The primary symptoms of bulimia are recurrent episodes of binge eating and compensatory measures to purge the calories. Symptoms of bulimia can be quite invisible because the bulimic can maintain normal weight.
Some bulimics have a telltale scar on the first two knuckles of their hand from inducing vomiting.
Some purge themselves up to several times a day. What is less clear is which patients are most likely to benefit from antidepressant medications and how to best sequence the various therapeutic interventions available. The utility of antidepressant medications in bulimia nervosa has led to their evaluation in binge eating disorder. The limited information currently available suggests that antidepressant treatment may be associated with a reduction in binge frequency in obese patients with binge eating disorder, but does not lead to weight reduction. The results of psychopharmacological treatment studies of patients with bulimia nervosa have overall been more favorable than those of anorexic patients.