We bring body and soul back into balance

It’s hardly noticeable on the outside, but people suffering from bulimia are torn in two inside: Bulimics stand between two extremes. On the one side, an unrestrained, ravenous appetite and a desire for more and more. On the other side, the fear of getting fat, a guilty conscience and disgust for oneself.

At Schoen Clinic, we have years of experience in treating this psychological eating disorder. With a variety of therapeutic measures, we support you in conquering your illness. Of course, accompanied by constant medical and psychological assistance.

Causes & symptoms

What is bulimia?

Patients with bulimia suffer from frequent ravenous appetites with uncontrollable eating binges. At the same time, they are terrified of gaining weight. To avoid this, they take a number of actions: They vomit up the meal, exercise excessively, fast or take laxatives. The angel on the right shoulder says: “Eat! If you eat, you won't be sad any more. Then you’ll feel better.” The devil on the left shoulder says: “Disgusting! You shouldn’t eat anything. You’ll get fat and no one will like you any more.”

Since bulimia is often outwardly undetectable, many people who suffer from it can successfully hide it from friends and family for a long time. The illness usually starts around age twenty.

Causes: How does bulimia develop?

Psychological, societal and biological-genetic factors play a role in the development ofbulimia.

Psychological factors
Often, affected persons try to compensate for their low self-esteem through their exterior appearance. They strive for an exaggerated beauty ideal because they believe: Thin people are pretty people and pretty people are loved. At the same time, bulimics are typically psychologically insecure due to domestic, professional or educational conflicts. Fear, stress and excessive demands make them emotionally unstable. Their sense of self-worth continues to decrease.

Societal factors
Today, there is an excessive variety of foodstuffs, in particular, tempting foods like chocolate. This poses a huge risk for eating disorders. Affected persons try to fulfil the social slimness ideal and go on a diet. However, this increases the drive to eat so severely they are no longer able to withstand it. They binge eat and the diet fails.

Biological-genetic factors
In several cases, bulimia can also be very conditional, which twins studies and observed famlial frequences of eating disorders support.

Symptoms: Indications of bulimia

Binge eating, during which the affected person eats far more than the normal 500-600 calories per meal, sometimes up to 20,000 calories, in a very short time is characteristic Vomiting directly after, however, results in many affected persons being of normal weight. Thus, they are able to hide the illness from their environment for a long time.

Warning signs that suggest bulimia

dissatisfaction with exterior appearance
  • dissatisfaction with one’s own body
  • constant desire to get thinner
  • fear of gaining weight
  • excessive athletic activity
  • chaotic, time-consuming eating behaviour
  • frequent diets
  • uncontrollable ravenous appetites
  • vomiting in secret
  • consumption of laxatives, diuretics or appetite suppressants
Physical indications
  • Pain the throat, stomach, intestine and oesophagus
  • Water accumulation under the skin
  • Swelling in the salivary glands
  • Tooth pain and tooth destruction
Emotional indications
  • Depression
  • Mood swings
  • Frailty and impulsiveness (alcohol abuse, frequent changes in partners, compulsive stealing)
  • Withdrawal from people who might be able to offer support and help


Diagnosis: How we determine bulimia

In general, a psychotherapist comes to a diagnosis by means of a comprehensive survey taken in the form of a conversation. The therapist collects information about eating habits, feelings and exercise habits. He or she will also observe weight development and fluctuations throughout a lifetime, the last six months and the past few weeks. Lab tests will check the blood for electrolyte disorders, liver function disorders and digestion enzymes. Consequences such as arrhythmias can be detected by an ECG. The physical exam is performed to detect potential consequential damage such as salivary gland infections and oedemas. Based on test psychological exams, the severities of individual symptoms can be determined.