Bulimic behavior refers to engaging in manners associated with bulimia nervosa. Although an individual who practices bulimic behavior may not be officially diagnosed with bulimia nervosa, it is important to understand this disorder in order to be able to recognize signs and symptoms associated with bulimic behavior.
Bulimia nervosa is a serious emotional eating disorder that involves eating excessive amounts of food in a short period (binging) followed by guilt and shame leading to self-induced vomiting, extreme exercise, or laxative abuse (purging). Many refer to it as a binge and purge eating disorder. Bulimia nervosa is often associated with depression, anxiety and self-harm behaviors such as cutting. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM5), defines bulimia nervosa by the five following criteria:
- Eating excessive amounts of food in a two-hour period (binging) accompanied by feelings of loss of self-control
- Repetitive inappropriate self-induced compensated behaviors such a vomiting, diuretic use, laxative use, and extreme exercise (purging) in order to avoid weight gain potentially causes by the bingeing episodes
- These behaviors occur at least once a week for at least three months in duration
- Body shape and weight are the main influencing factors of this binging and purging behavior
- These behaviors do not occur specifically with anorexia nervosa and these disorders must be completely separated
Binging episodes are characterized by eating a large amount of food in a two-hour period. It is possible for an individual diagnosed with bulimia nervosa to consume as much as 3,400 calories in little more than an hour, and as much as 20,000 calories in eight hours. Dozens of donuts, boxes of cupcakes, multiple bags of chips, ten candy bars and multiple boxes of cookies are some common items that are consumed within this two-hour period. It is common for individuals to binge eat when they are not physically full or eat these large amounts of food until they are uncomfortably full. Individuals with bulimia nervosa usually binge alone and even in hiding out of fear and embarrassment someone may see them. Guilt, shame, depression, and feelings of disgust usually accompany the individual immediately after the binge episode.
Purging episodes are classified as self-induced compensatory behaviors to prevent weight gain after a binge. The purging sub-type of bulimia nervosa is more common and the most common behavior in this subtype includes self-induced vomiting, laxative abuse, and diuretic abuse. The non-purging subtype is less frequent of the two subtypes and is characterized by extreme exercise or fasting in order to compensate for the recent binge-eating episode. Extreme exercise may include exercising for multiple hours at a time or exercising in extreme heat wearing multiple layers of clothing. Diuretics, laxatives, and self-induced vomiting can cause severe electrolyte imbalances in the body creating many potential medical complications.
Are you practicing bulimic behaviors?
The following are common unhealthy behaviors associated with bulimia nervosa:
- Do you eat to the point of being uncomfortably full and making yourself sick?
- Do you worry about controlling how much you eat?
- Have you recently lost more than 14 pounds in a 3-month period?
- Do you feel out of control followed by deep remorse when you eat large amounts of food?
- Do you constantly compare your body shape and image to other women?
- Are you unhappy with your overall appearance?
- Are you constantly trying new diets and weight loss programs?
- Are you experiencing anxiety, depression, infertility, bowel irregularities, fatigue, or heart palpitations?
- Do you believe yourself to be fat while others say you are thin?
- Would you say that food and eating dominate your life?
- Do you consume large amounts of food in one sitting and feel guilty afterward?
- Do you eat in secret or avoid eating in front of other people?
- Have you used vomiting, laxatives, excessive exercise, fasting, diuretics, or other medications to control your weight?
- Have you sought help for mental disorders, emotional trauma, relationship problems or substance abuse from a mental health professional but did not feel comfortable addressing your concerns with your body shape or eating habits?
- Do you feel that your self-worth is determined by your body’s shape and size?
- Are you depressed, anxious, or have a substance abuse problem?
- Do you use feel you use food to hide your emotions?
- Do you feel you cannot control yourself when in the presence of food?