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Bulimia: signs, symptoms and where to get help

Worried a friend or family member is suffering with bulimia? Find out more about this mental illness and how you can help to support them.

Bulimia nervosa symptoms, side-effects and support
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Bulimia nervosa (otherwise known as bulimia) is a serious mental health illness. According to the eating disorder charity Beat, some 1.25 million people in the UK are currently suffering with an eating disorder, with a 2015 study by Hay et al suggesting that 19 per cent of these have bulimia.

But what exactly is bulimia, and how can you help support someone if you suspect they have this illness? We speak to Lynn Crilly, a mental health counsellor and author of Hope With Eating Disorders, about bulimia symptoms, long-term effects and how to support a loved one:

What is bulimia?

Bulimia is an eating disorder characterised by repeated episodes of eating in an out of control way (known as binge eating) and also behaviour intended to cause rapid weight loss including vomiting, purging, fasting or excessive exercising.

‘Bulimia is a binge/purge cycle that provides a release from emotional tension,’ explains Crilly. ‘It’s a way to inflict punishment on the body and it’s normally down to feelings of guilt, self-loathing or inadequacy.’

People with bulimia are often caught in a vicious binge-purge cycle that they feel unable to control.

People with bulimia are often caught in a vicious binge-purge cycle that they feel unable to control. During a binge (which can involve eating a very large amount of food in a short space of time – perhaps an hour or two), the person may not feel that they have any control. According to Beat, they may even feel disconnected from what they are doing.

Following the binge, the person gets flooded with feelings of guilt, shame and self-loathing, which brings on a ‘purge’. This purge often involves making themselves sick, but it can also involve laxative abuse, fasting or extreme exercise.



Who is affected by bulimia?

As with other eating disorders, including anorexia, there is no one stereotypical image of someone who is suffering from bulimia, although according to Beat, it’s a mental illness that typically develops during adolescence and early adulthood. Men as well as women are affected.

Bulimia signs and symptoms

If someone close to you is suffering from bulimia it can be hard to spot the symptoms, as it's common for people to keep their bingeing and purging a secret.

‘Most people with bulimia appear to be at a “normal” weight,’ reveals Crilly, ‘but that doesn’t mean it’s any less serious. This can make it a hard illness to spot, especially as the sufferer will be very secretive about their binges and learn to hide it as best they can.’

Some of the physical and psychological signs and symptoms of bulimia can include:

Bulimia physical symptoms

  • Vomiting
  • Tooth deterioration
  • Bad breath
  • Weight fluctuation - although it often remains ‘normal’
  • Bloating
  • Constipation
  • Callouses on the backs of hands - if fingers are used to induce vomiting
  • Poor skin
  • Swollen hands and feet
  • Sore throat

    Bulimia psychological and behavioural symptoms

    • An obsession with body shape/size
    • Mood swings
    • Irritability
    • Personality change
    • Hoarding food
    • Secrecy around eating and food
    • Disappearing after mealtimes - to purge
    • Anxiety around mealtimes
    • Fear of weight gain


      Bulimia long-term effects

      If a person suffers with bulimia for a long period of time, there may be some irreversible health consequences. ‘Permanent tooth damage and throat damage are two of the most common,’ reveals Crilly.

      A sufferer may also do long-term damage to their stomach, intestines and kidneys, as well as putting more strain on the heart and other organs. Support and early intervention is therefore important.

      Supporting a loved one with bulimia

      As with other eating disorders such as anorexia, Crilly says the most important first step if you suspect a family member or friend is suffering with bulimia is to arm yourself with as much knowledge as possible. ‘Educating yourself as to the nature of the illness is paramount,’ she says.

      If you suspect a family member or friend is suffering with bulimia, arm yourself with as much knowledge as possible.

      When it comes to approaching them, always do it in a non-judgemental way, in an environment that feels safe for them. ‘They may not be ready to open up to you about it, but always let them know you’re there for them whenever they want to talk to you, and always encourage them to seek professional help – this can be from their GP in the first instance,’ says Crilly.



      Bulimia treatment options

      Treatment for bulimia is almost always offered in an outpatient setting, in the form of counselling, therapy and/or self-help groups.

      The aim is to help the sufferer address the underlying thoughts and feelings that lead to the bulimia, such as feelings of anxiety, low self-worth and shame, and then helping them find more healthy ways of managing and dealing with these emotions.

      Therapies that can be useful in treating bulimia include:



        Further bulimia help and support

        There are lots of places you can find additional help, advice and support for people suffering from bulimia:

        • Beat - the UK’s eating disorder charity offers support and advice to sufferers and their loved ones. Beat also runs three helplines: Helpline 0808 801 9677; Youthline 0808 801 0711; Studentline 0808 801 0811.
        • Sane – this leading UK mental health charity runs a daily helpline, which you can call for support and advice: Saneline 0300 304 7000, 4.30pm-10.30pm daily.
        • Young Minds – the UK’s leading charity fighting for children’s and young people’s mental health: Parents’ Helpline 0808 802 5544, 9.30am-4pm, Monday to Friday; YoungMinds Crisis Messenger offers urgent help for young people under 25 – text YM to 85258, available 24/7.
        • Anorexia & Bulimia Care (ABC) – this national UK eating disorders organisation provides emotional support and practical guidance: Helpline 03000 11 12 13, 9.30am-5.30pm Monday to Friday.


          Last updated: 03-12-19

          Dr Juliet McGrattan Dr Juliet McGrattan spent 16 years working as an NHS GP.
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