Bulimia Nervosa
Bulimia nervosa involves recurrent binge eating followed by compensatory behaviors to prevent weight gain, defined per DSM-5 and treated per the APA 2023 Practice Guideline for the Treatment of Patients With Eating Disorders.
Symptoms
Recurrent binge eating episodes followed by compensatory behaviors -- self-induced vomiting, laxative misuse, fasting, or excessive exercise -- occurring at least once a week for 3 months, along with self-evaluation unduly influenced by body shape and weight.
Causes and risk
A combination of genetic vulnerability and social/psychological factors, including internalized pressure around thinness and body dissatisfaction, per current disease-primer research.
How it is evaluated
Diagnosis follows DSM-5 criteria; medical evaluation checks for complications from purging, including electrolyte imbalances and dental erosion, since these often go unrecognized by patients themselves.
Treatment
Eating disorder-focused CBT plus an SSRI -- fluoxetine 60mg daily has the most evidence -- is recommended for adults per the APA guideline.
When to seek care
Irregular heartbeat, fainting, chest pain, or blood in vomit warrant emergency evaluation, since purging can cause dangerous electrolyte imbalances, per ACOG guidance. Any thoughts of self-harm require immediate crisis support.