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This page was medically reviewed by David Waller, (BACP, FDAP), Eating Disorder Programme Lead at Life Works.

Bulimia nervosa is a compulsive behaviour by which sufferers seek to control their weight through binge eating and then purging their body of that food.

Although not always easy to look out for, there are some signs and symptoms that can indicate someone may be struggling with bulimia and may benefit from professional eating disorder treatment.

Signs of bulimia to look out for

The main symptoms of bulimia someone will experience is commonly consuming large amounts of food, whether or not they are hungry, until they feel discomfort. Then, they will purge themselves via self-induced vomiting or the use of laxatives, ultimately trying to get rid of the food they have consumed. This is a cycle that someone can go through several times a week.

Signs someone may have 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
  • Low self-esteem and a reduction in confidence
  • Mental health problems such as anxiety, depression, stress, anger, and self-harm
  • Social withdrawal and isolation – not wanting to meet with family and friends, in order to avoid answering questions about your eating habits or avoid situations where food is involved

Binging and purging

Someone struggling with bulimia nervosa will be stuck in the habit of binging and purging. Binging is the process of someone purposefully consuming too much food to the point they are uncomfortably full and experiencing discomfort. Purging is then how someone gets rid of that food with unnatural processes, such as self-induced vomiting or laxatives.

Signs of binging are:

  • Eating larger than normal amounts of food in one sitting
  • Binging 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 binging 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

Signs of purging are:

  • 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

Depending on the severity of the eating disorder, someone with bulimia may experience more of these symptoms than others, and act on their binging and purging urges more frequently than others.

Bulimia is known to be a very secretive illness, and sufferers will often go to extreme lengths to hide their unhealthy bingeing and purging behaviours. This, combined with the fact that the binge-purge cycles don’t result in dramatic changes in weight, can make this eating disorder very difficult to identify.

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Long term effects of bulimia

The constant rounds of binging and purging associated with bulimia can lead to a number of physical and mental problems, some of which can be life threatening. These include:

  • Swollen cheeks – swelling of the face, particularly of the jaw caused by the disturbances to the body’s fluids. This can also be known as ‘chipmunk cheeks’ or ‘bulimia face’.
  • Tooth decay - frequent vomiting means that the teeth are exposed to stomach acids that cause erosion of the enamel, so exposing the teeth to decay.
  • Psychological problems – bulimia sometimes leads to depression and mood swings, as well as low self-esteem and feelings of guilt.
  • Bowel problems – laxatives, which bulimics sometimes take to excess, can damage both the bowel muscle and nerve endings, sometimes resulting in abdominal pain and permanent constipation.
  • Electrolyte imbalance – frequent vomiting and excessive use of laxatives affects the body’s chemical balance. Reduced calcium levels can cause muscle spasms, while other deficiencies can cause kidney damage, abnormal heart rhythms, fatigue and weakness.
  • Irregular menstrual periods – the poor diet associated with bulimia can affect hormone levels that can cause irregular periods, the cessation of periods or, in the case of younger sufferers, impede the onset of periods at puberty.
  • Throat problems – bulimics often experience throat irritation and damage to the oesophagus, causing a ‘raspy’ or ‘scratchy’ voice
  • Internal problems – ulcers, internal bleeding, inflammation of the pancreas and even rupturing of the stomach can occur as a result of bulimia.

When to get help

If you, or someone you know, is struggling with the symptoms of bulimia, it’s important to reach out for help. It can be daunting letting people know you’re struggling, but seeking help is the best way to overcome bulimia nervosa and get your life back on track.

We understand that eating disorders are unique to each and every one of our clients and that recovery is a process. We offer a variety of different bulimia treatment options at Life Works that will help someone with bulimia overcome feelings of guilt and shame about food.

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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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