If you have come to this page looking for signs of bulimia nervosa, you probably know about this eating disorder already or suspect that you suffer from it. But if you’ve stumbled on this quite accidentally then bulimia is an eating disorder characterized by binge eating followed by compensatory behaviors like purging, use of laxative, starving, etc to avoid weight gain. Coming into the limelight as the eating disorder Princess Diana had, bulimia nervosa is quite prevalent among both men and women.
Most of the time, bulimia is mistaken for its close cousin anorexia nervosa. In both the cases, the patients are trying to keep their weight below a self-imposed threshold which is almost always less than their normal weight. But unlike in anorexia, where the patient restricts food intake severely, bulimia nervosa has the patient exercising no control on eating for a specific period of time followed by compensatory behaviors. Moreover, in contrast to patients with anorexia, patients with bulimia tend to be heavier and more sexually active, and they menstruate more regularly and are fertile.1
As we have already mentioned, bulimia nervosa is an eating disorder and most cases have their roots in body image issues. For the same reason, it is more prevalent among women than men. That is not to say men don’t suffer from body image issues or eating disorders but statistics show that women suffer from them more. In fact, the prevalence is double among women. In the US, 20 million women and 10 million men are estimated to suffer from one eating disorder or the other in their lifetime.2
Coming to bulimia, however, 1.5 percent of American women suffer from it in their lifetime.3 The figure may seem insignificant but the real threat is in the comorbidities like anxiety, mood disorders, and substance abuse disorders that seem to accompany the condition.
All these make it significant that bulimia is detected on time and treated without much delay. Let’s look at what some
Symptoms Of Bulimia Nervosa
1. Binge Eating And Compensatory Behaviors
One telltale symptom of bulimia is repeated episodes of binge eating or eating large quantities of food in a short span of time which is followed by attempts to compensate for the bingeing either through vomiting, use of laxatives or diuretics, starving or exercising. Detecting this symptom, however, is not as simple as it may sound. Because bulimics are often discreet in their behavior and look and behave normally.4 They have normal body weight unlike anorexic people and seem capable, positive and on top of things. But in reality, they are suffering inside–from shame, guilt, and body negative images of themselves.
2. Dental Problems
The constant binge eating and purging, which is the mainstay of bulimia, results in a very distinct oral profile of the patients that is characterized by one or more dental problems like enamel erosion, dental caries, dental pain, orthodontic abnormalities, xerostomia, reduced saliva secretion, parotid enlargement and dysphagia, among others.5 Dental erosion–the loss of dental tissues without the working of bacteria–is found in bulimia cases because most bulimics are frequent vomiters.
This also makes dentists and dental hygienists the primary detectors of any eating disorders in their patients. A good degree of understanding of eating disorders among dentists and dental hygienists are essential to detect the disease at the initial stage itself. Unfortunately, a study has found that only 16 percent of dentists and 28 percent of dental hygienists have a good knowledge of oral cues of eating disorders.6
3. Dehydration And Electrolyte Imbalance
Dehydration is a given in the case of frequent vomiting or laxative abuse. In many cases, it is also found to cause electrolyte imbalance in the body. In a
4. Mood Disorders, Depression, And Anxiety
Eating disorders, which find a place in the American Diagnostic and Statistical Manual or DSM, are primarily psychiatric disorders that
5. Gastrointestinal Issues
In the case of an eating disorder, the stomach is often at the receiving end. In bulimia, you are stuffing the stomach with food at first and later irritating it to a point that all that you have eaten comes out one way or the
6. Change In Menstrual Pattern
Bulimia can severely restrict nutrition in the body. In women and young girls, it most often manifests as changes in the menstrual pattern. Depression, anxiety and other
7. Skin Disorders
Russell’s Sign is what a bulimic needs to watch out for. Repeated self-induced vomiting could result in calluses, abrasions or bruises of the dorsum of the hand or thumb, collectively called Russell’s Sign. These damages to the skin occur mostly while trying to induce vomiting. Hemorrhages in the eye and rashes on the face could also happen, though less frequently.15
An eating disorder like bulimia is difficult to detect in the beginning. If you feel your relationship with food is not the best, these signs and symptoms will help you understand if you are suffering from this eating disorder or not.
|↑1||Russell, Gerald. “Bulimia nervosa: an
|↑2||Research on males and eating disorders. NEDA.|
|↑3||Eating Disorder Statistics. ANAD.|
|↑4||What is bulimia nervosa?. Bodywhys.|
|↑6||DeBate, Rita D., Lisa A. Tedesco, and Wendy E. Kerschbaum. “Knowledge of oral and physical manifestations of anorexia and bulimia nervosa among dentists and dental hygienists.” Journal of dental education 69, no. 3 (2005): 346-354.|
|↑7||Mitchell, James E., Richard L. Pyle, Elke D. Eckert, Dorothy Hatsukami, and Richard Lentz. “Electrolyte and other physiological abnormalities in patients with bulimia.” Psychological Medicine 13, no. 2 (1983): 273-278.|
|↑8, ↑12, ↑15||Fairburn, Christopher G., and Kelly D. Brownell, eds. Eating disorders and obesity: A comprehensive handbook. Guilford Press, 2005.|
|↑9||Cooper, Peter J., and Christopher G. Fairburn. “The depressive symptoms of bulimia nervosa.” The British Journal of Psychiatry 148, no. 3 (1986): 268-274.|
|↑10||Kaye, Walter H., Cynthia M. Bulik, Laura Thornton, Nicole Barbarich, Kim Masters, and Price Foundation Collaborative Group. “Comorbidity of anxiety disorders with anorexia and bulimia nervosa.” American Journal of Psychiatry161, no. 12 (2004): 2215-2221.|
|↑11||Bulimia Symptoms. NHS.|
|↑13||Lionetti, Elena, Mario La Rosa, Luciano Cavallo, and Ruggiero Francavilla. “Gastrointestinal aspects of bulimia nervosa.” In New Insights into the Prevention and Treatment of Bulimia Nervosa. InTech, 2011.|
|↑14||Gendall, Kelly A., Cynthia M. Bulik, Peter R. Joyce, Virginia V. McIntosh, and Frances A. Carter. “Menstrual cycle irregularity in bulimia nervosa: Associated factors and changes with treatment.” Journal of psychosomatic research 49, no. 6 (2000): 409-415.|