Bulimia is a serious mental illness where people feel that they have lost control over their eating and evaluate themselves according to their body shape and weight. People with bulimia are caught in a cycle of eating large quantities of food (called ‘bingeing’), and then vomiting, taking laxatives or diuretics (called purging), in order to prevent gaining weight. This behaviour can dominate daily life and lead to difficulties in relationships and social situations. Usually people hide this behaviour pattern from others and their weight is often in a healthy range. People with bulimia tend not to seek help or support very readily and can experience swings in their mood as well as feeling anxious and tense.

They may also have very low self-esteem and self harm. They may experience symptoms such as tiredness, feeling bloated, constipation, abdominal pain, irregular periods, or occasional swelling of the hands and feet. Excessive vomiting can cause problems with the teeth, while laxative misuse can seriously affect the heart. Bulimia in children and young people is rare, although young people may have some of the symptoms of the condition. Bulimia usually develops at a slightly older age than anorexia. In some instances, although not all, bulimia develops from anorexia.

Behavioural signs

  • Bingeing – eating large amounts of food
  • Purging after bingeing – vomiting, over exercising, using laxatives or diuretics, fasting
  • Preoccupied with thoughts of food and life may be organised around shopping, eating and purging behaviour
  • Usually secretive about bulimic episodes 
  • Mood swings
  • Feeling anxious and tense 
  • Distorted perception of body shape or weight
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after bingeing and purging Isolation 
  • Can be associated with depression, low self-esteem, misuse of alcohol and self-harm

Physical signs

  • Vomiting
  • Excessive exercising 
  • Misuse of laxatives and diuretics 
  • Disappearing soon after eating 
  • Fatigue, lethargy
  • Feeling bloated
  • Constipation
  • Stomach pain
  • Swelling of the hands and feet
  • Periods stop or are irregular (amenorrhea)
  • Enlarged salivary glands
  • Calluses on the backs of the hand from forcing down throat to vomit 
  • Electrolyte abnormalities/ imbalance 
  • Gastric problems 
  • Regular changes in weight 

People with bulimia have told Beat

I used to go to the food cupboard, fridge or freezer and eat as much as I could, as quickly as possible, to try to make myself feel happier and fill the hole I felt inside. Afterwards I felt physically and emotionally upset and guilty about all the food I had eaten, so I would make myself sick.
People thought I was really popular and together, but I knew I wasn’t, I felt like a fake.  I thought that people wouldn’t like me if they knew what I was really like.
The more I denied my body the food it needed, the deeper my hunger became, and the greater the sense of control I felt being restored. One day the hunger finally overwhelmed me. I began to purge. This quickly developed into a dangerous cycle of binge eating and vomiting.

Find out more about getting help and treatment for bulimia.

Issue date: July 2014
Review date: July 2017
Version 1.0
Sources used to create this information are available by contacting Beat on 0300 123 3355 or emailing info@b-eat.co.uk. We welcome your feedback on our information resources and whether you found them helpful. Email info@b-eat.co.uk with your comments.

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