Overview
Bulimia nervosa is an eating disorder in which someone cycles between binge eating and a behavior like vomiting, fasting, or excessive exercise in an attempt to offset the amount eaten.
History and Etymology
The pattern of purging as a potential mechanism to improve health goes back to ancient civilizations where physicians often attributed diseases to having eaten something toxic, and we have ample evidence of zealous partygoers across the world who deliberately purge so they can keep eating. While this can’t be declared healthy behavior, it also doesn’t show the same kind of body image distortion and weight monitoring that produces distress and urges we associate with a consistent psychiatric disorder. Once eating disorders were acknowledged by psychiatrists, the pattern of binge eating and purging were assumed to be a dysfunction related to anorexia nervosa or obesity rather than a distinct phenomenon. In 1979, Gerald Russell identified 30 patients he met who maintained a healthy weight but still presented with a cycle of binge eating and purging and published Bulimia nervosa: an ominous variant of anorexia nervosa. The DSM-III came out in 1980 and introduced bulimia nervosa as its own diagnostic category. [^0]