Eating Disorders
(Including Anorexia and Bulimia)

Symptoms of Bulimia

By Toby Goldsmith, M.D., Sue Craven, Ph.D. and John M. Grohol, Psy.D.
05-Oct-2005

In the Eating Disorders Series:

People with bulimia nervosa do two things. First, they eat. Second, they work very hard to get rid of what they have eaten. People with bulimia binge eat. That is, in a small amount of time they eat copious amounts of food, much more than an average person would eat in an equivalent amount of time. They often lose control over their eating, and are unable to stop until the food is gone. When the food is gone, guilt over the consumption appears and they have to get rid of the evidence. So they will vomit, or use laxatives, diuretics, enemas or other medications. Sometimes they choose to fast for days in response to a particularly bad binge. Others will exercise excessively. But the goal is to not absorb or to burn off any of the calories that were consumed in the binge.

Unlike people with anorexia nervosa, you cannot readily identify people with bulimia based on their weight and public eating behavior. Often body weights hover around the average range, although one might see remarkable weight fluctuations in a person.

People with bulimia are often ashamed of their eating problems and attempt to conceal their symptoms. Binge/purge behavior is often quite secretive, and one's obvious, or public, eating patterns vary from being relatively "normal" to being highly restrictive.

Typically people with bulimia are very body and weight conscious and are frequently dieting. They place excessive emphasis on body weight and shape in their self-evaluation. Often these factors are the most important ones for them in determining self-esteem.

Specific Symptoms of Bulimia Nervosa:

This disorder is characterized by recurrent episodes of binge eating, occurring at least twice a month for a minimum of three months, which consists of:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

Individuals who suffer from this disorder often engage in behavior in order to try and prevent themselves from gaining any weight. This behavior may include such things as self-induced vomiting; overusing laxatives, diuretics, enemas, or other medications; refusing to eat (fasting); or excessive exercise.

Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. A person's self-image is usually directly correlated with their weight, with a great deal of attention focused on how their body looks.

This disorder can only be diagnosed if it is not better accounted for by anorexia nervosa.

There are two types of bulimia nervosa:

  • Purging Type: -- The person regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
  • Non-purging Type: -- The person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

The Body Mass Calculator is one simple way to calculate your healthy weight.

» Next in Series: Symptoms of Binge Eating



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Last reviewed: By John M. Grohol, Psy.D. on 26 May 2013
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