•  Loss of a lot of weight in a short period of time.

•  Intense, irrational fear of weight gain and/or of looking fat, obsession with fat, calories and weight.

•  A need to be perfect or in control in one area of life.

•  Distorted body image; the person feels and sees herself or himself as fat despite being a normal weight for height and age.

•  Marked physical signs, such as loss of hair, slowed heart rate, and low blood pressure. The person feels cold due to decreased body temperature. In females, menstrual periods can stop.

•  Repeated acts of binge eating and purging, which can be through vomiting, taking laxatives, water pills, and/or diet pills, fasting, and exercising a lot to “undo” the binge.

•  Excessive concern about body weight.

•  Being underweight, normal weight, or overweight.

•  Dieting often.

•  Dental problems, mouth sores, chronic sore throat.

•  Spending a lot of time in bathrooms.

•  Because of binge-purge cycles, severe health problems can occur, including an irregular heartbeat and damage to the stomach, kidneys and bones.

•  Counseling. This can be individual, family, group, and/or behavioral therapy.

•  Support groups.

•  Medication.

•  Nutrition therapy.

•  Outpatient treatment.

•  Hospitalization, if needed.

•  Learn to accept yourself and your body. You don’t need to look like anyone else. Spend time with people who accept you as you are, not people who focus on “thinness.”

•  Know that self-esteem does not have to depend on body weight.

•  Eat nutritious foods. Focus on whole grains, beans, fresh fruits and vegetables, low-fat dairy foods, and lean meats.

•  Commit to a goal of normal eating. Realize that this will take time. It will also take courage to fight fears of gaining weight.

•  Don’t skip meals. If you do, you are more likely to binge when you eat.

•  Limit white flour, sugar and foods high in sugar and fat, such as cakes, cookies and pastries. People who have bulimia tend to binge on junk food. The more they eat, the more they want.

•  Get regular, moderate exercise at least 3 to 4 times a week. If you exercise more than your doctor advises, do more non-exercise activities with family and friends.

•  Find success in things you do. Hobbies, work, school, etc. can promote self-esteem.

•  Discuss with family and friends how TV, movies and social media can send the message that only a certain body type is acceptable.

•  Learn as much as you can about eating disorders from reputable websites, books and organizations that deal with them.

•  To help children avoid eating disorders, parents should promote a balance between their child’s competing needs for independence and family involvement.

•  Follow your treatment plan from your health care provider. To be successful, you need to be actively involved in your treatment.

•  Attend counseling sessions and/or support group meetings as scheduled.

•  Set small goals that you can easily reach. Congratulate yourself for every success. This is a process. Accept set backs. Learn from them.

•  Talk to someone instead of turning to food.

•  Work toward the point where weight is no longer a way you rate your success. Think about your accomplishments, positive personal qualities, and valued relationships.

•  Learn to express your rights. You have the right to say no and the right to express your feelings and your opinions. You have the right to ask that your needs are met.

•  Keep a journal of your progress, feelings, thoughts, etc., but not about what you eat. The journal is just for you, not for others to read or judge. This is a safe place to be honest with yourself. The journal can also help you identify your “triggers” so that you can deal with them in the future.

•  Don’t let the scale run your life. Better yet, throw out the scale!