Bulimia Nervosa is the second most common eating disorder in the world, the first being Anorexia Nervosa. Those who suffer from it have frequent periods of binge eating, consuming inordinate amounts of food in little time, and then purge through vomiting, excessive work-out or severe fasting.
Some of the symptoms of Bulimia Nervosa are: worrying about food, secretly binge eating and then vomiting, abuse of laxatives, diuretics and diet pills, denial of hunger, using drugs to induce vomiting, exercising compulsively.
Physically, bulimics have chronic gastric reflux after eating, dehydration, electrolyte imbalance (causing cardiac arrhythmia or arrest, sometimes leading to death), inflammation of the esophagus, oral trauma because of insertion of fingers or objects causing lacerations in the mouth or throat, broken blood vessels in the eyes, teeth decay, suspended menses, infertility, constipation, enlarged glands in the neck under the jaw line, calluses or scars on the back of the hands from inserting fingers in the mouth, constant weight fluctuations, among other consequences. 
The difference between common binge eating, which happens because of miscalculation or overindulgence, and the binge eating of a bulimic, is that they consume a huge amount of food in a short period of time (2 hours or less) and they feel they can’t stop eating, also feeling physical and emotional anguish.
Then next comes purging, which is, as described above, done by taking extreme measures to rid the body from the food. The problem is that it seldom works for losing weight. Diuretics and laxatives make a person lose water not weight. Also vomiting is useless, as 50-75% of the calories have already been absorbed. As a result, bulimics can either have normal weight, be overweight or underweight, or can change weight constantly, and in the meantime, they can lead “normal” lives on the outside, working, studying, etc, which can make it very difficult to identify those who suffer from it early on.
The frequency in which such behavior happens is also worrisome, it may occur over 2 times a week and for at least 3 months, which is certainly a terrible aggression against the body.
Those who suffer from Bulimia Nervosa are overly concerned about their looks, having self-deprecating thoughts, and keep the habit of binge eating/purging as a compensation for something that is going bad in their lives, and also as an attempt to achieve a better image of themselves. However the compulsion eventually leads to isolation, constant anguish, and more desperate actions, as the inner pain obviously doesn’t go away. 
Below are three accounts of people who have suffered from Bulimia Nervosa and overcame it. For information on how to help bulimics, check the first article in this series about eating disorders, and visit the sites mentioned at the bottom of the post.
“The image that I used to see reflected on the mirror was more of a monster than of a young girl. I was in a state where nothing was more important to me than to “look good” and if that meant to be sick I wouldn’t care.
“Many years later and 100% recuperated, I value more how I feel than how I look and these pictures reflect, in one way or another, my physical and mental state. I have accepted and love myself the way I am; I respect my body and take care of it like a temple.
“Rather than looking perfect, I value the fact that I can run or walk for an hour without getting exhausted or losing my breath. I value more the fact that my endurance has increased incredibly and that I have fulfilled successfully the physical challenges that I have set out. When I thought I couldn’t any more, I could…”
- Rosa Acosta 
“It's hard to say where my addiction began. I would have to say sometime in middle school. That's when I began to hate my body. I started off skipping meals and working out off and on. By the time I got into high school, my eating disorder became my life. By my freshman year, no one recognized me. I dropped a few sizes and I didn't even notice it till my friends began to talk. I went from a size 6 to a size 2. When I looked in the mirror, all I saw was fat. I could of sworn that I gained 50 pounds.
“When I got really hungry, I would go into my kitchen and eat tons of food. I remember sitting on the kitchen floor at 2am and eating a loaf of bread, a box of gram crackers, a bag of chips and then drinking some orange juice to help it all go down. I would feel so guilty that I would go and throw it all up.
“This happened for a few months then it got even worse. I began to take laxatives and diuretics as meals and kept up the binging and purging. If I was really bad I would bring a heater into my room and crank it up. Plus I would wrap myself with a garbage bag and put on a few layers of sweat pants and sweaters. I lived like this all throughout my high school days.
“Bulimia, to me, is like a giant mental mind game. Everyday I woke up and I hated to look into the mirror. I didn't like the person I saw and I felt so guilty every time someone looked at me and said how healthy I was. I felt like such a liar. I used to work out for three hours a day. That was my life. I started to do triathlons so I would get to work out even more without people questioning me.”
- Anonymous 
“It is a very dangerous illness to have, because I carried on at school, I did my exams, I didn't do very well, but I did my exams, I'd go into university, I went abroad for a year, then, so I did carry on, meanwhile, I was secretly vomiting, my teeth were decaying, my period stopped for quite a while... and I unfortunately grew to learn to hate myself... it was on university actually that I realized I had to see somebody... and it was basically… I knew I had to stop, because I was living a dual life.
“There's absolutely nothing glamorous or exciting or positive at all about developing an eating disorder. All it does is… it's decaying your body, it shortens your life, you know, I still spend ridiculous amounts of money on my teeth, which are really in a bad way. It affects people's fertility, and I think really importantly, it affects one's identity and how one feels about oneself in the short life that we have here and it affects your relationships with family, friends, partners. For many many years I didn't have a relationship because I was too afraid to. Because I was living in this terribly self-destructive bubble.
“In terms of getting help, I think the difficulty is you can't force somebody to talk to somebody, especially with an illness like this, because you're living in denial, and for me there was a huge shame about it, terrible shame, it’s sort of the ultimate… it's grotesque, you know, people don't want to know about your disfunctioning, whereas, you just want to be normal, you want to fit in. And it's an addiction. So until you realize that there's something wrong in your behavior, it's not a way of surviving, it's the opposite, only then will you want to get help.”
- Liselle Terret, who was 38 at the time of the interview, was bulimic from age 14 to 23. 
Come back tomorrow for the last article in this series: Media & The Way We See Ourselves.
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