The most common element surrounding ALL Eating Disorders is the inherent presence of a low self esteem

Men and women who live with Bulimia seek out binge and purge episodes -- they will eat a large quantity of food in a relatively short period of time and then use behaviors such as taking laxatives or self-induced vomiting -- because they feel overwhelmed in coping with their emotions, or in order to punish themselves for something they feel they should unrealistically blame themselves for. This can be in direct relation to how they feel about themselves, or how they feel over a particular event or series of events in their lives. Those suffering with Bulimia may seek episodes of binging and purging to avoid and let out feelings of anger, depression, stress or anxiety.

"... the shackled anger I am accustomed to... reflecting on myself... and with every tear there are a thousand more that need to follow so I may climb from the darkness... "

Men and women suffering Bulimia are usually aware they have an eating disorder. Fascinated by food they sometimes buy magazines and cook-books to read recipes, and enjoy discussing dieting issues.

Some of the behavioral signs can be: Recurring episodes of rapid food consumption followed by tremendous guilt and purging (laxatives or self-induced vomiting), a feeling of lacking control over his or her eating behaviors, regularly engaging in stringent diet plans and exercise, the misuse of laxatives, diuretics, and/or diet pills and a persistent concern with body image can all be warning signs someone is suffering with Bulimia. See Also, Signs and Symptoms.

"... my need to do this... it is almost instinctually protective.... a mechanism shielding out the real me in my mind... and I don't think I even know who the real me is... "

It is important to realize that what makes a person Bulimic -- as opposed to Anorexic -- is not the purging, but the cycle of binging and purging. Purging may be using laxatives or self-induced vomiting, but there are Bulimics who use other inappropriate compensatory behaviors such as compulsive exercise (ie., excessive jogging or aerobics), to attempt to burn off the calories of a binge, or fasting the day following a binge. It is not uncommon for a man or woman suffering with Bulimia to take diet pills in an attempt to keep from binging, or to use diuretics to try to lose weight. A sufferer will often hide or "store" food for later binges, will often eat secretly and can have large fluctuations in their weight.

"...I sense a stranger filling this silent room with anguish... a silence that rattles against the windows leaving me so cold and numb... and somehow... this feeling I do not understand is my best friend and enemy all wrapped up in one... "

Both Anorexia and Bulimia...
There are many similarities in both illnesses, the most common being the cause. There seems to be a common occurence of sexual and/or physical and emotional abuse in direct relation to eating disorders (though not all people living with Eating Disorders are survivors of abuse). There also seems to be a direct connection in some people to clinical Depression. The eating disorder sometimes causes the depression or the depression can lead to the eating disorder. All in all, eating disorders are very complex emotional issues -- Though they may seem to be nothing more than a dangerously obsessive weight concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.

"... I want to free myself... and find security in my tears. How can I touch my innerself and know of the existence... when this painful essence has beaten me down?... "


Diagnostic Criteria
The following is considered the "text book" definition of Bulimia Nervosa to assist doctors in making a clinical diagnosis... it is in no way representative of what a sufferer feels or experiences in living with the illness. It is important to note that you can still suffer from Bulimia even if one of the below signs is not present (also see the Signs and Symptoms section). In other words, if you think you have Bulimia, it's dangerous to read the diagnostic criteria and think "I don't have one of the symptoms, so I must not be Bulimic".

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
   
   • eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
   • a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
   • Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
   • Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas