Bulimia Nervosa is characterized by recurrent episodes of binge eating (i.e. eating in a discrete time period an amount of food that is larger than most people would eat; a sense of not feeling in control over their eating during the episode).
Furthermore, individuals suffering from Bulimia also engage in inappropriate compensatory behavior in order to prevent weight gain (i.e. self induced vomiting, misuse of laxatives, diuretics, enemas, fasting or excessive exercise). The above noted behaviors occur on average, at least twice a week for three months. Moreover, individuals suffering from bulimia often struggle with self esteem issues. In fact, their esteem is strongly influenced by body shape and weight (DMS-IV-TR). To be diagnosed with bulimia, an individual has to engage in episodes of both bingeing and purging.
Although the cause of bulimia is not known, there are a number of psychosocial factors that contribute to the development of this disorder. Factors that contribute to the disorder include family disturbance or conflict, history of sexual abuse, maladaptive learned behavior, struggle for control or self-identity, cultural overemphasis on appearance, and parental obesity. Bulimia nervosa has also been associated with depression, anxiety, phobias, and obsessive-compulsive disorder (Professional Guide to Diseases, 8th edition, 2005).
Bulimia nervosa usually begins in adolescence or early adulthood and can occur in conjunction with anorexia nervosa. Bulimia is much more common in women, affecting nine women for every man. Nearly 2% of adult women meet the diagnostic criteria for bulimia nervosa; 5% to 15% have some symptoms of the disorder (Costin, 2007).
About 30% of individuals suffering from bulimia also struggle with addiction problems, most commonly alcohol or stimulant drugs. Stimulant use tends to begin as a weight loss method but oftentimes takes on a life of it’s own. Individuals who have been dually diagnosed need a treatment program that can address both of these issues simultaneously since they are so intertwined (Costin, 2007).
Medical complications are often evident in individuals suffering from bulimia. Some medical issues that could arise as a result of the eating disorder, include, but are not limited to: acid reflux, cardiovascular problems, dehydration, dental problems, digestive difficulties, dry skin, hair and nails, edema, electrolyte imbalance, gastrointestinal complaints, hypo and hyperglycemia, low sodium, infertility, anemia, ketoacidisus (acid build up in the blood), kidney infection, pancreatitis, parotid gland swelling, seizures, sleep problems, esophageal tearing, weakness and fatigue. While most medical complications can be reversed through nutritional rehabilitation, it is important to note that some of the above mentioned conditions could result in death, and should not be treated lightly (Costin, 2007).
Prognosis for recovery from Bulimia Nervosa is good with effective therapy, most notably, Cognitive Behavior Therapy, Interpersonal Therapy and Dialectical Behavior Therapy. Results from multiple studies reflect that approximately 50% of people with bulimia recover and maintain their recovery; 30% show improvement but remain symptomatic; and 20% continue to meet DSM-TR criteria (in full) for this condition. (Costin, 2007)