Bulimia nervosa is a serious eating disorder that can be fatal if left untreated. People who have bulimia nervosa routinely "binge," consuming large amounts of food in a very short period of time, and immediately "purge," ridding their bodies of the just-eaten food by self-inducing vomiting, taking enemas, or abusing laxatives or other medications. If left untreated, bulimia nervosa can lead to serious and even life-threatening problems, such as depression, anxiety disorders, heart damage, kidney damage, injury to all parts of the digestive system, and severe dental damage. Those with bulimia nervosa are at risk for dangerous impulsive, self-destructive behaviors, such as kleptomania, self-mutilation, alcohol and/or drug abuse, and sexual promiscuity.

Bulimia nervosa typically begins during adolescence, and while it most often occurs in women, it also affects men. Individuals with the disorder usually feel acutely out of control during both their bingeing and the purging episodes and afterwards suffer from intense feelings of shame, guilt and self-loathing. Embarrassed by their behavior, they typically "binge and purge" in secret and are often successful in hiding their problem from others. Even family members and close friends may have difficulty detecting bulimia nervosa in someone they know.

Symptoms

• Obsessive preoccupation with food.
   
• Excessive concern about body shape and weight.
   
• Episodes of bingeing, consuming excessively large amounts of food in a short period of time (usually within two hours).
   
• Episodes of purging to immediately get rid of just-consumed food using self-induced vomiting, taking enemas, or abusing laxatives or other medication.
   
• Binge/purge behavior at least twice a week for a period of three months or longer.
   
• Excessive exercise, often accompanying periods of fasting to counteract or prepare for binge episodes.
   
• Disparaging self-criticism; depressed mood; feelings of shame and guilt during and after bingeing and purging episodes.

Although bingeing and purging usually occurs in secrecy or as inconspicuously as possible, the signs that a person has bulimia nervosa eventually become detectable. Warning signs include:

• Abdominal pain and bloating.
   
• Irregular menstrual cycle.
   
• Constipation.
   
• Swollen "chipmunk cheeks."
   
• Dental erosion and decay.
   
• Overall weakness.
   
• Swelling (edema).
   
• Swollen salivary glands.
   
• Callouses and scabs on the back of the hand from constantly scraping them against their teeth while inducing vomiting.

Causes

While an exact cause or causes are yet unknown, bulimia nervosa is likely brought on by a complex interplay of factors which can include emotional and personality disorders, family stress, possible genetic or biologic susceptibilities, and a culture that is obsessed with body image and thinness.

Treatment

The first course of action should be to seek help from a physician to diagnose and treat any physical problems. To treat the symptoms of bulimia nervosa, people often benefit significantly from therapy. There are therapists who are especially experienced at helping people who have eating disorders. Therapy provides a safe, comforting, and confidential setting in which to receive the kind of help that can best determine and treat any underlying emotional and psychological causes for the disturbed eating. behavior, as well as address the effect it has had on their sense of self, their relationships with others, and their capacity to function optimally in everyday life.