Bulimia Nervosa

binges:  out-of-control eating episodes

purging: attempts to get rid of food consumed, e.g., though vomiting or abuse of laxatives, enemas, or diuretics

In bulimia nervosa, eating is experienced as out-of-control.  People experience episodes when they eat more than they intended to, often more calories than an average person would eat in several days (binge-eating).  In order to avoid weight gain, they undertake some form of compensation, usually purging, sometimes excessive exercise.  This sets up the cycle that characterizes bulimia:  binge-eating followed by purging.

There are two subtypes of bulimia nervosa:

• the purging subtype - In this subtype, people compensate for binge-eating episodes through self-induced vomiting or misuse of laxatives, diuretics, or enemas.
• the nonpurging subtype - In this subtype, people compensate for binge-eating episodes through excessive exercise or fasting.

The majority of people with bulimia are within 10% of their normal weight-for-height.  They may even be slightly overweight.  (If they were excessively thin, more than 15% below average weight, a diagnosis of anorexia would be considered.) 

Purging runs the risk of inducing an electrolyte imbalance, which may  have serious, even fatal, consequences.

Bulimia is commonly comorbid (co-occurs with) mood disorders, anxiety disorders, and substance abuse disorders.

Bulimia nervosa is more prevalent than anorexia, and the prevalence of bulimia appears to be increasing, while that of anorexia remains relatively stable.  Experts agree that the lifetime risk of bulimia is considerably higher for people born after 1960 than for those born before 1950 or between 1950 and 1959.

Estimates of the prevalence of bulimia vary.  A good guess is that about 9% of high school girls, 6-8% of college women, 2% of women age 25-44, and 0.4% of some age 45-64 meet criteria for bulimia nervosa.

90-95% of individuals with bulimia are women.  Of the 5-10% of bulimics who are male, most are homosexual or bisexual.  However, male athletes in sports that require weight regulation (e.g., wrestling) also comprise a significant male subgroup.

Age of onset of bulimia is typically 16-19 years for females; males have a slightly later age of onset.

This page was last updated on Tuesday October 21, 2003.