Binging and purging are regarded as signs of bulimia nervosa.  This is a serious, potentially life-threatening disorder in which control of a person's weight is accomplished by repeated episodes of eating large amounts of food in a short period of time (binging) and then attempting to get rid of the extra calories in an unhealthy manner (purging).  Purging may be accomplished by induced vomiting, excessive exercise, or inappropriate use of laxatives, diuretics, or enemas.  People with bulimia nervosa are overly concerned with body shape and weight; the disorder is about body image and not about food.  The disorder may not be easily recognized because the individual may be a normal weight or even a bit overweight.

There are two types of bulimia nervosa:

1. Purging - regularly self-induced vomiting or the misuse of laxatives, diuretics, or enemas
2. Non-purging - excessive exercise or refusing to eat (fasting) to control weight

A person with bulimia nervosa feels a loss of control and a constant concern about food and weight.  They may eat secretly and rapidly and cannot stop the urge to eat once the binge has started.  Eating binges may occur several times a day and they may stop eating only when they feel painfully full, are interrupted, or run out of food.  They are usually aware that their eating pattern is not normal.  After a binge, the person feels disgust and guilt and purges to get rid of the excess calories.

Bulimia nervosa is believed to be caused by a combination of genetic and environmental factors.  It tends to run in families and is more common in girls and young women.  Certain behaviors, psychological disorders, and family and societal influences may all have a bearing on the onset of bulimia.

Symptoms of bulimia may include:

• Feeling a lack of control about eating
• Eating until the point of discomfort or pain
• Eating much more food in a binge episode than in a normal meal or snack
• Forced or self-induced vomiting after eating
• Exercising excessively
• Misuse of laxatives, diuretics or enemas
• Being preoccupied with body shape and weight
• Going to the bathroom after eating or during meals
• Abnormal bowel functioning
• Damaged teeth and gums
• Swollen salivary glands
• Sores in the throat and mouth
• Dehydration
• Irregular heartbeat
• Sores, scars or calluses on the knuckles or hands
• Menstrual irregularities or loss of menstruation
• Depression
• Anxiety

Treatment involves a combination of support groups, cognitive-behavioral therapy, and nutritional therapy.