Bulimia Nervosa, What Are
The Signs And Symptoms? 

The main features of Bulimia Nervosa are recurrent episodes of binging and purging, and an intense fear of gaining weight.

However, a sufferer will often keep their problem secret because they feel ashamed or confused about what they are experiencing. Often they will not seek help for many years if at all. So if you are worried about your own behaviour or that of someone close to you, it can help to know what signs and symptoms to look out for.

People who have this condition are usually of average weight, or slightly above average, so it is not as outwardly noticeable as Anorexia Nervosa, which shares many similar symptoms and behaviours.

The types of 'purging' behaviours that Bulimia sufferers do to get rid of the food and calories they have consumed in an effort to prevent gaining weight, can include:

Picture by Kyknoord on flickr.com

• Making oneself sick (vomiting)

• Abusing laxatives, enemas, diuretics (medicines that make you pass urine), diet pills, or emetics (medicines or substances that cause vomiting)

It may be noticed that the person is also:

• Fasting or going on strict diets

• Frequently weighing themselves

• Excessively exercising

• Showing recurring changes in weight

• Making frequent visits to the bathroom

• The smell of vomit may be noticeable on the breath or in the bathroom, even though the sufferer may use air freshener, mouthwash, chewing gum or perfume to cover up the smell.

• Bulimia Nervosa sufferers develop 'puffy' cheeks and a more rounded looking face - this results from a swelling of the salivary glands caused by the repeated vomiting over a long period of time.

• Damaged and discoloured teeth - from the acid in the vomit eroding tooth enamel

• Scarring on their knuckles - from repeatedly sticking fingers down throat to induce vomiting.

• The person may often experience abdominal upsets such as bloating, diarrhoea, constipation or nausea

• They may complain of weakness, lethargy, dizziness and other symptoms. These can be caused by electrolyte imbalance from chronic dehydration, or malnourishment or other imbalance.

Most of the signs and symptoms of Bulimia Nervosa we have mentioned so far are physical and behavioural in nature. There are of course many psychological signs such as:

• Symptoms of depression or anxiety

• Very low self esteem is an almost universal feature. This is compounded by the feelings of shame, guilt, or self-disgust that the sufferer often experiences following an episode of binging and/or purging.

• With Bulimia, a persons self-worth is often intrinsically linked to their perception of their body shape, weight and appearance - even if they are not medically overweight.

• Many sufferers will talk about "feeling fat".

• Some may have the feeling that if they start eating, they just wont be able to stop.

• They may find themselves thinking obsessively about food, discussing diets and recipes, buying food magazines, constantly worrying about ingredients, fat content and calories.

Periods of relapse are common with Bulimia Nervosa, and once recovered, someone who has suffered in this way needs to be aware of the early warning signs of it re-emerging.