Student Resources

Bulimia Nervosa

Bulimia Nervosa is characterized by a secretive cycle of binge eating and purging.

Primary Features:

• Recurrent episodes of binge eating. An episode of binge eating is characterized by eating a large amount of food and feeling out of control while eating (e.g., a feeling that one cannot stop eating or control what or how much one is ea ting).
• Purging after a binge (vomiting, misuse of laxatives, diuretics, or amphetamines, fasting, or excessive exercise)
• Extreme concern with body weight and shape

Associated Features:

Physical Characteristics:

• Weight fluctuations due to alternative gorging and fasting
• Menstrual irregularities
• Swollen salivary glands; "chipmunk cheeks"; puffiness around face
• Burst blood vessels in or under eyes because of frequent vomiting
• Tooth decay and gum disease
• Damage to esophagus; sore throat and/or hoarse voice
• Abdominal pain and constipation (stomach distress and hiatal hernia)
• Edema (swelling due to retention of body fluids)
• Headaches
• Chemical imbalance in the blood caused by low potassium (and sodium) which can produce dehydration, muscular fatigue, cardiac rhythm irregularities, and/or cardiac arrest

Behavioral Characteristics:

• Binge eating
• Purging; vomiting; laxative, diuretic, or diet pill abuse; use of other emetics (e.g., ipecac); fasting
• Compulsive exercising
• Drug and alcohol abuse
• Shoplifting and/or petty stealing of money to buy binge-food
• Secretive food foraging, hoarding, and eating
• Promiscuous behavior (mask for a desire to be accepted and respected)
• Compulsive patterns (e.g., highly organized)
• Food rituals (e.g., binges on certain foods or food combinations

Emotional and Attitudinal Characteristics:

• Perfectionistic tendencies; high performance and achievement expectations
• Low self-esteem; self-loathing
• Desperate desire for help
• Extreme preoccupation with body weight and shape
• Façade of normalcy (seemingly "has it altogether")
• Constant feeling of being out of control
• Difficulty identifying and expressing negative emotions (e.g., anger)
• Depression and/or anxiety
• Obsessive thinking; constant preoccupation with food control