Bulimia is characterized by two main behaviors- binging and purging. Purging is an attempt to rid the body of calories. Many people associate vomiting with bulimia, and in fact this is one of the more common forms that purging can take. Those who purge through vomiting often do it immediately after a binge, but sometimes a significant amount of time can lapse between binging and purging.
What many people don’t know is that purging can also take other forms - some people may exercise excessively, fast for a period of time, or take diuretics or laxatives. For some people purging may feel like a “necessary evil” in order to relieve guilt about binging, but others find the sense of relief and emptiness that they gain from purging a motivation in itself.
Another part of the diagnosis is that a person’s “self-evaluation is unduly influenced by body shape and weight”. For someone with any eating disorder, weight gain is associated with a terrible spiral of guilt, shame, and unworthiness. It can be difficult to understand from the outside why somebody would be so preoccupied with their body shape and size, but it is enough to know that your partner’s weight likely symbolizes much more to them. A person must also be able to maintain a minimum healthy weight in order to qualify for the bulimia diagnosis (although the person may not see their weight as healthy), or else anorexia, binge-purge type, would be a more appropriate label. According to the National Association of Anorexia Nervosa and Associated Disorders, 1.5% of American women will suffer from bulimia at some point in their lifetimes.
Common Behaviors Associated with Purging/Bulimia:
- Anger, irritability and/or anxiety if unable to purge after binging
- Excusing oneself to the bathroom immediately after eating
- Running the shower or faucet while in the bathroom
- Spending an unusual amount of time in the bathroom
- Returning with watery, red eyes after suspected purging
- Spending hours at the gym
- Exercising even when injured
- Fasting or dieting in order to compensate for food eaten
- Hiding boxes of laxatives, diuretics, or enemas
- Obsessing over weight, body shape or size