Eight signs to tell if someone you know is bulimic

Finding out if someone you know is bulimic can be quite tricky. Chances are they are really skilled at hiding their eating disorder to other people. Learning the signs to spot their struggles as early as possible is vital to help them.

Those who develop bulimia nervosa, typically deal with it in secret. They are constantly haunted by their negative emotions, which they often fail to control. This suffering puts them under so much stress they repeatedly fall into the vicious “binge and purge” cycle.

However, the majority of those who get the courage to seek treatment will eventually reach full recovery in due time. Lending a hand to a friend or relative dealing with bulimia can change their lives. Your help could be the only thing they’re desperately looking for.

If someone you care about is fighting against this problem, you should seek medical help right away. The longer it goes on, the worse the psychological and physical consequences will be.

In this article, we will tell you how to recognize the signs of this subtle eating disorder.


What is bulimia nervosa?

Bulimia nervosa is an eating disorder characterized by repeated episodes of overeating (binges) followed by compensatory purges. Purging is used to prevent weight gain and usually takes the form of self-induced vomiting or defecation through the use of laxatives.

Eating binges can be frequent, and the binge-purging cycles can last for weeks or months. More than anything else, people who deal with bulimia fear to gain weight. They desperately want to lose it by any means necessary.

Many bulimic patients must also deal with body dysmorphia, meaning that they have a distorted ability to perceive their bodies. Even when they’re severely underweight, they keep seeing themselves as being “fat.”

Bulimia nervosa affects about 0.6% of adult population in the United States. However, this percentage is almost three-fold higher in women. In addition to that, a remarkable number of teenagers show possible signs of potential eating disorders.

Bulimia can be very dangerous since it is associated with many other medical conditions. These include osteoporosis, cardiovascular and gastrointestinal disorders, and other adverse health outcomes.

Those who live with bulimia put their bodies and lives at risk. Vomiting and medications such as laxatives and diuretics may cause dehydration and electrolyte imbalances. Long-term consequences may include permanent digestive system damage, life-threatening irregular heartbeat and kidney failure.

What are the differences between anorexia and bulimia?

Both anorexia nervosa and bulimia nervosa are both common eating disorders among the American people. However, there are a few key differences to tell if a friend or a loved one suffers from one condition or the other.

The anorexic patient focuses on losing weight at all costs, even resorting to starvation if necessary. He or she will mostly skip meals, obsess over calorie counting, and adopt many strange eating rituals to avoid food entirely.

An anorexic individual will take extreme solutions to lose weight. These include highly restrictive diets or refusing any social contact with other people to avoid being observed during starvation periods.

The life of a bulimic patient, instead, is characterized by constant cycles of binge followed by purging. The purging aspect is central and is not present in anorexia.

Bulimics tend to be very secretive when eating and will try to avoid being watched during meals. Most of them will be within normal weight limits and will hide their condition in every way possible.

Here are a few hints to detect if someone you know is dealing with bulimia:

Food Disappears

People who deal with bulimia might often go through large amounts of food very quickly, especially highly caloric or junk food. They may consume up to 5,000 calories in one day!

Before guilt forces them to purge themselves, you may notice that large quantities of food suddenly disappear. However, there’s a chance you’re not around when binges occur because of the secretiveness of bulimic persons.

frozen food

In particular, if he or she is usually obsessed with healthy eating, look out for packages of junk food in the garbage or recycling bin. This apparently odd behavior may constitute evidence of a possible eating disorder.

Overuse Of Medications

Bulimic patients often make abuse of purgatives, diuretics and laxatives to shed the excess calories. Although this method is largely ineffective, look out for wrappers or packages of these medications, enemas, diet pills and appetite reducers.

Strange behaviors after meals

Purging often occurs by vomiting just right after a meal to prevent calories absorption. Frequent trips to the bathroom or disappearing for too long after meals can be a sign that they’re purging themselves.

The smarter ones may use showers or running water to cover the strange sounds they make in the bathroom. Keep an eye for clogged drains or sinks. They may have used them to purge instead of the toilet.

