00671-1
- Virtual eating disorder support group utilization is associated with lower eating disorder symptoms and multiple types of social support https://pubmed.ncbi.nlm.nih.gov/40079247/
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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