Bulimia Nervosa is characterized primarily by a cycle of binge eating and compensatory behaviors such as self-induced vomiting in an attempt to undo or compensate for the effects of binge eating.

The primary symptoms of Bulimia Nervosa are:

• Recurrent episodes of binge eating.  An episode of binge eating is characterized by both of the following:

(1)    eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.

(2)     a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

·        Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.

·        The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.

·        Self-evaluation is unduly influenced by body shape and weight.

·        The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

There are two subtypes of Bulimia Nervosa:

Purging Type:  during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Nonpurging Type:  during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.