Bulimia Nervosa (BN)
According to the Diagnostic and Statistical Manual of Mental Disorders, Bulimia Nervosa (BN) is characterized by:
Recurrent episodes of binge eating characterized by BOTH of the following:
Eating in a discrete amount of time (within a 2-hour period) large amounts of food.
Sense of lack of control over eating during an episode.
Recurrent inappropriate compensatory behavior in order to prevent weight gain (purging).
The binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of anorexia nervosa.
Binge eating is different than simply overeating once in a while. Individuals with eating disorders often binge in secret and experience the feeling that they cannot stop and experience physical and/or emotional distress including feelings of extreme guilt, disgust, or shame. Purging behaviors may vary and often include vomiting, using laxatives/water pills, excessive exercise, or extreme food restriction after a binge. It is common for weight to shift dramatically during the course of Bulimia.
Signs of binge eating - disappearance of large amounts of food in short periods of time or finding wrappers and containers indicating the consumption of large amounts of food.
Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
Preoccupation with exercise; may have excessive, rigid exercise regimen.
Unusual swelling of the cheeks, salivary glands, and jaw area.
Calluses on the back of the hands and knuckles from self-induced vomiting.
Tooth discoloration, decay, or erosion of tooth enamel.
Evidence of laxative/diuretic overuse.
Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
Withdrawal from usual friends and activities.
Behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
Continued exercise despite injury; injuries caused by overuse.
Common co-occurring disorders and behaviors include substance abuse, depression, anxiety disorders, shoplifting (often of food, laxatives, or diuretics), and suicidal thoughts or attempts.
Electrolyte imbalances caused by dehydration and loss of potassium, sodium and chloride, can lead to irregular heartbeats and possibly heart failure and death.
Potential for gastric rupture during periods of bingeing.
Inflammation and possible rupture of the esophagus from frequent vomiting.
Tooth decay and staining from stomach acids released during frequent vomiting.
Chronic irregular bowel movements and constipation as a result of laxative abuse.
Peptic ulcers and pancreatitis.
Fainting or loss of counsciousness, often due to low blood pressure.
Low body temperature.
Bone density loss (Osteoporosis).