When estrogen receptors do not work the right way, they can also lead to bulimia, suggesting that there is a correlation between sex hormones and the disorder (Hay & Claudino, 2010).
Studies have also shown that even those who do not have any biological causes or reasons to be bulimic may end up that way because of social issues (Patton, et al., 2008; Russell, 2009). The media portrays an "ideal" body shape that is often severely underweight and typically not realistic for the average person (Russell, 2009). The difficulties with that are seen more commonly among women, but men can still be affected by it. In just a few years of media exposure, studies have shown that the incidence of purging rose dramatically among young women (Russell, 2009). This does not mean that all people who see media portrayals of what people "should" look like will develop bulimia or another eating disorder, but it is very important to consider how bulimia can be affected by what people see on television and in other forms of media. By understanding how significant this is as a reason for bulimic behaviors, more ways to recognize bulimia and more ways to treat it successfully can be located.
The other mental health disorders that are most commonly related to bulimia are anxiety and depression (Russell, 2009). As many as 70% of bulimics are or have been depressed during their lifetimes (Russell, 2009). Substance use and abuse, as well as substance dependency, are also very common in those who have bulimia (Palmer, 2004; Patton, et al., 2008). Problems with dental health are seen in the majority of people who have bulimia, as well, because of the level of acid that crosses the teeth from frequent vomiting (Palmer, 2004). While these disorders and issues are very commonly seen in individuals who have bulimia, whether they are officially diagnosed or not, it is not necessary for someone who is bulimic to have any other disorders that surround or relate to it. Bulimia may exist all on its own, without any other disorders or conditions being present (Palmer, 2004).
Both therapy and prescription medication are common treatments for bulimia (Hay & Claudino, 2010). Antidepressants have been used quite often when it comes to bulimia treatment, because there is a belief that these medications alter brain chemistry enough to reduce the risk of the bulimic person relapsing both during and after treatment (Hay & Claudino, 2010). These medications are not guarantees of success in treating bulimia, but they can be beneficial to a number of patients with the disorder. They are often coupled with therapy, because that can help get to the root of the problems when it comes to media exposure, feelings of inadequacy, past experiences with obesity, and other problems that are not related to genetics or brain chemistry but that still may lead a person to become bulimic (Russell, 2009). While it is possible for a person to find his or her way out of bulimia in some cases, that is much more rare than success based on treatment with medications and discussions with a professional (Hay & Claudino, 2010).
While many people respond well to treatments such as cognitive behavioral therapy, family-based treatment can also be used with younger people in order to help them understand their triggers for bulimia (Patton, et al., 2008; Russell, 2009). Sometimes, those triggers can be other family members, and healthy ways to interact and protect the patient have to be addressed. When a family is empowered to work together, especially in the case of an adolescent with bulimia, much more progress can be made and a more successful outcome can often be found (Russell, 2009). There are other options, such as Cue Exposure and hypnotherapy, that have also had some success with bulimia patients who have been resistant to other forms of treatment (Hay & Claudino, 2010). Some of these individuals do not respond well to medications, and others have struggled with a lack of success with cognitive behavioral therapy or other methods (Russell, 2009).
Because bulimia is such a significant health issue, especially for adolescents, the study of it is very important. Ever since it became an official disorder in the Diagnostic and Statistical Manual of Mental Disorders, it has gained more attention. That is significant, and highly valuable to the cause of determining what makes someone become bulimic and how those individuals who do develop the disorder can best be treated. While not everyone who is bulimic can be treated successfully, the goal is certainly to try to get help for anyone who struggles with an eating disorder. Whether that help comes through medication or therapy is less important than simply getting help in general.