NEDA TOOLKIT for Parents
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
Looks bloated from
fluid retention
Drinks excessive
amounts of water
Frequently diets
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
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
Withdraws from usual
friends and activities
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