Journal of Clinical Psychology Practice

In 1979, Gerald Russell described and named Bulimia Nervosa (Palmer, 2004). His rich clinical description allowed clinicians and researchers to detect and study the disorder and an explosion of attention and literature followed in the next decade (Palmer, 2004). Bulimia is a disorder characterized by recurrent, episodic binge eating, self-induced purging, restrictive dieting, or excessive exercising in order to prevent weight gain. Bulimia may also include a persistent over-concern with weight, size, and shape, distortion of body image, and a desire to be thin (Thackwray, Smith, Bodfish, & Meyers, 1993). Binge eating is a feature of bulimia and is defined as the consumption of an abnormally large amount of food in addition to the perception of being out of control. Compensatory behaviors aimed at preventing weight gain are common in bulimia. They may include the misuse of laxatives, diuretics, or other agents, dieting, vomiting, and excessive exercise (Shapiro et al., 2007). The prevalence of Bulimia Nervosa has been estimated to be 1/100 for women and 1/1000 for men across the United States and Western Europe (Shapiro et al., 2007). Sub-threshold cases are those that fall below the threshold of diagnostic criteria for Bulimia Nervosa in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), resulting in a diagnosis of Eating Disorder Not Otherwise Specified (Nauert, 2008). The prevalence of sub-threshold Bulimia Nervosa has been estimated to be 1.5/100 for full syndrome and 5.4/100 for partial syndrome (Shapiro et al., 2007). No one etiological factor in itself is powerful enough to cause an eating disorder, and the emergence of these disorders likely result from an interaction of various influences, such as societal, biological, and cognitive factors, as well as familial characteristics and personality features of the Summary