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Bulimia nervosa, or bulimia for short, is an eating disorder characterized by a "binge and purge" behavioral pattern, often with an unhealthy obsession with body size or weight. Individuals will ingest a large amount of food in a short period of time (binging), but then get rid of the food (purging). There are many different ways to get rid of the food or "make up" for the binge. These could be things like vomiting, excessive exercise, taking diuretics, fasting, etc. Someone battling bulimia might struggle with depression and/or other medical issues as well. The disorder can often be brought on by severe life changes or stress. If you or someone you care about is dealing with bulimia, seek medical help right away.
Steps
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Look for red or swollen eyes and cheeks. If someone is inducing vomiting, they will often have a swollen jaw and cheeks. It is also common for them to strain so hard that they burst blood vessels in their eyes. This will cause swollen red eyes and is a sign of bulimia. -
Take note of any calluses or scars on their hands and fingers. When you vomit, stomach acid comes up with the food. Frequent exposure to this acid can cause damage to the skin and nails on a person’s hands and fingers. It is also common for someone dealing with bulimia to have scars on their hands and knuckles from hitting their teeth while trying to induce vomiting. [1] X Trustworthy Source US Office on Women's Health U.S. government agency providing resources for women's health Go to sourceAdvertisement -
Pay attention to how they smell. One common way of purging is to induce vomiting. This is a difficult smell to mask, and if you are paying attention you might notice it. If a person smells like vomit once, they may simply be sick (and maybe even embarrassed of it). If you smell vomit on a person frequently, it is likely that this could be a way of purging. -
Watch for fluctuations in weight. Purging is not an effective way to eliminate calories from your body (which is usually the goal), and thus a person with bulimia will not usually be underweight. Most people with this disorder are slightly overweight or are normal weight. It is common, however, for someone battling bulimia to fluctuate frequently in weight (e.g., dropping ten pounds this month, then gaining fifteen next month, then dropping seventeen shortly after). [2] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source -
Look at their mouth. If someone is purging by inducing vomiting, they will likely have dry, cracked lips. Another sign is bleeding gums or discolored teeth. A dentist or doctor might notice swollen saliva glands or eroded enamel, also. -
Discuss your concerns with their doctor. If the person you are concerned about is a minor (and you are their guardian) then you can discuss your concerns with their doctor. The doctor can look for signs of bulimia such as metabolic acidosis or alkalosis. High cholesterol is can also be a sign of bulimia.
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Take note of where they go after a meal. If someone is binging and purging, they will often excuse themselves from the table before anyone else. They will also go to purge if they feel that they have eaten too much or eaten the wrong foods. This often means they will go to the restroom, but not always. You should pay close attention to after meal habits. -
Pay attention to bathroom habits. It is common for someone purging in the bathroom to run water to cover up the sounds of purging. [3] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source They also may flush the toilet several times, as the smell is unpleasant in between bouts of purging. These episodes usually happen shortly after eating. -
Notice any signs of withdrawing. When someone is combatting bulimia, there is an underlying component of guilt and low self-esteem. This will cause someone to stop engaging socially, such as making eye contact. It can also cause a person to stop engaging physically and emotionally in relationships. -
Check for a consistent eating schedule. It is common for someone with bulimia to have trouble sticking to a meal schedule. They may skip meals and they eat large portions, stopping only when they are physically uncomfortable. Sometimes clear cycles of overeating and then fasting will be clear. These are all signs of bulimia. [4] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source -
Listen for any signs of obsessions around body image. These obsessions can be elusive and well hidden under the guise of “being concerned about health.” Common body image obsessions include picky eating, calorie counting and crash diets, excessive exercise habits, constantly worrying over food and weight, and obsessing over the way they look. While it is healthy to take care of one’s self, obsessing over “health” or “looks” can be a sign of bulimia. -
Pay attention to defensive behaviors. If someone you care about is hiding bulimia, they do not want you to find out. The guilt and shame that fuels the binging and purging cycles also makes the thought of being caught unbearable for most. If you bring up food or eating habits, it is likely that someone struggling with bulimia will become irrationally defensive. -
Note the excessive use of breath fresheners. If a person is purging by inducing vomiting, they will likely use minty breath fresheners (e.g., gum, mouthwash, or mints) to cover their breath. If you are noticing other signs of bulimia, or have a strong suspicion of bulimia, this is another sign to watch for. Remember that just having gum is not a cause for suspicion. -
Be aware of other behaviors linked to bulimia. Bulimia stems from emotional and self-esteem struggles. It is very common that someone with bulimia will engage in other behaviors that reflect those struggles. Drug use, depression, anxiety, and anorexia are all common in people struggling with bulimia.
