Symptoms of Bulimia Nervosa

The main symptoms of bulimia nervosa are binge eating and purging, but a number of the symptoms of bulimia are not discussed nearly as much, particularly the mental symptoms behind the physical behaviors. Note that the physical, mental, and behavioral worlds of a person struggling with bulimia overlap: Each area has the potential to affect the other two.

Physical Symptoms of Bulimia Nervosa

The physical symptoms of bulimia may not be as obvious as those of anorexia, but they are debilitating:

• Tooth decay: Stomach acid (hydrochloric acid) will erode tooth enamel when a person vomits repeatedly to rid herself of food.
• Enlarged salivary glands
• Scarred hands: The back of the hand becomes irritated and scarred by contact with the teeth when inducing vomiting.
• Dehydration: Much of what is purged from the body by vomiting or laxative use is vital fluids.
• Amenorrhea: Without adequate nutrition, the body cannot support a regular menstrual cycle.
• Esophageal tears: Pressure on the esophagus from vomiting can rupture it in certain cases.
• Gastric (stomach) rupture: Though rare, the stomach may be unable to handle the amount of food eaten in a binge.
• Electrolyte imbalance: Purging food forces potassium, sodium, and chloride from the body. An electrolyte imbalance can be extremely dangerous. Electrolyte problems include the following:
  • Hypokalemia (abnormally low potassium): Symptoms can include heart palpitations, cramping, and paralysis.
  • Hyponatremia (abnormally low sodium): Symptoms can include fatigue, cramping, and convlulsions.
  • Hypochloremia (abnormally low chloride): Chloride helps to regulate sodium level.
• Cardiac arrhythmias: When electrolytes become imbalanced, the body has a more difficult time regulating the heartbeat's rhythm through electrical impulses.
• Chronic bowel problems: Constant laxative use may train the body to need laxatives even for normal digestion. Laxative abuse can lead to irregular bowel movements and constipation.

Mental and Behavioral Symptoms of Bulimia Nervosa

Behavioral changes accompanying bulimia nervosa often harm the self directly, whether physically, emotionally, or relationally:

• Binge eating and some form of purging of food (vomiting, laxative use, or some other method)
• Physical isolation (which provides safety for binging and purging)
• Overachieving behavior
• Guilt and shame
• Self-evaluation influenced excessively by body composition/shape
• Self-destructive and impulsive behaviors:
  • Smoking (popular because it is thought to help prevent weight gain)
  • Sexual promiscuity
  • Cutting and other forms of self-harm
  • Kleptomania (often in the form of shoplifting)

Questions About Bulimia Nervosa Symptoms?

Remember that only a trained professional can make an accurate diagnosis and determine the proper subtype of an eating disorder. Also, not having all the symptoms of bulimia nervosa does not mean that you don't have another eating disorder. If you have questions, make an appointment with a treatment provider near you.

Back to Eating Disorder Symptoms