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For further information, see CMDT Part 29-06: Bulimia Nervosa

Key Features

  • Uncontrolled episodes of binge eating at least once weekly for 3 months

  • Recurrent inappropriate compensatory behavior to prevent weight gain

    • Self-induced vomiting

    • Laxatives

    • Diuretics

    • Fasting

    • Excessive exercise

  • Excessive concern with body weight and body shape, with undue influence of weight on self-worth

  • Occurs predominantly in young, white, middle- and upper-class women

Clinical Findings

  • Consuming large quantities of easily ingested high-calorie foods, usually in secrecy, followed by vomiting, cathartics, or diuretics accompanied by feelings of guilt or depression

  • Body weight fluctuates but generally within 20% of normal BMI

  • Menstruation is usually preserved


  • History and identification of behavioral features

  • Differential diagnosis

    • Anorexia nervosa

    • Depression

    • Obsessive-compulsive disorder

    • Personality disorder

    • Substance abuse


  • Antidepressant medications such as fluoxetine and other selective serotonin reuptake inhibitors

  • Psychotherapy (individual, group, family, and behavioral)

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