What is Bulimia nervosa?
A psychological eating disorder characterized by abnormal perception of body image, constant craving for food and binge eating, followed by self-induced vomiting or laxative use.
Frequent signs and symptoms
Recurrent episodes of binge eating (rapid consumption of a large amount of food in a short time, usually less than 2 hours), plus at least 3 of the following:
- Preference for high-calorie, convenience foods during a binge.
- Secretive eating during a binge. Patients are aware that the eating pattern is abnormal, and they fear being unable to stop eating.
- Termination of an eating binge with purging measures, such as laxative use or self-induced vomiting.
- Depression and guilt following an eating binge.
- Repeated attempts to lose weight with severely restrictive diets, self-induced vomiting and use of laxatives or diuretics.
- Frequent weight fluctuations greater than 10 pounds from alternately fasting and gorging.
- No underlying physical disorder.
Unknown; thought to be largely emotional.
Risk increases with
- Strict, compulsive, perfectionistic family environment.
- Anorexia nervosa.
- Stress, including lifestyle changes, such as moving or starting a new school or job.
- Personality disorders.
- Neurotic preoccupation with being physically attractive.
- Being a ballet dancer, model, cheerleader or athlete (especially a gymnast).
- Encourage a rational attitude about weight.
- Enhance self-esteem.
- Avoid stress and overly high self-expectations..
Outcome is variable; patients can learn to control the behavior with counseling, psychotherapy, biofeedback training and individual or group psychotherapy.
- Fluid and electrolyte imbalance from vomiting; dental disease from vomiting gastric acid; stomach rupture (rare); malnutrition.
- Without treatment, complications can be fatal.
Bulimia nervosa treatment
- The goal of treatment is to establish healthy eating patterns to regain normal weight. This can be accomplished with behavior modification training supervised by a qualified professional.
- Those who stay in therapy have the best chance to improve.
- Additional information available from Anorexia Nervosa and Associated Disorders, Helpline : (630) 577-1330 (9 AM-5 PM Central Time, Monday through Friday.)
Antidepressants are sometimes helpful.
No restrictions. Don't overexercise to lose weight.
- If hospitalization is necessary, intravenous fluids may be prescribed. During recovery, vitamin and mineral supplements will be necessary until signs of deficiency disappear and normal eating patterns are established.
- For outpatient therapy, supervision and regulation of eating habits, maintenance of a food diary and reintroduction of feared foods.
Notify your physician if
- You have symptoms of bulimia or you suspect your child has bulimia.
- The following occur during treatment:
- Rapid, irregular heartbeat or chest pain.
- Loss of consciousness.
- Cessation of menstrual periods.
- Repeated vomiting or diarrhea.
- Continued weight loss, despite treatment.
Last updated 20 December 2011