There are several differences between rumination disorder and bulimia nervosa including behaviours and underlying motivation.
Bulimia nervosa is a serious mental illness characterised by recurrent binge-eating episodes (the consumption of abnormally large amounts of food in a short period of time), immediately followed by compensatory behaviours such as self-induced vomiting, fasting, over-exercising and/or the misuse of laxatives, enemas or diuretics. Rumination disorder typically involves frequent regurgitation, usually within half an hour of eating but does not involve the binge-purge cycle of bulimia nervosa.
Rumination is understood to be subconscious behaviour whereby the individual won’t appear to make an effort to bring up their food, nor do they appear distressed or disgusted by the behaviour. In contrast, those experiencing bulimia nervosa engage in compensatory behaviours such as purging as a way to cope with feelings of shame and guilt following a binge and use these behaviours as an attempt to control weight or shape. An individual experiencing rumination disorder may re-chew, re-swallow or spit out food. However, elimination is the motivation of compensatory behaviours exercised by an individual experiencing bulimia nervosa.
It is important to note that rumination disorder is a serious condition and people with the condition often do not feel in control of their disorder. The condition may also intersect with other feeding and eating disorders and individuals with anorexia nervosa, bulimia nervosa, binge eating disorder or avoidant/restrictive food intake disorder (ARFID) may also experience rumination disorder.