The main signs of bulimia are binge eating and purging (ridding your body of food by making yourself vomit or taking laxatives).

There may also be psychological symptoms, such as:

an obsessive attitude towards food and eating

unrealistic opinions about body weight and shape

depression and anxiety

isolation – losing interest in other people

Without treatment, bulimia can lead to a number of physical complications. Read more about complications of bulimia.

Binge eating

Binge eating is repeatedly eating vast quantities of high-calorie food, without necessarily feeling hungry or needing to eat. The urge to eat can begin as an attempt to deal with emotional problems, but can quickly become obsessive and out of control.

Binge eating is usually a very quick process and you may feel physically uncomfortable afterwards. When binge eating is a symptom of bulimia, it happens regularly, not just once or twice.

Binge eating episodes are sometimes spontaneous, where you eat anything you can find. They can also be planned, where you make a shopping trip to buy foods specifically to binge on.

Read more information about binge eating.

Purging

Purging is a response to binging. After you have eaten lots of food in a short space of time, you may feel physically bloated and unattractive. You may also feel guilty, regretful and full of self-hatred.

However, the main impulse to purge is a powerful, overriding fear of putting on weight.

The most common methods of purging involve making yourself vomit or using laxatives to encourage your body to pass the food quickly.

Less common methods of purging include taking diet pills, over-exercising, extreme dieting, periods of starvation or taking illegal drugs, such as amphetamines.

Cycle of guilt

Bulimia is often a vicious circle. If you have the condition, it is likely that you have very low self-esteem. You may also think you are overweight, even though you may be at or near a normal weight for your height and build.

This may encourage you to set yourself strict rules about dieting, eating or exercising, which are very hard to maintain. If you fail to keep to these strict rules, you binge on the things that you have denied yourself. After feeling guilty about binging, you purge to get rid of the calories.