Bulimia nervosa
An eating disorder with recurrent binge episodes, loss of control and regular compensatory behaviour, often at a normal weight but with potentially dangerous electrolyte, cardiac, dental and gastrointestinal complications.
Definition
Bulimia nervosa is an eating disorder characterised by recurrent binge-eating episodes with a sense of loss of control, regular inappropriate compensatory behaviour to prevent weight gain, and self-evaluation unduly influenced by weight and shape.
First principles
The binge-purge cycle is maintained by restriction and shame
Dietary restraint and overvaluation of weight and shape create hunger and emotional pressure, which can precipitate a binge. Vomiting, laxatives, fasting or driven exercise temporarily relieves fear and guilt but reinforces the cycle. Treatment therefore targets regular eating and the maintaining cognitions, not just the purging behaviour.
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