The exact cause of bulimia nervosa is not thoroughly understood. It occurs more frequently in economically developed nations, which may be due to media portrayals of ideal beauty and attractiveness. These messages often promote thinness as the female ideal. In order to be as thin as some of current pop culture’s celebrities and models, some people strive to maintain a weight that may not be healthy for their bodies. In some cases, though, it is possible to be slender and healthy at the same time. However, it becomes a serious health problem when people use methods detrimental to their body (e.g., purging) to achieve the desired results.

Generally, it is a combination of various factors that may contribute to the development of bulimia nervosa. These include:

• Gender. Females are more likely than males to develop bulimia. One reason females may be at greater risk for developing bulimia is their tendency to go on strict diets to achieve the “ideal” (thin) figure, which is often promoted by the media. However, males may also develop this type of eating disorder. According to the U.S. National Institute of Mental Health (NIMH), about 5 to 15 percent of patients with bulimia or anorexia nervosa are male.
  
  
• Age. Bulimia is more common among adolescents and young adults (people in their 20s and early 30s).
  
  
• Heredity. Bulimia is more common among people with close family members with bulimia or another eating disorder.
  
  
• History of chronic dieting and/or anorexia nervosa. Many patients with bulimia report that their eating binges began in the context of or immediately following a diet. Some studies also indicate that many patients with anorexia nervosa later develop bulimia.
  
  
• History of abuse (e.g., physical, sexual, emotional).
  
  
• Low self-esteem and feelings of inadequacy or lack of control over one’s life.
  
  
• Emotional and/or behavioral disorders. Oftentimes, people with bulimia have other mental health disorders including clinical depression and anxiety disorders (e.g., obsessive-compulsive disorder). Generally, the presence of a pre-existing emotional disorder often reinforces the eating disorder and vice versa. Other types of behavioral or emotional problems associated with this eating disorder include substance abuse, and in many cases, suicidal ideation.
  
  
• Family and social influences. Individuals whose parents, siblings or other close family members and friends are overly critical of their weight, appearance and/or eating habits appear to be at increased risk of developing bulimia.
  
  
• Competitive sports. People, especially females, who participate in highly competitive athletic activities (e.g., gymnasts, figure skaters, wrestlers, jockeys) may be at greater risk of developing bulimia due to the strict weight requirements of certain sports or performance arts.
  
  
• Stress. Sometimes, bulimia may be triggered by stressful situations and/or traumatic events including a dysfunctional family, divorce, death of a family member or friend or starting a new school, college or job.