Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating) and feeling a lack of control over the eating. This binge-eating is followed by a type of behaviour that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.
Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear to gain weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behaviour is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.
Other symptoms include:
- chronically inflamed and sore throat
- swollen glands in the neck and below the jaw
- worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
- gastroesophageal reflux disorder
- intestinal distress and irritation from laxative abuse
- kidney problems from diuretic abuse
- severe dehydration from purging of fluids
As with anorexia, treatment for bulimia often involves a combination of options and depends on the needs of the individual. To reduce or eliminate binge and purge behaviour, a patient may undergo nutritional counselling and psychotherapy, especially cognitive behavioural therapy (CBT), or be prescribed medication. Some antidepressants may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behaviour, reduces the chance of relapse, and improves eating attitudes.