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Symptoms
By Mayo Clinic staffBulimia symptoms may include:
- Feeling that you can't control your eating behavior
- Eating until the point of discomfort or pain
- Eating much more food in a binge episode than in a normal meal or snack
- Forcing yourself to vomit after eating
- Exercising excessively
- Misuse of laxatives, diuretics or enemas
- Being preoccupied with your body shape and weight
- Having a distorted, excessively negative body image
- Going to the bathroom after eating or during meals
- Abnormal bowel functioning
- Damaged teeth and gums
- Swollen salivary glands in the cheeks
- Sores in the throat and mouth
- Dehydration
- Irregular heartbeat
- Sores, scars or calluses on the knuckles or hands
- Menstrual irregularities or loss of menstruation (amenorrhea)
- Depression
- Anxiety
When you have bulimia, you may regularly vomit or exercise excessively after binge eating. Sometimes, however, people with bulimia feel a need to purge after eating only a small snack or a normal-size meal.
A binge is considered eating a larger amount of food than most people would eat under similar situations. For instance, when you have bulimia, you may eat an entire cake, rather than just a slice or two. And you may continue eating until you're painfully full.
Binges often occur in private. Once the binge episode ends, the purging begins. This may mean heading to the bathroom to vomit, hitting the treadmill for hours of exercise, or not eating for long periods of time (fasting). Because most people with bulimia are of normal weight or even slightly overweight, it may not be readily apparent to others that something is wrong.
Bulimia may be categorized in two ways:
- Purging bulimia. You regularly engage in self-induced vomiting or the misuse of laxatives, diuretics or enemas to compensate for binges.
- Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting or overexercising.
However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method.
When to see a doctor
If you have any bulimia symptoms, seek medical help as soon as possible. Bulimia usually doesn't get better on its own. It may even get worse if left untreated and take over your life.
If you have a primary care doctor, talk to him or her about your bulimia symptoms and feelings. Or seek help directly from a mental health provider. If you're reluctant to seek treatment, try to work up the courage to confide in someone about what you're going through, whether it's a friend or loved one, a health care professional, a teacher, a faith leader, or someone else you trust. They can help you take the first steps to successful bulimia treatment.
Helping a loved one with bulimia symptoms
If you have a loved one you think may have symptoms of bulimia, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You may even be able to go to an appointment with him or her.
Red flags that family and friends may notice include:
- Persistent worry or complaining about being fat
- Repeatedly eating unusually large quantities of food in one sitting, especially high-fat or sweet foods
- Not wanting to eat in public or in front of others
- Use of dietary supplements or herbal products for weight loss
- Excessive exercising
- The use of laxatives or diuretic medications
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- Forman SF. Eating disorders: Treatment and outcome. http://www.uptodate.com/home/index.html. Accessed Nov. 2, 2009.
- Sim LA, et al. Family-based therapy for adolescents with anorexia nervosa. Mayo Clinic Proceedings. 2004;79:1305.
- Douglass L. Yoga as an intervention in the treatment of eating disorders: Does it help? Eating Disorders. 2009;17:126.
- Sim LA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 18, 2009.
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