Hidden Signs of Bulimia Nervosa and How to Help Your Loved Ones Acquire Treatment

As bulimia nervosa affects each person differently, it can be difficult to notice the development of this condition at first. There may be a lack of obvious signs and symptoms that can delay the process of bulimia nervosa treatment for their loved ones. Without timely treatment and support, mental and physical health complications could arise.

When family members fear their loved ones are at risk of bulimia nervosa, they can learn more about this condition to closely watch for the signs. Not all signs are easy to see, however, so they have to learn about all the different ways to notice the need for bulimia nervosa treatment. Upon noticing any related symptoms, they can start the discussion about acquiring treatment from skilled care teams. To get started, family members can utilize this guide and explore the hidden (and not-so-hidden) signs of bulimia nervosa and ways to help their loved ones acquire treatment when they need it most.

Signs of Bulimia Nervosa That Can Be Hard to See

As bulimia nervosa symptoms and their effects can cause immense shame and guilt, many people hide this condition from their loved ones. Even if family members do notice something is wrong, but are not quite sure what, the signs of bulimia nervosa can be hard to see. As a result, family members may simply overlook the symptoms or attribute them to a completely different cause. For a deeper look into these hidden signs of bulimia nervosa, here are a few that are often overlooked by concerned family members and friends.

Inability to Stop Eating

Without an open dialogue, it is nearly impossible to tell that people are experiencing strong urges and feelings that are causing an inability to stop eating. Family members can watch to see if their loved one regularly consumes large amounts of food over the course of a two hour period to understand if binging behaviors, common with bulimia nervosa, are occurring. Unfortunately, this is not often foolproof, as many people with bulimia nervosa will sneak and hide food to eat it in secret.

With bulimia nervosa, the compulsive urge to eat and continue eating can have a harmful impact on mental health and wellbeing. Although this symptom can cause mental distress, the anxiety may be blamed on a different event. Family members may have a hard time pinpointing the cause of the stress, beyond knowing that the incidents occur around mealtimes. They may need to speak with an eating disorder therapist to make better sense of the patterns they notice and create a suitable plan of action.

Purging Behaviors

Whether through self-induced vomiting or laxative use, purging can cause painful gastrointestinal problems, electrolyte imbalances and other serious health issues. Damage to the heart and other vital internal organs can eventually occur from the constant stress caused by purging.

Unfortunately, as with bingeing, purging is also extremely difficult to notice as many people keep this behavior secret. Family members can pay attention to when and how long their loved ones go to the bathroom, especially if it is right after meals, to start to notice telltale patterns. Also, note any laxative use or cuts around their fingers as those could also be signs of bulimia nervosa.

Negative Body Image

Not all people vocalize their dislike of their body shape, size and look. Family members may not hear any complaints about body image nor see signs of any worries at all, but that does not mean a problem does not exist.

People with a negative body image show much subtler signs of their dysfunctional thought patterns. They may make off-hand disparaging comments about their body in a joking manner or seem overly preoccupied with the way they look. They may either gaze in the mirror for long periods of time or not at all. There are a wide range of experiences when it comes to having a negative body image, so there is not just one sign to look for as family members try to figure out if there is a need for help.

Disordered Thoughts and Feelings

Dysfunctional thinking and poor control over emotions both commonly occur with bulimia nervosa. Distorted thought patterns can make it difficult for loved ones to recognize the need for treatment. Family members may also miss the signs as their loved one keeps their thoughts and feelings private.

Although the signs of poor emotional control tend to stand out more, people with bulimia nervosa may offer alternative explanations that leave family members second-guessing themselves. The absence of open dialogue can make it difficult to get to the heart of the matter, as well. They can offer a listening ear and provide support without judgment to help their loved one feel comfortable enough to talk about their challenges.

Why Bulimia Nervosa Signs and Symptoms Remain Hidden

Feelings of shame may occur for those with eating disorders in general and bulimia nervosa in particular. With the shame comes an urge to hide the disordered thoughts, feelings and behaviors from the view of everyone in their lives. The secretive behaviors compound the shame they feel, causing a never-ending loop of negative experiences until they can acquire bulimia nervosa treatment.

People with eating disorders may fear judgment from strangers and their loved ones alike. This fear can cause these individuals to stay quiet and try to work through their challenges on their own, if at all. Without reaching out for help, health complications from bulimia nervosa can quickly start to develop as stress on the body multiplies. Not all bulimia nervosa symptoms can remain hidden, however, especially as the condition progresses.

