Also known as the binge-purge syndrome, bulimia nervosa is a psychiatric disturbance of body perception almost invariably occurring in middle to upper class young females, and may be associated with anorexia nervosa. The main difference between these diseases is the way in which the patients see themselves – the bulimic has a fear of being fat, the anorexic has a desire to be thin.
There is no known specific cause, but patients tend to be high achievers, perfectionists, desperately eager to please others and have an anxious personality.
Symptoms are characteristically a voracious and continuous consumption of huge quantities of food followed by purging, vomiting and the use of fluid tablets in order to maintain a normal weight. Patients are secretive, and appear to eat normally in public, but binge eat and vomit in private.
Other symptoms may be menstrual irregularities, sore throat, bowel problems, dehydration, lethargy and dental problems due to the repeated exposure of the teeth to stomach acid. Suicide can be a risk in severe cases.
Close family support, psychotherapy and careful medical monitoring over a period of several years are the main forms of treatment. Maudsley family therapy can also be used for this disorder.
Most patients recover and go on to lead normal lives.