What triggers a bulimic episode?
Many situations and feelings can trigger bulimic behavior: extreme emotional distress, anxiety, depression, dieting, exposure to certain foods (especially high-sugar or high-fat foods), or sudden dissatisfaction with body image. People with bulimia nervosa have reported extreme mood changes before, during, and after binge eating and purging or non-purging compensatory behavior. They have also reported feeling depressed or anxious before binge eating, and then feeling temporary relief or even euphoria afterwards. These feelings are often followed by feelings of guilt, shame, and self-loathing. Then purging or excessive exercise occurs to regain feelings of self-control.