Support for bulimia nervosa
Bulimia nervosa often exists behind closed doors. Many people live with it for years without those around them realising what is happening, carrying a constant sense of shame, fear of being found out, or feeling “out of control” around food.
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Bulimia is not always visible. Weight and appearance may not change in obvious ways, which can make it harder to recognise the seriousness of what is going on, both for the person affected and for others. Internally, however, bulimia can be deeply distressing, exhausting, and isolating.
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Bulimia nervosa is not about a lack of self-discipline. It is commonly linked to difficulties managing emotions, high levels of self-criticism, and patterns of eating that feel compulsive and hard to interrupt. Support needs to address these underlying drivers, not just the behaviours themselves.
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We provide specialist, online support for bulimia nervosa across the UK. Our approach is calm, respectful, and non-judgemental, offering a space to talk openly and begin to understand what is maintaining the difficulties, at a pace that feels manageable.
What is bulimia nervosa?
Bulimia nervosa is an eating disorder characterised by repeated episodes of eating that feel difficult to control, followed by behaviours aimed at undoing the effects of eating. These patterns are typically driven by intense emotional distress rather than a desire to lose weight alone.
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For many people, bulimia develops as a way of managing overwhelming feelings, stress, or self-criticism. Eating can bring brief relief, which is then followed by guilt, shame, or fear, reinforcing a cycle that becomes hard to interrupt without support. Over time, this can begin to dominate thoughts, routines, and emotional wellbeing.
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Unlike some other eating disorders, bulimia may not be immediately visible. People often maintain work, study, and relationships while struggling privately, which can delay recognition and help-seeking. This hidden nature can increase isolation and make it harder to talk openly about what is happening.
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Bulimia nervosa is a serious condition that affects both physical health and mental wellbeing. Understanding the emotional and psychological factors that maintain these cycles is an important part of recovery.
If you are unsure whether this describes your situation, a short free call can help clarify the next step. Ask about support
How bulimia can affect daily life
Physical and cognitive impact
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Ongoing fatigue or physical discomfort
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Disrupted sleep or difficulty concentrating
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Preoccupation with thoughts about eating that affect focus and productivity
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Avoidance of social activities or routines that feel risky
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Strain on relationships due to secrecy or withdrawal
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Difficulty feeling present or engaged in everyday life
Emotional and relational impact
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Persistent shame, guilt, or fear of being discovered
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Feeling out of control around eating despite strong efforts to change
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Intense self-criticism and perfectionism
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Anxiety linked to secrecy, social situations, or food-related events
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Fluctuating mood, frustration, or feelings of failure
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A sense of living “two lives”, one public and one private
How we support people with bulimia
Bulimia nervosa is often maintained by cycles of shame, secrecy, and emotional pressure. Many people want change but feel afraid of being judged or exposed. Our work starts by creating a space where difficulties can be spoken about openly, without blame or confrontation.
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Rather than focusing only on behaviours, we help people understand what drives urges and cycles around eating, including stress, self-criticism, and difficulties managing emotions. Support is paced and collaborative, with the aim of reducing reliance on eating disorder behaviours as a way of coping.
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All support is delivered online by clinicians experienced in treating bulimia nervosa, allowing people to engage privately and in a way that feels more contained and manageable.
Our clinical approach to bulimia
Our clinical approach to bulimia nervosa focuses on interrupting binge–purge cycles by addressing the emotional and cognitive processes that sustain them, rather than relying on control-based or punitive strategies.
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We draw on evidence-based therapies that help people understand urges, reduce self-criticism, and develop safer ways of responding to distress. Treatment aims to support more regular and stable eating patterns, while working directly with the anxiety, shame, and perfectionism that often drive cycles of bingeing and compensatory behaviours.
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Care is individualised and paced. The focus is on building insight, reducing the intensity of urges over time, and supporting change that can be maintained in everyday life.
These approaches are helpful because they focus on understanding how bulimia functions, rather than treating behaviours in isolation. By addressing emotional distress, reducing secrecy, and rebuilding stability around eating, people are better supported to make changes that feel sustainable and manageable in everyday life.
