Adolescent eating disorder: bulimia.

Bulimia, an eating disorder, recently has emerged as a major mental health problem, especially among adolescent females. The bulimic experiences periods of compulsive binge eating followed by purges to rid the body of unwanted calories. Binges are triggered by intense emotional experiences, such as loneliness, anger, rejection, or stress. Associated features of bulimia are secretiveness, depression, drug abuse, preoccupation with body image and sexual attractiveness, and an awareness that the behavior is abnormal. The physical side effects include dental problems, inflamed esophagus, EEG abnormalities, abdominal or urinary disturbances, and changes in blood sugar level. Cognitive disturbances related to binging and purging are perfectionistic, egocentric, and distorted thinking, misconceptions about nutritional requirements, unreasonable goals and expectations, and disturbed affect. Bulimics resist treatment; however, such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising.