Bulimia Nervosa

What is bulimia nervosa
Symptoms of bulimia
A note about weight and bulimia
Emotional and behavioral signs of bulimia
Physical signs of bulimia
Health consequences of bulimia
Facts about bulimia

What is bulimia nervosa?

Bulimia nervosa (bulimia for short) is a serious, potentially life-threatening eating disorder characterized by a cycle of binge eating and compensatory behaviors such as self-induced vomiting designed to “undo” or compensate for the effects of binge eating.

Symptoms of bulimia

  • Recurrent episodes of binge eating. Binge eating is characterized by:
    • Eating, in a discrete period of time (e.g., within a two hour period), an amount of food that is definitely larger than what most people would eat during a similar period of time and under similar circumstances.
    • Lack of control over eating during the episode (e.g., a feeling that you cannot stop eating, or control what or how much you are eating).
  • Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • Self-evaluation is unduly influenced by body shape and weight.

A note about weight and bulimia

One common misconception is that people with bulimia are underweight. It’s estimated that only 6% of people with a clinical eating disorder are medically underweight. Even in cases where a person is a “normal” or higher BMI, there are still serious medical risks. If this is you, please know that yes, you ARE sick enough to deserve treatment, even if you’re not underweight.

Emotional and behavioral signs of bulimia can include:

  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns
  • Evidence of binge eating, including disappearance of large amounts of food lots of empty wrappers and containers
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of packages of laxatives or diuretics
  • Skips meals or takes small portions of food at regular meals
  • Frequent dieting, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
  • Fear of eating in public, anxiety eating with others
  • Steals or hoards food in strange places
  • Drinks excessive amounts of water or non-caloric beverages
  • Uses excessive amounts of mouthwash, mints, and gum
  • Hides body with baggy clothes
  • Maintains excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury—due to the need to “burn off ” calories
  • Creates lifestyle schedules or rituals to make time for binge-and-purge sessions
  • Withdraws from usual friends and activities
  • Shows extreme concern with body weight and shape
  • Frequent checking in the mirror for perceived flaws in appearance
  • Extreme mood swings

Physical signs of bulimia can include:

  • Noticeable fluctuations in weight, both up and down
  • Gastrointestinal complaints (stomach pain, constipation, acid reflux, etc.)
  • Difficulty concentrating
  • Abnormal labs (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  • Dizziness and fainting
  • Feeling cold all the time
  • Sleep problems
  • Looks bloated from fluid retention
  • Cuts and calluses across the top of finger joints from inducing vomiting
  • Swelling of the cheeks or jaw area
  • Dental problems, such as discolored teeth, enamel erosion, cavities, and tooth sensitivity
  • Dry skin and dry and brittle nails
  • Hair loss, dry and brittle hair
  • Fatigue, muscle weakness
  • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

Health consequences of bulimia

Bulimia can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia include:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

Facts about bulimia

  • People struggling with bulimia can be at any weight.
  • 5 percent of American women suffer from bulimia nervosa in their lifetime.
  • Nearly half of bulimia patients have a comorbid mood disorder such as depression.
  • More than half of bulimia patients have comorbid anxiety disorders.
  • 1 in 10 bulimia patients have a comorbid substance abuse disorder, usually alcohol use.

Take the Eating Disorder Self-Test to find out if you might have an eating disorder like bulimia.

Please reach out for help and support.

If you think you are or someone you care about is struggling with bulimia, contact us here or click below to schedule an appointment online.