Eating Disorders

What is Bulimia Nervosa (BN)?

BN is defined as having recurrent cycles of binge eating followed by some form of compensatory behavior, such as vomiting, with the intent to undo or compensate for binge eating. Binge eating occurs when an individual eats an abnormally large amount of food in a short period of time compared to what the average person would eat under similar circumstances (usually within 2 hours). It also includes a sense of impulsiveness or lack of control in regards to what and how much the person is eating during that specific time period. Generally the individual eats until feeling uncomfortably full and experiences feelings of shame and guilt leading to compensatory behavior, such as forced vomiting, in attempts to prevent weight gain.

Similar to the presentation of anorexia, bulimia involves intense preoccupation with body weight and poor body image. Unlike anorexia, individuals with bulimia are often at a normal weight which can make it difficult to detect this dangerous eating disorder. Frequent trips to the bathroom immediately after eating and disappearance of large amount of food are warning signs for bulimia.

BN is diagnosed by these specific criteria:

  1. Recurrent episodes of binge eating. Binge eating is characterized by:
    a)Eating large amounts of food within a relatively short period of time (within 2 hours).
    b)Feelings of lack of control around eating during episode.
  2. Recurrent inappropriate compensatory behaviors in order to prevent weight gain. Behaviors can include self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting or excessive exercise. It is not uncommon for the individual to use more than one type of compensatory behavior.
  3. Both the binge eating and inappropriate compensatory behavior occur on average at least once a week for 3 months.
  4. Self-evaluation is unduly influenced by body shape and weight.
  5. The disturbance does not occur exclusively during episodes of anorexia nervosa

(Adapted from the DSM-5)