Symptoms:

In bulimia, eating binges may occur as often as several times a day for many months.

People with bulimia often eat large amounts of high-calorie foods, usually in secret. People can feel a lack of control over their eating during these episodes.

Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

• Forcing oneself to vomit
• Excessive exercise
• Use of laxatives, enemas, or diuretics (water pills)

Purging often brings a sense of relief.

People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder.

Symptoms can include:

• Compulsive exercise
• Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics
• Regularly going to the bathroom right after meals
• Suddenly eating large amounts of food or buying large amounts of food that disappear right away

Signs and tests:

A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit.

A physical examination may also show:

• Broken blood vessels in the eyes (from the strain of vomiting)
• Dry mouth
• Pouch-like look to the corners of the mouth due to swollen salivary glands
• Rashes and pimples
• Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit

A chem-20 test may show an electrolyte imbalance (such as hypokalemia) or dehydration.