Bulimia Nervosa

Persons who have bulimia nervosa are similar in behavior to the subset of
anorexics who binge and purge, but they tend to maintain their weight at or
near normal for their age and height. They intermittently have an overwhelming
urge to eat, usually associated with a period of anxiety or depression,
and can consume as many as 15,000 calories in a relatively short period
of time, typically one to two hours. Binge foods are usually high calorie and
easy to digest, such as ice cream. The binge eating provides a sense of numbing
of the anxiety or relief from the depression. Failing to recognize that they
are full, bulimics eventually stop eating because of abdominal pain, nausea,
being interrupted, or some other non-hunger-related reason. At that point,
psychological stress again increases as they reflect on the amount they have
eaten. Most bulimics then induce vomiting, but some use laxatives, diuretics,
severe food restriction, fasting, or excessive exercise to avoid gaining weight.
Bulimics tend to be secretive, binge eating and purging when alone.
These episodes may occur only a few times a week or as often as several times
a day. As with binge-eating/purging anorexics, bulimics are likely to abuse
alcohol and other drugs, make suicidal gestures, and engage in other kinds
of impulsive behavior such as shoplifting. Because of the electrolyte imbalances
and other adverse consequences of repeated vomiting or the use of
laxatives or diuretics, bulimics are at risk for multiple serious medical complications
which, if uncorrected, can lead to death.