Bulimia Nervosa: Signs and Symptoms
Eating disorders, including bulimia nervosa, are complex, but treatable mental and physical illnesses. Eating disorders can affect anyone of any age, gender, or background. Because there are different types of eating disorders, recognizing the signs and symptoms of them and seeking treatment is necessary for a successful recovery.
By: Ekin Kiyici
Bulimia nervosa is one of several types of eating disorders an individual may develop. With an average age of onset at 18 years old, bulimia nervosa can be challenging to catch. The National Eating Disorder Association collected data that suggests 1.0% of young women and 0.1% of young men will meet the criteria for a bulimia nervosa diagnosis at any given point in time. Further, professionals believe between 1.1% to 4.6% of females and 0.1% to 0.5% of males will develop bulimia in their lifetime. That roughly translates to over 5 million females and 1.5 million males.¹
The behaviors individuals struggling with bulimia engage in are often concealed, allowing this disorder to go undetected for an extended period of time potentially. Unlike other eating disorders, individuals struggling may experience no apparent change in their weight and may even fall within a “healthy” weight range. A seemingly “healthy” BMI can further facilitate the hidden nature of bulimia. Although there may be no fluctuation in weight, there is often a great fear of weight gain, a strong desire for weight loss, and intense negative body image.
Signs and Symptoms
Emotional and Behavioral Symptoms²
Engaging in behaviors and attitudes surrounding weight loss, dieting, or an attempt to control food intake.
Episodes of binge eating can include large quantities of food in a short duration.
Purging behaviors can include frequently going to the bathroom after mealtimes, signs or smells of vomit, or usage of laxatives or diuretics.
Discomfort in eating around others.
Skipping meals or having unusually small portions of food during mealtimes.
Consistently going to the bathroom right after eating.
Stealing or hiding food in more private locations.
Engaging in excessive and rigid exercise regimens.
Frequent body checking for perceived flaws.
Physical Symptoms²
Discolored, stained teeth and cavities.
Body weight that lies within the normal weight range for their body type and height.
Noticeable fluctuations up or down in weight.
Fainting and dizziness.
Difficulty sleeping and concentrating.
Calluses across the top of their finger joints.
Dry skin and nails.
Thinning of hair on the head and fine hair on the body.
Menstrual irregularities.
Diagnostic Criteria³
Recurrent episodes of binge eating during a discrete period, characterized by eating an amount of food larger than most would have during a similar period or a lack of control of eating during an episode.
Recurrent inappropriate compensatory behavior to prevent weight gain, including self-induced vomiting, laxative abuse, diuretics, fasting, excessive exercise, or more.
Binge eating and compensatory behaviors both occur at least once a week for three months, on average.
Critical self-evaluation of body shape or weight.
Treatment Options
Prevention from developing an eating disorder is achieved through early detection and treatment. An eating disorder can emerge at any stage of life, meaning early intervention is possible at any age. Individuals should seek help if they feel themselves practicing unhealthy or disordered eating habits, have thoughts of negative body image, or thoughts to binge, purge, use laxatives, or compensate through exercise. Although binge and purge behaviors characterize the diagnostic criteria for bulimia, the root cause is often underlying anxiety, depression, low self-worth, traumatic experiences, and other uncomfortable feelings about themselves, food, or body.
The appropriate level of care for treatment is dependent upon the severity and frequency of behaviors and thoughts. Some levels of care for treating bulimia are in-patient, residential, partial hospitalization, intensive outpatient, group therapy, and individual therapy or nutritional support.⁴ If you or a loved one struggles with these thoughts and behaviors, seeking professional aid is crucial for a successful recovery.
At BALANCE eating disorder treatment center™, we treat the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behavior and body image issues. In addition to our full-time Day Treatment Program and Weeknight Intensive Outpatient Program, we offer nutrition counseling with a licensed dietitian, meal support, and various other groups and resources to assist those seeking help for food concerns.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call below, or read more about our philosophy here.
This post was written by BALANCE Admissions Assistant, Ekin Kiyici.
Ekin Kiyici is an Admissions Assistant at BALANCE eating disorder treatment center. She graduated in 2020 from the University of California, Los Angeles, with a Bachelor of Science in Psychobiology. During her undergraduate career, she coordinated four studies as a research assistant for both the Anxiety and Depression Research Center and the Mind-Body lab. She is also currently a writer for a mental health and wellness platform, The Human Condition. Ekin is very passionate and dedicated to aiding in the treatment of eating disorders and wants to better understand the variables that span across eating, anxiety, and mood disorders. She plans to pursue a doctoral program in Clinical Psychology with the hopes of providing accessible treatment to eating disorder and anxiety populations as a clinical psychologist.
References
Ward ZJ, Rodriguez P, Wright DR, Austin SB, Long MW. Estimation of Eating Disorders Prevalence by Age and Associations With Mortality in a Simulated Nationally Representative US Cohort. JAMA Netw Open. 2019;2(10):e1912925. doi:10.1001/jamanetworkopen.2019.12925
Bulimia Nervosa. National Eating Disorders Association. (2018, February 22). https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia.
Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 20, DSM-IV to DSM-5 Bulimia Nervosa Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t16/
Agras, W. S., Schneider, J. A., Arnow, B., Raeburn, S. D., & Telch, C. F. (1989). Cognitive-behavioral and response-prevention treatments for bulimia nervosa. Journal of Consulting and Clinical Psychology, 57(2), 215–221. https://doi.org/10.1037/0022-006X.57.2.215