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Do I have bulimia?

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If you’ve been struggling with your eating habits lately, and especially if you’ve been 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 
October 28, 2022
In this article

Recognizing patterns of bulimia

Perhaps the best way to start understanding whether you have BN is to understand more about the disorder itself.

Bulimia nervosa is officially considered a mental health disorder, as it’s categorized in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), or the latest edition of the diagnostic tool listing all recognized mental health disorders.

The behaviors traditionally associated with bulimia nervosa are binging and purging or other compensatory behavior. That means consuming a large amount of food over a short period of time, and then making an effort to get rid of it or compensate for it whether through self-induced vomiting, use of laxatives, excessive exercise, or other methods.

Certainly, if you’ve noticed yourself partaking in any of these behaviors, even if only once, it’s a cause for concern and you should consider seeking out help. The DSM-5 lists a number of other considerations that come into play in bulimia nervosa, including: (1)

  • A feeling of helplessness or lack of control during binging episodes.
  • Binge/purge cycles that happen at least once a week, over the course of at least three months.
  • Near-constant attention paid to body weight, shape, and size.

It’s also important to remember that while bulimia nervosa has a strong 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 (simultaneous) cases of depression and anxiety, as well as substance use disorders. 

As with many areas of human behavior, it’s difficult—if not impossible—to parse out whether the mood disorders drive the bulimia nervosa or the other way around, but both contribute to the sustaining, or even worsening, of the behavior involved.

Common signs of bulimia

While bulimia nervosa is most often associated with binging and purging/compensating behaviors , the disorder has a number of other common signs you may want to familiarize yourself with, including:

  • Avoiding eating with other people.
  • Damaged teeth and gums or perpetually sore throat.
  • Puffy cheeks (also known as “bulimia cheeks”).
  • Sores, scars, or calluses along the knuckles or the hands.
  • Dressing in baggy clothes that hide body shape.
  • Fainting spells or dizziness.
  • Heartburn/acid reflux.
  • Extreme fatigue/mental fog.
  • Electrolyte imbalance.
  • Brittle or thinning hair.
  • Irregular heart rhythms or low blood pressure.
  • Heightened sensitivity to cold temperatures. 

It doesn’t necessarily mean you have bulimia nervosa if you (or someone you know) is experiencing any of these signs and symptoms, but it’s likely a cause for concern, and you should start looking into the situation more seriously.

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When (and how) 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. Without a timely response, the disorder tends to get worse, and can be life-threatening.

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.

Unfortunately, these programs are often expensive (even with insurance), or difficult to gain access to. Oftentimes, hospitals and other treatment facilities will require a patient to meet every part of a DSM-5 criteria of a disorder before considering taking them in, even though patients can be struggling immensely without meeting exact criteria. (1) A number of other complications—such as cost and distance from treatment facilities —can also come into play. At Within Health, we work with you and your insurance to find affordable treatment options in our virtual care program for eating disorders. 

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 offering 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 therapy for eating disorders. It is beneficial to seek out a medical doctor first, in order to outline the best treatment for your specific needs. 

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.

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.


  1. Grilo, C. M., Ivezaj, V., & White, M. A. (2015). Evaluation of the DSM-5 severity indicator for bulimia nervosa. Behavior Research and Therapy, 67, 41–44. https://doi.org/10.1016/j.brat.2015.02.002 
  2. Mayo Foundation for Medical Education and Research. (2018, May 10). Bulimia nervosa. Mayo Clinic. Retrieved April 29, 2022, from https://www.mayoclinic.org/diseases-conditions/bulimia/symptoms-causes/syc-20353615


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