How To Spot Anorexia and Bulimia

Aug 1, 1997

If you have an eating disorder and need help, contact the American Anorexia/Bulimia Association (AABA) at (212) 575-6200 or write them at 165 West 46th Street, Suite 1108, New York, NY 10036. You can also contact psychologist William Polonsky, PhD, CDE, for referrals at (619) 965-5659 or he can be contacted by e-mail at

The internet is also a great resource for both information and references to clinics and doctors who can help.

Anorexia Nervosa and Bulimia Nervosa - How to spot them

Symptoms of anorexia:

  • a significant amount of weight loss
  • feeling fat and continuing to diet even after losing large amounts of weight
  • developing amenorrhea (loss of monthly menstrual periods)
  • compulsive exercising
  • bingeing and purging
  • an excessive preoccupation with calories and food

Bulimia means frequent episodes of binge eating and purging. The person with bulimia usually feels out of control and has feelings of guilt and shame. According to the American Anorexia/Bulimia Association, up to 5% of college women in the United States are bulimic.

Symptoms of bulimia:

  • uncontrollable binge eating
  • purging through omitting insulin, vomiting, excessive exercising, diuretics, fasting, or strict dieting - the person will often frequently visit the bathroom after eating to purge
  • irregular periods
  • irrational mood swings or depression
  • swollen cheeks/glands, heartburn, bloating and dental problems may develop

- - - -

When asked what she would recommend to others struggling with diabetes and eating disorders, Jennifer gave these 5 tips:

  1. Find a good psychologist who knows about diabetes and eating disorders. Look for a sense of humor and mutual respect.
  2. Learn to forgive yourself. I had a breakthrough when my psychologist, Dr. Polonsky, said, "Why not omit insulin? It's so easy." I knew then that he understood my diabetes, and that I wasn't a bad person.
  3. Take it one step at a time. Start with smaller goals because they'll get bigger.
  4. Learn to trust yourself again. Since I've started trusting myself again, I don't have to panic anymore if I'm invited to somebody's house for dinner.
  5. Try visualization techniques. If I get the urge to omit insulin I visualize the way I'll feel later on - I picture dragging myself out of bed. After a few seconds I know it's not worth it.

- - - - -

Dr. Polonsky emphasizes that it is not craziness or stupidity that drives people with diabetes to omit their insulin.

According to Polonsky, there are a number of reasons why insulin omission is a particularly difficult thing to resist:

  1. Regular omission leads to liberation from eating restraints (for example, because omission promotes higher blood glucose levels, patients may reduce the frequency of blood glucose testing - "Why bother? It's always high anyway."
  2. With fewer self-care efforts, omitters may find it relieving that they do not need to think about diabetes as often.
  3. With chronically high BGs, low blood sugar is less likely to occur. (Many omitters report being more fearful of hypoglycemia than non-omitters.)
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