What is Bulimia Nervosa?

It’s important to know that everyone will not have the same symptoms. Some people will have a mix of symptoms and you do not need to have all these symptoms to have an eating disorder.

It was only in 1979 that bulimia nervosa was recognised by doctors as an eating disorder in its own right. The term bulimia nervosa means literally ‘the nervous hunger of an ox’. The hunger, however, is really an emotional need that cannot be satisfied by food alone. After binge-eating a large quantity of food to fill the emotional or hunger gap, there is an urge to immediately get rid of the food by vomiting or taking laxatives (or both), by starving or reducing food intake, or by working off the calories with exercise in an attempt not to gain weight.

Bulimia is more difficult for others to notice as you tend not to lose weight so dramatically, or your weight will fluctuate. Even people close to you at home or work may not recognise the illness, so it can persist for many years undetected. People with bulimia may have demanding jobs that require them to be out-going and self-assured even when they feel inadequate inside. As with anorexia, people who develop bulimia become reliant on the control of food and eating as a way of coping with emotional difficulties in their life. You may also find you become obsessed with maintaining your weight.

You are most likely to develop bulimia in your late teens to early 20s. This sometimes occurs because of a belief that bulimia will help you to diet successfully where other attempts to lose weight have failed. It is also often associated with low self-esteem or a general lack of self-confidence. You may have previously had anorexia.

The effects of bulimia on your body

• Frequent weight changes
• Sore throat, tooth decay and bad breath caused by excessive vomiting
• Swollen salivary glands making the face rounder
• Poor skin condition and possible hair loss
• Irregular ‘periods’ or loss of interest in sex
• Lethargy and tiredness
• Increased risk of heart problems and problems with other internal organs

Psychological signs of bulimia

• Uncontrollable urges to eat vast amounts of food
• An obsession with food, or feeling ‘out of control’ around food
• Distorted perception of body weight and shape
• Emotional behaviour and mood swings
• Anxiety and depression; low self-esteem, shame and guilt
• Isolation - feeling helpless and lonely

Behavioural signs in bulimia

• Bingeing and vomiting
• Disappearing to the toilet after meals in order to vomit food eaten
• Excessive use of laxatives, diuretics or enemas
• Periods of fasting
• Excessive exercise
• Secrecy and reluctance to socialise
• Shoplifting for food; abnormal amounts of money spent on food
• Food disappearing unexpectedly or being secretly hoarded

What is a binge?

At first you may begin to binge in an attempt to cope with emotional difficulties or to ease tension, but this can rapidly get out of control. You may find that the foods you eat are generally high in calories, carbohydrates and fat. In some circumstances, you may resort to eating things like uncooked pasta, partially defrosted frozen food or condiments, or retrieve and eat previously discarded food. As you start to feel full, feelings of guilt and shame come into your mind. It is not uncommon for people to eat two, three or even four times a normal amount of food in one go. In desperation, you may vomit or take laxatives to purge yourself of everything you have consumed. At this point, some people describe feeling emotionally relieved and physically light-headed. This cycle can keep inner pain and unhappiness at bay - but only for a brief time.

The frequency of these bulimic cycles will vary from person to person. You may suffer from an episode every few months or if you are more severely ill, you may binge and purge several times a day. Some people may vomit automatically after they have eaten any food. Others will eat socially but may be bulimic in private. Many people do not regard their illness as a problem, whilst others despise and fear the vicious and uncontrollable cycle they are trapped in.

Long-term effects of bulimia

In a similar way to anorexia, bulimia can take over the life of the person with the disorder, making them feel trapped and desperate. Bingeing, purging and dramatic loss of fluids can cause physical problems which can usually be corrected once the body is nourished in an even and moderate way.

Bulimia can, in extreme cases, be fatal due to heart failure. An imbalance or dangerously low levels of the essential minerals in the body can significantly, even fatally affect the working of vital internal organs. Other dangers of bulimia include rupture of the stomach, choking, and erosion of tooth enamel, painful swallowing and drying up of salivary glands. Laxative abuse can lead to serious bowel problems.

Read some survivors stories to help understand what it is like to have an eating disorder, or click here for information on how to get help.

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