By Stephanie Elliot

This is part three of a five-part series exploring eating disorders.

Part 1: What is an eating disorder?

Part 2: What is anorexia nervosa?

Part 3: What is bulimia?

Part 4: What is binge eating?

Part 5: What is ARFID?

Bulimia is another type of an eating disorder we will be exploring in this five-part series. Bulimia involves binge-eating followed by self-induced vomiting, severe fasting, or extensive exercising. Bulimics use these tactics in order to rid themselves of the food that they have binged. There is a strong feeling of a loss of control when it comes to bulimia. Once a person binges and realizes what she has done, guilt and shame set in from having eaten large amounts of food. In order to ‘regain’ control, bulimics will purge themselves of the foods eaten.

When we’re talking about bulimia, there are two types: those who purge or vomit, and those who do not. For those who purge, they may induce vomiting or use laxatives or diuretics to relieve themselves of the food they have eaten. Those who do not vomit may binge and, instead of purging, they will often fast for long periods of time or exercise as a way to lose the calories they have consumed. Some exercise extensively and to the point of exhaustion, and almost always feel the need to do so immediately after eating.

Bulimia, like all other types of eating disorders, is psychological and is considered a mental health issue. While there is no known cause, someone can be affected by bulimia because of the environment or genetics. It can also be a cultural issue as well. A person affected by bulimia may have low self-esteem and poor body image, and sometimes it is sparked through a difficult life change, abuse, or trauma.

It’s not necessarily true that bulimics are all very thin and that it can be detected just by looking at a person, but there are some signs to look for if you think someone you love might have bulimia. Oral hygiene is usually compromised from constant vomiting, and sometimes, there may be scratches on a person’s fingers from self-purging. Some bulimics may have blood-shot eyes from the trauma of vomiting. Weight can fluctuate, and there may be intestinal problems as well.

Other signs that someone may be bulimic is when large amounts of food ‘suddenly’ disappear, secret eating, or eating large proportions in an uncontrollable manner. If you notice that she excuses herself to use the bathroom after every meal, and if you can smell vomit, there is probably a problem.

Bulimia is a serious eating disorder that can be life-threatening. If you think you know someone who might be suffering, please seek help. You can learn more about bulimia at NEDA, National Eating Disorder Association. Their helpline (800-931-2237) is also available Monday-Thursday from 9 a.m. to 9 p.m. ET, and Friday from 9 a.m. to 5 p.m. ET.