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Bulimia nervosa: the disorder of bingeing and vomiting

Bulimia nervosa: the disorder of bingeing and vomiting

February 28, 2024

The bulimia nervosa It is an eating and psychological disorder.

1. Diagnosis of Bulimia nervosa

The bulimic syndrome is a eating disorder characterized by abnormal feeding patterns, with episodes of massive food intake followed by maneuvers that seek to eliminate those calories. After these episodes, the usual thing is that the subject feels sad, in a bad mood and has feelings of self-pity

This disorder has a higher incidence rate between Western women between 18 and 25 years old , coming from any sociocultural stratum.

Despite the fact that bulimia nervosa encounters certain diagnostic difficulties, the criteria provided by the DSM-IV and the ICD-10 are very useful. According to the DSM-IV, these are the diagnostic criteria :


  • Presence of binge eating , characterized by the ingestion of a food in a short space of time, and the sensation of loss of control over its intake.
  • Compensatory behavior inappropriate and repeated that seek not to increase body weight. These behaviors include provocation of vomiting, use of laxatives, diuretics, enemas, fasting and inappropriate exercise.
  • Binge eating and compensatory behaviors are observed at least twice a week for a period of three months.
  • The self-evaluation It is significantly influenced by body weight and silhouette.

1.1. Types of Bulimia nervosa

Purgative type

During the episode of bulimia nervosa, the subject vomit is regularly provoked or use laxatives, diuretics or enemas.


Non-purging type

During the bulimic episode, the individual uses other inappropriate compensatory behaviors, such as fast or the excessive exercise , but does not resort to purgative methods.

2. Clinic of Bulimia nervosa

2.1. Alterations in behavior

The person affected by the bulimic disorder generally presents a disorganized behavior, initially only linked to food, but later also in other facets of his life. The behavioral pattern associated with feeding is disorganized and unpredictable, unlike in the case of Anorexy .

Binge eating can vary in frequency according to mood and availability. Purging behaviors are not regular and the fear of gaining weight is contingent upon mood or other circumstances.

2.2. Purging behaviors

After the episodes of large food intakes, the patients of bulimia become aware that the food eaten will make them gain weight; This possibility frightens them, creates anxiety and resolves these thoughts eliminating what is ingested through induced vomiting, laxative abuse, diuretics or intense physical exercise.


The most common behavior is the provocation of vomiting, and the least common, the consumption of diuretics. In addition, vomiting and laxatives are usually linked methods.

2.3. Alterations in cognition

The bulimic patient, in the same way as the anorexic patient, presents altered thoughts about food, body weight and figure. Both pathologies show a great rejection of the possibility of being overweight or obese.

Some bulimic patients come from the anorexia nervosa when, when the disorder becomes chronic, it evolves into bulimia. At that moment they go from a strict control of their diet to an intermittent control, appearing binge eating and purging behaviors.

3. Psychopathologies associated with Bulimia nervosa

People who develop a bulimic type eating disorder show, for the most part, an extensive associated psychopathology. Depression is the disorder most frequently related to bulimia, although it has also been detected that bulimic patients score high on anxiety scales.

4. Medical complications associated with Bulimia nervosa

There is a general symptomatology that is likely to be present in most people affected by bulimia nervosa. This set of symptom it is nonspecific and, generally, does not allow identifying the disorder from these data. Apathy, fatigue, sleep disturbances and irritability can accompany the loss of academic or work performance and abandonment in personal care.

In the examination of patients in the first stages of the disease, slight abdominal distensions with constipation, hypertrophy of the parotid glands, wear in the tooth enamel and abrasions on the back of the hands can already be seen.

Complications in the Cardiovascular system They include hypokalemia, which can produce severe alterations in the ECG, with disastrous consequences.This high risk factor is due to the loss of potassium in the blood caused by regular purges.

As for the endocrine system , patients for bulimia may have a normal menstrual cycle, but it is not uncommon for them to have irregularities or even amenorrhea , with low rates of estradiol and progesterone.

5. Treatment of Bulimia nervosa: objectives

In a particularly summary way, these are the main therapeutic objectives for bulimia nervosa:

  • Restoration of healthy nutritional guidelines .
  • Recovery of physical condition : stabilization of body weight, rehydration, correction of physical defects.
  • Normalization of the psychic state : improvement of mood, treatment for possible personality disorders, avoid substance abuse, correct dysfunctional cognitive style.
  • Restoration of family relationships : increase participation, communication and re-establish guidelines and functional roles.
  • Correction of social interaction patterns : accept the disorder, face failures, accept responsibility, reject degrading social frameworks.

Bibliographic references:

  • Jarne, A. and Talarn, A. (2011). Manual of clinical psychopathology. Madrid: Herder
  • Sarason, I.G. and Sarason, B.R. (2006). Psychopathology. Pearson Prentice Hall.

Bulimia and Binge Eating in Teens: What We Know and What To Do (February 2024).


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