Binge eating disorder (BED) is one of the newest entrants to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the list of all officially recognized mental health problems. But the condition is already considered the most common eating disorder in the United States. [1]

People who experience gender dysphoria (also referred to as gender identity disorder) may engage in these behaviors to try to change parts of their bodies to more closely align with their gender identity. These disordered eating behaviors can progress into a clinical eating disorder.

The COVID-19 crisis spurred a dramatic rise in online therapy, but even before the pandemic took hold, virtual mental health treatment was becoming increasingly popular.

If you or a loved one are struggling with bulimia nervosa (BN), it may seem like recovery is out of reach. But it is entirely possible to overcome the unhelpful thoughts and behaviors that drive this condition.

If you specifically have a health insurance policy through Aetna health insurance, you may be curious about what the company can offer you or have additional questions about Aetna eating disorder coverage.

Eating disorders like bulimia nervosa (BN), anorexia nervosa (AN), and binge eating disorder (BED), among others, are complex mental health conditions that can have serious consequences if left untreated.

Everyone overindulges every once in a while, but binge eating is different. These episodes are an extreme form of overeating, involving large amounts of food consumed in relatively short periods of time.

A binge eating episode can leave you feeling uncomfortable, but if this behavior starts recurring, it can lead to more concerning issues.

Eating disorders and substance use disorders frequently occur together. The conditions operate through similar genetic, biological, and environmental mechanisms, and often work in complex ways to maintain one another. 

It’s an unfortunate reality that bulimia nervosa (BN), anorexia nervosa (AN), and many other eating disorders are often connected to a history of trauma, with post-traumatic stress disorder (PTSD) being a common co-occurring condition with these illnesses.

Psychotherapy is a cornerstone of nearly all treatment plans for eating disorders. Through a series of sessions, trained mental health professionals can help you shed light on some of the factors behind your behaviors and teach you new, healthy coping strategies for moving forward.

Eating disorders are complex mental health conditions that can manifest in any number of ways, causing a range of physical, behavioral, and emotional consequences.

Still, some of the most common eating disorders have a number of more-predictable symptoms. And learning to spot them can be crucial if you think you or a loved one may have one of these conditions.

An eating disorder isn’t just a person “choosing” to engage in unhealthy eating behaviors. It is a serious mental health condition which can have serious consequences if left untreated.

Choosing a bulimia nervosa treatment program, or a program to help with other eating disorders like anorexia nervosa (AN) or binge eating disorder (BED), can feel like an overwhelming process.

Interpersonal psychotherapy (IPT) is a form of talk therapy that has been shown to be potentially beneficial in helping people with eating disorders, including bulimia nervosa (BN).

While there are many evidence-based treatments that are often used to help people struggling with bulimia nervosa (BN), some types of alternative and holistic therapy may also be able to help.

Acceptance and commitment therapy (ACT) is a type of psychotherapy commonly used to help people struggling with eating disorders of all types, including bulimia nervosa (BN), binge eating disorder (BED), and more.

Cognitive behavioral therapy (CBT) is a common type of therapy used for treating mental disorders of all types, including bulimia nervosa (BN). It has a heavy focus on restructuring how a person thinks, teaching them to redirect, and, eventually, eliminate negative thought patterns in order to engage in healthier behavior.

Bulimia nervosa (BN) is a serious mental health condition that can contribute to a number of consequences on someone’s physical and emotional well-being. And unfortunately, some studies have shown that one of the physical effects of BN is a higher risk of developing esophageal cancer.

Research into the connection between the two conditions is still ongoing, and some unknowns about the specifics remain. However, what is known is that bulimia nervosa may be an important risk factor for esophageal cancer and numerous other health issues connected to the throat.

Does Bulimia Nervosa Cause Cancer?

Bulimia nervosa may not be a direct cause of cancer, but the additional stress it puts on the body—particularly that caused by self-induced vomiting—could make the body more vulnerable to developing cancerous cells. When found in the lining of the throat, the condition is called squamous cell carcinoma.

Bulimia can make the body more vulnerable to developing cancer.

The repeated presence of stomach acid in the throat can lead to microtrauma in the esophageal mucosa, or essentially tiny tears and other forms of cellular damage. This could eventually lead to issues like gastroesophageal reflux disease, which can further hurt the throat, and chronic physical damage. Similar types of damage have been previously associated with esophageal cancer.

Eating Disorders and Cancer

For people struggling with eating disorders of all types, there are also some factors that may lead to a higher risk of developing cancer.

People with eating disorders tend to be susceptible to substance use disorders, notably those related to smoking and alcohol. These are both noted contributors to cancerous cellular growth. [1]

Eating disorders also tend to lead to chronic nutritional deficiencies, and this has similarly been linked to the development of unhealthy cells or difficulty overcoming illnesses. 

