Bulimia nervosa is characterized by binge eating, consuming large quantities of food in a way that feels out of control. The binge is followed by some form of purging, designed to prevent weight gain.

Common purging behaviors include:

• Self-induced vomiting
• Emetic abuse
• Laxative abuse
• Diuretic abuse
• Fasting
• Excessive exercise

Important Facts

• Occurs in both women and men
• Typically develops in late adolescence to early adulthood
• Usually preceded by dieting behavior
• Usually affects individuals of average or above average weight
• Self-evaluation unduly influenced by size and weight
• Complex lifestyle develops to accommodate eating disorder behaviors
• Ongoing feelings of isolation, self-deprecating thoughts, depression, and low self-esteem
• Full recognition of the behavior as abnormal

Warning Signs
Because most bulimics are within a normal weight range, the illness may go undetected by others for years. Bulimia should be considered when a normal-weight person frequently:

• Makes excuses to go to the bathroom after meals
• Shows mood swings
• Buys large amounts of food that suddenly disappear
• Has unusual swelling around the jaw
• Has scars, marks or abrasions on the back of the hands
• Eats large amounts of food on the spur of the moment
• Often leaves laxative or diuretic wrappers in his/her trash can
• Has unexplained disappearances of food at home or in the residence hall

Who’s at Risk
Individuals who:

• Aspire to work in fields with high emphasis on thinness
• Previously were overweight or teased about weight
• Have a family history of eating disorders, weight consciousness
• Have low self-esteem, are perfectionists, are socially insecure
• Have families on the extremes of being overprotective or disengaged
• Have a history of physical or sexual abuse
• Present a public image different from how they really feel about themselves
• Have difficulty identifying and/or verbalizing feelings, especially anger
• Have a family history of alcoholism