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What is bulimia nervosa?

Bulimia nervosa is an eating disorder in which a person binge eats followed by some type of behavior intended to prevent weight gain from the calories consumed. The disorder, first described in modern medical literature in 1979 by a physician named Russell, seriously affects mental and physical health. Bulimia nervosa can even lead to death if untreated. (Please see section What are the complications of bulimia nervosa?)

Binge eating is defined as eating more food than most people would eat in a similar timeframe and associating that consumption with a feeling of a loss of control. The behavior to prevent weight gain is called "compensatory behavior." The compensatory behavior usually takes one of the following forms: purging by self-induced vomiting, or excessive use of enemas or laxatives; or non-purging by excessive exercise, fasting for long periods before binge eating again, or in the case of a person with diabetes, omitting insulin intake.

Bulimia nervosa is listed as a mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders Volume IV (DSM-IV). This manual is the 4th edition of a diagnostic reference book by the American Psychiatric Association that lists mental disorders and describes the characteristics or criteria used to diagnose each disorder. Individuals with a diagnosis of bulimia nervosa often have a co-existing disorder such as obsessive-compulsive disorder (OCD), major depressive disorder, or substance abuse. People who fit many, but not all, of the criteria may be given a diagnosis of "eating disorder, not otherwise specified" or ED-NOS, which is also listed in the manual.

The clinical terms used for the disorder and the criteria listed in the manual have changed several times over the past 25 years. At times the disorder was called just "bulimia," but now is clinically referred to as bulimia nervosa, which we use throughout this resource guide.

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Bulimia nervosa is an eating disorder in which a person engages in binge eating (eating a lot of food in a short time) followed by some type of behavior to prevent weight gain from the food that was eaten. This behavior can take two forms: self-induced vomiting, misuse of enemas, laxatives, diet pills (called purging) and excessive exercise, fasting, or diabetic omission of insulin (called non-purging). Some people with bulimia nervosa may also starve themselves for periods of time before binge eating again. Bulimia nervosa has important mental, emotional, and physical aspects that require consideration during treatment.

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