What is bulimia nervosa?

Bulimia nervosa is an eating disorder centered around binge eating

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Bulimia nervosa is an eating disorder where the main feature is binge eating followed by unhealthy behaviors to compensate for such binge eating in order to prevent weight gain (also called purging). According to the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders, to be diagnosed with bulimia nervosa, one needs to meet the following criteria:

  1. Reoccurring binge eating episodes that are characterized by eating in a two-hour period a larger amount of food than most people would eat, and feeling a lack of control over eating during the binge.
  1. Engaging in unhealthy compensatory behaviors to prevent weight gain, such as self-induced vomiting, laxative use, fasting, or excessive exercise.
  2. The binge eating and compensatory behaviors occur frequently (at least twice a week for three months or more).
  3. Self-image is largely determined or influenced by body shape and/or weight.
  4. The binge eating does not occur during an episode of anorexia nervosa.

Two Types of Bulimia Nervosa

In addition to the above criteria, the DSM-IV identifies two types of bulimia nervosa. The first is called the purging type. In this type, a person regularly engages in some type of purging method. In the non-purging type, a person uses other compensatory behaviors, such as fasting or excessive exercise.

Symptoms of Bulimia Nervosa

Bulimia signs and symptoms may include:

  • Constantly worrying about your body shape and weight
  • Fearing weight gain
  • Feeling a lack of control over your eating behavior

    Risk Factors for Bulimia Nervosa

    Factors that increase your risk of bulimia may include:

    • Gender. Girls and women more often have bulimia than boys and men.
    • Age. Bulimia often begins in the late teens or early adulthood.
    • Biology. There is a possible genetic link with bulimia. People with siblings, parents or children who have an eating disorder may be more likely to develop an eating disorder. In addition, a deficiency in the brain chemical serotonin may play a role. And, people who are overweight as children or teens may have an increased risk of developing bulimia.
    • Psychological and emotional issues. Psychological and emotional problems, such as anxiety disorder or low self-esteem, can contribute to eating disorders. People with bulimia may feel negatively about themselves. Triggers for binging can include stress, poor body self-image, food, boredom and restrictive dieting. In some cases, traumatic events and environmental stress may be contributing factors.
    • Media and societal pressure. TV and fashion magazines frequently feature thin models and actors. Oftentimes, such images seem to equate thinness with success and popularity. 
    • Sports, work or artistic pressures. Athletes, actors, dancers and models are at a higher risk of eating disorders. 


    Mayo Clinic. Bullemia Nervosa. http://www.mayoclinic.org/diseases-conditions/bulimia/basics/definition/con-20033050

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