*DSM- Bulimia Nervosa

Bulimia Nervosa is defined in the DSM-5 criteria.
Most individuals diagnosed with Bulimia Nervosa are typically within 10% of their normal weight.

A. Recurrent Episodes of Binge Eating:
   - Binge eating is characterized by two primary features:
     1. Amount of Food:
        - Eating an amount of food that is larger than what most people would eat in a similar period of time and context.
     2. Lack of Control:
        - Experiencing a sense of lack of control over eating during the episode.
B. Recurrent Inappropriate Compensatory Behaviors:
   - Engaging in behaviors to prevent weight gain, including:
     - Self-induced vomiting
     - Misuse of laxatives, diuretics, or other medications
     - Fasting
     - Excessive exercise
C. Frequency of Episodes:
- Binge eating and inappropriate compensatory behaviors occur on average at least once per week for 3 months.
- Self-evaluation is excessively influenced by body shape and weight.
D. Exclusion of Anorexia Nervosa:
- The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Restricting Type:
- This type involves not engaging in regular binge eating or purging behaviors.

Bulimia Nervosa possesses several medical consequences:
- Loss of body weight measured at a Body Mass Index (BMI) of 17.5 kg/m² and lower with moderate use of laxatives that could result in a BMI of 16.0 kg/m² or lower if excessively used.
- Vomiting can lead to a BMI of around 17 kg/m².
Common medical consequences observed with Bulimia Nervosa include:
  - Electrolyte Imbalance:
     - Can lead to life-threatening complications such as cardiac arrhythmias.
     - Risk of kidney inflammation and potential failure.
  - Dental Issues:
     - Enamel erosion resulting from repeated vomiting.
  - Parotid Swelling:
     - Enlargement of the salivary glands as a physical sign of purging.
Statistics indicate that about 70% of individuals diagnosed with Bulimia Nervosa may experience severe complications, marking it as having one of the highest mortality rates among eating disorders.

Reducing caloric intake is a common behavior, with a maximum reduction of calories being noted around 50% during binge episodes.
Certain interventions can help, as some treatments may act long after a binge episode has occurred, providing potential longitudinal support for recovery pathways.