Bulimia nervosa is characterised by repeated episodes of binge-eating followed by behaviour aimed at compensating for the out of control eating. These compensatory behaviours can include fasting, self-induced vomiting, the use of laxatives and diuretics or appetite suppressants and excessive exercising.

In many cases, bulimia begins with a diet but the preoccupation with food and weight becomes obsessive and can take over the person's life. Eventually, they will become locked into a compulsive cycle of bingeing and purging (getting rid of the food) or resorting to other ways of preventing weight gain. Attempts to break the cycle often fail. The person begins to feel more and more out of control. Self-esteem is very low as it is measured against the ability to control one's eating, weight, shape and size. On the outside, a person with bulimia may seem very capable, positive, successful and on top of things. However, on the inside, they may be struggling desperately with feelings of guilt, shame, self-loathing and ineffectiveness.

For some people, bulimia develops after a period of anorexia. In such cases, diagnosis is not always clear-cut and treatment can be more complex.

Many people with bulimia maintain a normal body weight. As a result, the disorder can sometimes go unnoticed and untreated for a long time. The longer the binge-purge cycle remains in place, the harder it becomes to overcome it.

Other Signs & Symptoms

Physical signs and symptoms: