The Joint Commission
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Bulimia Nervosa

A serious, potentially life-threatening eating disorder characterized by a cycle of binge-eating and then compensating for it with behaviors like self-induced vomiting, abusing laxatives or diuretics, and/or excessive exercise.

Symptoms of Bulimia Nervosa

  • Regular intake of large amounts of food, along with feeling helpless to eating behaviors.
  • Regular use of inappropriate behaviors to compensate for eating, such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
  • Extreme concern with body weight and shape.

Warning Signs of Bulimia Nervosa

  • Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or many empty wrappers and containers of food.
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, and wrappers or packages of laxatives or diuretics.
  • Excessive, rigid exercise regimen – despite weather, fatigue, illness or injury – to burn calories.
  • Unusual swelling of the cheeks or jaw area.
  • Calluses on the back of the hands and knuckles from self-induced vomiting.
  • Discoloration or staining of the teeth.
  • Unexplainable lifestyle schedules or rituals to make time for binge-and-purge sessions.
  • Withdrawal from friends and activities.
  • Weight loss, dieting and control of food seem of primary concern.

Health Consequences of Bulimia Nervosa

  • Electrolyte imbalance: caused by dehydration, and loss of potassium and sodium from the body as a result of purging behaviors. Can lead to irregular heartbeats, and possibly heart failure and/or death.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

About Bulimia Nervosa

  • Affects 1-2 percent of adolescent and young adult women.
  • Approximately 80 percent of sufferers are female.
  • Those struggling are often of average body weight.
  • Those struggling recognize the behaviors are unusual and dangerous to their health.
  • Frequently associated with symptoms of depression and changes in social adjustment.

Description adapted from the National Eating Disorder Association