Bulimia Signs & Symptoms

Bulimia is an eating disorder in which the person binge eats (the consumption of excessive amounts of food in a brief period of time) followed by behaviors to avoid weight gain (called purging). Binges can range from a few minutes up to a couple of hours before purging. This binge-purge pattern becomes a persistent, often weekly or daily pattern. Individuals with bulimia frequently report feeling out of control of the behavioral pattern and, despite repeated efforts, frequently fail to break the cycle. These recurring frustrated efforts along with feeling out of control often leave the individual feeling powerless over the disorder.

Symptoms

The symptoms for bulimia nervosa from the current version of the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders are: "Recurrent episodes of binge eating characterized by eating an unusually large amount of food in a discrete period of time and feeling unable to stop eating or control what or how much one is eating; recurrent inappropriate compensatory behaviors occur, on average, at least twice a week for three months; self-evaluation is unduly influenced by body weight and shape."

Associated Signs

Those with bulimia frequently report that they are aware of feeling nausea or discomfort from the bingeing, but cannot stop eating. Some report that binge eating takes on a pattern found in other addictive behaviors including obsessive thoughts and a powerful compulsion to eat. Bulimia shares a feature with anorexia in that people focus on their weight and often measure their value based on weight. However, those with bulimia are typically not under weight.

As in anorexia, people with bulimia experience elevated depression and anxiety. Additionally those with bulimia usually manifest greater instability in mood and report more difficulty controlling impulses than those with anorexia. It is common for bulimia to co-occur in people who have a personality disorder. Many of the physical signs of bulimia are related to the medical problems that arise from repeated vomiting such as damage to the throat, mouth, salivary glands and teeth. Other common physical signs are dehydration, anemia, low blood pressure, lowered metabolism, lanugo (the growth of fine pale hair on the face and upper body), imbalances in electrolytes and, in women, irregular menstrual cycles.

Sub-Types

Bulimia is divided into two sub-types based on the method used to avoid gaining weight. With purging type bulimia, the person forces ingested food out through the use of laxatives, diuretics, enemas or vomiting. With non-purging type bulimia, the person attempts to avoid weight gain through excessive physical activity and/or long periods of fasting following a binge. Regardless of the sub-type, the person eventually experiences powerful cravings for food that often trigger another bout of binge eating.