Most bulimics are nearly normal or a bit over their ideal weight. Almost all share an intense longing to be thin and a fear of fatness.
Bulimia is often associated with anxiety or depression, guilt, shame, moodiness and isolation. It is sometimes associated with substance abuse or other risky or self-harming behaviors.
Bulimia is a confusing term because it comes in many forms. The most frequent type of bulimia is a cycle of binges, guilt and fear of weight gain, purging, dieting and then another round of binges.
The usual form of purging is self-induced vomiting, but some bulimics misuse laxatives, usually not realizing that they do not remove any calories.
Other groups with bulimic behaviors include:
Non-Purging Bulimia - Marked by binges, either in volume or perception, followed by strict dieting and/or exercise to avoid weight gain
Purging Disorder - People with self-induced vomiting but without a preceding binge
Bulimic Subtype of Anorexia - Half of women with anorexia nervosa binge and purge as a part of their anorexia. They have bulimic behavior but are significantly low in weight.
Bulimia is a highly curable illness and treatment does not require weight gain. In fact, because calories are absorbed from each binge despite purging, in our experience many women with bulimia actually lose weight with treatment. Those who have abused laxatives need special care to avoid rebound water retention when they are changing behaviors.