Bulimia nervosa is characterized by a binge and purge eating habit. Generally, people with bulimia nervosa will have normal or slightly low body weight due to excessive caloric intake combined with purging or excessive exercise.
One of the defining characteristics of bulimia nervosa is the binge and purge eating habit. Some may use laxatives, diuretics or emetics to expel calories.
Due to increased purging or laxative use, people suffering from bulimia nervosa typically have electrolyte disturbances. It is common for these patients to have hypokalemia and hyponatremia.
Due to extreme electrolyte imbalances and increased purging, alkalosis occurs. Bulimia nervosa leads to alkalosis for a few reasons, one is that acidic content is lost with emesis. Further, if laxatives are used, potassium is lost at increased rates.
Hypokalemia occurs with bulimia nervosa because potassium is lost through the act of purging. In addition, the use of laxatives decreases potassium at increasing rates from the gastrointestinal tract.
Parotitis, or inflammation of the parotid glands, may occur in bulimia nervosa. The main contributing factor to this characteristic is increased levels of serum amylase.
Enamel erosion is a key characteristic of bulimia nervosa. This occurs due to the acidic emesis eroding tooth enamel.
Due to self-induced vomiting, patients with bulimia nervosa may present with calluses, lacerations, or scars on their hands (dorsum or anterior side) and fingers. This characteristic is referred to as Russell’s sign.
To diagnose bulimia nervosa, the patient must engage in at least one episode of binging and purging per week according to the DSM V.
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