Bulimia Nervosa

Bulimia nervosa, as defined by the DSM-IV, is characterized by:

• Recurrent episodes of binge eating
• Recurrent inappropriate compensatory behavior in order to prevent weight gain, such a self induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting, or excessive exercise
• Binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months 

Binge eating is the consumption of a large amount of food in a short period of time. Individuals who engage in bingeing can eat 2000-3000 calories in one sitting, which is the average daily intake for a young healthy man. The binge is associated with a feeling of loss of control and ends when no more food is available, or when the individual develops stomach pain, becomes tired, or is interrupted. It is often followed by the compensatory behavior of purging or other compensatory brhavior.

Purging is classically considered to be vomiting; however, it may take the form of laxative, diuretic, or enema abuse, excessive exercise, or periods of fasting. Some women use ipecac to assist their purging. The bingeing and purging behaviors must occur twice weekly for 3 months to meet diagnostic criteria. Preoccupation with body shape and size accompanies the disease. Like anorexia nervosa, bulimia nervosa is also divided into 2 subtypes: (1) the purging type, in which the patient uses laxatives, diuretics, and/or vomiting to empty herself of the food, and (2) the non-purging type, in which she follows her binge with excessive exercise and/or fasting.