Symptoms and Warning Signs of Bulimia Nervosa

Symptoms and Warning Signs of Bulimia Nervosa Eating Disorders Symptoms Print The Different Symptoms of Bulimia Nervosa Physical, Behavioral, and Emotional Symptoms By Susan Cowden, MS facebook linkedin Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders. Learn about our editorial policy Susan Cowden, MS Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 19, 2020 More in Eating Disorders Symptoms Treatment Diagnosis Awareness and Prevention People who are experiencing bulimia nervosa may exhibit some of the following symptoms and/or warning signs of the disease. Sometimes family members and friends will remark after a diagnosis has been made that they are surprised that they didn’t notice the eating disorder or didn’t realize that certain behaviors or physical complaints were related to an eating disorder. However, people who are struggling with bulimia nervosa often experience emotions of shame and guilt about their behaviors. This means that many people with bulimia nervosa will go to great lengths to hide their behaviors to avoid anyone finding out about the eating disorder. It is important to note that this is not an exhaustive list of symptoms and people who do not have all of the symptoms below may still be struggling with bulimia nervosa or another eating disorder. Also, these signs and symptoms are not specific to eating disorders and may reflect other conditions. Physical Symptoms Bulimia nervosa is characterized by?? Repeated episodes of binge eating, which is eating a large amount of food in a short period of time and feeling out of control while doing so,  andThe use of compensatory behaviors such as vomiting, using laxatives or diuretics,  or engaging in  extreme amounts of exercise in order to offset eating. Because many sufferers are of average weight, physical symptoms of bulimia may not be noticeable to others until the disorder has become extremely severe. It is important for anyone experiencing the following physical symptoms to be assessed by a physician. Swollen glands, roundness in jaw area, bloodshot eyes,Calluses on the back of the handLightheadedness or loss of balance (may experience fainting)Yellowing, graying, spotted or decaying teethTooth sensitivityTooth cavitiesMouth ulcersChest painsHeart palpitationsHeadacheStomach achesFrequent sore throatElectrolyte imbalances and dehydrationSwelling of hands and feetChronic bouts of constipation (resulting from laxative abuse)Vomiting blood Dentists are often the first to notice signs of self-induced vomiting in patients with bulimia nervosa because of the tell-tale pattern of dental erosion primarily on the internal surface of the teeth.?? Bulimia and Your Teeth Puffy cheeks among patients who vomit are one of the other noticeable physical signs. Calluses on the hand from inserting it in the mouth to cause vomiting may also be visible and are known as Russells sign.?? Later in the illness, this sign may not even be visible because patients are able to vomit without mechanical stimulation.   Behavioral Symptoms These are symptoms that are often noticed outwardly by family members and friends.?? Evidence of purging â€" Always needing to go to the restroom or showering after meals,  or finding packages of laxatives or diureticsEvidence of binge eating â€" Stashing food, stealing food, eating large amounts in one sittingFamily members or roommates may notice large amounts of food that are missing from the cabinets or pantry or notice large amounts of food packaging in trashcans or vehiclesFrequent trips to the bathroomExtreme eating habits (strict dieting followed by overeating)Desperate to exercise even when it gets in the way of other activitiesWanting to exercise a specific amount to ‘burn off’ the calories that have been taken inCreation of schedules or rituals that allow for binging and purgingUses drugs as a way to suppress appetiteTalks about dieting, calories, food or weight so much that it gets in the way of regular conversationWithdrawal from friends, families and usual activitiesSeems fatigued Emotional Symptoms Although more difficult to notice than behavioral symptoms, emotional symptoms are often recognized by family members and friends, even when they don’t know about the binging and purging behaviors. These emotional issues are not unique to bulimia nervosa but may raise concerns.?? Self-esteem, self-worth, or attractiveness determined by appearance and weightDepressionMood swingsExtreme irritabilityStrong need for approvalExtremely self-criticalFeeling out of control Other Diagnoses Sometimes, people with anorexia nervosa will also use binging or purging behaviors. However, the distinction between bulimia nervosa and anorexia nervosa is that people struggling with anorexia nervosa have significantly low body weight.?? Patients who binge but do not purge, may meet the criteria for binge eating disorder.   If you or someone you know is showing signs of bulimia nervosa, please seek out or encourage your loved one to seek out professional help. Simply having a conversation about your behaviors toward food, eating, stress, and more can give your doctor valuable insight to help you. Bulimia Discussion Guide Get our printable guide for your next doctors appointment to help you ask the right questions. Download PDF A Word From Verywell Most of the symptoms and signs associated with bulimia nervosa are reversible with treatment.  If you dont have a doctor who specializes in mental health, feel free to start out speaking with your primary care physician. You Can Hurt Someone With an Eating Disorder by Saying the Wrong Thing