What is Bulimia?

Reprinted from Bulimia: A Guide to Recovery
By Lindsey Hall and Leigh Cohn

Bulimia is an obsession with food and weight characterized by repeated overeating binges followed by compensatory behavior, such as forced vomiting or excessive exercise. For an epidemic number of women and men, bulimia is a secret addiction that dominates their thoughts, undercuts their self-esteem, and threatens their lives.

The symptoms of bulimia are described by the Egyptians and in the Hebrew Talmud; and bulimia (Greek for "ox-hunger") was widely practiced during Greek and Roman times. In the later half of the twentieth century, though, eating disorders, and particularly bulimia, have been identified as widespread cultural phenomena. Bulimia is also termed bulimia nervosa and bulimarexia. In 1980, the American Psychiatric Association formally recognized bulimia. In its fourth edition, the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) lists the following criteria that an individual must meet to be diagnosed:

A. Recurrent episodes of binge eating, with an episode characterized by (1) eating in a discrete period of time, usually less than two hours, an amount of food that is significantly larger than most people would eat during a similar period of time and under similar circumstances; and, (2) a sense of lack of control over eating during the episode, such as a feeling that one cannot stop eating.

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or enemas (purging type); or, through fasting or excessive exercise (nonpurging type).

C. These behaviors occur at least twice a week for at least three months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The behavior does not only occur during episodes of anorexia nervosa.

These cases are also life-damaging and need to be taken seriously. Although the overt symptoms of bulimia revolve around food behaviors and a fear of gaining weight, bulimia is actually a way to cope with personal distress and emotional pain. Eating binges take time and focus away from more disturbing issues, and purges are an effective way to regain the control and feelings of safety lost during the binge. Also, while bulimic behavior may have started as a seemingly-innocent way to lose weight, the cycle of bingeing and purging usually becomes an addictive escape from all kinds of other problems.