Bulimia nervosa is a serious eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise. People with bulimia place an excessive emphasis on body shape and weight in their self-evaluation, leading to a cycle of bingeing and purging in an attempt to control their weight.
Bulimia affects approximately 1-2% of young women and has one of the highest mortality rates of any psychiatric disorder, due to the severe medical complications that can result from the disorder. However, bulimia is also one of the most successfully treated eating disorders when caught early and intervention is started promptly.
Being able to identify the signs and symptoms of bulimia is extremely important for getting treatment as early as possible. Here are 5 of the main warning signs that may indicate someone is struggling with bulimia.
Warning Sign 1: Recurrent Binge Eating
The hallmark behavior of bulimia is recurrent episodes of binge eating, during which the individual consumes an objectively large amount of food within a discrete period of time, often 2 hours or less. The binge eating occurs with a sense of loss of control, meaning the person feels unable to stop eating once they start.
Binge eating episodes are usually triggered by negative emotions, interpersonal stressors, dietary restraint, or feelings of lack of control in life. Foods high in sugar, fat and calories are typically consumed during binges. A binge eating episode is often planned in advance and the person may purchase “binge foods” specifically to consume during the binge.
Some signs that may indicate someone is binge eating include:
– Disappearance of large amounts of food in the house
– Evidence of eaten food packaging hidden in the trash
– Eating large amounts of food even when not physically hungry
– Eating alone due to embarrassment about the amount of food being consumed
– Expressions of guilt, shame or disgust after overeating
Warning Sign 2: Compensatory Behaviors to Counteract Binges
After binge eating episodes, bulimics engage in inappropriate compensatory behaviors in order to prevent weight gain. The most common method is self-induced vomiting after eating, which can happen multiple times per day. However, other forms of purging may also be used, including:
– Misuse or abuse of laxatives or diuretics
– Fasting for a day or more after binges
– Excessive exercise intended to “work off” the calories consumed
Some signs of compensatory purging or fasting may include:
– Evidence of vomiting in the bathroom such as smell, clogged shower drain or toilet
– Wrappers or packages for laxatives, diuretics, ipecac syrup or enemas
– Going to the bathroom frequently after eating
– Avoiding eating around others or refusing to eat
– Disappearing after meals to exercise excessively
Warning Sign 3: Obsession with Body Image and Weight
People with bulimia place an excessive emphasis on body weight or shape in their self-evaluation, so much so that it impairs their emotional, physical and social functioning. They are obsessed with their body image and terrified of gaining weight.
Some signs of an obsession with body image and weight include:
– Expressing body dissatisfaction, weight concern or a distorted self image
– Severely limiting food intake or following strict diets apart from binges
– Evidence of scales around the house to weigh frequently
– Looking at oneself repeatedly in the mirror or avoiding mirrors
– Wearing baggy clothes to hide the shape of the body
– A strong desire for thinness and an intense fear of gaining weight
Warning Sign 4: Impaired Social and Emotional Functioning
The preoccupation with food, body image, and binge/purge behaviors often significantly impairs the person’s psychological, social, academic or occupational functioning. Relationships may suffer, school or work performance declines, and emotional problems like depression, anxiety and irritability increase.
Some signs of social or emotional impairment may include:
– Withdrawal from friends and family
– Lack of interest in activities once enjoyed
– Difficulty concentrating at school or work
– Moodiness, anxiety, anger or depressed mood
– Fluctuations in weight
– Secretive behaviors and increased isolation
– Lying about eating or purging behaviors
Warning Sign 5: Medical and Dental Problems
Bulimia can result in many medical complications affecting nearly every organ system in the body. Frequency of vomiting erodes dental enamel and causes swelling of the salivary glands. Electrolyte imbalances and dehydration can produce arrhythmias, heart failure, and even death. Other problems include gastrointestinal issues, hypoglycemia, musculoskeletal issues, and more.
Some physical signs and symptoms to look out for include:
– Calluses or scars on the backs of hands (from inducing vomiting)
– Swollen salivary glands, especially the parotid gland
– Broken blood vessels in the eyes
– Tooth decay, fillings falling out or chipped teeth
– Irregular heartbeat
– Low potassium levels
– Fainting or dizziness
– Fatigue or lack of energy
– Headaches
– Gastrointestinal problems like constipation, acid reflux, bloating or abdominal pain
Getting Help for Bulimia
If you recognize several of these warning signs in yourself or a loved one, it is very important to reach out for professional help with an eating disorder specialist. Bulimia causes extensive physical and emotional damage, but recovery is possible. With compassionate treatment and support, those struggling with bulimia can regain their health, self-esteem and quality of life.
Some options for seeking help include:
– Speaking to a doctor, school counselor or mental health professional
– Contacting the National Eating Disorders Association (NEDA) helpline at 1-800-931-2237
– Finding a therapist specializing in treating eating disorders
– Entering an eating disorder treatment program, residential or outpatient
– Joining a support group to reduce isolation and increase motivation for recovery
The sooner bulimia is identified and medically managed, the better the outcome typically is. There are many compassionate professionals ready to help anyone struggling with bulimia or showing signs of an eating disorder. Full recovery is absolutely possible, you just have to take the courageous first step of reaching out for support.
Conclusions
In summary, the 5 main warning signs of bulimia include:
1. Recurrent binge eating episodes
2. Compensatory purging behaviors like vomiting or laxative abuse
3. Obsession with body image and intense fear of weight gain
4. Impaired social, emotional and physical functioning
5. Medical and dental issues from the disorder
Noticing these signs early and seeking professional treatment can prevent bulimia from progressing further and threatening health. With compassionate support and evidence-based treatment, those with bulimia can regain a healthy relationship with food, themselves and others. Recovery is a process, but one definitely worth pursuing.