Binging, or overeating, helps a bulimic person to calm themselves. It may help them feel less angry, unhappy, or lonely. When binging, the person may consume thousands of calories. Purging helps a bulimic person to feel more in control of their body. It may be the way that the person overcomes feelings of helplessness and self-loathing. Bulimia is a cycle that is based on a person’s emotional responses, rather than rational reactions. Simply knowing that the behavior is out of control isn’t sufficient to change it.
Signs of binging include finding piles of empty high-caloric food wrappers, having food disappear from shelves and refrigerators, and hidden stashes of junk food or sweets. Some people who binge may eat normally when around others. They may even appear to eat somewhat less, or say that they’re dieting. Abnormal eating behaviors may not be easy to notice if the person with bulimia is hiding their behavior.
The person with bulimia may use mouthwash, breath mints, or cologne to hide the smell of vomit. Running the sink may be used to cover the sound of vomiting. You may also notice packages of diuretics or laxatives. These are both used for purging.
Because exercise is usually considered “good” and healthy, this may be difficult to understand as a sign of bulimia. However, over-exercising in this way can be as damaging to a person’s health as any other method of purging. If a person is increasingly socially isolated from their friends by their exercise, this might be a sign of using exercise to purge. They may skip work or school in order to exercise; prioritize working out over family, a social life, their own health and safety; feel guilt or anxiety when they’re not working out; and exercising alone to avoid attention or notice from others. If your friend shows these signs of compulsive exercise, they may also suffer from an exercise addiction.
They may use excuses to avoid eating with others, such as saying that they’re not hungry, have already eaten, or that they’re not feeling well. When they do eat, they may be very anxious about what people think of their food intake. They may become increasingly self-conscious.
Someone with bulimia may see themselves as being quite overweight even if they’re not. Look for yellowing teeth (a sign of purging) as stomach acid affects the tooth enamel. [7] X Research source
Physical signs that are less visible to the observer include anemia, muscle weakness, and muscle thinning. People with bulimia may also experience severe constipation. Osteopenia or osteoporosis (thinning of the bones) is commonly associated with bulimia.
Share your memories of specific incidents that resulted in your concern. Present your concerns in a nonjudgmental tone, and listen to anything your friend may say with openness and respect. Prepare to have multiple conversations. Because there is so much shame associated with eating disorders, it’s unlikely that your friend will admit their problem right away.
Remind them that you’re concerned about their health. Avoid giving compliments or criticism about the person’s appearance. No matter how well-intentioned, this only triggers negative responses in a person who has an eating disorder. Do your best to spend time together with your friend and listen to their struggles, without actually offering judgment or advice.
Never force a friend to seek help. The decision must come from the person with the eating disorder. Your role is only to encourage them. Remember that bulimia is essentially a person’s emotional response to feeling out of control. If your friend doesn’t want to seek help, ask if she’ll consider getting a regular physical just to rule out immediate medical concerns. Let them know that a dietitian or counselor trained in eating disorders can be a really good support to help them navigate the medical system and start getting professional help.
Getting into power struggles over food is usually a bad outcome. Focus on what your friend might be going through emotionally. Talk to them about the connection between eating and stress, for example. You might say, “I notice that you seem to spend more time alone when you’re stressed. What’s causing you to feel stressed?”
If there is a support group for friends and family of people with eating disorders, see if it helps you. Talking with someone who has recovered from their own eating disorder might help you learn more about the condition. A counselor may be able to help you better understand what you can do to help your friend, and what your friend must do for themselves.
Your friend needs your hope, encouragement, and kindness. Provide these in abundance! Remember that their eating disorder is not about you or your friendship.
Family therapy is also recommended in order to address the impact the eating disorder may have on the whole family. The goal of treatment for bulimia is to address the physical as well as the psychological aspects of the condition. Learning to have a healthier relationship with food and ways to better address stress and adversity are all part of treatment for bulimia.
Find time in your day for relaxation, meditation, and doing things you enjoy. If you aren’t able to take care of yourself, you won’t be of use to your friend. If you find that you’re having difficulty managing to care for yourself, consider taking some time apart.
