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Signs and symptoms of bulimia nervosa

Bulimia nervosa (BN) is a serious mental health disorder, but the condition is often marked by a number of physical and emotional signs and symptoms.

Learning more about the signs and symptoms of bulimia nervosa can be a big help toward spotting this disorder in yourself or a loved one, and getting treatment before it's too late.

Last updated on 
October 17, 2023
December 7, 2023
Signs and symptoms of bulimia nervosa
In this article

Physical signs of bulimia nervosa

“Signs” and “symptoms” are often thought of as synonyms and may appear together when describing the effects of an illness. But the two actually have slightly different medical meanings, and each is an important part of understanding and identifying an ongoing issue.

"Signs” are aspects of the illness that are outwardly measurable. This means a friend, family member or doctor can independently observe or track these factors. And while most signs of BN or other eating disorders manifest physically, they can also appear through a person’s emotions and behavior. 

Below are some common signs of bulimia nervosa.

Injured esophagus
Damage to the mouth, teeth and salivary glands
Bruised/injured knuckles
Changes in bone density/muscle mass
Thin/brittle hair and nails
Irregular or absent menstrual periods
Heart problems

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Emotional and behavioral signs of bulimia nervosa

Bulimia nervosa takes a huge toll on the body, but the disorder ultimately originates in the mind. As such, there are a number of emotional or behavioral signs of bulimia, which may be related to the mental health aspect of the condition.1,2

Strange behavior around mealtime
Misuse of laxatives
Excessive exercise routines
Hiding foods or signs of eating
Wearing baggy clothes

Physical bulimia nervosa symptoms

As opposed to signs of an illness, which can be outwardly observed or measured, symptoms describe the suite of issues that can only be felt by the person experiencing them. While these may be more difficult to track, they can often feel more intense or uncomfortable for the person with the illness or eating disorder.

There are also many common symptoms of bulimia.

Binge eating episodes
Severe diet swings
Constipation/GI discomfort

Emotional and behavioral bulimia nervosa symptoms

Unlike the signs of bulimia nervosa, the symptoms of bulimia nervosa are more likely to manifest in someone's behaviors and emotions than in a physical way. These effects of the disorder may be some of the most insidious, as they can potentially be both the hardest to detect and the most difficult to change.1,2

Preoccupation with body size and weight
Anxiety and/or depression
Mood swings

When to get help for bulimia nervosa

Bulimia nervosa is a serious medical issue that can be potentially fatal if left unchecked. Fortunately, the illness is entirely treatable, with many patients able to make a full recovery after receiving proper help.

If you think you or someone you love may be struggling with any of the signs and symptoms of bulimia nervosa, it’s important to seek help as soon as possible.

How to find help for bulimia nervosa

There are a few things to keep in mind when seeking out professionals who can help with BN or other eating disorders, like anorexia nervosa (AN) and binge eating disorder (BED).

As eating disorders impact physical, mental, and emotional health, a comprehensive treatment approach is often the best way to address these diverse issues. Generally, this is performed by a multidisciplinary team of experts, including dietitians, therapists, psychiatrists, primary care physicians, and other practitioners.

When looking for this type of help, you can start by contacting your primary care provider or therapist. These experts can help you secure an eating disorder diagnosis—often the first step toward securing a spot in a treatment program—or guide you in the next best steps.

Remote treatment for bulimia nervosa

We understand the many facets of eating disorders like BN and offer a virtual care program to help cater to each patient's specific needs. Our multidisciplinary team will craft individual treatment plans for each patient, and sessions can all be completed at home, through our easy-to-use website and app.

Call our team to learn more about our compassionate client care.

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. Bulimia Nervosa. (2018, May). Mayo Clinic. Accessed October 2023.
  2. Bulimia nervosa. (n.d.). National Eating Disorders Association. Accessed October 2023.
  3. Mallory Weiss Tear. (n.d.). Cleveland Clinic. Accessed October 2023.
  4. Lopes, M., Robinson, L., Stubbs, B., et. al. (2022). Associations between bone mineral density, body composition and amenorrhoea in females with eating disorders: a systematic review and meta-analysis. Journal of Eating Disorders, 10(73). 
  5. Blas, G. G., Ferrer, A. D., Jimenez, N. D., & Alamillos Granados, F. J. (2018). Bilateral Parotid Sialadenosis Associated with Long-Standing Bulimia: A Case Report and Literature Review. Journal of Maxillofacial and Oral Surgery, 17(2), 117–121.
  6. Handler, M., Tosti, A. (2012). Eating Disorders and the Nails, Eating Disorders and the Skin, 79-82.
  7. Marques de la Luz Neto, L., Nassar de Vasconcelos, F., Elineuza da Silva, J., et. al. (2019). Differences in cortisol concentrations in adolescents with eating disorders: a systematic review, Jornal de Pediatria, 95(1), 18-26.
  8. Gendall, K., Bulik, C., Joyce, P., McIntosh, V., Carter, F. (2000). Menstrual cycle irregularity in bulimia nervosa: Associated factors and changes with treatment, Journal of Psychosomatic Research, 49(6), 409-415.
  9. Tith, R., Paradis, G., Potter, B., et. al. (2019, October). Association of Bulimia Nervosa With Long-term Risk of Cardiovascular Disease and Mortality Among Women. JAMA Psychiatry, 70(1), 44-51.
  10. Eating Disorders: About More Than Food. (2021). National Institute of Mental Health. Accessed October 2023.
  11. Sato, Y., & Fukudo, S. (2015). Gastrointestinal symptoms and disorders in patients with eating disorders. Clinical Journal of Gastroenterology, 8(5), 255–263.
  12. Levinson, A. C., Zerwas, S., Calebs, B., Forbush, K., Kordy, H., et. al. (2017). The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis. The Journal of Abnormal Psychiatry, 126(3), 340-354.

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