Given the constant barrage of sales pitches for diet pills and “miracle aids” for weight control, it’s no surprise that the prevalence of eating disorders in the United States continues to increase. In a recent entry, I discussed a CNN special that focused on different eating disorders. The interview with Jane Fonda provided a candid account of her personal struggle with bulimia.

According to the National Eating Disorders Association, bulimia nervosa affects approximately 1 to 2 percent of adolescent and young adult women. Just like other eating disorders, bulimia is a psychological disorder, affects mostly women, and is underreported, making it difficult to ascertain how widespread it really is. Unlike anorexia, whose most visible symptom is dangerously low body weight, patients with bulimia often appear to be normal in weight or even moderately overweight, making detection more difficult.

Bulimia is a disease characterized by recurring episodes of binge eating and behaviors to prevent the binges from causing weight gain. The behaviors used to prevent weight gain are characterized as either purging or non-purging. Purging behaviors include, in addition to self-induced vomiting, the abuse of laxatives, diuretics, and other medications. Non-purging behaviors include excessive exercise and fasting. Health risks associated with bulimia are numerous and include dehydration, electrolyte imbalance, gastrointestinal problems, and heart failure.

Because bulimia can be very challenging to identify, I have listed some of its common signs and symptoms here, starting with some of the physical consequences of frequent vomiting:

• Tooth decay, enamel erosion, and ultimately tooth loss
• Scrapes on the backs of the hands in the knuckle area
• Complaints of persistent sore throat and hoarseness
• Sores on or around the mouth
• Bloodshot eyes
• Persistent tooth-brushing, use of mouthwash or breath mints to disguise bad breath
• Need to leave the room immediately after finishing a meal
• Repeated or prolonged use of the bathroom after meals

Like all other eating disorders, bulimia is a psychiatric disorder which requires multidisciplinary treatment that involves medical, mental health, nursing, and nutrition professionals. All eating disorders require professional help. Early detection is essential to improve the chances for successful treatment of this disease.