What It Really Means When You Have Bulimia Nervosa

Trigger warning: The following article includes language depicting eating disorders.

Society is more open to talking about eating disorders than ever. As younger generations discuss once-taboo topics like mental health and sexuality, they inspire others to feel comfortable sharing their own struggles with disordered eating, via Voxburner. This isn't just an American phenomenon, either since anyone, anywhere, can be affected, and there are events like World Eating Disorders Day to educate people on a global scale.

Disordered eating can present itself in many different ways. Some disorders, like anorexia, have been documented for decades; some — like orthorexia, a fixation on eating "perfectly" — are becoming more frequently observed. One, however, stands out for its complicated nature: bulimia nervosa, or a binge-eating disorder characterized by extreme steps to avoid weight gain, via Mayo Clinic. It may sound fairly straightforward or be mistaken for bad habits that can be overcome by simply "eating less." 

However, since bulimia is linked to a person's self-image, this serious disorder complicates not just mealtime, but all aspects of life. 

Symptoms go beyond binge-eating and purging excess calories

Our understanding of disorders are often formed by how they're represented in the media. Pop culture often depicts bulimia targeting young women after a meal, but the realities are far from what we've seen play out on-screen. While the gist of that image seems true –- people with bulimia may eat to excess, then purge -– the details can vary. 

First, eating disorders can affect anyone, regardless of their weight, appearance, or gender identity. Not only conventionally attractive, thin, teenage girls are affected, regardless of what the stereotype may show, via Women's Media Center. Surveys show that 1.5%  of women and 0.5% of men in the US have experienced bulimia, via American Addictions Center. Another variable is how calories are purged. Even if someone doesn't induce vomiting after eating, they may still exercise to exhaustion, use laxatives or enemas, or abuse dietary supplements in an effort to lose weight. These habits all speak to the core symptoms of bulimia: an intense, overwhelming fear of gaining weight, accompanied by a loss of control while binge-eating.

These cycles of binging and purging can lead to many other symptoms. People with bulimia may experience tooth decay from excess vomiting, facial swelling from damaged salivary glands, hemorrhoids, dry skin, and even pregnancy complications. If bulimia goes untreated, it can wreak havoc on someone's body and can even cause permanent conditions that may be fatal, via Healthline.

Bulimia isn't just disordered eating; it's also a mental health disorder

Eating disorders live in the mind before they affect the body. According to the National Alliance of Mental Illness (NAMI), "eating disorders are caused by people attempting to cope with overwhelming feelings and painful emotions." People with bulimia may start binging for many reasons, such as poor emotional health, abuse, or even the pressures of society. However, they may then feel ashamed or embarrassed by their binge-eating, which will lead them to purge.

A doctor can't diagnose someone with bulimia just off a physical examination. A mental health professional also has to evaluate a patient via criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). A professional may also recognize warning signs that go beyond the physical, such as someone having "food rituals" or fearing eating in public, via NEDA. Bulimia can impact not just a person's eating habits, but also their relationships, self-esteem, and quality of life. 

Regular therapy, rehab centers, and mutual support groups can all help someone with bulimia at any stage of their illness and recovery. Bulimia may be complicated, but with help at individual -– and even societal -– levels, it can be understood and overcome.

If you are struggling with an eating disorder, or know someone who is, help is available. Visit the National Eating Disorders Association website or contact NEDA's Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).