Signs and symptoms of bulimia
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Signs and Symptoms of Bulimia
Physical Signs of Bulimia
Oral Health Issues
Bulimia nervosa often presents with several distinct oral health issues. Common signs include dental enamel erosion, which is caused by the frequent exposure of teeth to stomach acid due to vomiting2 4 8. Other oral symptoms include salivary gland enlargement, xerostomia (dry mouth), oral mucosal erythema, and cheilosis (cracking at the corners of the mouth)2 4 9. These symptoms can develop within six months of the onset of bulimia and are critical for early detection by dental professionals8.
Hand and Skin Changes
Physical examination may reveal ulceration or scarring on the dorsum of the hand, known as "Russell's sign," which results from self-induced vomiting1. Dermatologic complaints such as edema and bloating are also noted7.
Gastrointestinal and Systemic Symptoms
Patients with bulimia may experience gastrointestinal complaints, including abdominal pain and bloating5 7. Laboratory tests often reveal fluid and electrolyte abnormalities, particularly hypokalemic alkalosis, and elevated serum amylase levels1. Rare but severe complications include myopathies from misuse of ipecac, ruptured esophagus, and pneumomediastinum associated with vomiting1.
Psychological and Behavioral Symptoms
Binge Eating and Compensatory Behaviors
Bulimia nervosa is characterized by episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, laxative abuse, or excessive exercise3 5 6. These behaviors are often secretive and accompanied by feelings of guilt and shame, making the disorder difficult to detect5 6.
Preoccupation with Weight and Shape
A central psychological symptom of bulimia is an intense fear of weight gain and an overvaluation of weight and body shape3 6 7. This preoccupation often drives the cycle of binge eating and purging behaviors.
Anxiety and Depression
Bulimia frequently co-occurs with symptoms of anxiety and depression. Sensitivity to physical sensations, such as changes in appetite and feeling dizzy, can act as bridge symptoms linking bulimia with anxiety and depressive disorders3. Addressing these psychological symptoms is crucial for effective treatment.
Conclusion
Bulimia nervosa manifests through a combination of physical, psychological, and behavioral symptoms. Key physical signs include dental erosion, salivary gland enlargement, and electrolyte imbalances, while psychological symptoms often involve a preoccupation with weight and co-occurring anxiety and depression. Early detection and comprehensive treatment addressing both the physical and psychological aspects of the disorder are essential for effective management.
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Medical complications and medical management of bulimia.
Bulimia can cause serious psychological and physical complications, and medical management is essential for effective treatment.
Highly CitedOral signs and symptoms in the diagnosis of bulimia.
Oral signs and symptoms of bulimia, such as enamel erosion, salivary gland enlargement, xerostomia, oral mucosal erythema, and cheilosis, can facilitate an earlier diagnosis and help eliminate unnecessary laboratory tests.
The Core Symptoms of Bulimia Nervosa, Anxiety, and Depression: A Network Analysis
Fear of weight gain is central to bulimia nervosa psychopathology, and interventions focusing on exposure to physical sensations may address both bulimia and co-occurring anxiety and depressive symptoms.
Observational StudyHighly CitedOral profiles of bulimic women: Diagnosis and management. What is the evidence?
Bulimic women experience various oral complications, including dental caries, tooth erosion, and dental pain, but early detection by dentists and physicians is crucial for preventing harmful effects of frequent vomiting on oral/dental tissues.
Systematic ReviewBulimia: the secretive syndrome.
Bulimia is a common, secretive disorder in teenage and young adult women, characterized by binge-eating episodes followed by vomiting, abdominal pain, laxative use, or sleep, and is associated with food preoccupation and mild weight fluctuations.
Case ReportHighly CitedBulimia: Symptoms and Syndromes in an Urban Population
The prevalence of bulimia in urban populations is closer to 1–2% when using new DSM criteria, aligning with clinical experience.
Observational StudyBulimia: diagnostic clues.
Bulimia can be identified by examining preoccupation with weight, gastrointestinal complaints, dental and oropharyngeal changes, salivary gland enlargement, edema and bloating, amenorrhea, dermatologic complaints, substance abuse, laboratory changes, and serious consequences.
Case ReportDental aspects of bulimia nervosa: Implications for the health care team
Involving the dental profession in early identification of bulimia nervosa cases can improve patient outcomes and help identify early warning signs for specialist referral.
Literature ReviewOral symptoms in bulimia nervosa. A survey of 34 cases.
Bulimia nervosa is associated with a high frequency of oral symptoms, including hypersensitive teeth, tooth pain, and increased caries rate, as well as dry mouth or dry eyes.
The prevalence of bulimia among college students.
4 percent of college women and 0.4 percent of men were diagnosed with bulimia, with symptoms like binge eating, purging, and extreme fear of gaining weight being more prevalent.
Observational StudyHighly Cited