Bulimia Nervosa is a type of eating disorder.
*Definition and Description
What is Bulimia Nervosa? Bulimia nervosa is an eating disorder. The condition was first defined as an eating disorder in 1979. It is defined as uncontrolled behaviors of overeating which is usually followed by purging or self-induced vomiting, misuse of laxatives or medications that cause increased production of urine, fasting, or excessive exercise to control weight. 
Who is affected by Bulimia Nervosa?
Bulimia Nervosa can affect both men and women but, statistically, women are ten times more likely to develop bulimia than men. However, bulimia is becoming more common in boys and men. Recent studies suggest that around eight in every 100 women will have bulimia at some point in their lives. The condition can occur at any age but it often starts around the age of 19. Bulimia can affect children, but this is extremely rare. 
What causes Bulimia Nervosa? The cause of bulimia is not known. Factors that are believed to contribute to the rise of the disorder include cultural ideals and social attitudes toward body appearance, body weight and shape, and family problems. TV and media portrayal of thin body figures and emphasis on being skinny are other contributors as well. Thirty to fifty percent of persons with bulimia will also have met the criteria for anorexia nervosa at the onset of their disorder. 
*Symptoms The main symptoms of bulimia are bingeing and purging. Bingeing Bingeing refers to a behavior that involves repeatedly eating a huge amount of high calorie food, without necessarily feeling hungry. The eagerness to eat can begin as an attempt to deal with emotional conflicts, but it can quickly become obsessive and out of control. Bingeing is usually a very quick process and you may feel physically uncomfortable afterwards. Bingeing is a typical symptom of bulimia, and it does not happen just once or twice. Sometimes, the binges are spontaneous: you eat anything that you can find at that moment, and the situation goes out of control. Purging Purging is a response to the bingeing. After you have eaten lots of food spntaneously, you may feel physically full, fat, and unattractive. You may also feel guilty, regretful, and blame yourself for eating so much. However, what mainly drives the purging process is the fear of gaining weight. The most common methods of purging involve making yourself sick, or using laxatives to encourage your body to pass and digest the food quickly. Less common methods of purging include taking diet pills, over-exercising, extreme dieting, periods of starvation, or taking illegal drugs, such as amphetamines. Bulimia is often a vicious circle that one cannot get off so easily. Low self esteen is a direct result of the disorder. You may also think that you are over-weight, even though you maybe at, or near or even below, a normal weight for your height. This may encourage you to set yourself strict and unrealistic rules about dieting, eating, or exercising. If you fail to keep to these strict rules, you binge to soothe the stress. After feeling guilty about bingeing, you purge to get rid of the calories and food you've taken in. And the cycle repeats. Other signs of bulimia
- regular changes in weight,
- an obsessive attitude towards food and eating,
- large amounts of money being spent on food,
- disappearing soon after eating (usually visiting the toilet to vomit),
- episodes of over-eating,
- periods of starvation,
- scarred knuckles (from forcing fingers down the throat to induce vomiting),
- depression and anxiety,
- distorted opinions about body weight and shape, and
- isolation. 
* Therapies and Treatment
"You can recover from bulimia but it may be a long and difficult process. The types of treatment that can be offered to help with bulimia include psychological treatments and medication. Treatment usually begins with psychological treatments, aimed to help you to re-establish healthy attitudes towards eating.
Cognitive behavioural therapy Cognitive behavioural therapy is the most common type of psychological treatment for bulimia, and involves talking with a therapist. CBT will help you to look at your emotions in detail and to work out new ways of thinking about situations, feelings, and food. It may also involve keeping a food diary which will help to determine and assess the triggers for your binge-eating.
Interpersonal therapy As with CBT, interpersonal therapy involves meeting with a therapist to discuss your condition. However, the focus is more on your personal relationships than your problems with food. You are more likely to be referred for this type of psychological treatment if you have recently lost a loved one, and have experienced a big change in your life. The aim of IPT is to help you to establish supportive relationships. This can help to draw your focus away from eating.
The medications used are known as selective serotonin reuptake inhibitors. SSRIs are a group of antidepressants that include:
- fluoxetine (brand name Prozac)
- paroxetine (brand name Seroxat)
- citalopram (brand name Cipramil)
- escitalopram (brand name Cipralex)
- fluvoxamine (brand name Faverin)
- sertraline (brand name Lustral)
Bulimia is not usually treated at hospital. However, if you have serious health complications and your life is at risk, you may be admitted to hospital. Hospital treatment is also considered if you are at risk of suicide or self-harm." 
* Case Study
"Lisa is a 10-year-old female with mixed Caucasian and Native-American ethnicity. Her fourth grade teacher consuited with the clinical nurse specialist assigned to work with the school system via a local community mental health center. With an office in the school building, the nurse had easy access to students and to teachers who had concerns or questions about particular students. Mrs. G, Lisa's teacher, sought help from the clinical nurse specialist after noticing a dramatic change in Lisa's weight over the first 10 weeks of the school year. Lisa had begun the year as a somewhat overweight, cheerful youngster with dark hair and bright green eyes who excelled at school and had a reputation as a perfectionist in her work.
While Lisa's schoolwork remained exemplary, her mood and appearance had changed dramatically. She preferred to stay in the classroom at recess and read, her social contacts with female peers lessened, and Mrs. G noticed that Lisa no longer ate lunch. She was observed giving most of her lunch away and nibbling at a small piece of fruit or vegetable. Yet, when extremely stressed, she would consume a lot of food then vomit. Her eating habbit and fear of gaining weight are definite symptoms of bulimia nervosa. The typical eating disorder develops in young females during adolescence; it also may develop before menarche or during adulthood (Heebrink, Sunday, & Halmi, 1995). Bulimia nervosa tends to occur later in adolescence. Its prevalence varies. Levine (1987) found that between 1 and 6 of every 200 girls will develop anorexia before the age of 21. This means about 1% to 6% of all teenage and college-age women will develop anorexia, and 5% to 8% will develop bulimia (Grothaus, 1998). While boys occasionally develop the disorder, the prevalence of males with anorexia is much lower, about 1.8 per 100,000 (Steiner & Lock, 1998), and approximately 1% to 2% of all boys will be bulimic during their high school years (Levine). Evidence exists that certain athletes are prone to eating disorders, especially if the sport accentuates leanness for improving performance. For example, gymnastics, wrestling, ballet, and figure skating all require leanness for best performance, and anorexia and bulimia are more common among participants in these disciplines (Garner,1993)." 
*List of Related Disorders
"Bulimics are much more likely than non-bulimics to have an affective disorder, such as depression or general anxiety disorder.
Other eating disorders:
compulsive overeating disorder
This eating disorder, also called binge eating disorder is characterized by an addiction to food. An individual suffering with compulsive overeating disorder has episodes of uncontrolled eating or binging, during which he or she may have a pressured, frenzied feeling. The person may continue to eat even after becoming uncomfortably full." 
Anorexia nervosa is an illness that usually occurs in teenage girls, but it can also occur in teenage boys, and adult women and men. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia isn't just a problem with food or weight. It's an attempt to use food and weight to deal with emotional problems."