There are two subtypes of Bulimia Nervosa:

• Purging, or regular vomiting and/or misuse of laxatives, diuretics,
  or enemas
• Nonpurging, which does not involve regular purging, and instead involves fasting and/or excessive exercise

Eating Disorder Information Index
National Eating Disorder Association

Who is at Risk?

It is estimated that between one to just over four percent of females experience Bulimia Nervosa in their lifetime, and an estimated 0.5 to nearly four percent of females suffer from Anorexia Nervosa in their lifetime.² Far fewer men suffer from either of these disorders.^1,3 Typically Anorexia Nervosa and Bulimia Nervosa develop in adolescence or early adulthood.¹

Identifying "Normal Weight"

Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women. Calculate your BMI and determine where you fall in these BMI categories:

• Underweight = <18.5
• Normal weight = 18.5-24.9
• Overweight = 25-29.9
• Obesity = BMI of 30 or greater

Health Risks Associated with Eating Disorders

There are serious, and sometimes fatal, consequences associated with the lifestyle choices made by individuals suffering with both Anorexia Nervosa and Bulimia Nervosa:^{4, 5}

Starvation

• Abnormally slow heart rate and low blood pressure
• Osteoporosis
• Muscle loss and weakness.
• Dehydration
• Dry hair and skin.
• Hair loss.
• Lanugo (growth of a fine downy hair layer to keep the body warm).
• Sensitivity to the cold.
• Abnormal or absent menstrual cycle and infertility
• Headaches
• Anemia (iron deficiency)
• Fainting

Purging

• Electrolyte imbalances
• Dental and gum problems
• Inability to menstruate and infertility
• Osteoporosis
• Dehydration
• Tears in the esophagus
• Abdominal pain
• Indigestion and heartburn

Ipecac to induce vomiting

• Serious cardiac, skeletal, and nervous system abnormalities

Frequent laxative use

• Dependence on laxatives for bowel emptying
• Irregular bowel movements
• Rectal bleeding
• Dehydration

Frequent use of diuretics

• Low potassium (can damage the heart)
• Dehydration

Excessive exercise

• Stress fractures
• Abnormal or absent menstrual cycle

¹American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association.

²American Psychiatric Association Work Group on Eating Disorders. Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 2000; 157(1 Suppl): 1-39.

³Hoek, H. W. (2002). Distribution of eating disorders. In C. G. Fairburn & K. D. Brownell (Eds.), Eating disorders and obesity: A comprehensive handbook (pp. 233-237). New York: The Guilford Press.

⁴Lock, J., & Schapman, A. M. (in press). Bulimia Nervosa. In J.E. Fisher & W. ’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.

⁵Centre for Excellence in Eating Disorders (2006). Health risks of eating disorders. Accessed 5/30/06.