What is bulimia?

Photo by Curology on Unsplash

Binge, purge, repeat — the vicious cycle

Bulimia is characterized by two things: episodes of binge eating followed by compensatory behaviors. According to the DSM-V, here’s what those mean.

  • Bingeing: Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances; characterized by a sense of lack of control over eating during the episode.
  • Compensatory behaviors: Recurrent inappropriate behavior in order to prevent weight gain, such as self-induced vomiting (purging), misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.

Warning Signs

There are tell-tale red flags that can give you a pretty good idea that something is up, such as:

  • Disappearing after eating, often to the bathroom
  • Being overly concerned with weight loss, dieting, and controlling food
  • Evidence of bingeing — i.e. disappearance of large amounts of food, lots of empty wrappers or containers
  • Evidence of purging — i.e. signs/smells of vomiting, packages of laxatives or diuretics
  • Cutting out foods or food groups — i.e. going vegan, no sugar, etc
  • Drinking excessive amounts of water
  • Maintains rigid exercise regimen despite sickness or injury
  • Unusual swelling of cheeks or jaw
  • Discolored/stained teeth
  • Calluses on backs of hands from self-induced vomiting
  • Extreme mood swings

Physical complications

You’ll notice that significant weight loss/low body weight isn’t part of the diagnosis for bulimia; this is the main way bulimia is different from anorexia. However, the possible physical complications are not all that different:

  • Stomach cramps, constipation, acid reflux
  • Dizziness and fainting
  • Cold intolerance
  • Hair loss
  • Dry skin, brittle nails
  • Menstrual irregularities for females
  • Impaired immune function
  • Noticeable fluctuations in weight, both up and down
  • Slowing of the heart rate (can lead to cardiac arrest)
  • Severe electrolyte abnormalities (can also lead to cardiac arrest, often unexpectedly)

Common misconceptions

Myth #1: Bulimia is only about making yourself throw up. Although this is a common presentation, other means such as excessive exercise and food restriction can be used to compensate for binge episodes.

How bulimia helps people

For anyone who doesn’t have this disorder, the thought of making yourself throw up on a regular basis might be unfathomable. But it is helpful to understand why the act of purging is the cornerstone of this disease.

First steps toward recovery

The very first thing we work on when moving towards recovery with people with bulimia is to stop purging behaviors immediately. Of course, it is not so easy as to be done with a snap of the fingers, but beginning to learn alternative ways to cope with overwhelming feelings will help provide another way out.



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Abbie Joy Womack

Abbie Joy Womack

Ice cream lover. Dog mom. Registered dietitian. Downtown HTX city dweller.