What Meds

Bulimia Nervosa

The essential features of Bulimia Nervosa are binge eating and inappropriate compensatory methods to prevent weight gain. In addition, the self-evaluation of individuals with bulimia nervosa is excessively influenced by body shape and weight. To qualify for the diagnosis, the binge eating and the inappropriate compensatory behaviors must occur, on average, at least twice a week for 3 months.

A binge is defined as eating in a discrete period of time an amount of food that is definitely larger than most individuals would eat under similar circumstances. The context in which the eating occurred must be considered — what would be regarded as excessive consumption at a typical meal might be considered normal during a celebration or holiday meal.

Continual snacking on small amounts of food throughout the day would not be considered a binge.

Binge food typically includes sweet, high-calorie foods such as ice cream or cake. However, binge eating appears to be characterized more by an abnormality in the amount of food consumed than by a craving for a specific nutrient, such as carbohydrate. There is a lack of being "in control" of eating. Individuals with bulimia nervosa may fast for a day or more or exercise excessively in an attempt to compensate for binge eating.

Exercise may be considered to be excessive when it significantly interferes with important activities, when it occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications. Individuals with this disorder may, in rare cases, take thyroid hormone in an attempt to avoid weight gain.

Purging Type

This subtype describes presentations in which the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode.

Non-purging Type

This subtype describes presentations in which the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode.

Bulimia Nervosa has been reported to occur with roughly similar frequencies in most industrialized countries, including the U.S., Canada, and Europe. Individuals with this disorder are primarily white, but the disorder has also been reported among other ethnic groups. 90% of individuals with bulimia are female. Some data suggest that males with bulimia have a higher prevalence of premorbid obesity than do females with bulimia.

Diagnostic criteria

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