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Bulimia Nervosa

Bulimia Nervosa is marked by repeated out of control food consumption, followed by behaviors to counteract the overeating. People who suffer from this condition can look healthy and nourished, even overweight.

Methods to compensate for overeating can include:

 

  • vomiting

  • excessive use of laxatives or diuretics

  • fasting

  • excessive exercise

 

A combination of the above

According to the NIMH - National Institute of Mental Health, complications of Bulimia Nervosa can include:

  • Sensitive and decaying teeth

  • Worn tooth enamel

  • Acid reflux along with other GI issues

  • Inflamed or sore throat

  • Intestinal distress from laxative abuse

  • Dehydration

  • Electrolyte imbalance, which can lead to a stroke or heart attack 

DSM V Criteria for Bulemia Nervosa:

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A. Recurrent episodes of binge eating, as characterized by both:

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  1. Eating, within any 2-hour period, an amount of food that is definitively larger than what most individuals would eat in a similar period of time under similar circumstances.

  2. A feeling that one cannot stop eating or control what or how much one is eating.

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B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting or excessive exercise.

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C. The binge eating and inappropriate compensatory behaviors occur, on average, at least once a week for 3 months.

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D. Self-evaluation is unjustifiability influenced by body shape and weight.

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E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

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Specify if:

  • Partial remission: After full criteria were previously met, some but not all of the criteria have been met for a sustained period of time.

  • Full remission: After full criteria were previously met, none of the criteria have been met for a sustained period of time.

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Not a criterion.Current severity1:

  • Mild: An average of 1–3 episodes of inappropriate compensatory behaviors per week.

  • Moderate: An average of 4–7 episodes of inappropriate compensatory behaviors per week.

  • Severe: An average of 8–13 episodes of inappropriate compensatory behaviors per week.

  • Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.

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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 20, DSM-IV to DSM-5 Bulimia Nervosa Comparison.

Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t16/​

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