Bulimia nervosa is known as the "binge-purge syndrome", which in its extreme form, can also lead to death. Sufferers of this disorder usually binge large amounts of food in a small period of time, then purge the food. There are several ways of purging, including self-induced vomiting, Laxative abuse, fasting, and excessive exercise. They do this, so that much of the food will not be able to absorb into the body. Bulimia is not only a physical appearance disorder, but is also a mental disorder, that usually effects young women in their 20's and 30's as well as some men. These bulimics have ongoing feelings of isolation, no self-confidence, depression, and low self-esteem. Bulimics show great concern for their weight and body shape, but bulimia may go undetected for many years because most bulimics are within normal weight range.

There are three types of bulimia. Bulimia Nervosa is best considered as three separate illnesses that share the important features. There is Simple Bulimia Nervosa, Anorexic Bulimia Nervosa

The second type of Bulimia is Anorexic Bulimia Nervosa. Anorexic Bulimia Nervosa is an illness that usually follows a short period of Anorexia Nervosa. Usually the sufferer recovers from this short period of Anorexia without treatment. The control of the Anorexic is continuous and bingeing begins in very small amounts and becomes more severe once the vomiting begins. Usually this begins by vomiting after a normal meal, but leads to the loss of control of the appetite drive and true bingeing starts. Occasionally the vomiting and bingeing start first, but then there is a period of the limitation of eating known as an anorexic phase. The illness becomes conquered by the bingeing and vomiting behavior, but the weight stays low for a while before slowly rising to normal and maybe even above normal.

Course and Outcome of the three types of Bulimia

Boskind-White, Marlene, White Jr., C., William, Bulimarexia the Binge/Purge Cycle. New York, WW Norton & Company. 1983

Amenorrhea- Abnormal suppression of absence of menstruation.

"Simple Bulimia Nervosa often runs a benign course and there are probably many girls who have mild illnesses, never ask for help, and yet give it up successfully. When more severe it is often an illness that can be successfully treated on an outpatient basis." The sufferer needs to want to stop the illness more than she wants to control her weight by vomiting. Treatment is often along behavioral lines at first and progressively focuses more on emotional problems. In the hands of experts, the result of such treatment is good.

Http://www.priory-hospital.co.uk/htm/bulimi.htm

Anorexic Bulimia Nervosa is more likely to need day patient care, particularly if the weight remains low because the return of normal weight is necessary to appetite control. The emotional disorder is often greater and the level of emotional maturity is less, so that greater support and psychological contribution may be needed. Ultimately, the result depends on the severity of the basic problems and their successful decision, as it does with Anorexia Nervosa.

, and Multi-impulsive Bulimia Nervosa. Simple Bulimia Nervosa is an illness that begins usually when the girls are about 18 years old. These groups of girls are usually fairly normal before the illness and tend to have been slightly under confident. These girls are usually fairly popular. This illness is usually started by a period of unhappiness. This might have been caused by a destructive relationship with a boyfriend. The girls have a feeling of self-dislike about their appearances, so they start to diet hoping that this will improve their self- esteem. Vomiting is used to achieve this weight loss, and so the cycle of bingeing and vomiting occurs. The weight of the bulimic will remain close to normal weight, but the eating patterns will gradually worsen. This form of bulimia is!

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