Bulimia Nervosa, often referred to as bulimia, is one type of eating disorder. People with bulimia binge uncontrollably on large amounts of food – sometimes thousands of calories at a time – and then purge the calories out of their bodies through vomiting, starving, excessive exercise, laxatives, or other methods.Bulimia Nervosa is a psychological disorder that produces many medical and physical problems. Bulimia Nervosa is often accompanied by feelings of guilt, depression, and self-condemnation.

Types and Criteria

Purging Type: During the episode, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
Nonpurging Type: During the episode the person has used other inappropriate compensatory behaviors, such as fasting, excessive exercise w/o purging behaviors.


  • Binge Eating on a regular basis. Binge eating is characterized by:Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
  • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)
    • Recurrent inappropriate compensatory behavior in order to prevent weight gain:
    • Self-induced vomiting
    • Misuse of laxatives, diuretics, enemas, or other medications
    • Fasting
    • Excessive exercise
  • Frequency: the binge eating and purging both occur, on average, or at least twice a week for three months.
  • Body image issues: Self-evaluation is unduly influenced by body shape and weight (i.e. making your weight the only thing you judge yourself on)

Warning Signs

  • Excessive concern about weight
  • Strict dieting followed by eating binges (diet – binge – purge cycles)
  • Frequent overeating, especially when distressed
  • Bingng on high calorie, sweet foods
  • Use of laxatives, diuretics, strict dieting, vigorous exercise, and/or vomiting to control weight
  • Leaving for bathroom after meals- excessive requirements for privacy in bedroom or bathroom
  • Being secretive about food/binges/vomiting
  • Planning binges or opportunities to binge
  • Feeling out of control
  • Impulse control problems in other areas (may shoplift, be promiscuous, and/or abuse alcohol, drugs, credit cards and/or other risk taking behavior)
  • Competent front to hide depression, shame, and emptiness inside
  • Difficulty talking about feelings
  • Believes self-worth requires being thin
  • Bloodshot eyes
  • Swollen neck glands or frequent sore throat
  • Unusual or frequent dental problems
  • Bleeding or irritated gums
  • Buys large amounts of food that disappear with no explanation
  • Sudden changes in food likes or dislikes
  • Drinks excessive amounts of water or soda
  • Repeated excuses for not eating at regular meals with family and friends

Physical Complications

The Most Common Complications Leading to Death in Bulimia are:

  • Electrolyte imbalance
  • Irregular heart rhythms
  • Suicide

Other physical symptoms seen with Bulimia:

  • Bleeding or irritated gums
  • Worn tooth enamel, and increase in tooth sensitivity and decay
  • Chronically inflamed sore throat
  • Swollen glands in the neck and below the jaw
  • Intestinal problems
  • Bloodshot eyes
  • Callused and/or discolored skin on the finger joints
  • Abnormal blood test results
  • Kidney problems due to diuretic abuse
  • Severe dehydration from purging behaviors
  • Acid reflux
  • See the diagram below on how bulimia affects the entire body: