Abstract
The current paper reviews the rapidly growing literature on bulimia, alternatively known as bulimarexia or bulimia nervosa. Research on the prevalence and topography of the binge response (i.e. place, duration, frequency and foods consumed) and vomiting is presented. Particular attention is given to the role of negative cognitive/emotional states and negative reinforcement in the binge-purge chain. Examination of personality characteristics suggest global personality deficits which may contribute to the negative emotional states of the binge-purge cycle. Family history and biologic tests suggest the role of depression in the bulimic syndrome. In addition to psychological distress, bulimia has the potential for severe medical consequences. An initial model of the disorder, integrating global personality deficits, emotional changes in the binge-purge chain, and psychological effects of medical complications, is offered. Finally, review of initial treatment studies suggests the potential efficacy of assertion training, stimulus control, self-control relaxation, exposure and response prevention, and anti-depressant medication as components of a comprehensive treatment package.
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