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Bulimia Nervosa Bulimia meaning ox-like hunger was first mentioned in the literature in the 18th century However it was not recognized as an illness by the American Psychiatric Association until 1979 and was not officially named Bulimia Nervosa until 1987 by G Russell in England Individuals with Bulimia Nervosa are similar to those with Anorexia Nervosa in that they are preoccupied with their shape and weight In contrast to anorectics bulimics binge eat and then use inappropriate methods such as self-induced vomiting abusing laxatives abusing diuretics or misusing enemas to prevent weight gain The diagnosis of bulimia nervosa is only made if the bulimic behaviors do not occur during an episode of Anorexia Nervosa A binge is defined as uncontrollably eating often rapidly a large amount of food than what others might eat in a similar situation Bulimics are often ashamed of their behavior and binges typically take place in secrecy Binges may be planned or unplanned and are often related to stress or intense hunger caused by dieting Individuals often feel out of control during the binge and are typically overwhelmed with depression and self-criticism after the episode Individuals with Bulimia Nervosa use a number of different kinds of methods to prevent weight gain Vomiting as a purging behavior is seen among 80 to 90 percent of all bulimics Individuals will use various methods to stimulate a gag reflex and induce vomiting some with more advanced disease are able to vomit at will In many vomiting reduces physical discomfort and reduces the fears associated with gaining weight Interestingly Kaye et al found that regardless of the size of the binge bulimics retain about 1200 k calories after vomiting Approximately one-third of individuals with bulimia nervosa use laxatives to purge following a binge episode Other less common purging behaviors include the use of diuretics and enemas Despite the use of purging techniques bulimics are typically of normal weight but may
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