People who experience bulimia nervosa may be a normal weight and are not necessarily thin. Therefore, it's important to look for signs and symptoms other than physical size when considering bulimia. But what other symptoms of bingeing also occur?

Behavioral symptoms
Bulimia manifests with behavioral symptoms as well as emotional or physical symptoms. However, some behavioral symptoms may be difficult to identify because people experiencing bulimia may hide behavior as much as possible. Symptoms of bulimia which are related behavior include:

• constant dieting
• eating until the point of discomfort or pain
• excessive exercise, even when sick, injured, or very tired
• extreme focus on body shape and weight
• going to the bathroom after eating or during meals to throw up
• having a distorted, excessively negative body image
• hoarding food
• laxative use
• overachieving behaviour
• sense that eating behaviour cannot be controlled
• self-induced vomiting

Emotional symptoms
Additionally, anxiety and depression are often diagnosed with bulimia a person who is bulimic may appear irritable, moody, and may decline to go out with friends.In fact, a range of emotional problems or disorders may accompany bulimia or are a result of bulimia. In addition to feeling the shame and guilt from hiding the binge and purge episodes, people with bulimia also usually experience:

• anxiety
• depression
• substance abuse problems

Physical symptoms
Binge and purge episodes may occur several times per week. The following physical symptoms may be a result of bulimia:

• abnormal bowel functioning
• bloating
• blood vessels that are broken in the eyes (due to throwing up)
• damaged teeth (e.g. clear teeth) and gums
• dehydration
• dry skin
• fatigue
• irregular heartbeat
• menstrual irregularities or loss of menstruation (amenorrhea)
• sores in the throat and mouth
• sores, scars or calluses on the knuckles or hands
• swollen salivary glands in the cheeks

When to seek help
The binge and purge cycle can manifests serious health consequences. Once you notice any symptoms of bulimia or suspect that you or a loved one is experiencing bulimia, you should seek medical help. A doctor's diagnosis is one step closer to getting better. Some of health consequences include:

• chronically inflamed and sore throat
• constipation
• enlarged, swollen lymph nodes in the neck and below the jaw
• gastroesophageal reflux disorder
• intestinal irritation due to excessive use of laxatives
• irregular heartbeats, heart failure, and death from loss of electrolyte imbalances
• (especially due to the loss of potassium)
• kidney problems due to excessive use of diuretics
• pancreatitis
• peptic ulcers
• sensitive, decaying teeth and weakened tooth enamel due to exposure to stomach acids
• severe dehydration from both purging and use of diuretics

Always contact a doctor if you or a loved one exhibits signs of bulimia nervosa. But what does a doctor look for during diagnosis? To learn more about the tests and procedures use during diagnosis of bulimia, and what to expect at a doctor's office, continue reading the section on Diagnosing Bulimia for more bulimia nervosa information.