Bulimia nervosa is an eating disorder that involves a pattern of binge eating and purging. Individuals with bulimia may eat large amounts of food with loss of control. To prevent weight gain, they will then purge to try and get rid of the calories they have consumed. Self-induced vomiting is a common form of purging, but people with bulimia may also misuse laxatives and weight-loss supplements or engage in excessive exercise.

It is estimated that 1.5% of American women and 0.5% of American men will suffer from bulimia nervosa in their lifetime. In many cases, bulimia manifests as an extremely unhealthy way to cope with self-perceived flaws. It can have life-threatening consequences if left untreated. If you or someone you love is struggling with an eating disorder such as bulimia, it is important that you seek professional help as soon as possible.

Diagnostic Criteria

To be diagnosed with bulimia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (or DSM-5), the following criteria must be met:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating an amount of food that is larger than most people would eat during a similar period of time and under similar circumstances.
    • Sensed lack of control overeating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  • Recurrent inappropriate compensatory behaviors to prevent weight gain. This may include self-induced vomiting, fasting, misuse of laxatives or diuretics, or exercising excessively.
  • The binge eating and inappropriate compensatory behaviors both occur, on average at least once a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of anorexia nervosa.

Signs and Symptoms of Bulimia

Due to the secretive nature of the disorder, it is difficult to determine if someone is struggling with bulimia just by looking at them. Furthermore, this condition affects people of all body shapes and sizes. Potential warning signs of bulimia include:


  • Noticeable fluctuations in weight, both up and down
  • Thinning hair on head
  • Cavities or discolored teeth, from vomiting
  • Cuts and calluses on top of finger joints, from induced vomiting
  • Swelling in the cheeks or jaw area
  • Dry or yellow skin
  • Fatigue, dizziness, or fainting
  • Problems sleeping or insomnia
  • Stomach cramps or constipation
  • Menstrual irregularities
  • Muscle weakness
  • Difficulties concentrating

Behavioral and Emotional

  • High level of concern with weight loss, dieting, and control of food
  • Disappearance of large amounts of food in short periods of time
  • Frequent trips to the bathroom after meals
  • Signs or smells of vomiting
  • Steals or hoards food in strange places
  • Appears uncomfortable eating around others or in public
  • Drinks excessive amounts of water or non-caloric beverages
  • Uses excessive amounts of mouthwash, mints, or gum
  • Frequent checking of appearance in the mirror
  • Excessive exercise regimen
  • Dressing in large or baggy clothes
  • Withdraws from friends and loved ones

Other Co-Occurring Conditions/Behaviors

People with bulimia may have other disorders or exhibit behaviors such as:

  • Self-injury (cutting and other forms of self-harm)
  • Substance use
  • Mental health disorders such as anxiety or depression
  • Impulsivity (risky, potentially dangerous behaviors)

Health Consequences of Bulimia

Bulimia nervosa’s cycle of bingeing and purging can severely impact the body’s digestive system. It can lead to electrolyte and chemical imbalances which can lead to severe medical consequences such as:

  • Damage to the brain, heart, and other vital organs
  • Increased risk of illness due to decreased white blood cell count
  • Lower production of hormones, which could lead to infertility
  • Increased risk of bone damage or broken bones

Treatment Options for Bulimia

There are many effective treatments for bulimia. It’s important to get help as soon as possible to prevent severe health issues. Some people try outpatient therapy first, while others need to spend time in inpatient or residential treatment. Medication might also be helpful, especially if there are any co-occurring psychiatric disorders like anxiety or depression.

At Seeds of Hope, our staff has the expertise to help anyone struggling with bulimia. Each client’s unique needs are met with a customized treatment plan. If you or someone you love is suffering from bulimia nervosa, contact our staff today to have a friendly, non-judgmental conversation and see how we can help. You can also call us at (610) 644-6464.