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Watch for food to go missing. For someone with bulimia, eating is often something to be ashamed of. It is common for someone with bulimia to sneak or steal food and eat it in secrecy. If large amounts of food go missing often, this deserves your attention. -
Monitor the trash or recycling. If someone is eating in secrecy, they will likely dispose of the evidence. Even if you do not notice food missing, large quantities of wrappers or food containers being thrown away might suggest binging. Be sure to look in the trash or recycling right before taking pick up, as someone who is being diligent to hide wrappers may wait until the last minute to dispose of them. -
Look for purging products. Not all people struggling with bulimia purge by inducing vomiting. It is common to use laxatives or diuretics to purge. Diet pills and appetite reducers may also be used to help in fasting stages. [5] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source -
Pay attention to anything that smells like vomit. Sometimes it is difficult to notice the smell of a person after they purge. However, you might notice that the bathroom often smells like vomit. You can also take note of whether their dirty clothes smell like vomit. These might be signs of bulimia. -
Take note of stopped up drains. Not all induced vomiting happens in the toilet. Some people choose to vomit in the sink, and others find the shower to be very convenient because the water covers up the sound of purging. If you are having drain issues, this could be a sign that someone is struggling with bulimia.
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Tips
- Remember that people with eating disorders are often unable to stop their behavior. Criticizing them for their behavior can often fuel their low self-esteem and make the behavior worse. If someone you know is dealing with bulimia, seek professional help.Thanks
- Some people have the ability to purge very quietly.Thanks
- If your friend/family member is suffering, be supportive but do not make comments about their appearance. Instead, try to be supportive by reminding them that you are there to help them, and that they don't have to be bulimic/anorexic forever. There is always hope.Thanks
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Warnings
- Do not confront a person about your concerns in front of other people.Thanks
- Do not pressure someone to tell you if they are struggling with an eating disorder. It might take medical attention to get them to acknowledge it.Thanks
- Avoid making generalized assumptions based on your perception of the person's behavior. Just because a person exhibits certain behaviors and habits associated with bulimia does not always mean that they are actually dealing with the disorder.Thanks
- If you think that someone has bulimia, take action immediately. Bulimia can harm a person very quickly, and it is important to get help as soon as you can.Thanks
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References
- ↑ https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/bulimia-nervosa
- ↑ http://www.helpguide.org/articles/eating-disorders/bulimia-nervosa.htm
- ↑ http://www.helpguide.org/articles/eating-disorders/bulimia-nervosa.htm
- ↑ http://www.helpguide.org/articles/eating-disorders/bulimia-nervosa.htm
- ↑ http://www.helpguide.org/articles/eating-disorders/bulimia-nervosa.htm
About This Article
Article Summary
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Bulimia is the medical term for a disorder that causes people to ingest large amounts of food and then get rid of it by purging. People suffering from bulimia may often have depression and other serious medical issues as well, so you should be respectful and sensitive when you talk about it. One way to identify bulimia is to check for physical signs and symptoms. Common physical signs of bulimia are red or swollen eyes and cheeks, the smell of vomit, and fluctuations in weight. You can also look for behavioral signs of someone suffering from bulimia such as frequent trips to the bathroom right after a large meal, excessive use of breath mints, and an inconsistent eating schedule. For tips about how to look for purging products to tell if someone is bulimic, keep reading.
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