Still, the outlook for bulimics is generally better than it is for anorexics. Women with bulimia are less likely to require hospitalization, although 20 percent of women still struggle with the disease after 10 years.

Symptoms of binge eating include:

• episodes of binge eating when not physically hungry
• frequent dieting
• feeling unable to stop eating voluntarily
• awareness that eating patterns are abnormal
• weight fluctuations
• depressed mood
• feelings of shame
• antisocial behavior
• obesity

Medical consequences of binge eating are:

• high blood pressure
• high cholesterol
• gall bladder disease
• diabetes
• heart disease
• certain types of cancer

Your health care professional may draw some of your blood to conduct the following tests to assess your likelihood of having an eating disorder:

• electrolyte balance — to check for dehydration, malnutrition, self-induced vomiting, and laxative and/or diuretic abuse. Electrolytes are a specific combination of minerals that your body needs to maintain balance to function properly. Common symptoms of imbalance are leg cramps, heart palpitations, high or low blood pressure and swelling in the legs and feet. An electrolyte imbalance can lead to kidney failure, heart attack and death.
• B12 and folic acid intake assessment — because of the important role folic acid and the B complex vitamins play in the onset of depression and anxiety. Lack of B12 and folic acid can lead to, or be caused by problems with the metabolism of protein, carbohydrates and fat, and with the body's ability to absorb nutrients.
• Blood glucose (blood sugar) level — can determine things like hypoglycemia and diabetes; a disturbance can be caused by dehydration and malnutrition; an elevated or low blood sugar level can be dangerous.
• Liver function tests — can be important in determining things like gallbladder and liver disease
• Cholesterol measurements — binge eating can affect blood cholesterol levels
• Thyroid function tests — to rule out any possible problems with the thyroid, which can affect weight; this can also be an important test for a person in recovery who may be having a hard time gaining or losing weight.

Your health care professional will likely ask you for a urine sample, so he or she can do a complete analysis of your urine. This urinalysis will help accurately evaluate kidney function, urine sugar levels and ketone levels, as well as help diagnose systemic diseases and urinary tract disorders. Ketones, which can accumulate in the blood rather quickly when the body is starved of food and nutrients, indicate the body is "eating its own fat" for energy. Accumulation of ketones in the blood can lead to ketoacidosis, which can cause coma and death.

Your health care professional may also take a blood pressure reading, a bone density test and an electrocardiogram, which finds heartbeat irregularities.

Copyright 2003 National Women's Health Resource Center, Inc.