Shared Risk Factors for Eating Disorders and Cancer

One study found a connection between disordered eating behavior and cancer that was strikingly high, with people who were previously hospitalized with an eating disorder having a six-fold increased risk of developing esophageal cancer. [1] However, researchers involved in the study noted some significant limitations of the findings, including a large number of overlapping risk factors between people with eating disorders and people who develop this form of cancer.

Those hospitalized with an eating disorder are 6x more likely to develop esophageal cancer. [1]

Indeed, the study posited that it was these shared risk factors that ultimately posed the greatest risk for people with BN going on to develop esophageal cancer, as opposed to the damage caused to esophageal tissue.

Are People in Recovery at Risk?

It’s difficult to estimate how long someone who has experienced bulimia nervosa or other eating disorders remains at an increased risk for developing esophageal cancer. The outcome depends on incalculable factors, from someone’s genetics and personal health history to the severity of their condition and other risk factors they may experience.

A Case Study

One case study found a woman developed esophageal cancer at 27 years old, nearly 10 years after her struggle with bulimia nervosa. [2] Again, however, lines get blurred when more details are considered. The patient, in this case, had also been a smoker for nearly 7 years and quit only shortly before her cancer diagnosis.

It may be so that chronic bulimia or chronic eating disorders—the terms used to describe more severe cases that last a year or longer—lead to a higher risk of developing cancer later on due to the increased time for microtrauma and severe malnutrition to develop.

Still, lacking further research, it’s unwise and inadvisable to make too many assumptions about why or how BN and other eating disorders can present a greater cancer risk.

Other Health Risks Associated With Bulimia

Unfortunately, esophageal cancer isn’t the only major health risk presented by BN. The condition has been linked to a number of symptoms and potential health consequences, including: [3]

Heart failure

Organ damage

Extreme mood swings

Dry skin

Yellowing skin

Dry and brittle nails

Dental problems

Sleep difficulties

Dizziness

Stomach cramps

Difficulty concentrating

Thinning hair

Muscle weakness

Poor wound healing

Weakened immune system

As BN primarily impacts the digestive system and causes nutritional imbalances in the body, this can cause a cascade of symptoms, which can lead to numerous health issues.

One of the biggest dangers of bulimia nervosa is the potential for a serious electrolyte balance, which can lead to death without any obvious warning signs. Similarly, BN can cause sudden cardiac arrest, which is often also deadly.

When to Get Help for Bulimia Nervosa

If you or a loved one are struggling with bulimia nervosa, it’s important to seek out help as soon as possible. By its very nature, the condition can make a significant impact on your physical and mental health, as well as your quality of life. 

If you’re not sure where to look for help, you can reach out to your physician or a mental health therapist. These trained professionals will be able to offer you advice about the best next steps and point you in the direction of qualified programs. A number of eating disorder hotlines also exist to help people access help and additional resources about these conditions.

Bulimia nervosa is a dangerous and potentially deadly condition, but it doesn’t have to be your destiny. Seeking out treatment can help you get on the path toward a sustained recovery and a happier and healthier future.

Resources

Brewster DH, Nowell SL, & Clark DN. (2015). Risk of Oesophageal Cancer Among Patients Previously Hospitalised with Eating Disorder. Cancer Epidemiology; 39(3):313–320. 

Shinohara ET, Swisher-McClure S, Husson M, Sun W, & Metz JM. (2007). Esophageal Cancer in a Young Woman With Bulimia Nervosa: A Case Report. Journal of Medical Case Reports; 1:160.

Bulimia Nervosa. (2018, February 22). National Eating Disorders Association. Retrieved September 13, 2022.

“Diet culture” has made an increasing mark on society over the years.

While sometimes cloaked in the language of “wellness,” this system of beliefs and social expectations, in fact, revolves around the idea that there exists an “ideal” body type. And rather than achieving a healthier lifestyle at any shape or size, the goal of diet culture is achieving this idealized body type, regardless of a person’s natural physiology or health history.

Whether well hidden or directly addressed, this concept is not only pervasive but can be dangerous, spreading ideals and ideas that may promote disordered eating behaviors, as well as encourage low self-esteem, poor body image, and other factors that often lead to eating disorders.

What is Diet Culture?

Diet culture is an umbrella term that refers to a number of different beliefs which revolve around the concepts of body weight, shape, and size. Often, these beliefs are tied to different methods for achieving an “ideal” body weight, shape, and size.

Almost always, diet culture promotes a thin body—or possibly a “fit” body—as the ideal type and will equate this body type with not just optimal health but moral virtue.

