What is bulimia nervosa?

Bulimia nervosa is an eating disorder in which a person eats excessive amounts of food and then tries to compensate for this overeating by forced vomiting, abusing laxatives or diuretics, or excessive exercise.

These behaviors generally occur repetitively, with the individual cycling through alternating episodes of excessive binge eating and then purging. People with this eating disorder eat until they feel out of control or sick, and then try to regain control through purging. This behavior may happen between several times a day and several times a week.

Unlike people diagnosed with anorexia nervosa, another eating disorder, those with bulimia are not necessarily excessively thin. Their body types may be underweight, average weight, overweight or obese. Because bulimia sufferers are ashamed of their binge eating and purging habits, they almost always perform these behaviors in secret. As a result of this and because their weight may be normal, it is often difficult for others to recognize the problem.

Like other eating disorders, bulimia most commonly occurs in women aged 18 to 35 years.

People with bulimia nervosa may exhibit some of these signs:

chronic sore throat/inflammation of the throat
swelling of the salivary glands (in the neck and jaw area), causing a puffy face
worn tooth enamel, or decaying/sensitive teeth, due to stomach acid exposure
ongoing gastrointestinal problems, such as acid reflux
intestinal problems due to laxative abuse
dehydration from loss of fluids
electrolyte imbalance (inappropriate levels of sodium, calcium, potassium or other minerals, which can cause heart attack)

The goal of treatment for bulimia nervosa involves stabilizing the patient’s eating habits and health while addressing the underlying issues. Patients with bulimia may receive nutritional counseling to learn healthy eating habits, as well as cognitive-behavioral therapy (CBT) or other psychotherapy. CBT helps a patient to recognize and change their unhelpful thinking patterns and beliefs, and then alter the unhealthy behaviors associated with them. CBT designed specifically for treating bulimia has proven effective in changing binge/purge eating behaviors. The CBT may occur in an individual or group setting.

In addition, some patients may benefit from treatment with an antidepressant. Currently, the antidepressant fluoxetine is the only drug approved by the FDA for treating bulimia. Fluoxetine has been shown to decrease binge/purge behaviors and lessen the chance of bulimia recurrence.

Sources:

http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml

http://www.psychiatry.org/eating-disorders