Signs of Bulimia

Some of the more common signs of bulimia nervosa are:

Behavioural signs

If someone is developing bulimia, often changes in behaviour are noticeable before changes to physical appearance. Signs include:

  • Either frequently checking body shape or weight or avoiding looking at their body or checking their weight.
  • Comparing their body with those of others
  • Eating large amounts of food (bingeing)
  • Purging after bingeing by vomiting, over-exercising, using laxatives or diuretics, fasting
  • Organising life around shopping, eating and purging behaviour
  • Secrecy, especially about eating
  • Hoarding food
  • Mood swings
  • Irritability
  • Social withdrawal
  • Misuse of laxatives and diuretics 
  • Misuse of alcohol
  • Self-harm
  • Compromise of education and employment plans
  • Disappearing during or soon after eating (in order to purge)
  • Excessive exercising 
  • Lack of sexual interest

Psychological signs

  • Spending a lot or most of their time thinking about food
  • Feeling anxious and tense, especially around meal times or when eating in front of others
  • Difficulty concentrating
  • Low confidence and self-esteem
  • Worries about weight and shape
  • Fear of gaining weight
  • Distorted perception of body shape or weight
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after bingeing and purging 
  • Other mental illnesses, such as depression or anxiety

Physical signs

  • Vomiting
  • Difficulty sleeping
  • Tiredness
  • Bloating
  • Constipation
  • Stomach pain
  • Swelling of the hands and feet
  • Poor skin condition
  • Damage to teeth
  • Irregular or stopped periods
  • Swollen salivary glands
  • Calluses on the backs of the hands if fingers are used to cause vomiting 
  • Imbalance in electrolytes (essential substances found in the blood)
  • Stomach problems 
  • Blood sugar swings, potentially leading to mood swings and fainting
  • Regular changes in weight, which may go up or down, though often remains “normal”, making bulimia harder to spot

Long term effects of bulimia

Bulimia can cause serious damage to the body. Long-term effects of bulimia include:

  • Permanent damage to teeth
  • Damage to the vocal chords and throat
  • Damage to the intestines and stomach
  • Increased risk of heart problems
  • Kidney damage

If left untreated, bulimia nervosa can cause long-term harm to the body and may even be fatal. However, many physical effects of bulimia are reversible or can be prevented from worsening with the right treatment, and eating disorders are treatable, with full recovery possible.

Last reviewed: December 2020  Next review date: December 2023 Version 2.0 Sources used to create this information are available by contacting Beat. We welcome your feedback on our information resources.