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            Women make up 90% of all people who suffer from bulimia nervosa (bulimia). People suffering from bulimia may look, normal, too thin or overweight. Bulimia is a psychological disorder characterized by binge eating. Vomiting, fasting, enemas, excessive use of laxatives and diuretics or compulsive exercise are followed by binge eating for weight control. Bulimics often deny their condition, therefore it may be difficult to determine if someone has bulimia.1, 2.
             There are many symptoms that can help detect bulimia:.
             • Uncontrollable eating, dieting, obsession with exercise, purging, fasting.
             • Using laxatives, diuretics or vomiting (blood) to lose weight.
             • Making excuses to use the bathroom frequently after meals.
             • Low self-esteem.
             • Swollen glands (neck or face).
             • Irregular menstrual cycles.
             • Weakness.
             • Dental problems.
             • Heartburn, bloating, indigestion, constipation.
             • Sore throat1,3,4.
             The causes for bulimia nervosa are unknown. This depends on personal standards and environment. Pressure from family, friends, or even the media can cause a person to develop an eating disorder. Professions such as modeling, dancing, gymnastics, wrestling, and long-distance running may also influence bulimia. Another cause could be that people try to diet by fasting early in the day. This usually causes intense hunger and leads to binge eating later in the day. This behavior may take up to one year before the person begins to use an improper method to get rid of their food.1,5,6 .
             There are many serious complications with bulimia. The acid from vomiting may cause inflammation of the stomach and esophagus. Also forceful vomiting can cause tears. These tears may develop in the esophagus or stomach and can cause death. Low calcium in the person's diet can cause osteoporosis. Lower-than-normal levels of certain body chemicals such as chloride, sodium, and potassium lead to muscle cramps and a missed or slowed heartbeat.

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