Bulimia nervosa. Associated physical problems.

1. Bulimia involves more serious problems than previously thought. Bulimia nervosa is a psychiatric disorder characterized by binge eating followed by some form of combination of purging, including laxative or diuretic use, strenuous exercise, and self-induced vomiting to eliminate unwanted calories. 2. Physical problems of bulimia include oral and neck problems, metabolic acid-base imbalances, volume depletion, hypochloremia, hypokalemia, hyponatremia, hypomagnesia, hypocalcemia, hyperuricemia, gastrointestinal problems, and edema. 3. The physical problems of bulimia are less well known than those of anorexia. Nurses must be alert for clues, act on suspicions, use a nonjudgmental approach, and be knowledgeable of all assessment factors, including psychological parameters.