What is Bulimia Nervosa?

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a secretive cycle of bingeing and purging.

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Symptoms

Bulimia Nervosa has three primary symptoms:

	Eating large quantities of food in short periods of time, often secretly, without regard to     feelings of "hunger" or "fullness," and to the point of feeling "out of control" while eating.
	Following these "binges" with some form of purging or compensatory behavior to make     up for the excessive calories taken in, such as self-induced vomiting, laxative or diuretic     abuse, fasting, and/or obsessive or compulsive exercise
	Extreme concern with body weight and shape

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Warning Signs

	Evidence of binge-eating, including disappearance of large amounts of food in short     periods of time or the existence of wrappers and containers indicating the consumption     of large amounts of food
	Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs     and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
	Excessive, rigid exercise regimen--despite weather, fatigue, illness, and injury, the need     to "burn off" calories taken in
	Unusual swelling of the cheeks or jaw area
	Calluses on the back of the hands and knuckles from self-induced vomiting
	Discoloration, staining of the teeth.
	Creation of complex lifestyle schedules or rituals to make time for binge-and purge     sessions
	Withdrawal from usual friends and activities
	In general, behaviors and attitudes indicating that weight loss, dieting, and control of food     are becoming primary concerns

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Health Consequences

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

	Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure     and death. The electrolyte imbalances are caused by losses of potassium and sodium     from the body and dehydration as a result of purging behaviors.
	Inflammation and possible rupture of the esophagus from frequent vomiting
	Chronic irregular bowel movements and constipation as a result of laxative abuse
	Tooth decay and staining from stomach acids released during frequent vomiting
	Peptic ulcers and pancreatitis
	Potential for gastric rupture during periods of bingeing
	The chances for recovery increase the earlier bulimia nervosa is detected. Therefore, it is     important to be aware of some of the warning signs of bulimia nervosa.

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For more information about Bulimia Nervosa, visit the National Eating Disorders Association web site.

References:

Gidwani, G.P. and Rome, ES. (1997). Eating Disorders. Clinical Obstetrics and Gynecology, 40(3),601-615.

Levine, M. (1994)."A Short List of Salient Warning Signs for Eating Disorders." Presented at the 13th National NEDO Conderence, Columbus, Ohio.

Zerbe, KJ. (1995). The Body Betrayed. Carlsbad, CA: Gurze Books.

Source: Eating Disorder Awareness and Prevention (EDAP), Inc 603 Stewart St., Suite 803, Seattle, WA 98101.