Bulimia Nervosa



An eating disorder which includes binge eating and inappropriate compensatory behaviors; symptoms include:

  • Episodes of binge eating, lack of self-control for eating
  • Inappropriate compensations
    • For example, excessive exercise, self-induced vomiting, inappropriate diuretics use
  • Alternating binge eating and compensations for prolonged time
  • Distorted self-body image
  • System(s) affected: oropharyngeal, endocrine/metabolic, gastrointestinal, dermatologic, cardiovascular, pulmonary, psychiatric


  • Mean age of onset: 18 to 21 years
  • Predominant sex: female > male (13:1)

Up to 3% of females and ~1% of males in their lifetime

Etiology and Pathophysiology

Combination of biologic, psychological, environmental, and social factors

Heritability estimated to be up to 41%

Risk Factors

  • Female gender
  • History of obesity and dieting
  • Body dissatisfaction: critical comments about weight, body shape, or eating: low self-esteem
  • Depression, social anxiety, severe life stressor
  • Poor impulse control, substance abuse
  • Family history of substance abuse, affective disorders, eating disorder, or obesity
  • Diabetes
  • Childhood trauma (sexual or physical abuse, neglect)

General Prevention

  • Realistic and healthy weight management strategies and attitudes
  • Decrease body dissatisfaction and promote self-esteem.
  • Reduce focus on thin as ideal.

Commonly Associated Conditions

  • Major depression, dysthymia, anxiety, obsessive-compulsive, bipolar disorders
  • Substance use disorder
  • Personality disorders: borderline, schizotypal, antisocial (1)

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