Bulimia is an eating disorder that stems from a loss of control over eating habits and a longing to stay thin. Many people associate the condition with throwing up after eating. But there is much more to know about bulimia than this one symptom.

Here are 10 facts about bulimia to change misconceptions you may have about this dangerous eating disorder.

If you have bulimia or another eating disorder, you may be obsessed with your body image and go to severe measures to alter your weight. Anorexia nervosa causes people to restrict their calorie intake. Bulimia causes binge eating and purging.

Bingeing is consuming a large portion of food in a short period of time. People with bulimia tend to binge in secret and then feel immense guilt. These are also symptoms of binge eating disorder. The difference is that bulimia includes purging by behaviors such as forced vomiting, excessive use of laxatives or diuretics, or fasting. People with bulimia may continue to binge and purge for a while, and then go through periods of not eating.

If you have bulimia, you may also exercise compulsively. Regular exercise is a normal part of a healthy lifestyle. But people with bulimia may take this to the extreme by exercising for several hours a day. This can lead to other health problems, such as:

  • body injuries
  • dehydration
  • heatstroke

Bulimia is an eating disorder, but it can also be referred to as a mental disorder. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), eating disorders such as bulimia are the most fatal mental conditions in the United States. This fact is attributed to long-term health problems, as well as suicide. Some patients with bulimia also have depression. Bulimia can cause people to feel shame and guilt about their inability to control compulsive behaviors. This can worsen preexisting depression.

There is no proven cause of bulimia. However, many believe there’s a direct correlation between the American obsession with thinness and eating disorders. Wanting to adapt to beauty standards can cause people to engage in unhealthy eating habits.

Societal pressures and mental disorders such as depression are just two of the possible causes of bulimia. Some scientists believe that the disorder may be genetic. You may be more prone to developing bulimia if your parent has a related eating disorder. Still, it’s not clear whether this is due to genes or environmental factors at home.

While women are the most prone to eating disorders, especially bulimia, the disorder is not gender specific. According to ANAD, up to 15 percent of people being treated for bulimia and anorexia are male. Men are often less likely to exhibit noticeable symptoms or seek appropriate treatments. This can put them at risk for health problems.

Not everyone with bulimia is ultra-thin. Anorexia causes a large calorie deficit, leading to extreme weight loss. People with bulimia can experience episodes of anorexia, but they still tend to consume more calories overall through bingeing and purging. This explains why many people with bulimia still retain normal body weights. This can be deceptive to loved ones, and can even cause a doctor to miss the diagnosis.

This eating disorder causes more than just unhealthy weight loss. Every system in your body is dependent on nutrition and healthy eating habits to function properly. When you disrupt your natural metabolism through binging and purging, your body can be seriously affected.

Bulimia can also cause:

  • anemia
  • low blood pressure and irregular heart rate
  • dry skin
  • ulcers
  • decreased electrolyte levels and dehydration
  • esophageal ruptures from excessive vomiting
  • gastrointestinal problems
  • irregular periods
  • kidney failure

Women with bulimia often experience missed periods. Bulimia can have lasting effects on reproduction even when your menstrual cycle goes back to normal. The danger is even greater for women who get pregnant during episodes of “active” bulimia.

Consequences can include:

  • miscarriage
  • stillbirth
  • gestational diabetes
  • high blood pressure during pregnancy
  • breech baby and subsequent cesarean delivery
  • birth defects

Antidepressants have the potential to improve bulimic symptoms in people who also have depression. According to the Office on Women’s Health in the U.S. Department of Health and Human Services, Prozac (fluoxetine) is the only FDA-approved medication for bulimia. It has been found to help prevent binges and purges.

Bulimia is treatable, but symptoms often come back without warning. According to ANAD, only 1 out of 10 people seek treatment for eating disorders. For the best chance at recovery, identify your underlying cues and warning signs. For example, if depression is your trigger, then pursue regular mental health treatments. Seeking treatment can help prevent relapses in bulimia.

The real solution for long-term weight maintenance is a sensible diet and exercise plan. Bulimia ultimately disrupts normal weight maintenance, which sets up the body for greater challenges as the eating disorder progresses. Working to develop a healthy body image and lifestyle is a must. See a doctor right away if you or a loved one needs help treating bulimia.