Bulimia: primary care approach and intervention.

Bulimia is a serious and increasingly prevalent eating disorder involving both the ingestion of large quantities of food and the subsequent purging of the ingested calories. Nurse practitioners can effectively intervene in cases of bulimia because of their ability to assess the bulimic's potential medical problems and provide the health education and counseling necessary to stop the dangerous binge/purge cycle. Clues aiding in the diagnosis of bulimia include frequent weight fluctuations, enlargement of the patient's parotid glands, dental erosion, menstrual irregularity, electrolyte imbalance and depression. Interventions should address the patient's medical problems, disrupt the binge/purge cycle, help the patient to establish normal eating patterns, raise the bulimic's self-esteem and help resolve underlying depression.