Signs of atypical bulimia nervosa
Medically speaking, “signs” of a condition are those effects that can be outwardly observed or measured.13 There are many signs of atypical bulimia nervosa.
Physical signs of atypical bulimia nervosa
Tooth decay
One reason someone may be diagnosed with ABN instead of bulimia nervosa is how often they use purging behaviors. They may still utilize compensatory behaviors to make up for binge eating episodes, but not as frequently or consistently as someone diagnosed with BN.
Even so, it’s still possible for this purging behavior to lead to
dental health issues, particularly when someone favors self-induced vomiting.
Stomach acids are corrosive and can wear away tooth enamel after repeated exposure.
2 Temperature sensitivity in the teeth, tooth decay, frequent sore throats, and
swollen salivary glands are also all possible side effects of self-induced vomiting.
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Digestive tract issues
Self-induced vomiting doesn’t just cause damage to the teeth. It can also wreak havoc across the digestive tract in general.
People with BN and ABN may suffer from
gastrointestinal issues like chronic heartburn, trouble swallowing, esophageal bleeding, and gastrointestinal reflux disease (GERD).
3 In severe cases, damage to the esophagus has been found to contribute to the development of certain cancers.
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Hair, skin, and nail problems
Even when not engaging in binging, purging, fasting, and laxative use as frequently as those with BN, patients with atypical bulimia nervosa can still experience nutritional imbalances that can lead to other issues, such as effects on the hair, skin, and nails.
Some of the most common include:
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- Abnormally dry skin or membranes
- Lanugo-like body hair
- Hyperpigmentation
- Acne
- Discoloration of the extremities due to poor circulation
- Dry and brittle hair and nails
- Infections around the nails and cuticles
- Slow wound healing
One of the most characteristic signs of ABN and purging behavior is
Russell’s sign, which is calluses on the knuckles and minor cuts on the back of the hand. They are caused by repeated contact of the fingers on the teeth during self-induced vomiting episodes.
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Emotional and behavioral signs of atypical bulimia nervosa
Unusual behavior around food
Just as those with bulimia nervosa, those with atypical bulimia nervosa may try to hide the truth of their condition or be in denial of the severity of their thoughts or behavior. But the truth may come out in other ways, including how they behave around food.
Some food-related behaviors to watch out for include but are not limited to:
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- Stealing or hoarding food
- Frequently disappearing after meals, especially to use the bathroom
- Skipping meals or taking small portions
- Drinking excessive amounts of water or no-calorie beverages, such as coffee
- Avoiding eating with others or frequently eating alone
Unhealthy fixations
Sadly, people with ABN and BN share many of the same underlying mental health concerns.
Chronically low self-esteem is common and may manifest as frequent comments about their body or negative comparisons between themselves and others.4 Overall, people with BN and ABN tend to conflate self-worth with appearance.4
A fixation on food or eating is also common and may present as frequently dieting, counting calories, or obsessing over nutritional information.4
Symptoms of atypical bulimia nervosa
“Symptoms” of a condition can’t be measured by a test or an outside perspective but are only felt and experienced by the person going through the issue.14
Physical symptoms of atypical bulimia nervosa
Gastrointestinal complaints
The binge/purge cycle of ABN, although it occurs less frequently, can still result in numerous gastrointestinal complaints. These include feeling overly full or bloated, abdominal pain, belching, acid reflux, heartburn, and nausea without an apparent cause.6
In the long term, those suffering from ABN may develop the symptoms of irritable bowel syndrome, experiencing constipation, diarrhea, chronic lower abdomen pain, and feelings of anal blockage.7
Fatigue
Fatigue is a common symptom of bulimia nervosa due to a combination of malnutrition, dehydration, and frequently co-occurring mood disorders, including depression.11,15
Emotional and behavioral symptoms of atypical bulimia nervosa
Distorted body image
People with atypical bulimia nervosa often have a
poor self-image, believing that they are bigger than they are. You may notice someone has started wearing baggy clothes in an attempt to hide their body, which could also be a sign that they’re suffering from body dysmorphic disorder, as well as ABN.
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However, not all those with ABN experience the same concern about their weight and body type or have a disproportionately negative view of their body.
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Feelings of guilt and shame
Many people with ABN associate their binge eating episodes and the loss of control they experience with feelings of guilt and shame.4 This can lead to:
- Eating in secret
- Lying about eating habits
- Hoarding or hiding food
- Feeling the need to purge
When to get help for atypical bulimia nervosa
People with atypical bulimia nervosa face a variety of physical and psychological challenges.
ABN often co-occurs with other mental health struggles. For example, people with bulimia or atypical bulimia nervosa have an increased risk of suicide.10 Therefore, it’s crucial that someone potentially struggling with ABN gets help as soon as possible before it severely impacts their physical and mental health.
Even if there isn’t a preoccupation with weight or frequent binging episodes, anyone experiencing ABN symptoms may benefit from seeing a doctor. It is important to find a practitioner who has experience with eating disorders, as they may have a better understanding of the nuances of ABN and related conditions.
Remote treatment is effective and convenient
Learn more
It can be hard to talk to anyone about your or your loved one’s disordered eating. But, the right help and proper treatment can work to address disordered eating habits and the associated physical effects of ABN, understand the reasons behind them, and help improve overall well-being.
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