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Published On: Apr 23, 2024|Categories: Eating Disorder Information|

Bulimia nervosa is an eating disorder characterized by cyclical episodes of binge eating, followed by purging of some sort. This could be excessive exercise, induced vomiting or misuse of laxatives, fasting, or a combination thereof. People who struggle with bulimia are hyper focused on body weight and body image, and they oftentimes have a fearful and disordered relationship with food and eating. 

If you think you or a loved one may be suffering from bulimia, you are not alone. Bulimia affects about 1.5 percent of women in America (4.7 million), as well as 0.5 percent of American men (1.5 million). Among the men affected, homosexual males are at highest risk for this disorder.

Bulimia often emerges in the teenage years, as there is heightened cultural pressure associated with image and appearance as the youths continue to individuate and determine their identity. People who have a family history of eating disorders may be at higher risk for bulimia nervosa, and it commonly co-occurs with other mental health disorders such as anxiety and depression. There are many additional contributing factors to bulimia, including societal ideals of beauty, family attitudes towards weight, health and wellbeing, and overall physical health.

Signs of Bulimia

There is often a great deal of shame and secrecy associated with bulimic eating habits, and people are sometimes effective in keeping their disorder hidden for long periods of time. Here are some telltale signs to look out for, as early detection can be pivotal for overall healing and recovery. 

Secretive behavior around food and eating. 

Hidden stashes of food in one’s room or closet and covert episodes of impulsive eating can be a dead giveaway to the presence of bulimia eating disorder. 

Rapid consumption of large amounts of food

Excessive speed of great nutrient quantities can indicate a disordered relationship with food and the act of eating.

Shame or embarrassment around the topic or activity of eating. 

Peoples’ attitude towards food and eating can shed light on a potential underlying eating disorder such as bulimia. Pay attention to the ways you or your loved one express emotion around food.

Frequent trips to the bathroom around mealtime. 

Purging is generally done behind closed doors, so habitual and frequent visits to the bathroom during or after meals may be a sign that this is taking place.

Physical signs and symptoms. 

People with bulimia bear the marks of bulimia on their bodies, including red eyes, dry skin, scarring on their hands, swollen faces, and tooth decay. 

Short Term Effects of Bulimia Nervosa

There are some severe physical side effects that can have a fairly rapid onset in the early stages of this disorder, due to its intense physical nature. These include but are not limited to: 

  • Soreness or irritation of the throat, associated with induced vomiting
  • Irritation or irregularity of the bowels
  • Bad breath
  • Dehydration 
  • Fatigue 
  • Dizziness 
  • Acid reflux or heartburn
  • Hair loss
  • Swollen glands around the jaw and neck
  • Bloating 
  • Muscle soreness or tears due to excessive exercise
  • Aching joints

In isolation, these symptoms may seem insignificant, but can have severe implications on overall health when combined. 

Long Term Effects of Bulimia Nervosa 

Eating disorders can wreak havoc on people’s lives, as well as their mental and physical well being. If they are not detected and treated in the early stages, they can have lasting consequences on the body, including chronic diseases and even death. 

Bulimia nervosa dramatically impacts many different body systems. Frequent and forceful vomiting and laxative-induced bowel movements can cause permanent and irreparable physical damage. The systems and organs most frequently affected by bulimia are the mouth, heart, gastrointestinal system, and endocrine system. 


  • Tooth decay
  • Decay or rupture of the esophagus
  • Gum disease
  • Tooth loss


  • Cardiac arrest
  • Irregular heartbeat
  • Heart palpitations
  • Low blood pressure

Gastrointestinal System

  • Chronic acid reflux
  • Ulcers
  • Rupture of the stomach lining
  • Damage to the bowels 
  • Irritable bowel syndrome (IBS)

Endocrine System

  • Chronic hormonal imbalances
  • Type 2 diabetes
  • Shrinking of reproductive organs 
  • Inconsistent or nonexistent menstrual cycles
  • Infertility 

Kidney function and bone density are also frequently impacted by long-term bulimia nervosa.

Bulimia Nervosa Diagnosis and Treatment

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) dictates five criteria to warrant the diagnosis of bulimia nervosa. 

  1. Recurrent episodes of binge eating. These episodes must be characterized by both a lack of control while eating, and an inordinately large quantity of food consumed 
  2. Compulsive behavior to prevent or control weight gain, such as fasting, extreme exercise, induced vomiting or improper use of laxatives or diuretics 
  3. Weekly occurrence of these binge and purge cycles, for the duration of three months minimum
  4. Excessive preoccupation with body weight, image, size and shape
  5. Binge and purge behaviors are unique from patterns characteristic of anorexia nervosa

If all five of these criteria are met, bulimia nervosa can be diagnosed by a medical doctor or mental health provider. They will most likely suggest an assortment of testing and evaluation to assess the physical, mental and emotional condition of the individual. 

Treatment options will vary per person, may include various therapeutic modalities to determine and address the deeper root of the issue. Cognitive behavioral therapy (CBT) has the highest rates of effectiveness in helping people overcome bulimia. 

Outpatient programs such as group therapies and support groups may also be effective in providing a path to healing from bulimia. The community aspect of these options is powerful in accompanying the participants on their journey, and the outpatient setting allows the flexibility to maintain a normal daily lifestyle while addressing the disorder. Inpatient therapy is a live-in treatment option, where the person goes to stay for an extended period of time in an intensive therapeutic environment. The most severe cases may require hospitalization.

Find Help in Your Recovery Journey Today

If you or a loved one are suffering from bulimia nervosa, you are not alone in this journey. Seeds of Hope has the resources you need to work towards preventing the negative effects of this disorder. Contact us online today, or call 610-644-6464 for more information about finding healing, peace and freedom from disordered eating.

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