Most diets promoted by these beliefs focus heavily on how to lose weight and speak little, if at all, about the potential health consequences involved in essentially forcing the body to become a certain size.

Diet Culture Beliefs

Diet culture is typically very black and white. There are “correct” types of bodies and inferior types of bodies. There are also foods that are widely considered “good” and foods that are widely considered “bad.” This false dichotomy can involve certain foods, such as chocolate, or an entire food group, such as carbs.

Strenuous exercise is also often part of these weight-loss programs. Rather than focusing on the joys of moving the body, exercise is presented in diet culture as a means to “earn” a treat or “burn off” a certain number of calories.

Essentially, diet culture centers all aspects of self-worth around physical appearance in general and a specific body type in particular. This sets up the idea that all other body types—and the people occupying them—are, by extension, less than ideal.

This concept can easily be internalized, leading someone to believe they’re lazy, unworthy, or generally “lesser” if they don’t look a certain way. It can also lead someone to take extreme measures to lose weight, which can, unfortunately, sometimes lead to the development of eating disorder behaviors.

Negative Effects of Diet Culture

Diet culture does not promote a healthy relationship with food or exercise, and it can contribute to disordered eating, harmful thoughts and behaviors, and other mental health concerns. 

Dieting, especially the restrictive dieting generally promoted by diet culture, can lead to unhelpful thought and behavioral patterns. In fact, dieting is often considered one of the most common forms of disordered eating. [3, 4] 

It’s generally not healthy to cut out entire food groups or to eat only during limited hours of the day. This kind of unhealthy relationship with food can lead to yo-yo dieting or extreme weight swings, which are accompanied by their own set of health concerns, particularly around cardiovascular health. [3]

And when eating is no longer pleasurable but rather seen as the means to an end, people also may start to fixate on nutritional facts or eating habits. This is a driving factor in many eating disorders.

Diet Culture and Eating Disorders

The tenets of diet culture commonly propagate eating disorders, make eating disorder symptoms worse, or complicate recovery for those who have previously struggled with these mental health conditions. [5] 

The perpetuation of an “ideal” body type, particularly one that is especially thin or fit, has been linked to worsening fatphobia and weight stigma. [1] This preoccupation with “fatness” and fear of being considered fat can manifest as fat shaming, or it can be internalized by people in bigger bodies, who may grow to believe they are the “wrong” shape or size.

Even those in smaller bodies may experience low self-worth when attempting to measure up to an “ideal,” which is often unattainable.

Low self-esteem of this kind, especially when chronic, is thought to be the primary prerequisite for developing an eating disorder, whether it’s binge eating disorder (BED), anorexia nervosa (AN), bulimia nervosa (BN), or other common eating disorders. [2]

And frequent dieting is also widely considered to be one of the biggest risk factors for BED, which is thought to be the most common eating disorder in the United States. [6]

How to Spot Diet Culture

One of the most insidious aspects of diet culture is how easily its agendas can be hidden.

Many diets, companies, or influencers may claim they’re promoting “wellness” or a healthier lifestyle when they’re actually spouting the harmful beliefs of diet culture. Diet culture has become so embedded in popular culture that it’s possible these people and companies may not even be aware of the ideals they’re actually promoting.

Diet culture ideals often masquerade under different language. Buzzwords like “clean eating,” “wellness protocol,” “detox,” “cleanse,” or “reset” are often referring to measures that are actually designed to obtain an “ideal” body rather than optimal health. [7]

“Clean eating,” “detox,” and “cleanse” are common buzzwords that promote diet culture.

Similarly, diet culture often sets up false dichotomies and operates in very black-and-white terms. There are “good” and “bad” foods, “good” and “bad” body shapes, “healthy” or “unhealthy” diets, or “clean” and “unclean” meals. [7]

And when there are numerous rules around what “can” and “can’t” or “should” and “shouldn’t” be consumed, that’s usually diet culture talking. This can look like everything from restrictions on how much or when food can be eaten to the types of food that can be eaten to rules around the number of calories, fat, protein, or other nutritional values that can be consumed. [7]

Still, perhaps the best way to spot diet culture is to look for the focus. If a diet, company, or influencer is preoccupied with body shape, weight, or size rather than overall well-being, there’s a good chance they’re promoting diet culture ideals.

How to Resist Diet Culture (And Still Be Healthy)

Diet culture is unfortunately extremely prevalent in today’s society, with its tenets delivered both overtly and subliminally through various aspects of pop culture and media. But it’s still possible to resist these social messages and to build an individual healthy and happy relationship with your body.

