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- A pattern of discrete periods of uncontrolled eating, followed by compensatory behaviors
- System(s) affected: Oropharyngeal; Endocrine/metabolic; Gastrointestinal; Dermatologic; Cardiovascular; Nervous
- Predominant age: Adolescents and young adults
- Mean age of onset: 18–21 years
- Predominant sex: Female > Male (10–20:1)
28.8 women, 0.8 men per 100,000 per year
- 1–3% in women age 16–35 years
- 0.5% in young men (higher among gay and bisexual men)
- Female gender
- History of obesity and dieting
- Body dissatisfaction
- Critical comments by family or others about weight, body shape, or eating
- Severe life stressor
- Low self-esteem
- Perceived pressure to be thin
- Perfectionist or obsessive thinking
- Poor impulse control, alcohol misuse
- History of anorexia nervosa (AN)
- Environment stressing high achievement, competition, thinness, or physical fitness (e.g., armed forces, ballet, cheerleading, gymnastics, or modeling)
- Family history of substance abuse, affective disorders, eating disorder, or obesity
- Early feeding problems
- Low birthweight for gestational age
- Hyporeactivity at birth
- Type I diabetes
- Sexual abuse is not causally related to bulimia.
- Prevention programs can reduce risk factors and future onset of eating disorders (1)[C].
- Target adolescents and young women ≥15 years.
- Encourage realistic and healthy weight management strategies and attitudes.
- Decrease body dissatisfaction and promote self-esteem.
- Reduce focus on thin as ideal.
- Moderate overly high self-expectations.
- Decrease anxiety/depressive symptoms and improve stress management.
Combination of biological, psychological, environmental, and social factors. Unique contribution of any specific factor remains unclear.
Commonly Associated Conditions
- Major depression and dysthymia
- Anxiety disorders
- Substance abuse/dependence
- Bipolar disorder
- Obsessive-compulsive disorder
- Borderline personality disorder
- Schizophrenic disorder