Bulimia nervosa, also called bulimia and binge-purge syndrome, is an eating disorder that is characterized by a pattern of binge eating followed by harmful purging behaviors, especially self-induced vomiting, to control or prevent any resulting weight gain. Eating disorders involve abnormal eating habits and can cause serious health problems.

Bulimia is more prevalent in females than males, especially adolescents and young adults. According to the U.S. National Institute of Mental Health (NIMH), an estimated 1 to 4 percent of females suffer from bulimia during their lifetime.

There are two types of bulimia nervosa:

• Purging bulimia. In this type of bulimia, patients regularly engage in purging behaviors (e.g., vomiting, use of laxatives [usually mild drugs for stimulating bowel movement]) to control their weight. This is the most common type of bulimia.
  
  
• Nonpurging bulimia. In this type of bulimia, patients do not engage in purging methods to avoid weight gain. Rather, individuals with nonpurging bulimia follow episodes of binge eating by strict dieting, fasting and/or excessive exercise.

It is important to note that bulimia should not be confused with another eating disorder characterized by chronic, strict calorie restriction and/or purging behaviors, anorexia nervosa. Unlike anorexia nervosa patients, who must weigh more than 15 percent below the expected range for their age and body size, patients with bulimia are almost never underweight. 

It is not known what causes bulimia nervosa, but it is believed to result from a combination of factors including heredity, history of physical or sexual abuse, societal pressures to be thin, participation in competitive sports or activities (e.g., figure skating, cheerleading, gymnastics) and low self-esteem.

Patients with bulimia often have other types of mental illnesses including clinical depression, anxiety disorders (e.g., obsessive-compulsive disorder), and substance abuse.

Patients with bulimia often exhibit symptoms including regular uncontrollable eating binges, misuse of laxatives or diuretics, extreme unhappiness or concern about body shape and size, swollen cheeks, menstrual irregularities, dry skin, dental problems (due to ongoing vomiting) and chronic fatigue.

Bulimia is usually diagnosed after a physical examination, which includes a medical history. Patients may be referred to a psychiatrist or other mental health professional for a mental health evaluation.

Due to the complex nature of eating disorders, bulimia usually requires a comprehensive treatment plan including medical care and monitoring of health complications (e.g., irregular heart rhythms), psychotherapy, dietary counseling by a nutritionist and dental care to treat any tooth or gum erosion that results from ongoing vomiting.

Receiving support from family members and friends is important because patients with bulimia usually resist treatment, believing they do not need help.