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Learn more about the results we get at Within

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Do I have bulimia?

If you’ve been struggling with your eating habits lately—especially if you’ve found yourself binging or purging—you might be asking yourself, “Do I have bulimia?”

But when does a behavior turn into a disorder? The answer is not always clear, and there are a few considerations to keep in mind when determining whether or not you might have bulimia nervosa (BN).

Last updated on 
December 13, 2023
Do I have bulimia?
In this article

How do I know if I have bulimia?

Recognizing an eating disorder in yourself, even one as well-understood as bulimia nervosa, can be trickier than it seems. Several variations can happen around the way this eating disorder manifests, and BN can also look similar to other types of eating disorders or mental health issues.

But if you're asking, "Do I have bulimia," understanding the common ways this issue presents is a good place to start looking for the answer.

Woman looking into the ocean

Recognizing patterns of bulimia

Primarily, BN follows a pattern of binging and purging, with someone eating large amounts of food over a short period of time, then using compensatory behaviors afterward to "make up" for the excess caloric intake.

These behaviors can be "purging" behaviors—those that physically expel food from the body—or "non-purging" behaviors, which use other methods to "work off" the calories consumed in a binging episode.

Purging-type bulimia nervosa includes compensatory behaviors such as:1

  • Self-induced vomiting
  • Misuse of laxatives or enemas
  • Abuse of diuretics

Non-purging type bulimia involves compensatory behaviors like:1

  • Fasting for an exceptionally long period after a binging episode
  • Excessive exercise after a binging episode

Further, the binging episodes are colored by a lack of control over how much or what is eaten. An official BN diagnosis also accounts for a few mental health considerations, including a sense of self-worth that is primarily influenced by body shape or weight.1

Experiencing any of these thoughts or behaviors is cause enough for concern, and if you or a loved one have expressed them, you should seek help. But to meet the criteria for a bulimia nervosa diagnosis, this pattern of binging and purging must occur, on average, at least once a week for at least three months.1

Bulimia vs. binge eating

Many people wondering, "How do I know if I have bulimia," may also be thinking, "Do I have bulimia or binge eating disorder?" And while the two conditions do share some similarities, they also have important differences.

Binge eating disorder (BED) also includes regular binge eating episodes, which are defined by a lack of control, as well as eating rapidly, eating until uncomfortably full, and eating large amounts of food when not feeling physically hungry.2

However, people struggling with BED do not use compensatory behaviors of any type following these episodes despite commonly feeling guilty or disgusted afterward. (2)

Common signs of bulimia

While bulimia nervosa is most often associated with binging and purging/compensating behaviors, there are many other common signs and symptoms of bulimia you may be experiencing.

The presence of these additional symptoms may help you know if you have bulimia:3

  • A preoccupation with body shape and weight
  • A fear of gaining weight
  • Feeling anxious or nervous about eating in public or with friends or family
  • Swelling in the hands and feet
  • Swelling in the cheeks (sometimes called "bulimia cheeks")
  • Absent or irregular periods
  • Digestive problems
  • Dehydration
  • Muscle weakness

It’s also important to remember that while bulimia nervosa has a solid connection to the physical body, the disorder is considered, first and foremost, a mental health issue. People struggling with BN have very high rates of comorbid, or co-occurring, depressive, anxious, and substance use disorders.4,5

If you or a loved one are experiencing these signs and symptoms, it doesn’t necessarily mean you have bulimia nervosa, but it’s likely a cause for concern and reason enough to start looking for help.

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Do I have bulimia? Quiz

If you're still wondering how to know if you have bulimia, you may want to try taking a "Do I have bulimia" quiz.

These types of quizzes are popular online, but not all of them are created equally. Make sure to consider a "Do I have bulimia" quiz that's written by a trusted, professional organization, like the Mental Health America (MHA) organization, which includes an official quiz/screening on its website.

A "Do I have bulimia" quiz should still not be considered an official diagnosis, even when conducted through a trustworthy website. However, it can give you a different perspective on your eating habits and be enough to lead you or your loved one toward seeking further help.

But remember: The only people who can—and should—issue an official diagnosis are educated and experienced mental health professionals and physicians. If you think you or a loved one may be struggling with bulimia nervosa, you should speak with a medical professional about the situation.

