An eating disorder, characterized by frequent consumption of excessive amounts of food, with a sense of loss of control over eating, followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of diuretics, laxatives, or weight loss medications and excessive exercise.
Two types-purging and nonpurging.
In young women risk is 2-5%.
30-70% have drug abuse.
45% have good outcomes, 18% have intermediate outcomes, and 21% have poor outcomes.
Patients who have borderline personality disorder have poor outcomes compared in those without this disorder, when treating with psychotherapy.
Diagnosis includes binge eating, and purging occurring at least once weekly for greater than or equal to three months.
Patients with bulimia fear weight gain, but typically have a normal or above normal body weight.
Individuals with bulimia engage in impulsive behaviors, such as non-suicidal self injury and substance use.
Bulimia nervosa complications include frequent vomiting with exposure of teeth to gastric acid with loss of enamel and dental erosion, parotid gland hyperplasia, elevated aldosterone levels from chronic dehydration with fluid retention and peripheral edema, self-induced vomiting and laxative and diuretic misuse associated with fluid and electrolyte disturbances, such as hyponatremia, hypokalemia, and acid imbalance.
Rarely Mallory-Weiss esophageal tears may occur from forceful vomiting.