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What triggers a bulimic episode?
Self-esteem and fulfilling deep emotional needs can be factors affecting bulimic episodes. "Triggers are something you really want that you don't get—the captain of a sports team, editor of the school paper, a high score on a test...a boyfriend or girlfriend saying something that undermines confidence," explained a parent of a bulimic child.

Many situations and feelings can trigger bulimic behavior: extreme emotional distress, anxiety, depression, dieting, exposure to certain foods (especially high-sugar or high-fat foods), or sudden dissatisfaction with body image. People with bulimia nervosa have reported extreme mood changes before, during, and after binge eating and purging or non-purging compensatory behavior. They have also reported feeling depressed or anxious before binge eating, and then feeling temporary relief or even euphoria afterwards. These feelings are often followed by feelings of guilt, shame, and self-loathing. Then purging or excessive exercise occurs to regain feelings of self-control.

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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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