Bulimia nervosa is characterized by repeated cycles of out-of-control eating followed by some form of purging, like vomiting. People with bulimia may also compulsively exercise, or fast or use certain medications, such as laxatives and diuretics, to keep from gaining weight. However, it is not always easy to recognize bulimia by looking at someone's appearance. Although rapid weight gains and losses are common, bulimics tend to be of average or slightly above average weight. They often suffer from low self-esteem and depression and have difficulty expressing their emotions. There may be some family and biological causes of bulimia.

If left untreated, bulimia can cause serious health problems, such as tears in the esophagus (from constant vomiting), erosion of tooth enamel, gastritis and dehydration. In severe cases, bulimia can lead to death.

Symptoms of bulimia:

• Vomiting, use of laxatives, diuretics, enemas, syrup of ipecac or diet pills
• Binge eating
• Frequent weight fluctuations
• Menstrual irregularities
• Swollen parotid glands (in front of the ear)
• Dieting followed by binges
• Inability to voluntarily stop eating
• Feeling guilty or ashamed about eating
• Feeling out of control
• Excessive concern about weight
• Frequent use of the bathroom after meals
• Depressive moods
• Overeating in reaction to emotional stress
• Secretive eating
• Preoccupation with food and body image

If you think you or someone you know might have bulimia, don't wait for the problem to go away by itself. Get help now.

When you need someone to talk to,  tun to Belmont Behavioral Health at 1-800-220-HELP or (215) 877-2000.