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\

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

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 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