Bulimia is characterized by episodes of binging and purging, in which large quantities of food are consumed over a short period of time, and then purged through induced vomiting, the use of laxatives or diuretics, fasting, or excessive exercising.
A clinical diagnosis of bulimia requires:
- Binging behaviour (eating significantly more than most people would eat in a discrete period of time)
- A sense of lack of control during the binge episode
- Inappropriate compensatory behaviour (i.e. purging, fasting, overexercising, laxative abuse, etc.)
- The occurrence of binging and compensatory behaviours at least twice a week for three months
- A self-evaluation that's unduly influenced by shape or size
- The disturbance does not occur exclusively during episodes of anorexia
Bulimia is estimated to affect 2 to 5% of the population. It was once considered a disorder primarily affecting girls and young women, but is increasingly prevalent in older women and in boys and men. One quarter to one third of those struggling with bulimia have a prior history of anorexia.
Depending on the chosen method of purging, a number of physical complications can result from bulimia. These include electrolyte imbalance, heart palpitations, erosion of tooth enamel, and gastrointestinal difficulties. Electrolyte imbalance is one of the most serious medical complications of disordered eating. Electrolytes include: chloride, calcium, magnesium, sodium, and potassium. Proper balance is essential for muscle coordination, heart function, fluid absorption and excretion, nerve function, and concentration.
Besides physical disturbances, men and women living with bulimia also experience intense psychological pain and feelings of guilt, shame, and helplessness in the face of the cyclical nature of this disorder.