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What are the signs and symptoms of bulimia nervosa?

At Life Works, we understand that bulimia nervosa is a complex and debilitating eating disorder that can have a hugely detrimental impact on your health, wellbeing and general quality of life.

Bulimia is a secretive disease and many of the symptoms are very hard to see. The most common bulimia symptoms are bingeing on foods that you feel guilty about eating, and then purging yourself of those foods through excessive exercise, vomiting or abusing laxatives. Other less visible symptoms of bulimia include an obsession with food, fear or embarrassment about eating sugary or fatty foods in front of other people and constantly counting calories.

The signs and symptoms of bulimia can vary from person to person and can be categorised into psychological, physical and behavioural/social symptoms.

Psychological symptoms of bulimia:

  • Having an overwhelming obsession with food, calories and controlling your diet
  • Having a preoccupation with having a certain body shape and looking a certain way
  • Having an excessively distorted, negative body image
  • Experiencing intense feelings of guilt, shame and self-disgust after binge eating, which then adds to the desire to purge
  • Spending a lot of time thinking about food and feeling as though this has taken over your life
  • Depression
  • Anxiety
  • Stress
  • Self-harm
  • Panic attacks
  • Frustration
  • Mood swings
  • Anger, irritability and impatience – finding that you get angry for no reason and taking this out on those who are closest to you
  • Low self-esteem and a reduction in confidence
  • Exacerbation of any existing mental health problems such as anxiety, depression or obsessive compulsive disorder (OCD)
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Physical symptoms of bulimia:

  • Problems with vital internal organs due to a lack of essential vitamins, minerals and other nutrients
  • Gastric reflux
  • Bowel problems and abnormal bowel functioning, as a result of laxative abuse
  • Kidney damage
  • Ruptured stomach
  • A painful throat and damaged vocal chords, causing a ‘raspy’, ‘scratchy’ voice
  • Tooth decay, bad breath and scars on the knuckles as a result of making yourself sick
  • Persistent sores and ulcers in the mouth
  • Swollen salivary glands
  • Choking
  • Fainting
  • Dehydration
  • Headaches
  • Dry skin
  • Heart palpitations
  • Muscle aches and cramps
  • Bloating
  • Chest pain
  • Seizures
  • Irregular periods in women, or a loss of periods
  • Sleep disturbances, including insomnia
  • Tiredness and fatigue

Behavioural/social symptoms of bulimia:

  • Obsessively counting calories
  • Repeatedly weighing yourself
  • Visiting pro-bulimia (pro-‘mia’) websites or social media platforms
  • Denying that you have a problem, both to yourself and others
  • Telling people that they are making too much fuss about your eating habits
  • Social withdrawal and isolation – not wanting to meet with family and friends, in order to avoid answering questions about your eating habits
  • Reduced school or work performance

Bingeing

  • Eating larger than normal amounts of food in one sitting
  • Bingeing on foods that you feel guilty about eating, such as those that have a high fat/sugar content
  • Feeling as though you experience a complete loss of control during your bingeing episodes
  • Binge eating until the point of physical pain and discomfort
  • Hiding or hoarding food to binge on at a later point
  • Binge eating alone or in secret

Purging

  • Going to the toilet straight after or during meals to make yourself sick
  • Abusing laxatives or diuretics (medication that removes fluid from the body)
  • Exercising excessively in an attempt to burn off the calories that you have consumed

What are the long-term effects of bulimia nervosa?

Without expert help, bulimia can result in a number of negative long-term consequences, including:

  • Internal bleeding
  • Infertility
  • Heart attack, organ failure and subsequent death, in rare cases
  • Strained or ruined relationships
  • Family breakdowns
  • Failure at school or work, resulting in expulsion or job loss
  • Financial difficulties due to the amount of money that is spent on food
  • Drug and alcohol addiction, as a means of helping you to cope with difficult emotions or physical complications
  • Suicidal thoughts/behaviours

This page was reviewed by Steve Clarke, Hospital Director, (MSc, NCFED) in 2019 and is scheduled to be reviewed again in 2021.

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To discuss how the Life Works team can help to support individuals and families dealing with an Eating Disorder and for further information on treatment and rehabilitation programmes, please call: 01483 745 066 or click here to make an enquiry.

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