Symptoms of Bulimia

signs of bulimia

Verywell / Laura Porter

Bulimia nervosa is a very common eating disorder. This condition affects men and women alike but is more often diagnosed in women. Studies have shown that women are around five times more likely to be affected by bulimia than men.

This disorder usually begins in adolescence, with teenage girls forming a large percentage of those affected. Up to 10% of college-aged women are affected by bulimia. Because of the nature of this condition, it can be very well hidden, leading to a habit that can continue into adulthood.

We’ll be examining bulimia and the symptoms of this condition. We’ll also look into the possible effects of this eating disorder, and the treatment methods popularly recommended to manage it.

What Is Bulimia?

Bulimia is an eating disorder that involves episodes of binge eating and a purge after the food has been consumed.

Many people that participate in binge eating do not actually fill their plate with large amounts of food but rather eat a large amount of food, in a short time, and feel out of control. Many times this is standing over the counter, getting seconds, picking here and there, etc.

After the plate is finished, the next step is usually a purge to prevent the food from getting digested and causing weight gain. This may be achieved by inducing a round of vomiting.

Other methods of purging include abusing laxatives and diuretics, fasting, or carrying out excessive physical activity.

While the factors responsible for developing bulimia remain unclear, risk factors for this condition include childhood sexual abuse, homosexuality in men, pressure from living in a sorority house, low self-esteem, dieting, participating in sports that focus on thinness or appearance, and belonging to an image-focused industry like modeling.

Symptoms of Bulimia

When a person is suspected of having bulimia, it’s important to remember that their weight may not be the best indicator of the condition. A person with bulimia may appear over or underweight, and can also present normal weight levels.

Instead, the following signs may be a better way to assess a person suspected of having this condition:

  • Eating large amounts of food
  • Noticeable absence right after eating
  • Frequently vomiting after eating
  • Excessive preoccupation with weight and appearance
  • Extreme commitment to physical fitness
  • Feeling guilt about eating
  • Mood swings
  • Abusing laxatives or diuretics 
  • Swollen glands in the neck and jaw
  • Heartburn
  • Unpredictable periods in girls
  • Weakness
  • Bloodshot eyes
  • Sore throat
  • Damaged enamel from stomach acids
  • Bleeding gums
  • Russell’s sign (i.e., calluses on the knuckles from inducing vomiting)

Health Effects of Bulimia 

In addition to the psychological and physical effects of bulimia, this condition could pose serious complications for well-being. These effects target everything from dental hygiene to heart health. They include:

  • Malnutrition
  • Distorted body image
  • Trauma within the mouth after inserting objects to induce vomiting
  • Inflammation in the throat
  • Nose bleeds
  • Cough
  • Cavities
  • Sensitivity in the teeth
  • Dehydration
  • Constipation
  • Tears in the stomach lining
  • Stomach ulcers
  • Swelling in the jaw from repeated retching
  • Damage to teeth enamel following frequent exposure to stomach acids

Bulimia also increases the risk of developing other psychological disorders like major depressive disorder. More than 70% of people living with this condition report suffering from illnesses like anxiety, substance use, and personality disorders. Very serious cases may worsen the chances of self-harm, suicidal ideation, and death.

This disorder may also lead to severe health conditions like a heart attack, or cardiac arrest.

Conditions Similar to Bulima

Despite having unique traits, not every person that retires to the bathroom after a meal is likely to be living with bulimia. There are conditions that share similar symptoms with this eating disorder, some of which include:

Binge Eating Disorder

Like bulimia, people with this condition tend to eat large amounts of food within a short period of time. However, unlike the former, binge eating comes without purging (vomiting or excessive exercise, etc.). Both conditions however produce a similar lack of control in eating habits, and guilt after food has been eaten.

Klein-Levin Syndrome

This very rare condition is identified by its excesses. In addition to excessive food intake, an excessive need for sleep, and a high sexual appetite are also symptoms of Klein-Levin syndrome. This condition is more common in adolescent males, although women and older men may be diagnosed with it.

Biliary Disease

A disease caused by an obstruction in the bile ducts, this condition may also cause nausea and vomiting.

Other conditions that present symptoms similar to bulimia include irritable bowel syndrome and neurological diseases.

Treatment of Bulimia

For a person to be diagnosed with bulimia, they typically have a lack of control over the amount of food they eat during a bingeing session. These sessions may take place repeatedly, and will usually be followed by compensatory behaviors to prevent weight gain.

Combined with a fixation on body weight and image, these behaviors must be noticeable at least once a week for three months. As shown, this behavior is dangerous and can have life-threatening implications, this makes treatment an immediate resort once bulimia is suspected. 

The primary aim of treating bulimia is to break the cycle of bingeing and purging. Treatment is also focused on developing healthier eating habits and thinking patterns. This may be achieved through the following.


Antidepressants are commonly recommended to manage bulimia. This includes SSRIs such as fluoxetine and sertraline. Fluoxetine has proven effective in reducing binge eating and vomiting after as little as four weeks of therapy.

Neuroleptics which help to manage psychosis may also be administered, as can SNRIs used to manage depression and anxiety.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is one of the most trusted ways to manage eating disorders. This form of therapy will help to challenge negative thinking and attitudes towards food, while teaching healthier ways to approach diet and physical maintenance.

Dialectical Behavior Therapy

Dialectical behavior therapy focuses on the triggers that encourage binge eating and the extreme preoccupation with weight gain. DBT will not only help to recognize these triggers, but it will also help with properly managing situations that would push to unhealthy eating behaviors.

Family-Based Treatment

By including the family in the recovery process, parents and guardians will have more input in the eating habits of their children living with bulimia. Caregivers are charged with providing those under their care their required nutritional needs.

A Word From Verywell

Bulimia has the potential to be a very dangerous disease. Its ability to hide in plain sight makes this condition one of the most easy-to-miss eating disorders, permitting its camouflage for years at a time.

Despite how severe the symptoms of this condition can be, it is also a very treatable condition. Anyone suspected of living with bulimia should be encouraged to seek professional help for the right measures to overcome this condition. If you are unsure if you, or a loved one, is struggling with bulimia, or another eating disorder, speak to a professional.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  7. Kleine-Levin Syndrome

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By Elizabeth Plumptre
Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.