ABSTRACT
Bulimia (literally 'ox hunger'), long recognized as a symptom of anorexia nervosa, was identified as a distinct eating disorder relatively recently. The original diagnostic criteria for bulimia nervosa were an irresistible urge to overeat followed by self-induced vomiting or purging, and a morbid fear of becoming fat. The importance of studying bulimic adolescents separately from adults has been emphasized. Bulimia nervosa was originally considered to be a 'culture bound' syndrome, largely confined to middle- and upper-class, achievement-oriented western families. The severity of the symptom complex (i.e., the frequency of binge eating and/or purging activity) is typically used to differentiate full from partial syndromes. Many fewer individuals meet full diagnostic criteria than experience milder forms, termed subthreshold, subsyndromal, or partial syndromes. Behaviors that adolescents typically use to promote their own development, and to deal with subclinical symptoms arising in their personal struggles to mature psychologically, can be enlisted to overcome severe symptoms.
