Bulimia nervosa is characterized by cycles of bingeing and purging. As with anorexia, this behaviour is driven by a desire to regulate feelings, with worries about body weight and shape.

The cycle begins with the person rapidly eating large amounts of food in a single sitting. The eating feels automatic and helpless. Initially this may numb uncomfortable feelings, like anger or sadness, but it also creates physical discomfort and anxiety about weight gain. As a consequence, the person tries to rid the body of the food by vomiting, using laxatives, enemas or diuretics, exercising excessively, skipping meals or dieting.

These purging behaviours don't achieve the desired goals - to feel more physically comfortable and not gain weight. Instead, they are very harmful to health.

Symptoms of bulimia nervosa include:

• Repeated episodes of bingeing and purging.
• Feeling out of control while eating.
• Vomiting, using laxatives, diet pills or diuretics, exercising excessively, and skipping meals to rid the body of food.
• Frequent dieting.
• Using body weight and shape as the main measure of one's self-worth.

People with bulimia may well have a weight that is regarded as "normal".

People may also develop a Binge Eating Disorder (BED).

Individuals with binge eating disorders eat excessive amounts of food at one time. They do this for two reasons:

• They are very hungry because they have been dieting or restricting their eating in some way. The binge is a response to that hunger.
   
• They over-eat to comfort themselves, to avoid uncomfortable situations, or to numb their feelings. The binge is an attempt to soothe themselves emotionally.

People who binge-eat are often ashamed and embarrassed. They also tend to be genetically heavier and larger than the "average" person. They do not, however, generally try to compensate for their over-eating by vomiting, fasting, over-exercising or abusing laxatives as people with anorexia or bulimia may do.

Symptoms of binge eating disorder include:

• Eating large amounts of food frequently and in one sitting.
• Feeling out of control and unable to stop eating.
• Eating quickly and in secret.
• Feeling uncomfortably full after eating.
• Feeling guilty and ashamed of their binges.
• In addition, people who binge eat may have a history of diet failures, and may also be obese. About one in five obese people engage in binge eating.

Excerpts from National Eating Disorders Information Centre www.nedic.ca