When to seek help for bulimia

The right time to find treatment for BN is always “as soon as possible.” If you’re asking yourself, “Do I have bulimia?” it’s likely already a good time to seek help.

There are a number of treatment options available for someone struggling with bulimia nervosa, including a suite of different therapies, medications, and treatment programs with varying levels of care.

At Within Health, we also strive to help. We can work with you and your insurance to find affordable treatment options in our virtual care program for eating disorders. 

Your doctor, therapist, or another medical professional can help you secure an official diagnosis, which is often the first step toward finding treatment, or guide you in making your next best steps.

How to seek help for bulimia nervosa

If you have insurance, you can begin your search by contacting the company and asking about:

  • In-network benefits vs. out-of-network benefits
  • Deductible and out-of-pocket costs
  • Any mental health services connected with your plan
  • Any treatment centers or providers either covered or recommended by your policy
It’s important to remember that even if you have a government healthcare plan, such as Medicare or Medicaid, you may still be accepted by some hospitals and treatment centers.

Without insurance, finding treatment is much more difficult. Some options may include: 

  • Providers who offer sliding-scale payment plans
  • Medical schools
  • Student health centers
  • Research programs (exchanging treatment for participating in eating disorder studies)
  • Free support groups 
  • Treatment scholarships

Many people have also benefited from self-help therapy, where a person uses books and other resources to guide themselves through a pre-planned therapeutic tract. This option is often the most affordable and easily obtained type of assistance for eating disorders, but it may not offer the help needed. It is beneficial to seek a medical doctor first to outline the best treatment for your specific needs. 

Learn about remote treatment

Struggling with bulimia nervosa is hard enough in itself, and struggling to find help is, unfortunately, also often a challenge. At Within Health, our admissions team assists in any way they can to reduce the burden and cost of finding proper care.

We can work with you to find a plan that is affordable and right for the care you need. Call our team to get started.

Get help today

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. DSM-IV to DSM-5 Bulimia Nervosa Comparison. (n.d.). Substance Abuse and Mental Health Services Administration. Accessed October 2023. 
  2. DSM-IV and DSM-5 diagnostic criteria for binge-eating disorder. (n.d.). Substance Abuse and Mental Health Services Administration. Accessed October 2023. 
  3. Bulimia nervosa. (n.d.). Mayo Clinic. Accessed October 2023. 
  4. Brewerton, T. D., Lydiard, R. B., Herzog, D. B., Brotman, A. W., O’Neil, P. M., Ballenger, J. C. (1995). Comorbidity of axis I psychiatric disorders in bulimia nervosa. The Journal of Clinical Psychiatry, 56(2), 77-80. 
  5. Baker, J. H., Mitchell, K. S., Neale, M. C., Kendler, K. S. (2010). Eating disorder symptomatology and substance use disorders: Prevalence and shared risk in a population based twin sample. International Journal of Eating Disorders, 43(7), 648-658.
  6. DSM-IV to DSM-5 Anorexia Nervosa Comparison. (n.d.). Substance Abuse and Mental Health Services Administration. Accessed October 2023.

FAQs

Do I have anorexia or bulimia?

Similarly to asking, "Do I have bulimia or binge eating disorder," many people may wonder, "Do I have bulimia or anorexia?” These two conditions can also present similarly, but there are a number of distinctions that can help you tell the difference.

Anorexia nervosa (AN) is primarily identified by a severe restriction of food intake relative to someone's caloric requirements based on their age, gender, health status, and other concerns.6 And while a fear of gaining weight may feature in BN, it is one of the driving factors of anorexia nervosa.

Non-purging BN may resemble AN when someone uses fasting as a compensatory behavior. However, those with bulimia nervosa will still experience frequent binging episodes, while those with anorexia nervosa largely don't engage in binging behaviors.

Do I have bulimia if I don't binge?

Another common question for those wondering, "How do I know if I have bulimia?" revolves around the absence of binging.

Binging episodes are a core part of bulimia nervosa, so if you're not experiencing these thoughts or behaviors, it's likely you don't have BN. But you may be struggling with another type of eating disorder, especially if you're still utilizing purging or compensatory behaviors.

If you're concerned about your thoughts or behaviors around food, eating, and body image, you should seek help.

Further reading

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The relationship between orthorexia and bulimia

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