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Bulimia Nervosa in Males

Bulimia nervosa is a severe, life-threatening disorder characterized by recurrent episodes of binge eating followed by self-induced vomiting or other purging methods (e.g., laxatives, diuretics, excessive exercise, fasting) to prevent weight gain. An individual struggling with bulimia is intensely afraid of gaining weight and exhibits persistent dissatisfaction with his body and appearance, as well as a significant distortion in the perception of the size or shape of his body.

Behavioral Characteristics:

Recurrent episodes of binge eating: eating an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
A sense of lack of control over eating during binge episodes Recurrent purging or compensatory behavior to prevent weight gain: secretive self-induced vomiting, misuse of laxatives, diuretics, or fasting, compulsive exercise (possibly including excessive running, body building, or weight lifting)
Hoarding of food, hiding food and eating in secret
Frequently weighing self
Preoccupation with food
Focus on certain body parts; e.g., buttocks, thighs, stomach
Disgust with body size or shape
Distortion of body size; i.e., feels fat even though he may be thin

Emotional and Mental Characteristics:

Intense fear of becoming fat or gaining weight
Performance and appearance oriented
Works hard to please others
Depression
Social isolation
Possible conflict over gender identity or sexual orientation
Strong need to be in control
Difficulty expressing feelings
Feelings of worthlessness -- uses weight, appearance, and achievement as measures of worth
Rigid, inflexible “all or nothing” thinking

Physical Characteristics:

Weight fluctuations
Loss of dental enamel due to self-induced vomiting
Edema (fluid retention or bloating)
Constipation
Swollen salivary glands
Cardiac arrhythmia due to electrolyte imbalances
Esophageal tears, gastric rupture
Lack of energy, fatigue