Bulimia: Symptoms & Diagnosis

Bulimia is a combination of self-destructive behaviors: compulsive over-eating (binging) and ridding the body of food and caloric intake by extraordinary means (purging). Diagnosis of bulimia is often complicated by a third behavior. Because most bulimic individuals feel guilt about their illness, binging and purging are both done in secret. When confronted, often the bulimic will deny that a problem exists. In addition, diagnosis may be difficult because those with bulimia may look perfectly normal. They may be average weight, underweight, or overweight. However, detection is possible by physical, psychological, and external symptoms of illness.

External symptoms

Most bulimics binge on foods that are commonly called “comfort foods”. These are foods that are usually sweet and high in calories such as ice cream, cakes, candy and pastry. In addition to purging by vomiting, the bulimic may use over-the-counter medications or engage in obsessive and excessive exercise. External clues to bulimia include:

Disposal of an abnormal number of food wrappers and/or empty food containers
Disposal of an abnormal number of wrappers and/or containers from over-the-counter diuretics, laxatives, and/or enemas.
Frequent use of the bathroom immediately after meals
Immediate vigorous exercise after meals – a compulsive “need” to “burn off” the calories.

Physical symptoms

Although bulimia is difficult to detect by an individual’s weight, several physical signs may indicate the presence of the illness:

Smell of vomit or presence of blood when vomiting
Calluses on the back of the hands and knuckles from self-induced vomiting.
Discoloration or staining of the teeth.
Sore throat
Swollen glands in neck and face, particularly in the cheeks or jaw areas.
Digestive disorders such as heartburn, bloating, indigestion, constipation
Irregular periods
Weakness, exhaustion
Bloodshot eyes

NOTE: Although these symptoms may be associated with bulimia, several may also indicate other serious medical problems that should be immediately attended by a medical professional.

Psychological symptoms

Behaviors and attitudes indicating that weight loss, dieting, and control of food are primary concerns are usually the first and most significant sign of an eating disorder.

Preoccupation with body weight or shape
Frequent or excessive dieting
Depression
Abrupt changes in mood (mood swings)
Feelings of helplessness.
Withdrawal from usual friends and normal activities.

NOTE: Although these symptoms may be associated with bulimia, several may also indicate other serious emotional or psychological problems that should be immediately attended by a skilled counselor or medical professional.

Although bulimia is often difficult to diagnose, experts believe that the earlier the illness is detected, the better will be the individual’s chances for recovery. Aside from the strain that compulsive over-eating puts on the body, frequent purging can alter or even cause some body functions to cease. In addition, since the same symptoms may indicate other eating disorders or severe health problems, immediate medical attention should be sought to obtain an accurate diagnosis.