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Feature Articles: Eating Disorders

Self-induced purgingBulimia nervosa

Greta Hopke, RD, and Candance Gabel, MS, RD, LD, associate state nutrition specialist, University of Missouri Extension


Bulimia nervosa, which means "morbid hunger," is an eating disorder often characterized by the binge/purge cycle. According to the American Psychiatric Association there are 4 diagnostic criteria:


  • Repeated episodes of binge eating (2 or more per week for at least 3 months)
  • Lack of control of overeating during binge
  • Regular use of self-induced vomiting, laxatives, diuretics, fasting, or excessive exercising to control body weight
  • Constant concern with body weight and shape


There are 2 types of bulimia nervosa: binge/purge and non-purging. Both types of bulimia are fueled by the obsession with thinness and food. Bulimia, as compared to anorexia, may be more difficult to identify due to the person being of normal weight or at least not so obviously underweight. Individuals with bulimia nervosa have a loss of control over the impulse to binge. An average binge can range between 1,200 to 11,500 calories (Kolodny, 2004)! Often overlooked, these individuals also have a loss of control for the impulse to purge or "control" weight by other methods. This disorder makes it almost impossible for the individuals affected to eat in a normal, unself-conscious way.

An eating disorder is a very serious issue. It affects an individual's physical, emotional, social, intellectual, and even economical aspects of life. A few possible physical complications for bulimics include rupturing of the stomach; liver, heart or lung damage; mouth sores; destroyed tooth enamel; and destroyed bowel function due to repeated laxative abuse that can cause constant diarrhea or rectal bleeding. As you can see the results of an eating disorder are devastating. Of course, an eating disorder brings more than physical complications; the disorder affects their social and family life as well. Most people with an eating disorder become depressed and withdraw or isolate themselves from friends and family.

In reported cases, anorexia and bulimia combined affect almost 10 million women and 1 million men (primarily teens and young adults). It is estimated the peak onset of an eating disorder among girls occurs at ages 11-13. (Statistics from National Eating Disorders Association Web site: Bulimia nervosa is more common than anorexia nervosa, and it has been estimated that up to 10 percent of college students are bulimic (Williams, 2005).


For more information, see the other Food, Fitness and Eating Disorders feature articles or visit the following websites:




Kolodny, N. (2004). The beginner's guide to eating disorder recovery. Carlsbad, CA: Gürze Books.


Williams, M. (2005). Nutrition for health, fitness, & sport. 7th Ed. New York: McGraw Hill.


National Eating Disorders Association urges parents and teens to 'get real'. (2004). Retrieved Feb. 8, 2005 from National Eating Disorders Association website at


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