Bulimia Nervosa (BN)

Bulimia nervosa is an eating disorder characterized by bingeing and purging. People often associate BN with vomiting to purge, but in reality, purging can also take many other forms including:

  • Using laxatives
  • Using diuretics
  • Exercising excessively

BN will affect 1-2% of people during their lifetime, and primarily begin during late teens and early adulthood (15-early 20s). It can also be chronic or intermittent.

DSM-V Diagnostic Criteria for BN

  • Recurrent episodes of binge eating:
    • Eating an amount of food that is definitely larger than what most individuals would eat in similar time/circumstances.
    • A sense of loss of control (LOC) over eating during the episode.
  • Recurrent inappropriate compensatory behaviors in order to prevent weight gain (e.g., vomiting, laxatives, fasting, exercise).
    • 1x/week for 3 months.
    • Self-evaluation is unduly influenced by body shape & weight.
    • The disturbance does not occur during episodes of AN.

Physical Consequences

  • Swollen glands in neck and jaw
  • Rotting teeth
  • Liver and kidney damage
  • Electrolyte imbalance
  • Rupture of the esophagus

Reference

  • van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021 Nov 1;34(6):515-524. doi: 10.1097/YCO.0000000000000739. PMID: 34419970; PMCID: PMC8500372.
  • Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry, 61(3), 348-358.
  • Herpertz-Dahlmann B. Adolescent eating disorders: definitions, symptomatology, epidemiology and comorbidity. Child Adolesc Psychiatr Clin N Am. 2009 Jan;18(1):31-47. doi: 10.1016/j.chc.2008.07.005. PMID: 19014856.
  • Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731.
  • Ulfvebrand, S., Birgegard, A., Norring, C., Hogdahl, L., & von HausswolffJuhlin, Y. (2015). Psychiatric comorbidity in women and men with eating disorders results from a large clinical database. Psychiatry Research, 230(2), 294-299.