It is not uncommon to be living with an eating disorder for many years without receiving support or recognizing how big of a problem it is to your health and disruption to your life. Eating disorders often occur in secret and thrive in isolation. The less an eating disorder is "exposed” or addressed, the more likely it is to exist under the radar. That is why it is so important to recognize these 5 signs and seek help, or encourage your loved one to get support.
What is Bulimia Nervosa?
Bulimia Nervosa is a serious eating disorder that affects your physical and mental health. The National Eating Disorder Association describes Bulimia Nervosa as:
Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
National Eating Disorder Association
Since Bulimia Nervosa is considered a mental illness, it’s diagnostic criteria comes from the DSM 5 (Diagnostic Statistical Manual, Fifth Edition). Bulimia Nervosa is characterized by bingeing and purging cycles.
You may have experienced a binge if you eat a larger quantity of food in one sitting (a quantity that is much larger than you would typically eat and leaves you feeling uncomfortably full or sick), and a sense of lack of control while eating.
A key part to bingeing that is a hallmark of Bulimia Nervosa, is that after a binge you use some sort of compensatory behavior. Meaning there is an urge to “get rid of” the food you just consumed by using behaviors such as vomiting, laxatives, exercise, etc.
To receive a diagnosis of Bulimia Nervosa, one must be using those behaviors for a specific duration as outlined in the DSM 5. However, if you or your loved one struggle with this, even on what feels like an infrequent basis, I would strongly urge you to get support rather than let this continue. You are deserving of a better relationship with food and your body.
If you’re wondering if you or your loved one may have Bulimia Nervosa, here are 5 signs to look for:
5 Signs of Bulimia Nervosa
Sudden and extreme weight fluctuations
It is a common misconception that individuals with eating disorders must look frail and very thin. This is not the case for every eating disorder and individual. If you notice a drastic fluctuation in weight, this could be a sign that something is going on. Although, it is also possible for someone’s weight not to change in a noticeable way. Note: please be cautious if you have noticed changes in your loved one’s weight and feel concerned. Body image is a strong component to developing an eating disorder and your loved one may be sensitive to this information.
Frequent trips to the bathroom after eating
Frequent trips to the bathroom right after eating could be a potential warning sign. When someone is suffering from bulimia nervosa they may be using the bathroom after a meal or snack as an opportunity to purge the food they just ate via vomiting, laxatives or diuretics.
Obsessive behaviors and thoughts around food
This can be difficult to identify in today’s world where it is common to negatively talk about yours and others’ appearances or follow a restrictive diet. Food and weight are a normal conversation for many people. If you feel your loved one is struggling with an eating disorder, please know that these conversation topics can be a big trigger for them and cause them to use more eating disorder behaviors. Individuals struggling with an eating disorder may be obsessive around food to the point that it causes a lot of anxiety, fear, and may cause them to isolate or withdraw. The difference between dieting thoughts around food and eating disorder thoughts are that an eating disorder is much more disruptive to your quality of life.
Extreme mood swings, irritability and depression when food feels chaotic
Do you know how it feels to be hungry and cranky? Multiply this by 10 and now you know a glimpse of what it is like to be living with an eating disorder. Bulimia nervosa thrives off of trying to do things perfectly. When food feels chaotic or out of your control, it can cause big mood swings and fear. In addition, the restriction followed by bingeing and purging can be a dangerous combination.
Attempting to purge via vomiting or misuse of laxatives or diuretics
The most common aspect of bulimia nervosa is self-induced purging, or vomiting. If you are struggling with this, or suspect your loved one is struggling with this, please take caution in how you approach them and help them to find the support they need and deserve. Physical effects of purging includes damage to the teeth, specifically the enamel, and the esophagus. Often individuals who purge complain of acid reflux. Other forms of purging may include misuse of laxatives and diuretics. Both can be dangerous and cause irreversible side effects to the GI tract.
How do you approach a loved one?
First I want to say thank you for caring so deeply about your loved one and recognizing the difficult path they are on. Speculating your loved one has an eating disorder is a very hard space to be in because choosing whether or not to say something is a big decision.
It is normal for this conversation to elicit a strong reaction from the individual with the possible eating disorder. Recognize that this defensiveness is not coming from a place of ill-intent, but likely a place of fear, embarrassment, or the eating disorder itself being defensive.
Remaining calm and giving your loved one the opportunity to process next steps with you can be a great first step. Offer to help them find specialized providers and remind them you are a safe person for them to talk to.
I think I have Bulimia Nervosa, What do I do now?
You’re brave for reading this and for looking for guidance. It can be scary, the unknown of what to do next or what the next steps look like. However, you are deserving of a better life and it is possible to recover.
The first step is building your treatment team. Typically a treatment team consists of a therapist, registered dietitian, and physician. You deserve a team of professionals who are specialized in eating disorders, nothing but the best!
Once you have this team together, the hardest step is making the choice to show up to the appointments and trust in your team. Things sometimes can get worse before they get better, but don’t let this scare you. You are stronger than you think, heck, you’ve made it this far!
If you, or someone you care about, has disordered thoughts around food that may indicate a problem, do not hesitate to reach out or schedule a call.