Warning Signs of Bulimia to Never Ignore

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Bulimia Nervosa is, by now, a disorder many recognize. While much about eating disorders remains misunderstood, many people know that bulimia is an eating disorder which typically begins with distortion of body image and manifests itself in bingeing (over-eating) and purging (often vomiting or laxative abuse) behaviors.

Even with this knowledge, numerous cases of bulimia go unnoticed. An important part of assisting a loved one with an eating disorder is knowing the warning signs.

In regard to Bulimia Nervosa, there are various physical, emotional, and behavioral warning signs that should not be ignored if noticed.

Symptoms of Bulimia Nervosa

It is a good habit to always be aware of your loved one’s emotional state. With Bulimia Nervosa, some emotional symptoms may provide insight into the issue, such as signs of depression and anxiety, as these are often co-occurring disorders.

These symptoms may include difficulty concentrating or making decisions, decreased energy, feelings of guilt, worthlessness or helplessness, insomnia, and thoughts of suicide or self-harm.

Additionally, those suffering from bulimia are likely to have a negative and distorted body-image, a pre-occupation with body shape and weight, and a fear of weight gain (1). Anyone may have these thoughts or feelings at times, however, with bulimia, these thoughts become overwhelming and lead to unhealthy compensatory behaviors.

Woman on a benchBulimia Nervosa also has distinct physical symptoms that can indicate an issue. Some may be noticeable at a glance, such as sores/scars on hands, caused by self-induced vomiting, or a scratchy/raspy voice.

Clothing style is also a potential indicator, as research shows that those that avoid revealing and brightly-colored clothing and attempt to camouflage their bodies with their clothes are more likely to develop, or already have, bulimic symptoms (2).

Other symptoms are more likely to be noticed over time or by professionals, such as damaged teeth/gums, swollen salivary glands, sores in throat/mouth, or loss of menses.

Many of these signs are difficult to detect, as eating disorders involve the sufferer becoming adept at secrecy. Attempt to be aware of the physical changes occurring in your loved one.

Additional Red Flags for Bulimia to Keep in Mind

Finally, Bulimia involves its own unique set of red flags that can indicate a problem.

Isolation is important to look for, particularly if your loved one is eating in private. Additionally, remain conscious of bathroom habits, especially if your loved one is going immediately after, or during, meals.

Food hiding or hoarding may also indicate that one is stuck in a binge-purge cycle. Remember that purging does not always involve vomiting and be aware if your loved one has begun, or increased, purchasing of laxatives, diuretics, or enemas.

Noticing the warning signs of mental health issue can be difficult. Be aware of these potential signs of bulimia when interacting with loved ones, whether they are in recovery or you’re concerned they may have developed a new problem.

Above all else, remember that these signs are symptoms of a larger concern and, if you notice them and want to discuss it with your loved one, be sure to do so with love and empathy.

Image of Margot Rittenhouse.About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth. As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


[1] Levinson, C. A., Zerwas, S., Calebs, B., Forbush, K., Kordy, H., et al. (2017). The core symptoms of bulimia nervosa, anxiety, and depression: a network analysis. Journal of Abnormal Psychology, 126:3, 340-354.
[2] Trautmann, J., Worthy, S. L., Lokken, K. L. (2010). Body dissatisfaction, bulimic symptoms, and clothing practices among college women. The Journal of Psychology, 141:5, 485-498.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Reviewed By: Jacquelyn Ekern, MS, LPC on April 12, 2017.
Published on EatingDisorderHope.com