Bulimics have high levels of interpersonal sensitivity, as reflected in large increases in self-criticism
following negative social interactions.
Further binge episodes tend to be preceded by poorer than average social experiences, self concepts
Also reported that the binge episodes are followed by deterioration in self concept, mood state and
The person who is engaged in a binge often feels a loss of control over the amount of food being
consumed. Foods that can be rapidly consumed, esp sweets such as ice cream or cake are usually part
of a binge. Although research suggests that patients with BN sometimes ingest an enormous quantity
of food during a binge.
Binges are not always as large as the DSM implies and there may be wide variation in the caloric
content consumed by individuals with BN during binges. Patients are usually ashamed of their binges
and try to conceal them. They report that they lose control during a binge even to the point of
experiencing something akin to a dissociative state perhaps losing awareness of what they are doing
of feeling that it is not really they who are binging
After the binge is over disgust, feelings of discomfort and fear of weight gaistep ofto the 2
BN—[urging to undo the caloric effects of the binge. As seen with Ms. B purging can involve induced
vomiting and excessive exercise. The use of laxatives and diuretics is common even though this odes
not actually result in weight loss
The DSM diagnoses of BN requires that the episodes of binging and purging occur at least twice a
week for three months
Suggesting that there is a continuum of severity rather than a sharp distinction
Like patients with AN patients with BN are afraid of gaining weight and their self esteem depends
heavily on maintaining normal weight.
Observed that a morbid fear of fat is an essential diagnostic criterion for BN cuz 1) it covers what
clinicians and researchers view as the core psychopathology of BN 2) it makes the diagnosis more
restrictive and 3) it makes the syndrome more closely resemble the related disorder or AN
as with anorexia two subtypes of BN are distinguished: a purging type and a non purging type in
which the compensatory beh are fasting or excessive exercise. And recent evidence does not strongly
support the validity of this distinction
BN typically begins in late adolescence or early adulthood. About 90% of cases are women and
prevalence among women is thought to be about 1 to 2% of the population.
Find tat lifetime rates for females are approx 1.1% of the population for BN and 0.5% of the
population for AN
Suggests that bulimia is more common than anorexia among adolescents
One study found that by age 18 80% of young women in BC with normal height and weight indicate
that they would like to weight less.
Another study of more than 1,800 females from Ottawa, Hamilton, and T,O between the ages of 12
and 18 found that 27% has disordered eating attitudes and beh and approx 1 in 7 participants
engaged in binge eating with associated loss of control
Comparisons across time suggest that the frequency of BN may be increasing.
Cohort effect- with rates being higher among ppl born after 1960 who alsp tend to have younger ages
BN patients are somewhat overweight before the onset of the disorder and that the binge eating
often starts during an episode of dieting.
Long term follow up of BN patients reveal that about 70% recover although about 10% remain fully
BN is associated with numerous other diagnoses, notably depression, personality disorders ( esp
borderline person disorder) anxiety dis, substance abuse and conduct disorder
Suicide rates are much higher among ppl with BN than in the general population. A twin study had
found that bulimia and depression are genetically related Somewhat curiously BN has been associated with stealing. Patients with bulimia who steal tend also
to be illicit drug user