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Bulimia Nervosa: Signs and Symptoms

Bulimia Nervosa:
Signs and Symptoms



How does bulimia begin?
What will bulimia do to my body?


All human beings need to eat to stay alive and well. And most people want to eat because they enjoy it. In fact, sometimes you may eat too much of something you really like. Or, if you're busy, you may even forget to eat every once in a while. But for most people, eating is a normal part of everyday life.

That's not the case for everyone. In fact, millions of people in the United States today have what are called eating disorders. They eat too little or too much all the time—or some combination of the two. The three most common eating disorders are bulimia nervosa, anorexia nervosa, and obesity.

Bulimia is an eating disorder that affects mostly girls and women. (It affects boys and men, too, but not as often.) People with bulimia "binge," which means they eat too much at one time. Then, when they are completely full, they make themselves vomit or use laxatives to get rid of the food. That's why bulimia is sometimes called the "binge and purge" disorder.

Bulimia is actually more common than anorexia. Like girls with anorexia, girls with bulimia are afraid of becoming fat. In fact, some girls with bulimia have or have had anorexia, or they go back and forth between bulimia and anorexia. back to top

How does bulimia begin?
Girls with bulimia are close to a normal weight for their age and height, and may even be a little bit overweight. It might be hard at first to tell if a girl has bulimia because she seems to have a normal appetite, and seems fine about eating meals with friends and family.

But when she is alone, a girl with bulimia will binge—often every day. For an hour or two, she eats everything in sight as fast as she can, especially foods that are high in fat and sugar,such as ice cream, bread, candy, doughnuts, and soft drinks. She will keep eating until she feels guilty or until her stomach aches from all the food. Then she makes herself vomit, usually by sticking her finger in the back of her throat to trigger what's called the gag reflex. Many girls who have been bingeing and purging for a while can vomit automatically without sticking their fingers in their throats.

Sometimes people use food to comfort themselves when they feel blue. A girl may be upset and start to eat something she thinks is not good for her. Then she feels she has lost control, and she starts to binge.

It is also very common for girls with bulimia to use laxatives, which are pills, tablets, or liquid medicines that cause you to empty your bowels. Sometimes, they also use diuretics, which cause you to urinate more and lose water weight. They might also abuse diet pills or do rigorous exercise to work off the calories from their binges.

While girls with anorexia may not think that they have a problem, girls with bulimia know that they have abnormal eating habits. This can cause a girl to have strong feelings of guilt and self-hatred, and low self-esteem. But because she looks fine, a girl with bulimia can keep her secret from family and friends for a long time. In fact, friends may find out about the disease before family members because girls are with their friends for much of the day, including lunchtime at school. They might notice that the girl goes to the bathroom after every meal and may even catch her throwing up. Some girls throw up after every meal, or whenever they can.

It is also quite common for girls with bulimia to steal things, especially food. Parents might find a whole box of cookies or loaf of bread missing from the kitchen, or lots of food hidden in the girl's bedroom. Sometimes girls with bulimia get out of control in other ways. They may spend too much money or be extremely interested in sex. Many girls with bulimia abuse drugs and alcohol. They may be depressed or anxious, and their families may have problems with depression and substance abuse. Sometimes they need to fill themselves—stuff themselves with food—as a way to feel better. back to top

What will bulimia do to my body?
Girls with bulimia may look healthy, but the disease can cause a lot of damage to the body. Frequent vomiting can cause dangerous electrolyte imbalances, meaning that your system doesn't have a healthy amount of nutrients like sodium and potassium, which keep your body running smoothly. Vomiting can also cause dehydration. Using laxatives can give you an irregular heartbeat, or even a heart attack. If vomit gets caught in your lungs, you could get pneumonia. Vomiting all the time can tear your esophagus, the tube in your throat that you swallow with. It is very common for girls with bulimia to have problems with their stomach and intestines.

A girl with bulimia (unlike someone with anorexia) usually continues to get her period, but it might not come as regularly. She will probably get a lot of cavities, too, both because she is eating so much sugar during her binges and because the enamel on her teeth is worn down from vomiting. She can also get swollen glands that can give her puffy-looking cheeks and blood-shot eyes.

Girls with bulimia have deep emotional problems. They may suffer from depression or substance abuse, and may even be suicidal. It is important for people with bulimia to get help for both the physical and psychological parts of the disease—to see both a health care provider and a psychotherapist.

Even if you don't have bulimia, you may have eating habits that are dangerous to your body and mind. This is sometimes called "disordered eating." It's good to get help right away so that you don't develop a more serious problem. back to top

Last Modified Date: 3/30/2001
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