By Dr Irina Webster

People with bulimia are very secretive about their disorder. For this reason it is very difficult to notice anything as an observer. Bulimics look normal to other people. Even close family members initially have difficulty seeing what is going on with the person.

But you can observe some specific bulimic features if you know what to look for. These features are very subtle but are visible once you realize they are there. Surprisingly, being extremely thin and underweight is not common for bulimia sufferers, even though people with bulimia are concerned about being fat.

Bulimics usually are about normal weight or even can be slightly overweight; some can be thin too. But when you closely observe their behavior and know what to look for you can notice increased anxiety close to meal times.

Some sufferers can be reluctant to share their meal times with others. They will do things like refusing to go out to a restaurant or a family dinner. Some may refuse to sit at the table to eat while munching something on the run.

If they do go out for a meal, they may disappear to the bathroom straight after eating and stay away for a long period of time. Sometimes when they eat with others they only eat very small amounts of food, drink lots of water, separate the food on their plate and make strange choices and combinations of food.

Looking at their hands you may notice damaged knuckles from inducing vomiting, although this sign can take some time to develop. Discoloration of the skin on the outer surface of hands can also be noticed on bulimics.

Their face may appear to be puffy with small broken blood vessels under the skin. This is because the salivary glands increase in size making their cheeks look bigger especially below the area of the ears.

Dry lips and small ulcers on the lips or around the mouth are common in periods of extreme vomiting and look like cold sores.

People who use laxatives and diuretics will have extremely frequent visits to the bathroom. In these cases signs of dehydration can be noticed, like dark circles around the eyes, dizziness, nausea, dry skin and low blood pressure are common in sufferers.

There are bulimics who exercise excessively. They follow a strong exercise regiment and become fanatical about their running, jumping, cycling, aerobics etc.

Many bulimics have what is called ‘broken eye” syndrome. This is when they perceive themselves as fat, non-attractive and think that others are better then them. They look in a mirror and see a big fat person standing there even if they are not. These individuals have low self esteem and look very shy and non-confident among others.

Bulimics often complain of stomachaches that occur around meal times. Diarrhea or constipation can bother them as well. Their teeth can become discolored and decayed fast. Bad breath is one of the common bulimics symptoms especially for those who are less hygienic. 

If you ask a bulimic girl about her periods she may say that it is irregular or even absent, it depends on how much she vomits per day. 

To sum up, there are many bulimia symptoms but most of them are so subtle and difficult to notice it is hard for the average person to tell. If you suspect that someone has bulimia look for the signs described above. And if the person has at least two or three of these symptoms especially disappearing to the bathroom after meals, she is likely to have the disease. This means she may be in danger of becoming very sick and she needs help.

To learn how you can help go to http://www.mom-please-help.com