Bulimia Nervosa is characterized by recurrent and frequent episodes of binge eating—i.e., unusually large amounts of food consumed in a short time—and a feeling that one lacks control over eating. A bulimic can consume as much as 3,400 calories in little more than an hour, and as much as 20,000 calories in eight hours.
People with bulimia often know they have a problem and are afraid of their inability to stop eating. Binging is then followed by purging—namely, self-induced vomiting or the abuse of diuretics or laxatives. Binging and purging are often performed in secret, with feelings of shame alternating with relief.
Unlike anorexia, people with bulimia can maintain a normal weight for their age. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape, which may explain why bulimic behavior often takes place in secret. The binging and purging cycle usually repeats several times a week. As with anorexia, people with bulimia often have coexisting psychological illnesses, such as depression and anxiety, and substance abuse problems. Many physical dysfunctions result from the purging, including electrolyte imbalances, gastrointestinal troubles, and dental problems.