Individuals with bulimia, also known as bulimia nervosa, often take extreme measures to conceal their binging and purging compulsions. Over time, this serious eating disorder becomes more difficult to conceal as the emotional and physical effects begin to take their toll. Predominantly affecting young women, disease onset may be influenced by a variety of physiological, societal, and personal factors. Bulimics may initially demonstrate warning signs that, with time, may be replaced with dramatic and potentially life-threatening physical effects that worsen without treatment.
Signs of bulimia often revolve around an adopted thought process that consistently reflects an individual's preoccupation with self-image, dieting, and weight. Those who possess such obsessions frequently demonstrate additional signs of bulimia that often include a preoccupation with food consumption and counting calories that borders on anxiety and an unhealthy fear of gaining weight. Additionally, an obsession with weight and body shape that necessitates the use and abuse of diet pills, laxatives, and water pills to help facilitate weight loss may be a sign of bulimia. To supplement their use of pills and habitual purging, bulimic individuals may develop a harmful compulsion to exercise that supersedes rest in the wake of illness or injury.
It is not uncommon for an individual with bulimia to experience personality or mood changes, including anxiety, guilt, and depression. Some individuals often develop substance abuse issues that may become more pronounced if they are unable to act out their compulsions. Behavioral signs of bulimia may include the adoption of uncharacteristic and sometimes illegal actions to facilitate binging and purging compulsions. Some individuals may resort to shoplifting or stealing money to supplement their need for food or pills. Others may demonstrate methodical behaviors, such as patronizing various groceries in different parts of town, to conceal their compulsive behaviors.
Signs of bulimia often manifest in one's eating habits, which adopt characteristics that may serve to warn those close to the individual that something is not right. Many individuals with bulimia may choose to eat in private so as to not raise suspicion. Sneaking food, being secretive about food consumption, and repeated or extensive fasts are common red flags that something is amiss. Those who choose to eat in front of others will often excuse themselves immediately or soon after eating to seek out a bathroom in order to purge. It is quite common for bulimic individuals to exhibit pronounced weight fluctuations, such as losing a substantial amount of weight in a short period of time.
During the early stages of one’s binging and purging, physical signs of bulimia may include the development of swelling in the cheeks and jaw line. The distention generally occurs as a result of the stress placed on the salivary glands, blood vessels, and mucous membrane during the purging process. The repeated introduction of stomach acids into the oral cavity during purging often results in a loss of tooth enamel and, ultimately, tooth decay. The soft tissues of the oral cavity also become inflamed and irritated resulting in sore gums and, sometimes, the formation of ulcerated tissue. Calluses may also form on the fingers and knuckles of a bulimic’s hands as a result of consistent use during purging.
With time, binging and purging depletes valuable nutrients and electrolytes necessary for proper body function. Women who are bulimic may experience a disruption of their menstrual cycle or abnormal bleeding due to the chemical disruption the bulimia indirectly causes in the reproductive system. The stress bulimia places on the body may also induce lethargy joint discomfort and a loss of muscle tone. The consistent deprivation of potassium can result in a disorder known as hypokalemia, which if left untreated may lead to hypertension and cognitive impairment. Other serious conditions that may result from bulimia-induced malnutrition include heart arrhythmias, pancreatitis, and arterial disease.