Causes:
Bulimia always has an underlying psychological and emotional cause. Stress and depression have both been known to trigger bulimia under certain circumstances. For e.g. those who experience bullying or are in abusive relationships are at greater risk of suffering bulimia.

In particular, those who have low confidence and low self-esteem, or body-image issues, are at risk of bulimia. The myth of the ‘perfect body’ perpetuated through social media, and other forms of media, are certainly contributing factors in that regard.

Signs:
The following are some early warning signs that someone you know is suffering from bulimia:

• Negative body image – including an obsession with weight and appearance.
• Excessive exercising in a desperate attempt to lose weight.
• ‘Secret’ stashes of food at home.
• Constant visits to the restroom, especially just after a meal.
• Acting defensive on the subject of eating habits or weight.

The excessive vomiting, and use of enemas, diuretics and laxatives, that typically accompanies bulimia, can result in malnutrition. The common signs of this malnutrition are:

• Feelings of irritability, anger helplessness and other negative emotions. These are caused by the imbalance of chemicals that are the result of vomiting.
• Constant fatigue, that occurs because the food is expelled from the body through vomiting before it can provide energy to the eater.
• Hair loss caused by the lack of nutrients such as zinc, iron and certain B-vitamins.
• Muscle weakness, which is the result of a loss of potassium through vomiting. Potassium plays a significant role in muscle function, and an imbalance can result in cramping and uncontrollable spasms.
• Depression, which is already a strong underlying factor in bulimics, is further exacerbated by their low levels of Vitamin D – the result of a poor diet and lack of adequate exposure to sunlight.