Probability of Developing Bulimia Nervosa

Bulimia nervosa has a lifetime prevalence of approximately 1.5% in women and 0.5% in men in the United States. The condition is characterized by recurrent episodes of binge eating (consuming an objectively large amount of food with a sense of loss of control) followed by compensatory behaviors such as self-induced vomiting, laxative misuse, fasting, or excessive exercise.

Bulimia typically develops in late adolescence or early adulthood, with the average age of onset around 18-20. Unlike anorexia, people with bulimia are often at a normal weight, which can make the disorder harder to detect. Risk factors include dieting history, low self-esteem, family history of eating disorders, childhood obesity, and cultural pressure for thinness.

Medical complications of bulimia include severe dental erosion, electrolyte imbalances (which can cause cardiac arrhythmias), esophageal tears, chronic gastric reflux, kidney problems, and parotid gland swelling. Cognitive behavioral therapy (CBT) is the most effective treatment, with about 50-60% of patients achieving remission. Fluoxetine (Prozac) is the only FDA-approved medication for bulimia. With appropriate treatment, about 70% of patients recover, though relapse rates are about 30-50%.