Bulimia Nervosa is an eating disorder characterized by binge eating followed by purging. Individuals with Bulimia Nervosa feel a lack of control over their eating and purge to prevent weight gain through vomiting, excessive exercise, or laxative use. Long term effects include dental problems from acid exposure during purging, electrolyte imbalances, and damage to the esophagus and throat. Treatment options range from support groups for mild cases to cognitive behavioral therapy and medication combined with family support.

1. PUBLISHED PAPER REVIEW
BULIMIA NERVOSA
Bulimia Nervosa is an eating disorder. Individuals who suffer
from the illness have what is called a binge-purge behavior;
they overeat on regular intervals then try to rid themselves
of the food to prevent weight gain. Some individuals with
this disorder also suffer from Anorexia Nervosa.
There is no accurate cause for Bulimia, but the following
factors contribute; family, cultural influence, society,
psychological state, genetics, trauma. More men than
women suffer from this disorder, but it’s even more common
in younger women and adolescent girls.
A person suffering from this disorder, binges with hefty
amounts of foods high in calories several times a day for
months, then sensing a lack of control over what they are
eating they become overwhelmed resulting in self loathing
and disgust. For a sense of relief and to prevent weight gain
they purge by forcing themselves to vomit, excessively
exercising or using laxatives, diuretics or enemas.
Bulimic individuals are usually at normal weight making the
disorder unrecognizable by others, but bulimics see themself
as overweight.
EFFECTS
Dental exams may show cavities or gingivitis as the enamel
on the teeth becomes eroded due to frequent exposure to
the acid in vomit. Purging reduces the chewing surfaces of
the back molars significantly. Loss of tooth structure results
in nerve exposure which causes amplified sensitivity to
extreme temperatures and even nerve infection. The

2. salivary glands, mainly those in the cheeks may become
swollen as a result of the frequent vomiting.
Physical Examinations may show the following in prolonged
bulimics:
 Ruptured blood vessels in the eyes resulting due to
pressure buildup from the forced vomiting.
 Dry mouth due to dehydration from vomiting or the
use of laxatives.
 Tearing of esophagus, and swelling of throat from
vomiting.
 Small cuts and calluses across the tops of the finger
joints from forcing to vomit
 Electrolyte imbalances such as (i) hypokalemia (low
levels of potassium) that may result in: irregular heart
beats (dysrhythmias), constipation, exhaustion, muscle
damage (rhabdomyolysis), Muscle spasms and (ii)
dehydration which can lead to constipation.
 Hemorrhoids
 Pancreatitis
TREATMENT
Treatments vary according to the severity of the disorder.
For mild conditions with patient without health problems,
support groups may be helpful.
For those incapable of responding to support groups,
cognitive-behavioral therapy (CBT) nutritional is an initial
treatment.
Cognitive-behavioral therapy together with serotonin re-
uptake inhibitors (SSRIs) is also effective if CBT alone
proves ineffective.

3. Family support is highly recommended as this disorder is
quite difficult to overcome. This disease is long term so
even with treatment many patients still have symptoms.
References:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001381/
http://www.1dental.com/articles/dental/effects-bulimia-dental-
problems-affordable-dental-care-may-ease-damage/