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Symptoms
By Mayo Clinic staffWhen you have bulimia, you regularly engage in episodes of binge eating followed by attempts to prevent weight gain. A binge is considered eating a larger amount of food than most people would eat under similar situations.
For instance, when you have bulimia, you may eat an entire cake, rather than just a slice or two. And you may continue eating until you're painfully full, which is inevitably followed by some method of purging. Sometimes people with bulimia feel a need to purge after eating only a small snack or a normal-size meal.
Bulimia is categorized in two ways:
- Purging bulimia. You regularly engage in self-induced vomiting or the misuse of laxatives, diuretics or enemas to compensate for binges.
- Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting or overexercising, which is sometimes called exercise bulimia.
The line between the two types of bulimia often blurs or overlaps. In fact, the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method. And in either type, signs and symptoms are similar.
Physical signs and symptoms of bulimia
Physical bulimia symptoms may include:
- Abnormal bowel functioning
- Damaged teeth and gums
- Swollen salivary glands in the cheeks
- Sores in the throat and mouth
- Bloating
- Dehydration
- Fatigue
- Dry skin
- Irregular heartbeat
- Sores, scars or calluses on the knuckles or hands
- Menstrual irregularities or loss of menstruation (amenorrhea)
Emotional and behavioral symptoms of bulimia
Emotional and behavioral symptoms associated with bulimia may include:
- Constant dieting
- Feeling that you can't control your eating behavior
- Eating until the point of discomfort or pain
- Eating much more food in a binge episode than in a normal meal or snack
- Exercising for hours on end
- Misuse of laxatives, diuretics or enemas
- Being preoccupied with your body shape and weight
- Having a distorted, excessively negative body image
- Going to the bathroom after eating or during meals
- Hoarding food
- Depression
- Anxiety
Binges often occur in private. You may raid the cupboards when home alone, for instance. Or you may make the rounds of several fast-food restaurants during one bingeing episode, secretly eating in your car between stops.
Once the binge episode ends, the purging begins. This may mean heading to the bathroom to vomit or hitting the treadmill for hours of exercise. Because most people with bulimia are of normal weight or even slightly overweight, it may not be readily apparent that something is wrong.
