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NEDA TOOLKIT for Parents Signs of Bulimia Nervosa • In general, behaviors and attitudes indicate that weight loss, dieting, and control of food are becoming primary concerns • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics • Appears uncomfortable eating around others • Develops food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch) • Skips meals or takes small portions of food at regular meals • Steals or hoards food in strange places • Drinks excessive amounts of water • Uses excessive amounts of mouthwash, mints, and gum • Hides body with baggy clothes • Maintains excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury, the need to “burn off ” calories • Shows unusual swelling of the cheeks or jaw area • Has calluses on the back of the hands and knuckles from self- induced vomiting • Teeth are discolored, stained • Creates lifestyle schedules or rituals to make time for binge-and-purge sessions • Withdraws from usual friends and activities • Looks bloated from fluid retention • Frequently diets • Shows extreme concern with body weight and shape • Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over ability to stop eating • Purges after a binge (e.g. self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, fasting) • Body weight is typically within the normal weight range; may be overweight Signs of Binge Eating Disorder • Evidence of binge eating, including disappear­ ance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food • Develops food rituals (e.g., eats only a parti­ cular food or food group [e.g., condiments], excessive chewing, doesn’t allow foods to touch) • Steals or hoards food in strange places • Hides body with baggy clothes • Creates lifestyle schedules or rituals to make time for binge sessions • Skips meals or takes small portions of food at regular meals • Has periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full • Does not purge • Engages in sporadic fasting or repetitive dieting • Body weight varies from normal to mild, moderate, or severe obesity Page  | 13