Bulimia Nervosa

About Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating, meaning eating an unusually large amount of food in a discrete period with a sense of loss of control, followed by inappropriate compensatory behaviors such as self induced vomiting, misuse of laxatives or diuretics, fasting or excessive exercise. Under DSM-5, these behaviors occur on average at least once a week for three months, and self evaluation is unduly influenced by body shape and weight. Body weight is often in the typical range, which can make the disorder less visible, and many people feel shame and keep the behaviors secret. It most often begins in adolescence or early adulthood and is diagnosed more often in women. The British psychiatrist Gerald Russell described the condition in 1979. Medical complications of repeated vomiting include erosion of tooth enamel, swollen salivary glands, calluses on the knuckles known as Russell sign, tears in the esophagus and electrolyte disturbances such as low potassium, which can cause dangerous heart rhythm problems. Cognitive behavioral therapy adapted for eating disorders is the most established treatment, focusing on regular eating, triggers for binges and concerns about shape and weight, with interpersonal psychotherapy an alternative. Fluoxetine is the medication approved for bulimia in the United States.