Bulimia Nervosa

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Bulimia Nervosa presents as episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting, and/or the use or abuse of laxatives, enemas, diuretics or exercise. Body weight is usually within normal range.

Diagnostic criteria for Bulimia Nervosa are based on the following symptoms:

  • Repeated episodes of binge eating in which an excessive amount of food is consumed during a relatively short period of time, accompanied by a sense of urgency or lack of control and often resulting in an uncomfortable level of fullness
  • Repeated use of compensatory behaviors following a binge such as self-induced vomiting, misuse of laxatives, diuretics or enemas, excessive exercising or fasting
  • Episodes of bingeing followed by inappropriate compensatory behaviors occur at least two times per week for a three-month period to meet full criteria of Bulimia Nervosa
  • Preoccupation with body weight or shape and overemphasis on weight/shape as defining features of oneself

There are two sub-types of Bulimia Nervosa:

  • Purge Type: Engages in behaviors such as self-induced vomiting and/or misuse of laxatives, diuretics or enemas
  • Non-purge Type: Engages in behaviors such as excessive exercise or fasting but does not induce vomiting or misuse laxatives, diuretics or enemas

Checklist for Visible Characteristics

Behavioral Signs

  • Bingeing
  • Secretive eating, evidenced by missing food
  • Preoccupation with and constant talk about food and/or weight
  • The avoidance of restaurants, planned meals, or social events if food is present
  • Self-disparagement when too much has been eaten
  • Bathroom visits after meals
  • Vomiting, laxative abuse, or fasting
  • The use of diet pills
  • Rigid and harsh exercise regimes
  • Fear of being fat, regardless of weight

Physiological and Emotional Signs

  • Swollen glands, puffiness in the cheeks, or broken blood vessels under the eyes
  • Complaints of sore throats
  • Complaints of fatigue and muscle ache
  • Unexplained tooth decay
  • Frequent weight fluctuations, often within a 10- to 15-pound range
  • Attitude Shifts
  • Mood shifts that include depression, sadness, guilt, and self-hate
  • Severe self-criticism
  • The need for approval to feel good about herself
  • Self-worth determined by weight