Unlike some other eating disorders, BN may not affect a person’s body weight, so physical symptoms may not be apparent in the early stages of the disorder.
People with bulimia may engage in frequent postmeal visits to the bathroom (to purge) or compulsive exercise. They may also have a negative body image and may withdraw from social activities and previously enjoyed hobbies. They may also attach undue importance to their weight and experience body dysmorphia (an extremely distorted perception of their appearance).
Over time, people with purging behavior may develop physical signs caused by frequent vomiting, including swollen cheeks, calloused or scraped knuckles (from using fingers to induce vomiting), tooth decay, broken blood vessels in the eyes, severe dehydration, and gastrointestinal issues like acid reflux and constipation.[1][2]