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