Bulimia nervosa usually starts with restriction of food intake that leads to uncontrolled consumption of large amounts of food (bingeing). Feelings of guilt and panic can follow, leading to attempts to get rid of the food eaten. This eventually becomes a cycle of food restriction, bingeing and purging. Some studies indicate that behaviours associated with bulimia could be found in as many as 30% of adolescents. Bulimia affects 1-3% of adolescent and young adult females, and about 10 to 20% of sufferers are male.
People with bulimia can have serious problems with self-esteem, and may have clinical depression, relationship problems, health problems and difficulty with day to day life. Some people with bulimia may also have problems with substance abuse. Purging is not only found in bulimia – when associated with significant weight loss, it may indicate anorexia and this combination is very dangerous.
Physical Characteristics
• Near average weight or slightly over or underweight
• Dramatic weight fluctuations with related fluid retention
• Swollen salivary glands (puffy cheeks) and chronic hoarseness
• Forced vomiting can cause blistering, tearing and bleeding of the throat and oesophagus
• Dental decay from stomach acid (erosion of enamel, dental cavities)
• Disturbance of menstrual cycle
• Hair, nail and skin problems
• Constipation (laxative, diuretics and emetics may contribute)
• Gastro-intestinal disorders
Behavioral Characteristics
• Episodes of consuming very large amounts of food
• Restriction of food intake, possible fasting
• Purging behaviours such as abuse of laxatives or diuretics, excessive exercise, vomiting, or fasting
• Secretive behaviour (hiding binge-purge behaviours due to shame)
• Social withdrawal (isolation, spending time on food related activities)
Psychological Characteristics
• Low self-esteem, poor self-image
• An overwhelming fear of becoming fat
• Great importance attached to being slender
• Constant pre-occupation with food
• Feelings of guilt, shame and self-loathing
• Depression and possible suicidal thoughts
• Mood swings and increased irritability
• May hide symptoms successfully for years