Bulimia

Bulimia can drive feelings of guilt or anxiety around food which can affect someone's day to day mental wellbeing. It can also trigger other mental health problems such as depression, social withdrawal and self-harm. Signs of bulimia can be hard to spot as people can sometimes try to hide their symptoms.

Other than the signs mentioned already, disappearing after eating, mood changes, missing meals, fear of putting on weight, and feeling out of control around food, could all be signs of an eating disorder. People can also develop teeth problems or sores on their knuckles from inducing vomiting.

Bulimia can cause other physical symptoms of dry skin, bloating or swelling, stomach pain, constipation, dizziness, or fainting. If left untreated bulimia can lead to health problems such as anaemia and a lowered immune system. Heart problems or other organ problems are a risk due to electrolyte imbalances from the induced vomiting, which can be life-threatening. Electrolytes are types of salts in your body that are needed within specific ranges for your body to function.

Bulimia can start at any age and in any gender. It's more common in teenage girls although the amount of males suffering from bulimia is increasing. There is no exact cause for bulimia however it is thought to be a combination of genetic, societal and psychological factors meaning it is neither nature nor nurture but a combination of these together.

You are at a higher risk of developing bulimia if you live in a Western society, if a family member suffers from an eating disorder or is a frequent dieter, if you have low self-esteem or have had negative comments about your body weight or shape growing up, if you have suffered childhood trauma or if you started your periods at a young age.

There's an increased risk of developing an eating disorder if you are a competitive athlete in sports that have an emphasis on body shape or weight, such as dancing or gymnastics.

Many people do not seek treatment for bulimia; however, it is important to seek help and support as soon as you feel able to, as early intervention can improve recovery and give you a better quality of life. Treatment for bulimia is three-fold, it is about breaking the binge and restrict or purge cycle through eating regular meals and also supporting and treating the psychological side around the challenge and fears of eating regularly and any factors that may have led to the bulimia starting.

Finally, it is about making sure your physical health is ok (such are your heart and your vitamin and mineral levels).

Help can come in the form of talking therapies such as CBT (cognitive behavioural therapy) which can be online or in-person with a trained therapist, family therapy (for people under 18), and help from a nutritionist. Your doctor can help organise the support and also make sure that your physical health is ok.

It is important to seek help early and book to see your doctor when you notice any signs or symptoms that could be related to bulimia or any other eating disorder. If you already have a diagnosis then you should see your doctor if your symptoms get worse or if they are not improving. If you start to feel dizzy or faint or have palpitations (when you can feel your heart beating in your chest) call NHS 111 or book an urgent on-the-day doctor's appointment. In the event of someone collapsing call 999 immediately.

The doctor will ask you about your symptoms and when they started. They will also ask you other questions about eating, exercise, body image, your mental health and your periods if you are female and comfortable discussing this. Your doctor will not judge anything you say and keep what you tell them confidential (unless it is information where you or someone else may be in immediate danger, in which case the doctor would discuss this with you first).

They will also ask about your past medical history, any relevant family history and any medication or drug use. They will do baseline health examinations such as checking your heart rate, blood pressure, and your weight and height. They will also take blood tests and discuss with you the next steps and the right support and treatment for you. This may include a referral to a specialist eating disorder team for further support.