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.

Symptoms explained:

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.


Warning Signs

  • 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.

Health Complications

  • 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.

  • Abnormal heartbeat.

  • Low body temperature.

  • Bone density loss (Osteoporosis).