What is Bulimia Nervosa?
By Kelsey Chadwick, MS RDN
Tuesday February 27th, 2024
For National Eating Disorder Awareness Week 2024, we are sharing information about the types of eating disorders. We hope this can serve as a resource for folks looking to learn more about the distinctions between different disorder types.
Bulimia nervosa (BN) is an eating disorder characterized by a cycle of binging and compensatory behaviors to undo or compensate for the effects of binge eating. Compensatory behaviors include self-induced vomiting, fasting, excessive exercise, misuse of diuretics and laxatives.
The DSM-5 TR official diagnostic criteria for bulimia nervosa is:
Recurrent episodes of binge eating, which is characterized by both eating in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances and a sense of lack of control over eating during he episode, such as a feeling that one cannot stop eating or control how much one is eating.
Recurrent inappropriate compensatory behavior in order to prevent weight gain
The binge eating and inappropriate compensatory behaviors both occur on average at least once a week for three months
Self evaluation is unduly influence by body shape and weight
The disturbance does not occur exclusively during episodes of anorexia nervosa
The following are behavioral and physical signs of bulimia nervosa:
Behavioral Signs
Preoccupied with weight, shape and appearance
Develops food rituals
Appears uncomfortable eating around others
Steals or hoards food
Uses excessive amounts of mouthwash, mints and hum
Experiences shame and guilt after episodes of binge eating and compensatory behaviors
Physical Signs
Dizziness
Stomach cramps and other gastrointestinal symptoms
Noticeable fluctuations in weight
Cuts and calluses across the top of finger joints due to induced vomiting
Abnormal lab findings (electrolyte imbalances, slow heart rate)
Difficulties concentrating
Bulimia nervosa treatment involves working with a team of health and mental health providers that have expertise in eating disorders. A treatment team includes a physician, psychiatrist, psychotherapist, dietitian and psychiatric nurse. There are varying levels of care and can include outpatient treatment, intensive outpatient specialty eating disorder programs (IOP), partial hospital specialty eating disorder programs (PHP) , residential specialty eating disorder programs and inpatient specialty eating disorder programs.
Additional Statistics
Trauma rates are significantly higher among women and men with bulimia nervosa and binge eating disorder, compared with the general population. (1)