Eating Disorders

Bulimia Nervosa

Clinical Definition (According to the DSM-IV):

• Recurrent episodes of binge eating.
• An episode of binge eating is characterized by both of the following:

• Eating, in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
• A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

• The binge and appropriate compensatory behaviors both occur on average, at least twice a week for 3 months.
• Self- evaluation is unduly influenced by body shape and weight.

Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics or enemas.

Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise but has not has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Symptoms:

Behavioral:

• Eating uncontrollably
• Purging by strict dieting, vomiting, vigorous exercise, fasting, abusing laxatives, enemas or
diuretics in an attempt to lose weight
• Using the bathroom frequently after meals
• Obsessive compulsive or ritualistic patterns
• Eating normally in front of others while binging and purging in secret
• Drug/ Alcohol abuse

Emotional/ Psychological:

• Over concern about weight and shape
•Perfectionist
• low expectations of self
• Facade of normalcy
• Preoccupation with appearance or image
• Depression
• Recognition that the behavior is not normal
• Out of touch with feelings
• Inability to identify and express feelings
• Low self- esteem
• Constantly feels out of control
• Feels guilty about binges

Medical Consequences:

• Heartburn
• Abdominal Pain
• Vomiting Blood
• Weight Fluctuations
• Swollen parotid glands (chipmunk cheeks)
• Irritation of esophagus, stomach, salivary glands, and throat from persistent vomiting
• Damaged or Discolored Teeth
• Tooth Decay
• Gum Disease
• Sore Throat
• Hoarse Voice
• Lung Irritation: choking while vomiting causes food particles to lodge in the lungs causing
inflammation
• Respiratory Arrest
• Chronic loss of body fluids
• Constipation
• Laxative overdose
• Depletes blood potassium, sodium and chloride levels
• Muscle spasm
• Weakness
• irregular Heartbeat
• Kidney Disease
• Cardiac Arrest
• Death

Massachusetts Eating Disorders Association, 2003