Bulimia - What are the symptoms?

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Other symptoms

If you have bulimia, you know what the symptoms are. They have probably been a major part of your life for months, even years.

We've listed the main symptoms here.[1]

You binge on large amounts of food, usually in secret. See What is bingeing? for more information. When you binge, you feel out of control. You usually can't stop eating, and you can't control how often you binge either.
After a binge, you might make yourself sick, or you might take laxatives or pills that make you urinate a lot (diuretics) to try to avoid putting on weight. This is called purging. See What is purging? for more information.

You may have struggled with bulimia for years. It may even have become a way of life.[2] Or you might have this problem only once in a while. Doctors say you have bulimia if you've been bingeing and then purging an average of two times a week or more for three months or more.

Even a healthy activity like exercising can be harmful if you overdo it. Even if you never purge, you can still have bulimia. You might make up for a binge by exercising excessively.[1] For example, you might exercise so obsessively that it interferes with your job or your studies.

If you don't let anything get in the way of your exercise, this could be a warning sign. For example, perhaps you still exercise even though you feel ill. Or you go to the gym even when you're injured.

You might also make up for binges by not eating anything (fasting) for a day or more.

Other symptoms

If you've had bulimia for a long time, the cycle of bingeing and purging can start to affect your body. You might notice some of the symptoms listed below.

Your teeth become discoloured. The acid in vomit can take the enamel off your teeth and change their colour. Acid also causes tooth decay. Any damage to your teeth is permanent.
You get heartburn. Being sick all the time weakens the valve at the bottom of the tube that carries food from your mouth to your stomach (the oesophagus). This allows stomach acid to splash up into your oesophagus and cause heartburn.
You get patches of rough skin on your fingers. You can get these if you use your fingers to make yourself sick. Each time you vomit, your teeth scrape the skin on your fingers.
You are constipated. If you've been using laxatives regularly, your gut might not work without them. This can lead to bad constipation.
Your periods stop. About half the women who vomit regularly stop having periods or have them only occasionally. This is because the stress bulimia puts on their body affects their hormones.
You vomit blood. This can happen if you tear the lining of your oesophagus. It is rare, but it can occur if you are vomiting often and violently.

Bulimia can also make you feel depressed. See Feeling depressed to find out more.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th Edition. American Psychiatric Press Inc, Washington DC, USA; 2000.
Orbanic S. Understanding bulimia: signs, symptoms and the human experience American Journal of Nursing. 2001; 101: 35-41.

Glossary

laxative: Laxatives are medicines that empty your bowels by making you go to the toilet more often than usual.
hormones: Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone is made in a woman's ovaries. Oestrogen has many different effects on a woman's body. For example, it makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.