• Repeated episodes of binge eating
• A sense of a lack of control over eating during the episode (a feeling that one cannot stop eating or control what or how much one is eating)
• Inappropriate compensatory behaviours aimed at preventing weight gain (self-induced vomiting, misuse of laxatives, diuretics or other medications, fasting suppressants or excessive exercising)
• Self-evaluation is unduly influenced by body shape and weight

What does this mean?

This means that, when a person has bulimia, like in anorexia nervosa, they are driven by an intense fear of gaining weight, and they engage in and become trapped within a cycle of restriction, bingeing and purging.

In many cases, bulimia begins with a diet but the preoccupation with food and weight becomes obsessive and can take over the person’s life. Eventually, they will become locked into a compulsive cycle of bingeing and purging (getting rid of the food) or resorting to other ways of preventing weight gain. Attempts to break the cycle often fail. The person begins to feel more and more out of control.

Self-esteem is very low as it is measured against the ability to control one’s eating, weight, shape and size. On the outside, a person with bulimia may seem very capable, positive, successful and on top of things. However, on the inside, they may be struggling desperately with feelings of guilt, shame, self-loathing and ineffectiveness.

Many people with bulimia maintain a normal body weight. As a result, the disorder can sometimes go unnoticed and untreated for a long time. The longer the binge-purge cycle remains in place, the harder it becomes to overcome it.

What is a binge?

By definition, a binge is:

Eating, 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 (a feeling that one cannot stop eating or control what or how much one is eating).

However, it is important when talking and supporting someone that we understand that ‘binge’ can have a subjective meaning of:

• Eating something that wasn’t planned
• Eating in a way that feels out of control

This is important because when we are supporting someone, it is helpful not to assume we understand the meaning of their words, but rather we ask them to explain it to us. This helps to reduce resistance to talking about the eating disorder and also helps us to better understand how the person is thinking and feeling.