Bulimia Nervosa

Abstract

Bulimia nervosa is characterized by morbid overconcern with weight and shape leading to extreme and often dangerous weight-controlling behaviors. This eating disorder is generally conceptualized as a final common pathway, with symptoms resulting from the interplay of biological, psychological, familial, and sociocultural etiological factors. The clinical features and related psychopathology in bulimia nervosa are well documented and widely accepted. The essential features required for a diagnosis of this disorder are (1) recurrent episodes of binge eating (rapid consumption of a large amount of food in a discrete period of time) occurring at least twice a week for the past 3 months; (2) a feeling of lack of control over eating behavior during these binges; (3) self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercising in order to prevent weight gain; and (4) persistent overconcern with body weight and shape (APA, 1993). There are various associated psychological symptoms, such as depression, anxiety, poor self-esteem, hostility, somatization, social maladjustment, confused sex-role identity, and borderline personality features, that may or may not have etiological significance in bulimia nervosa but, in any case, contribute to the heterogeneity in the disorder on presentation. Finally, bulimia nervosa results in potentially serious physical and psychological sequelae that may not only perpetuate the eating disorder but may also cloud the assessment picture.