A Guide to Mental Disorders

Bulimia Nervosa

Bulimia is a serious illness that causes severe problems with a person's eating behaviors. If you have an eating disorder, you may have an obsession with food and weight. This obsession can harm your physical and emotional well-being.

Bulimia nervosa can be defined as a pattern of eating characterized by:
- Consuming an unusually large amount of food in a short period of time (binge eating).
- Getting rid of the food (purging). Purging may involve making yourself throw up (vomiting) or taking laxatives. Laxatives are medications that speed up the movement of food through your body.

Other characteristics of bulimia nervosa may include:
- Misuse of water pills (diuretics) or diet pills.
- Eating very little or not at all (fasting).
- Excessively exercising.
- Hiding food to binge and purge later.

People with bulimia are usually at a normal, healthy weight. But they judge themselves harshly based on their view of their body shape and/or weight. They usually have self-esteem issues closely linked to their body image.

Who does bulimia nervosa affect?
Bulimia nervosa affects people assigned female at birth more often than people assigned male at birth. It typically develops during adolescence or early adulthood. But it can affect people of all ages. Between 1% and 2% of people will experience bulimia during any given year. Bulimia can occur in people of any sex, gender, age, race, ethnicity or body type.

What's the difference between bulimia nervosa and anorexia nervosa?
People with bulimia nervosa usually have a normal weight. They engage in a cycle of binging and purging. People with anorexia nervosa are usually underweight. They engage in self-starvation, extreme diets and extreme exercise to lose weight. People with anorexia nervosa think they're fat even though they're very thin. They may get so thin they look sick.

What's the difference between bulimia nervosa and binge eating disorder?
People with bulimia nervosa binge eat and then purge, or try to get rid of the food or weight. People with binge eating disorder binge but they don't purge. Also, people with bulimia are usually at a weight that's healthy for them. People with binge eating disorder typically are overweight/obese.

What are the signs and symptoms of bulimia nervosa?
Bulimia nervosa can be hard to spot. People with the condition often binge and purge privately. But empty food wrappers and laxative packaging can be warning signs of bulimia.

Other behavioral and emotional symptoms of bulimia nervosa include:
- Frequent visits to the bathroom, particularly after meals.
- Repeatedly eating unusually large amounts of food in one sitting.
- Vomiting on purpose or exercising to extremes after binge eating so that you don't gain weight.
- Preoccupation with body image.
- Intense fear of gaining weight.
- Depression, anxiety or substance abuse.
- Feeling out of control during binge eating. You may feel like you can't stop eating or can't control what you eat.
- Feeling guilty or shameful about eating.
- Withdrawing socially from friends and family.
- Having extreme mood swings.

The physical symptoms of bulimia nervosa can include dental issues. Self-induced vomiting can cause erosion of your tooth enamel from your stomach acid. Your teeth may also appear clear instead of white and be more sensitive.

Other physical symptoms of bulimia nervosa can include:
- Swollen cheeks or jawline.
- Gastrointestinal problems such as constipation and acid reflux.
- Scars, scrapes or calluses on your knuckles (from forced throwing up).
- Fainting.
- Irregular menstrual periods.
- Muscle weakness.
- Bloodshot eyes.
- Dehydration.

Bulimia can prevent your body from getting the nutrients it needs. Many different complications can occur due to bulimia nervosa including:
- Throat and stomach ulcers.
- Tooth decay, cavities and gum disease.
- Esophagus inflammation (esophagitis) and tears.
- Damage to your intestines and stomach damage.
- Electrolyte imbalance.
- Abnormal heart rhythm (arrhythmia).
- Heart failure.
- Poor nutrition.
- Increased risk of suicide.