It’s Not Just Purging: Lesser-Known Symptoms of Bulimia Nervosa

For people living with bulimia nervosa, and for people with loved ones who are, it is helpful to realize that this eating disorder can manifest in many different ways. Without recognizing the many signs of bulimia nervosa, people may be less likely to seek the bulimia nervosa treatment which can help them or their loved one recover.

The diverse nature of bulimia nervosa is especially important to acknowledge because people of all backgrounds can develop the disorder. In other words, it is not possible simply to look at a person and assume to understand how this person feels about their body or their relationship with food. The reality is, there is much more to bulimia nervosa than someone’s appearance.

There is also more to this condition than the hallmark cycle of binging and purging, which most people have heard of. True, people with bulimia nervosa normally experience alternating episodes of excessive food consumption followed by compensatory actions as an attempt to mitigate the overeating (these actions often include vomiting, laxative abuse and extreme exercise).

However, someone experiencing bulimia nervosa is likely to experience a range of other signs and symptoms, all of which that can detract from a person’s quality of life and many of which that may go unnoticed by friends and family.

We will talk about some of these lesser-known signs of bulimia shortly. But before we do, let’s first explore some common bulimia nervosa causes. As we have experienced at Oliver-Pyatt Centers, understanding the roots of disordered eating helps individuals and their families affect more impactful change in the long term.

Understanding Bulimia Nervosa Causes 

According to available statistics, at least 1.5% of young women and 0.5% of young men will experience bulimia nervosa at some point in their lifetime. This represents millions of people from a wide range of backgrounds who may have some commonalities.

That said, bulimia nervosa causes can vary from person to person; no two people experiencing this disorder are exactly the same. And unlike certain medical conditions, there is usually not a singular cause or origin of bulimia, but rather a combination of elements which contribute to the development of the disorder.

Generally, both environmental and genetic factors influence whether a person develops bulimia nervosa (or other eating disorders, for that matter). These factors may include:

• Societal pressures and expectations (even or especially ones which are unrealistic)
• Households with high levels of family stress, competition and sub-optimal problem solving and communication skills
• Family history of certain physical and/or mental illnesses
• Personal history of trauma or abuse
• Participation in sports which require or idealize thinness, or sports with largely subjective performance measures (e.gymnastics, dance and ice skating)

Despite what popular belief may say, both men and women can experience bulimia nervosa, as is demonstrated in the above-mentioned prevalence statistic. Likewise, while the average age of onset is between 18 and 19 years old, bulimia nervosa can affect people of all ages.

Ten Lesser Known Signs and Symptoms of Bulimia Nervosa

While binging and purging are core characteristics of the person living with bulimia nervosa, other signs and symptoms of bulimia nervosa exist, many of which surprise individuals and their loved ones.

Consider these ten common, yet often overlooked, signs and symptoms which may affect a person living with this eating disorder:

1. Severe dehydration: This is due to a frequent purging of fluids from the body. Indicators of dehydration include dark and infrequent urine, fatigue, dizziness, lightheadedness, fainting, extreme thirst and confusion or mental sluggishness.
2. A frequently sore and inflamed throat: This occurs due to repeated exposure to gastric fluids. The highly acidic liquid can irritate the delicate lining in the esophagus, leading to redness, sores, swelling and vocal hoarseness.
3. Swollen glands in the neck and jaw: Salivary glands in the neck and throat area can swell, leading to the appearance of lumps, bumps, and rounded cheeks. It is not entirely clear why this happens, but some theories include an over-production of enzymes that help digest food and irritation from repeated exposure to stomach acids.
4. Gastrointestinal problems: The stress of repeated fasting, overeating, vomiting and laxative abuse can lead to uncomfortable issues such as acid reflux, heartburn, nausea, bloating, constipation, intestinal distress and gas.
5. Damaged teeth and gums: Like the throat and esophagus, teeth and gums that are frequently exposed to stomach acids can become inflamed and irritated over time. For instance, tooth enamel may erode away and cause teeth to look translucent, yellow and brittle. Teeth often become increasingly sensitive and at a greater risk for cavities. Sores can develop on the gums and inner lining of the mouth, which can be painful and at risk for infection.
6. Electrolyte imbalances: People with bulimia nervosa are at risk for disrupting electrolyte levels in their bodies. For instance, frequent binging and purging can lead to dangerously low or high levels of sodium, potassium, calcium and other nutrients. These electrolytes play essential roles in many bodily functions, including within the nervous and musculoskeletal systems. Unfortunately, this risk for electrolyte imbalance and nutritional deficiencies partially explains why research shows people with bulimia nervosa are at an increased risk for medical complications including high blood pressure, abnormal heartbeat, heart attack, insomnia, type 2 diabetes and more.
7. Recurring superficial injuries on the hands: If a person with bulimia nervosa uses their fingers to make themselves purge, they may accidentally scrape their knuckles against their teeth while doing so. This can lead to the frequent appearance of scabs, scrapes and scars.
8. Psychological symptoms: A person with bulimia nervosa may have a heightened preoccupation with his or her weight or appearance. He or she may be fearful of gaining weight, be overly self-critical and experience feelings of anxiety, depression and other mood dysregulation.
9. Behavioral symptoms: A person with bulimia nervosa may exercise excessively, avoid eating in public or frequently go to the bathroom following a meal. He or she may also exhibit self-harming behaviors, such as cutting.

Finally, it is important to realize people with bulimia nervosa are often living with co-occurring conditions such as obsessive-compulsive disorder, substance abuse and post-traumatic stress disorder (PTSD). These conditions, like eating disorders, are best managed with individualized therapy from professionals specially trained to diagnose and treat them.

For the recovered person, all of these conditions and contributing factors must be adequately addressed. Additionally, appropriate coping strategies must be adopted as a way to promote long-term healing and meaningful improvements in self-image.

Discover the Difference in Bulimia Nervosa Treatment With Oliver-Pyatt Centers

Like other eating disorders, bulimia nervosa is a highly individualized experience, and as such, requires a highly individualized approach to treatment. In order to be effective, such an approach must begin with awareness and insight into the unique person living with the condition.

As a proud affiliate of the ground-breaking Monte Nido eating disorder treatment program, Oliver-Pyatt Centers is honored to provide innovative, evidence-based and individualized bulimia nervosa treatment for men and women living in the greater Miami area.

It is our mission to help people recover from disordered eating conditions as well as empower them to re-establish a more mindful relationship with food and their self-image. We believe education, self-advocacy, societal awareness, and above all compassionate, individualized and integrative therapy is an essential piece of the treatment process.

We are inspired by the words of Monte Nido’s founder, Carolyn Costin: “One way to think about the process [of eating disorder recovery] is to remind yourself you are working toward something, you are learning to accept yourself where you are at this moment, are doing the best you can and will continue working toward change.”

For questions about our diverse programs or to learn more about bulimia nervosa and other mental health and/or addiction disorders, contact Oliver-Pyatt Centers at (866) 511-4325. We are confidential, caring and professional. Let us help you or your loved one experience our evidence-based, empathetic, and dignified treatment at whatever level of care is needed for you to begin on the path to true recovery.