What is Bulimia?

Like anorexia nervosa, bulimia nervosa is an eating disorder. But unlike anorexia, a person who has bulimia eats a lot of food in a very short period of time, called binging, and then tries to get rid of the food by purging to keep themselves from gaining weight.

Purging is done in one of two ways. The person can either make himself throw up after eating a large quantity of food, or take laxatives or other drugs to help speed up their bowel movement so that the food they ate will not be absorbed by the large and small intestine. Other drugs are sometimes used to speed up the metabolism to an unhealthy rate as a way to burn calories.

Like anorexia, bulimia affects mostly women and young girls. But approximately 10% of all people with bulimia are male. People who are bulimic can become very adept at hiding their disease from friends and family members. In fact, they may go to great measures not only to lose weight but to hide how they are losing weight.

Many, but not all, people who are anorexic are also bulimic. However, the main difference between anorexia and bulimia is that people with anorexia avoid all high-calorie foods and are obsessed with exercise. It is a struggle for them to put food into their mouths and they view it almost as a poison.

A person with bulimia will eat high-calorie foods and in large quantities. But instead of letting the body digest the food, they will immediate throw up or take laxatives so the body does not absorb any of the food. They do this in the hopes that they will not gain weight.

It is sometimes harder to diagnose a person with bulimia because they don't always lose as much weight as the person who is anorexic. In fact, a person who is bulimic isn't necessarily too thin at all, making it difficult for people around that person to suspect that there is even a problem.

Unlike a person with anorexia, who uses food as a means of control, someone who is suffering from bulimia is more likely to feel they are not in control of their behavior. Because of this they are more likely to admit there is a problem and seek help for it.

To further complicate a diagnosis of bulimia, only about half of the women who suffer from bulimia will have irregular menstrual cycles, one of the symptoms a doctor will use as a gauge for whether a person has an eating disorder. Nearly all women with anorexia will exhibit interruption in their menstrual cycle.

Because people with bulimia regularly vomit to purge their food, they will have a foul smell to their breath and often times will cover it up with mints or excessive brushing of their teeth. However, even with this, the acid from their stomach will make their breath foul. To combat this, a person with bulimia will make frequent trips to brush their teeth or rinse their mouth with mouthwash and consciously make time for this ritual as part of their normal day.

On a psychological level, people with bulimia are like people with anorexia in that many times they'd rather die than gain weight and be fat. But because their body image is so poor, they might wear baggy clothes and keep from looking into mirrors at all costs to avoid looking at themselves.

Another problem associated with bulimia is tooth decay and gum disease. Because vomit is acidic, acid exposure to the gums and teeth on a daily basis will cause decay. A doctor will take all this and more into consideration when diagnosing bulimia.

"I was cursed with big hips," Carol, a woman who was bulimic in her teens, said. "I was fine when I was in junior high school, but when I hit high school my body changed so much that I didn't know what happened to me. Since I'm adopted, I couldn't go to my mother and say, 'where did these hips come from?' and I'm not sure it would have mattered if she'd had an answer for me."

Carol, like many teenage girls who go through puberty quickly, detested her body when it started to develop.

"I hated my body. I mean, who wants great birthing hips when you're 14? I sure didn't. All I knew is that I'd gone from a size 4 to a size 12 in what felt like overnight. I was into sports so it wasn't like I was sitting on the couch all day when I wasn't in school. I was active. But because I was active in sports, I was always eating on the run.”

Carol, like many girls with bulimia, started to vomit to get rid of the food she ate as a way to keep her weight down. "I got really good at running to the girl's room between classes. It got so that I didn't even have to stick my fingers down my throat to throw up. All I had to do was lean over the toilet and it came up."

What finally made Carol see her doctor wasn't her bulimia at all. "To be in sports you needed to have a physical exam. My stomach had been giving me some grief and I told the doctor. He ordered a bunch of tests, which showed my potassium level was low, putting me at risk for having a massive heart attack. One thing led to another and he told me point blank that I had to go into treatment for bulimia or I could die."

Luckily for Carol, that and the threat of being pulled from sports was enough to scare her into going into treatment. But the effects of the bulimia on her body were long-lasting.

"I still have trouble with my intestines and I have scarring in my esophagus from all the vomiting I did for the years I was bulimic. It sometimes makes it hard to eat because food will feel like it is getting stuck in my throat."