Bulimia Nervosa

What it means to suffer from Bulimia Nervosa


Bulimia nervosa doesn't always lead to low body weight, but it can have serious medical complications. It is often accompanied by marked mental distress with difficulties in managing emotions and impulses, and feelings of inadequacy that maintain the eating disorder itself.

In practice

How to understand if the symptoms presented are related to bulimia nervosa?

(from: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR), American Psychiatric Association (2022).

Recurrent binge eating episodes

Binge eating episodes are characterized by excessive food intake in a short period of time. These episodes are always associated with a strong feeling of loss of control. These binges are recurrent (at least once a week for 3 months, according to DSM-5 TR criteria).

Compensatory behaviours for binge eating

Most commonly self-induced vomiting or the use of laxatives, but fasting or excessive physical activity are also quite common.

elf-evaluation closely connected to that of one's own body

for those who suffer from Bulimia, their self-esteem is completely determined by their weight, so it is not uncommon to have a self-devaluation, sometimes linked to depressive symptoms.

Case study:


Wanda is 24 years old. Her eating problems began in the early years of adolescence when she went on a diet despite having a normal body mass index. Later, when she moved to another city to attend university at the age of 18, she began to eat too much. Within a few months, she had gained almost 5 kg, so she usually avoided breakfast, often skipped lunch, but then became very hungry in the evening and started to eat excessively. Trying not to lose control, she began inducing vomiting, a method she had learned by reading on the Internet and which she initially considered acceptable to keep her fear of gaining weight under control. During her university years, she maintained an overall adequate functioning, also socially, although she always hid her behaviors by not talking about them with anyone. Over time, she started to reduce contacts with friends, isolate herself more and more, and her self-esteem weakened more and more.

(from DSM-5 Clinical Cases, 2014)