Comprehensive Care Center for Eating Disorders

Bulimia Nervosa is a pattern of eating large quantities of food in a relatively short period of time (binge eating) followed by behaviors intended to compensate for calories ingested or cause weight loss, such as vomiting, using of laxatives or diuretics, exercising excessively, or fasting. Individuals with bulimia nervosa feel a lack of control over both their binge eating and the behaviors that follow a binge. There can be a great deal of shame, guilt and embarrassment about the condition and much secrecy associated with it, as a result. Bulimia Nervosa affects 3-5% of the adolescent and young adult females and a smaller but still significant number of males. Approximately one fourth as many men as women are affected by bulimia nervosa, a more significant minority than in the case of anorexia nervosa. It is associated with an increased risk for medical and psychiatric complications.

Diagnostic Criteria for Bulimia Nervosa

The following criteria are established by the American Psychiatric Association and published in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

Recurrent episodes of binge eating at least twice a week for three months. The binge episodes are characterized by:

1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time under similar circumstances
2) a sense of loss of control over eating during these episodes (e.g. a feeling that one cannot stop eating or control what or how much one is eating)

Regular inappropriate compensatory behavior (at least twice weekly for three months) such as self-induced vomiting, laxative or diuretic abuse, enemas, fasting or excessive exercise

Undue influence of body weight or shape on self-evaluation

Anorexia nervosa is not present (i.e. weight is greater than 85% of expected body weight)

Subtype:

Purging Type: During the current episode of bulimia 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 regularly engaged in self-induced vomiting, laxative, diuretic or enema misuse.