• Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to "burn off" calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration or staining of the teeth.
• Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Health Consequences of Bulimia Nervosa:

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
• Potential for gastric rupture during periods of bingeing. Inflammation and possible rupture of the esophagus from frequent vomiting.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse.
  Peptic ulcers and pancreatitis.
  About Bulimia Nervosa:
• Bulimia nervosa affects 1-3% of middle and high school girls and 1-4% of college age women.
• Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997).
• People struggling with bulimia nervosa will often appear to be of average body weight.
• Often, people struggling with bulimia nervosa will develop complex schedules or rituals to provide opportunities for binge-and-purge sessions.
• Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.

References:

Gidwani, G.P. and Rome, E.S. (1997). Eating Disorders. Clinical Obstetrics and Gynecology, 40(3), 601-615.

Levine, M. (1994). "A Short List of Salient Warning Signs for Eating Disorders." Presented at the 13th National NEDO Conference, Columbus, Ohio.

Zerbe, K.J. (1995). The Body Betrayed. Carlsbad CA: Gurze Books.


For more information, contact Eating Disorders Awareness and Prevention, Inc. at 603 Stewart St., Suite 803, Seattle, WA 98101, 1-800-931-2237. www.nationaleatingdisorders.org © 2000 EDAP