Bulimia nervosa (BN) is characterized by binge episodes that happen at least once a week, plus purging or fasting to “compensate” for possible weight gain. Bulimics can be at or above normal weight, and in some cases, obese. This means that BN can be more difficult for families to physically detect, unlike anorexia nervosa where people typically become emaciated if the ED continues for long enough.  

Purging behaviors include (but are not limited to):

– Vomiting: Self-induced by sticking a finger or object down the throat, vomiting is used by bulimics to mitigate any weight gained from binge-eating. It should be emphasized that this practice results in esophagus tears, dehydration, and teeth decay from stomach acid that has been regurgitated. 

– Diuretic & laxative misuse: Diuretics, or water pills, are prescribed to rid the body of water for special medical conditions (e.g., high B/P), while laxatives help constipation. Mostly water weight is lost through abuse of diuretics and laxatives, which is gained back quickly. When abused, they both lead to electrolyte and mineral loss, as well as kidney and organ malfunctioning.

Common signs/symptoms:

• Vomiting after food consumption
• Loss of impulse control when eating
• Heartburn or reflux
• Diuretic/laxative abuse
• Constant sore throat
• Depression, anxiety
• Fatigue, irritability

Medical complications:

• Tears in the esophagus
• Erratic heartbeat
• Stomach perforation
• Electrolyte imbalance