More Noticeable Bulimia Nervosa Signs and Symptoms

There are quite a few noticeable bulimia nervosa symptoms that can develop at any point. When family members watch for these signs, they can offer their support and help their loved ones enter treatment with confidence. Here are a few signs of bulimia nervosa to consider.


Bingeing and purging can have a detrimental effect on the health of the stomach. Over time, the damage can cause the tissues to swell, resulting in obvious bloating. The stomach may look and feel as hard as a rock only to go back down to normal within a few hours. As the bloating tends to come with severe stomach pain, it is pretty hard to hide.

Even more difficult to hide, facial swelling can develop as the salivary glands respond to the ongoing irritation from the symptoms of bulimia nervosa. If family members notice their loved one dealing with any type of bloating or swelling of the abdomen or face, then it may need to be investigated further at the doctor’s office or bulimia nervosa treatment center.


Without regular food intake, vitamin and mineral deficiencies can leave people with bulimia nervosa completely fatigued and dragging day after day. The mental and physical fatigue can result in a total lack of energy for all activities required for the day. Family members might notice their loved one sleeping all day or having a hard time engaging in their normal activities. When severe, fatigue often presents with weakness as well. As these symptoms appear together, they require additional investigation from a skilled medical practitioner.

Teeth and Gum Damage

When people with bulimia nervosa engage in purging behaviors, they cause extensive damage to their teeth and gums. Every time stomach acid flows up into the mouth, the acidic compounds eat away at the tooth enamel, causing rot and decay. Furthermore, malnourishment from a lack of proper food each day can slow healing to a crawl, resulting in constantly worsening dental health.

They may notice a rapid decline in the health of their loved one’s teeth and gums after bulimia nervosa symptoms arise. Visible decay of the teeth may be just the start with excessive tooth loss to follow. Without bulimia nervosa treatment, the tooth and gum damage will continue to worsen, resulting in the total loss of the teeth over time.

Depression and Anxiety

Eating disorders commonly co-occur with mental health issues, such as depression and anxiety. When these issues arise, it is a sure sign that there is a need for support. Although depression and anxiety do not always link back to bulimia nervosa, there is a good chance they might if any other signs are noticeable. Even if not, it is important to acquire care for mental health problems of any kind to prevent complications from arising. With help, it is possible to restore the mental wellbeing of people with and without eating disorders and improve their quality of life.

When family members start to notice that something might be wrong, they can begin the tough conversations that could inspire change and healing. Their efforts can go a long way in motivating their loved one to take control of their health and seek care at a bulimia nervosa treatment center.

Starting the Discussions About Bulimia Nervosa Symptoms

Before family members can begin to discuss their concerns with their loved one, they must prepare for the conversation. By doing their research and organizing their thoughts, they can broach the subject with purpose and without too much emotion. They can also run a few scenarios through their mind to prepare to handle the full range of reactions from their loved one. It is very common to have fearful or stressed reactions when confronted, no matter how gently, about bulimia nervosa symptoms.

Family members should also pay close attention to the environment in which they will have this conversation by making it as comfortable and inviting as possible. A well-prepared environment can make people feel safe, comfortable and supported during the discussion about the possible need for eating disorder treatment. Family members should provide as many comfort items as they reasonably can before inviting their loved one over to talk.

Once family members are prepared, they can invite their loved one over to discuss their concerns and offer judgment-free support. Keep the confrontational language far from this conversation to maintain an open, honest dialogue. Family members need to remember to listen much more than they talk and only use “I” statements to show their love and concern.

If family members cannot make any headway in helping their loved ones go through bulimia nervosa treatment, then it might not be time for that step. There is no way to force the issue, though admissions specialists at eating disorder treatment centers may be able to help. Family members can continue to have open discussions without judgment to show their support and offer a path to healing from this eating disorder.

How Families Can Help Loved Ones Acquire Bulimia Nervosa Treatment

With support, people with eating disorders may start to open up their mind to treatment. When this happens, family members can provide the assistance they need in entering bulimia nervosa treatment. Family members can help their loved one speak with an admissions specialist to identify and acquire the right level of care. They can remain by their loved one’s side throughout this process to ensure they can make an easy transition into the inpatient or outpatient eating disorder treatment center. With their support, people can easily enter bulimia nervosa treatment and start working on becoming recovered.