Physical Signs

If someone is inducing vomiting, stomach acid will come up with the food, causing tissue damage, inflammation and irritation. Frequent exposure to acid can damage the patient’s hands, teeth, nails, lips and cheeks. The strain can also be so hard that blood vessels in their eyes burst, causing redness.

Here is a short list of physical symptoms you can quickly spot:

  • Red or bloodshot eyes
  • Swollen cheeks and jaw
  • Cracked, dry lips
  • Inflamed mouth
  • Bleeding gums
  • Discolored teeth
  • Scarred or calloused hands
  • Scraped knuckles
  • Damaged nails

Obsession with diets and exercise

Many teenagers are constantly concerned about their physical appearance. However, when this preoccupation turns into obsession, it can be a sign of a hidden eating disorder. Beware of any indication of a potential fixation with body shape or weight, diet plans, physical exercise or quick ways to “burn off” calories.

You should be concerned when physical activity goes beyond some healthy exercise program. For example, a bulimic person may keep exercising despite bad weather, injuries, illness or fatigue as a form of purging.

Whenever their diet or exercise plan cannot be followed strictly (such as during holidays), the subject can become anxious, upset or even angry.

Odd Eating Habits

Keep an eye out for strange or weird eating habits. Bulimic individuals often get obsessed with food as much as they’re obsessed with weight. They can be, for example, too interested in cooking although they never eat the meals they make.

Eating becomes some sort of ritual that must be properly scheduled to make time for the binge-purging sessions. Keeping track of the calories is of the utmost importance. A person affected by bulimia might prefer to make his or her own “safer” meal alone instead of eating with the family.

Whenever a situation cannot be controlled, such as when a restaurant doesn’t offer the food they planned to order, they can become exaggeratedly upset. Strange rituals such as eating dishes in a certain order, or cutting food into small pieces, might help them control their negative emotions.

Unusual smell of vomit

Most purges occur by inducing vomiting. Puke smell is difficult to mask, and you may easily notice it. Even after multiple flushes or by using potent hair fresheners to get rid of it, the bathroom will still keep smelling of vomit.

Patients who kept hiding their habit for a long time, often cannot wash that smell away. It will stick to everything they touch, especially their clothes. If you notice this foul odor while doing laundry, it might be a powerful warning sign. Excessive use of minty breath fresheners should also ring an alarm.

Bad mood and withdrawal

Mood swings are normal even in healthy teenagers, but if your son or daughter is always in a bad mood, something may be wrong.

Keep an eye out for any sign of social withdrawal. Adults and teenagers who deal with an eating disorder may feel guilty, irritable and might hate their bodies. They may find hard to make physical contact (or even just eye contact) with other people and will slowly isolate themselves.


Bulimia nervosa is a serious mental condition that should never be underestimated. Because of its secretive nature, it may be hard to detect the warning symptoms. Getting your friend or relative to admit they have a problem can be even more challenging.

Talking about what they’re going through can be very complicated, especially if their problem was kept secret for a long time. However, even if this process can be stressful, the pain of living with bulimia without anyone knowing can be much more painful.

Don’t take all this burden on your shoulders. Tell them to seek professional help. Talking with a psychologist or doctor can finally help them learn to eat normally again, and finally regain their health.

About the author:

Dr. Claudio Butticè, Pharm.D., is a former Pharmacy Director who worked for several large public hospitals in Southern Italy, as well as for the humanitarian NGO Emergency. He is now an accomplished book author who has written on topics such as medicine, technology, world poverty, human rights, and science for publishers such as SAGE Publishing, Bloomsbury Publishing, and Mission Bell Media. His latest books are “Universal Health Care” (2019) and “What You Need to Know about Headaches” (2022). A data analyst and freelance journalist as well, many of his articles have been published in magazines such as Cracked, The Elephant, Digital Journal, The Ring of Fire, and Business Insider. Dr. Butticè also published pharmacology and psychology papers on several clinical journals, and works as a medical consultant and advisor for many companies across the globe.


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