It may be difficult for people with bulimia to indicate that they have a problem. People with bulimia are aware of their inappropriate thoughts and behavior, but may work very hard to keep their secret from others. Frequently, the loved ones of a person with bulimia recognize the symptoms and help an individual access treatment.
People with bulimia binge eat frequently. Episodes may occur a couple of times per week or several times per day. An enormous amount of food is eaten in a short amount of time. Some people may eat the entire contents of a refrigerator or their cupboards. They may buy and hide large amounts of food. People with bulimia feel a loss of control while they binge eat. The food may be gulped so fast that it is not even tasted. The food and junk food may contain thousands of calories and is high in fats and sugars.
Following a binge-eating episode, people may feel shame or disgust. They may be sleepy or have stomach pain. They will purge to compensate for the binge-eating. People with bulimia may abuse laxatives, diuretics, enemas, or make themselves throw up to avoid weight gain. They may fast or exercise excessively. Their body weight may remain normal, although the person may think that he or she is overweight. For others, their body weights may range from being underweight to obese. Additionally, depression, anxiety, panic disorder, obsessive compulsive disorder, or substance abuse may accompany bulimia.
Bingeing and purging can cause serious medical complications. Repeated vomiting can cause stomach acid to irritate and inflame the throat. Tooth decay and gum disease can result because the excess stomach acid removes the enamel from teeth and irritates the gums. Repeated vomiting can result in gastroesophageal reflux disorder (GERD), a painful digestive tract condition or tearing of the esophagus. The glands in the neck and below the jaw may become swollen and result in a puffy or chipmunk looking face. Laxative abuse can lead to intestinal problems. It may cause ulcers, constipation, and hemorrhoids. Diuretic abuse can cause kidney problems. Dehydration can result from a lack of or loss of fluids. Bingeing and purging can also lead to severe problems including pancreas, liver, or kidney failure and electrolyte abnormalities, low blood pressure, and heart attack. It can even cause death.