The multidetermined nature of bulimia nervosa in adolescent girls: a cross-cultural examination

Eating disorders are pathological disruptions in normal eating patterns found primarily in adolescent and young adult women. Intentional self-starvation (anorexia nervosa) and failure to maintain body weight have a long history of being recognized as pathological. Yet, bulimia nervosa, or gorging and purging accompanying anorexia, was not officially recognized as an eating disorder until 1980 whan it was included in the Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (DSM; American Psychiatric Association, 1980). Tha DSM-IV (APA, 1994) describes bulimia nervosa (see Figure 1.1) as characterized by repeated incidents of binge or uncontrolled eating, recurrent attempts to inappropriately compensate for massive calorie intake in order to prevent weight gain, and use of weight and body shape to evaluate self-worth. Tha DSMIV recognizes two different catagories of bulimia nervosa, the purging and non-purging types. The purging type includes the use of salf-induced vomiting, and the misuse of laxatives, diuretics, or enemas to evacuate from the body tha large quantities of food eaten. In the non-purging type, fasting or excessive exercise is used to compensate for the high calorie intake without attempting to void food from the body.