Those who suffer from bulimia wake up in the morning filled with dread and self-loathing at the task that must be accomplished.

A ruthless self-evaluation based on the number the scale reveals will determine individual self-worth. The reading on the bathroom scale, above all else, dictates what kind of a day the bulimic will have. For those with an eating disorder like bulimia, the eating disorder overrides other messages about body image. Weight gain of any kind leads to despair, while a decrease in weight is cause for celebration. Bulimia creates a hatred of self and body that undermines other forms of accomplishment.

Bulimia is an eating disorder that involves regular episodes of binge eating, followed by compensating behavior such as vomiting, laxative abuse, over exercising and fasting. Despite the propensity to overindulge in unhealthy patterns, bulimics are desperately seeking measures to control their body weight (meet society’s standard of beauty) and prevent weight gain.

Bulimia evolves into a constant preoccupation with thoughts of food. A battle is waged between food and control of body weight. Bulimia affects more women than men, but in a weight conscious society like the United States where one third of the adult population is over weight or obese, some people are willing to resort to drastic measures like bulimia in an effort to achieve their desired body.

Warning signs for bulimia include the following:

• Preoccupation with thoughts about food.

• Weighing yourself on the scale multiple times a day.

• A desire to control your body weight.

• Fear of gaining weight.

• Depriving yourself of food.

• Uncontrollable urges to eat.

• Consuming large quantities of food.

• Feeling controlled by feelings about your body.

The eating disorder may have started out as adolescent imitation, a desire to quickly shed a few pounds for a big event or a desperate attempt to gain control over eating habits that felt out of control. Bulimia is a slow, subtle change — destructive behaviors sneak up on the individual as quietly and seductively as any form of addiction. In time the fear of weight gain and loss of self is so great that people will go to great lengths to conceal the extent of their obsession.

Bulimia has the highest result of physical and psychological complications of any psychological disorder. At its worst, 10 percent of those with an eating disorder will die due to complications associated with an eating disorder. Other health risks include: electrolyte imbalance, arrhythmia (a heart condition that is potentially fatal), fatigue, headaches, osteoporosis, menstrual irregularities, gastrointestinal complications, kidney complications, dental problems, depression, anxiety, mood swings, difficulty concentrating, social isolation, sleep disturbances and loss of self-esteem.

Dissatisfied with their overall appearance, bulimics will feel incompetent at more than just their own weight loss goals. Individuals become so preoccupied with food and weight that they will start to under perform and withdraw from social activities. The eating disorder starts to take on a life of its own, and the bulimic will be caught in a vicious cycle of self-destructive behavior.

If you or someone you know is victim to an eating disorder like bulimia, seek professional help before it is too late. The emotional and physical health complications of bulimia are dangerous. Bulimia is a serious psychological disorder that destroys self-identity.

Jennifer L. Gray, Ph.D., is a private practice therapist in Federal Way who provides individual and family therapy. Contact: (253) 653-0168.