Our approach may inlcude:
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Integrative psychotherapy, allowing flexibility to respond to emotional, cognitive, and behavioural factors that maintain bulimia
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Brief Strategic Therapy (BST) to disrupt compulsive symptom loops, secrecy, and patterns that unintentionally keep bulimia going
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Cognitive Behavioural Therapy for Eating Disorders (CBT-E) to address beliefs about food, weight, and control that sustain binge–purge cycles
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Strategic interruption of binge–purge patterns, using carefully timed behavioural tasks to weaken automatic responses
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Regular eating frameworks to restore rhythm and reduce the physiological and psychological drivers of bingeing
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Impulse and urge-management strategies to support safer responses when urges feel intense or overwhelming
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Shame-reduction and compassion-focused work to reduce self-criticism and support greater openness and engagement with change
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Food and nutrition psychoeducation, supporting understanding of regular eating, hunger, fullness, and the effects of binge–purge cycles
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Dietetic support, focused on stabilising eating patterns and reducing physiological drivers of binge eating
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Collaborative involvement of carers or partners, where appropriate, to reduce secrecy and support change
Ensuring care is safe and appropriate
Our service provides specialist, outpatient psychological and dietetic support for people with bulimia nervosa who are able to engage safely in online care.
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Bulimia is often managed within outpatient settings, and many people benefit from structured psychological and dietetic support delivered online. Our service is suitable for individuals who are medically stable and able to take part in regular sessions, with physical health monitoring overseen by their GP, NHS team, or another appropriate medical provider outside of our clinic.
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We do not carry out physical examinations, blood tests, or medical monitoring. These aspects of care remain the responsibility of an individual’s GP or other healthcare professional. Where there are concerns about physical safety, medical instability, or the need for urgent intervention, a different level of care may be more appropriate.
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If someone is experiencing frequent medical complications, severe risk, or is in immediate crisis, our outpatient, online service is unlikely to be the right starting point. In these situations, we will support individuals and families to think through alternative options, such as GP-led care, NHS specialist services, or more intensive treatment where needed.
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Decisions about suitability are always considered carefully and individually by our multidisciplinary team, with safety, wellbeing, and appropriate level of care as the priority.
Starting support with us
Step 1: A free call
The first step is a short free call with a non-clinical member of our team. This gives you the opportunity to talk things through, ask questions, and get a clearer sense of whether our service feels like the right fit.
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During this call, we can explain how support works, what options may be appropriate, and answer practical questions about availability and fees. We can also talk through whether our outpatient, online service is likely to be suitable at this stage. No clinical decisions are made during the free call.
Step 2: Initial Consultation
If it feels appropriate to go ahead, the next step is an initial online consultation with one of our Clinical Directors. This session focuses on understanding current concerns, any existing diagnoses, physical health context, and how anorexia is affecting day-to-day life.
The clinician will also consider whether outpatient, online support is appropriate and safe, and whether any additional medical input from a GP or other healthcare professional is needed alongside treatment.
Step 3: Planning ongoing support
Following the initial consultation, recommendations are discussed collaboratively. This may include ongoing outpatient treatment, further assessment, or guidance on accessing alternative services if a different level of care would be more appropriate.
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Support is never rushed. Decisions are made together, with a focus on safety, readiness for change, and what feels manageable at this stage.
You don’t need to manage this alone
Bulimia nervosa can be a very lonely experience. Many people spend a long time managing things privately, trying to keep difficulties hidden while feeling increasingly worn down by the effort it takes.
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Reaching out for support does not mean losing control or being judged. It creates a space to talk openly, to understand what is happening, and to explore change without pressure or exposure.
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Whether you are thinking about support for yourself or for someone else, you deserve care that is respectful, confidential, and grounded in clinical understanding. You do not have to carry this on your own.
Get support for bulimia nervosa
Whether you are seeking support for yourself or for someone you care about, we are here to help you think through the next steps at a pace that feels right. You do not need to have everything worked out before reaching out.
The free call is with a non-clinical team member and is a chance to ask questions about services, fees, and next steps.