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What Are Signs and Symptoms of Bulimia Nervosa?

Bulimia nervosa is characterized by recurrent episodes of binge eating followed by purging behaviors, such as self-induced vomiting, misuse of laxatives or diuretics, fasting, or obsessive exercise, in an attempt to prevent weight gain.

Bulimia occurs in adolescents and young adult women but is relatively uncommon in men, and typically develops in the late teens or early 20s. Fifty percent of bulimics have or had anorexia nervosa.

Some authorities believe that as many as 10 percent of women are affected over their lifetimes. Clinically speaking, a person with bulimia nervosa binges at least twice a week, eats large amounts of food in a relatively short period of time, and then purges to rid her body of the unwanted calories.

More than half of bulimics are severely depressed and often suffer from alcohol and drug abuse in addition to their eating problems. Unlike the anorexic, who is excessively thin, the bulimic’s weight is usually average or slightly above average and often fluctuates.

Do you (or someone you know) have any of the following symptoms? The more “yes” answers, the greater the likelihood that you (or she) may have bulimia nervosa.

  • Gorges, usually in secret, and may buy special binge food.

  • Is uncomfortable eating around others.

  • Makes excuses to go to the bathroom after meals.

  • Buys large amounts of food that suddenly disappear.

  • Displays unusual swelling around the jaw and cheeks; knuckles may be scraped or calluses formed on back of hand from inducing vomiting.

  • Has discolored or stained teeth due to vomiting.

  • Eats large amounts of food on the spur of the moment and feels out of control, unable to stop eating.

  • Withdraws from friends.

  • Doesn’t seem to gain an excessive amount of weight given the amount of food regularly consumed.

  • Often exercises excessively.

  • Runs water to cover the sound of vomiting, may use mouthwash and breath mints excessively, and may have a foul-smelling bathroom.

  • Can’t explain the disappearance of food in the home or residence hall setting.

  • May engage in drug or alcohol use and/or in casual or even promiscuous sex.

  • Experiences mood swings; may experience depression, loneliness, shame, and feelings of emptiness (although may pretend to be cheerful).

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