Bulimia is known for the classic symptoms of bingeing and purging, but this eating disorder has several other distinctive symptoms.
Bulimia nervosa, aka bulimia, is an eating disorder where you feel out of control when you eat – like you can’t stop. Then, after overeating, you may feel an intense sense of guilt and an overwhelming urge to make up for the binge.
These episodes of bingeing and purging are a continuous cycle that repeat over and over. It’s not uncommon to feel guilt or shame after each episode.
Though bingeing and purging are the most well-known symptoms of bulimia, there are other characteristics of the condition as well.
It’s not always easy to tell if someone has an eating disorder, especially bulimia.
People with different body types have eating disorders. While some people with bulimia may be thin, others can be a moderate weight or even overweight.
There are two types of bulimia according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). They’re separated by the type of purging behavior.
- Purging bulimia. After binge eating, a person with this type of bulimia will vomit or misuse diuretics, laxatives, or enemas. This is the most common type of bulimia.
- Non-purging bulimia. Instead of purging after binge eating, a person with this type will fast or obsessively exercise.
Like with other eating disorders, bulimia has a variety of symptoms including emotional, behavioral, and physical.
Bulimia can take a toll on the body, causing physical damage to parts of the body involved in eating and digesting food.
Some physical symptoms of bulimia include:
- swollen cheeks or jaw
- cuts or calluses on the knuckles or back of hands
- stained or discolored teeth
- tooth decay
- broken blood vessels in the eyes
- dry skin or dry and brittle nails
- stomach cramps or other gastrointestinal problems, like constipation or acid reflux
- feeling cold all the time
- dizziness and fainting, or syncope
- thinning hair or dry and brittle hair
Emotional and behavioral symptoms
People with bulimia are usually very careful about hiding their symptoms. However, friends and family may notice certain behaviors that indicate there’s something going on.
The emotional and behavioral symptoms of bulimia may include:
- going to the bathroom right after eating
- hiding food wrappers in unexpected places
- seeming uncomfortable eating in front of other people
- hiding packages of laxatives or diuretics
- stealing or hiding food in strange places
- frequently dieting
- excessively using mouthwash, mints, or gum
- obsessively exercising, even in bad weather or when tired or hurt
- acting moody or sad
- overly concerned with bodyweight and shape
- frequently making disparaging remarks about bodyweight and shape
- having extreme shifts in mood
- no longer wanting to hang out with friends or do activities they once enjoyed
- nausea and vomiting
- low blood sugar
- stomach pain and bloating
- inflamed or damaged esophagus
- swollen jaws or cheeks
- bowel obstruction, perforation, or infections
- gastroparesis, or slowed digestion
- stomach rupture
- drop in body temperature or hypothermia
- menstrual irregularities (missing or irregular periods)
- insulin resistance (which can lead to type 2 diabetes)
- bone loss (osteopenia or osteoporosis)
- high cholesterol
- reduced resting metabolic rate
- kidney failure
- difficulty falling or staying asleep
- problems concentrating
- numbness or tingling in the hands, feet, or other extremities
- muscle cramps
- sleep apnea