Recognize and Resist

Resisting diet culture involves education, awareness, and acceptance of the fact that bodies can be healthy (and unhealthy) in any shape and size. Learning how to spot these unhelpful messages and ideals is a great place to start. Once you realize you’re actually reading, seeing, or listening to messages related to diet culture, you can tune them out completely, knowing their true harmful nature.

Prune the social media accounts you follow to minimize diet culture messaging in your feeds.

To this effect, it may also be helpful to go through your social media feeds with an eye toward pruning. Unfollowing accounts that regularly promote diet or diet culture ideals is an easy way to reduce these messages in your daily life, and you can also look for accounts that promote true body positivity and well-being.

Change Your Perspective

Just as diet culture uses certain words to create a black and white world where there is only one “ideal” body, you can use your own terms to reintroduce shades of gray to the conversation.

It may feel almost ingrained to comment on someone else’s body or looks, but even complimenting someone on losing weight or “looking skinny” can reinforce diet culture ideals. Instead, try to focus on comments about someone’s achievements or step back from talking about body- or weight-related topics all together.

Don’t just look at exercise as a way to burn calories or lose weight.

A perspective shift on exercise can also be helpful for creating a more positive relationship with your body. Rather than look to workouts as ways to create a caloric deficit, focus on moving your body in ways you enjoy or that feel good.

And rather than thinking about all the things your body isn’t, think instead about all the wonderful things it can do. Everything from swimming to stretching to dancing and even hugging loved ones is something that can bring so much joy to this life, and our bodies should be appreciated as the vessels that make these things possible.

Do Your Research

In terms of working on more internal factors, you may want to investigate the idea of intuitive eating. This philosophy promotes a more natural and healthy relationship with eating and doesn’t paint any meals or ingredients as inherently good or bad.

The Health at Every Size (HAES) movement has additional ideas on how to resist diet culture and better respect yourself and others.

In a culture so fixated on achieving perfection, tuning out the negative messages and embracing all the positive aspects of food, movement, and our bodies themselves may be the most radical resistance of all.

Resources

Tran R. (2021, May 16). The Distasteful Truth About Diet Culture. The UCSD Guardian. Retrieved September 23, 2022.

Silverstone PH. (1992). Is chronic low self-esteem the cause of eating disorders? Medical Hypotheses; 39(4):311–315.

Which Diet is Right for You? (2020, July 15). Heart Foundation. Retrieved September 23, 2022.

Disordered Eating & Dieting. National Eating Disorders Collaboration (NEDC). Retrieved September 23, 2022.

Chastain R. (2022). Recognizing and Resisting Diet Culture. National Eating Disorders Association. Retrieved September 23, 2022.

Howard CE, & Porzelius LK. (1999). The role of dieting in binge eating disorder: etiology and treatment implications. Clinical Psychology Review; 19(1):25–44.

Adams M. Diet Culture and How to Spot It. Halsa Nutrition. Accessed March 2023.

The specifics of how an eating disorder affects a person is based on any number of individual factors, including the types of eating disorders they’re struggling with, their medical history, and any mental health concerns, among others.

Eating disorder hotlines can offer a great extension of help for people struggling with these mental health conditions, or those who are looking for eating disorder treatment centers where they can find further help.

Virtual treatment for bulimia nervosa (BN), or virtual treatment for any mental health disorder, can offer high-quality care. For many people, there isn’t a tangible difference in virtual therapy sessions versus traditional in-person treatment.

Negative body image and eating disorders are closely related, with negative body image being one of the most well-understood precursors to the development of an eating disorder.

Food addiction is an issue we’re only beginning to understand and thoroughly research, but there are a number of resources that can help with this condition and other associated disorders.

If you’re struggling with an eating disorder or in recovery, you may benefit from an eating disorder support group. There’s a variety of this type of help available, including online support groups and many free options.

Watching a friend, family member, or loved one struggle with an eating disorder can be incredibly difficult. Though you want to help, you may be unsure how to help someone with an eating disorder.

Eating disorders and substance use disorders (SUDs) often coexist.

Researchers say up to 50% of people with diagnosed eating disorders use illicit drugs or alcohol, while 35% of people who are dependent on alcohol or drugs have an eating disorder. This represents rates 5 times and 11 times greater than what’s seen in the general population, respectively. [1]

Bulimia nervosa (BN) is a serious mental health condition, marked by periods of binge eating and compensatory purging behaviors, such as self-induced vomiting or excessive exercise.

A partial hospitalization program (PHP) is a type of treatment for bulimia nervosa (BN) and other eating disorders.

This level of care is essentially a middle-ground, falling between residential or inpatient treatment and a typical outpatient treatment program.

Many different levels of care can help people struggling with eating disorders, including bulimia nervosa (BN). No type of eating disorder treatment is “better” or “worse,” but rather more well-suited for someone’s particular case.