Bulimia Nervosa

Overview

  • Binge eating: hallmark of bulimia nervosa and binge eating disorder   * Eating excess amounts of food in a discrete period of time   * Eating is perceived as uncontrollable   * May be associated with guilt, shame, or regret   * May hide behavior from family members   * Foods consumed are often high in sugar, fat, or carbohydrates\

Defining Features

  • Compensatory behaviors: designed to “make up for” binge eating   * Most common: Purging     * Most common purging method: Self-induced vomiting     * May also include use of diuretics or laxatives   * Excessive exercise   * Fasting or food restriction

Diagnostic Criteria

  • Recurrent episodes of binge eating
  • Recurrent inappropriate compensatory behavior in order to prevent weight gain
  • The binge eating and inappropriate compensatory behaviors both occur on average at least once a week for 3 months
  • Self-evaluation is unduly influenced by body shape and weight
  • Disturbance does not occur exclusively during anorexia

Associated Features

  • Associated medical features   * Most are within 10% of normal body weight   * Purging methods can result in severe medical problems     * Erosion of dental enamel, electrolyte imbalance     * Kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage
  • Associated psychological features   * Most are overly concerned with body shape   * Fear of gaining weight  Most have comorbid psychological disorders     * 20% meet criteria for a mood disorder     * 50 to 70% have met criteria for a mood disorder at some point     * 80% have met criteria for an anxiety disorder at some point     * Nearly two in five people abuse substances

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