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Warning-sign checks

Bulimia nervosa: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek urgent or emergency care for:

    • Fainting, a seizure, confusion, or severe weakness
    • Chest pain, trouble breathing, or a rapid or irregular heartbeat
    • Vomiting blood, black stools, or severe abdominal pain
    • Inability to keep fluids down or signs of severe dehydration
    • Thoughts of suicide, a suicide plan, or concern about immediate safety

    Elsewhere, use the local emergency number or crisis service.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Arrange a prompt appointment if bingeing or purging is occurring, symptoms are increasing, or dizziness, weakness, dental damage, reflux, or menstrual changes develop.

    A clinician should also review any laxative, water-pill, supplement, or medication use.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up is usually more frequent early in treatment.

    Appointments may track bingeing and compensatory behaviors, hydration, pulse, blood pressure, laboratory results, mood, and progress with regular eating.

    Dental follow-up may be needed when vomiting has affected the teeth.

The article also says

Recovery is rarely perfectly linear.

Increased urges or a return of symptoms does not mean treatment has failed.

Contacting the care team early can help prevent a brief setback from becoming a longer relapse.

In the United States, a person in a suicidal or mental health crisis can call or text 988.

Every sign above is quoted from the sofidex article on Bulimia nervosa. If you are not sure, err upward — it is always reasonable to be checked.