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A few facts about bulimia nervosa may surprise you. For example, the majority of people with bulimia nervosa are female. In fact, there’s a 10:1 female-to-male ratio. Also, contrary to popular belief, people with bulimia nervosa often appear to be of average body weight. This can make it easier for suffers to hide their problem. However, what are the symptoms of bulimia nervosa?

The symptoms of bulimia nervosa can be hard to spot unless you know what you’re looking for. Mental health professionals look for the following:

  • Recurrent episodes of binge eating (characterized by eating large amounts of food in a short period of time and a sense of loss of control over eating behavior)
  • Use of inappropriate, compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive/ compulsive exercise
  • The binge eating and compensatory behaviors occur at least once a week for 3 months
  • Self-evaluation is inappropriately influenced by the person’s weight and shape

Warning Signs of Bulimia Nervosa

In addition to its main criteria, bulimia can also cause the following:

  • Existence of binge eating (food wrappers and containers; food hoarding)
  • Evidence of purging behaviors (frequent trips to the restroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics)
  • Excessive, rigid exercise regimen
  • Unusual swelling of the cheeks or jaw area
  • Calluses on the back of the hands and knuckles
  • Discoloration or staining of the teeth
  • Creation of complex lifestyle schedules or rituals (in order to allow time for binge eating and purging sessions)
  • Withdrawal from friends, family, and/or activities
  • Behaviors and attitudes indicating a preoccupation with the importance of weight loss, dieting, and control of food

Health Consequences of Bulimia Nervosa

As the condition worsens, the symptoms of bulimia nervosa can eventually become more severe. Complications that can arise from an extended battle with bulimia include the following:

  • Electrolyte imbalances (can lead to irregular heartbeats and possibly heart failure and death)
  • Inflammation and/or rupture of the esophagus
  • Tooth decay and/or staining
  • Chronic irregular bowel movements and constipation
  • Gastric rupture

Description adapted from the National Eating Disorders Association and the DSM-5.

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