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Signs & Symptoms | Causes | Medical Complications

Bulimia is known as the “binge-purge” syndrome because it is typified by episodes of binge eating followed by purging. The purging is usually through self-induced vomiting, but it may also be in the form of diuretic and/or laxative abuse or excessive exercising and restricted eating, (non-purge type). The binge may involve large quantities of high caloric foods, although some bulimics experience a binge with large quantities of low calorie foods or moderate quantities of “forbidden” foods.

Bulimia can be hidden from others, since bulimics often appear to be within a normal weight range. The binge/purge episodes may be a few times a week or several times a day. Physical complications include dental problems, swelling of the parotid glands, digestive tract problems, edema, and throat and esophagus problems.

The purpose of the purging is to “undo” the binge. It is an attempt to relieve the guilt of the binge eating and to minimize any weight gain that might ordinarily take place as a result. Purging is probably more destructive than bingeing for two reasons. First, there are many more physical and medical dangers associated with purging. Second, purging helps legitimize bingeing; that is, by undoing the binge, purging makes bingeing more likely to occur in the future.

Persons with Bulimia have low self-esteem, negative self-thoughts, extreme concern with body weight and shape, depressed feelings, and a sense of shame. They may be coping with identity questions, concerns about relationships, family problems, or past sexual abuse. They feel out of control and pursue thinness as a way to feel better. However, the consequence of dieting and deprivation sets the stage for a binge, followed by a purge. The cycle repeats, as the underlying problems have not been addressed.

Signs & Symptoms of Bulimia Nervosa

• Makes excuses to go to the restroom after meals
• Mood swings
• May buy large amounts of food and then suddenly it disappears
• Unusual swelling around the jaw
• Weight may be within normal range
• Frequently eats large amounts of food (a binge), often high in calories, and does not seem to gain weight
• May decide to purchase large quantities of food and eat it on the spur of the moment
• Laxative or diuretic wrappers found frequently in the trash can
• Unusual food rituals such as shifting the food around on the plate to look eaten, cutting food into tiny pieces, making sure the fork avoids contact with the lips (using teeth to scrape food off of the fork or spoon) chewing food and spitting it out, but not swallowing,
• Dropping food into a napkin on the lap to later throw away
• Hiding food in strange places such as closets, cabinets, suitcases, under the bed etc. to avoid eating (Anorexic) or to eat at a later time (Bulimic)
• Flushing uneaten food down the toilet (can cause sewage problems)
• Vague or secretive eating patterns
• Keeping a “food diary” or list that consists of food and/or behaviors such as purging, restricting, calories consumed, exercise, etc.
• Pre-occupied thoughts of food, weight and cooking
• Hair loss, pale or gray appearance to the skin
• Dizziness and headaches
• Frequent sore throats and / or swollen glands

Causes of Bulimia Nervosa

Bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with Bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of Bulimia, but there are some factors that may play a role in why the disease manifests:

• Biology: Genes, hormones, and chemicals in the brain appear to be important factors in developing Bulimia.
• Dieting Behavior of Family: If you have a mother or sister with Bulimia, you are more likely to also have Bulimia. Parents who overemphasize appearance, diet themselves, or criticize their children's bodies are more likely to have a child with Bulimia.
• Culture: Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.
• Life changes or stressful events: Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to Bulimia.
• Personality traits: Low self-esteem is associated with Bulimia, as are mood disorders and personality disorder symptoms such as difficulty expressing and controlling emotions, impulsivity, and distrust in relationships with others.

Medical Complications of Bulimia Nervosa

• Poor concentration
• Loss of memory
• Irritability
• Damaged kidneys
• Osteoporosis
• Severe immune system damage
• Hormonal irregularities
• Heart damage / heart attack
• Enlarged salivary glands from vomiting
• Weakness of the whole body, lethargy and inactivity
• Problems with carrying pregnancy full term/risk of infertility and miscarriages
• Gastro-intestinal problems with food, constant reflux, stomach ulcers, aches and pains in the abdominal area, bloating, and esophageal problems

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