Bulimia Nervosa
Bulimia nervosa involves recurrent binge-eating episodes followed by compensatory behaviours and a self-evaluation strongly influenced by weight or shape.
The binge–compensation cycle
A binge is not simply eating more than intended; it includes a sense of loss of control. Compensation may include self-induced vomiting, misuse of laxatives or diuretics, fasting or excessive exercise. Secrecy, shame and rigid dieting can maintain the cycle.
Many people with bulimia are not underweight, so the condition may remain hidden. Dental erosion, swollen salivary glands, reflux, throat irritation, dehydration and menstrual changes can occur.
Assessment and medical safety
A professional assesses frequency and context of binges and compensatory behaviours, physical risk, mood, anxiety, self-harm and substance use. Medical tests may be needed because vomiting and laxative misuse can disturb electrolytes and heart rhythm even when appearance and weight seem unchanged.
Treatment
Evidence-based treatment commonly includes eating-disorder-focused psychological therapy, support to establish regular eating and medical monitoring. Treatment addresses the cycle rather than blaming the person. For young people, family-based involvement may be appropriate. Medication can sometimes be considered by a doctor, but does not replace psychological and nutritional care. Recovery is possible with coordinated care.