Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives. Other efforts to lose weight may include the use of diuretics, stimulants, water fasting, or excessive exercise. Most people with bulimia are at a normal weight. The forcing of vomiting may result in thickened skin on the knuckles, breakdown of the teeth and effects on metabolic rate and caloric intake which cause thyroid dysfunction. Bulimia is frequently associated with other mental disorders such as depression, anxiety, borderline personality disorder, bipolar disorder and problems with drugs or alcohol. There is also a higher risk of suicide and self-harm.Bulimia is more common among those who have a close relative with the condition. The percentage risk that is estimated to be due to genetics is between 30% and 80%. Other risk factors for the disease include psychological stress, cultural pressure to attain a certain body type, poor self-esteem, and obesity. Living in a culture that commercializes or glamorizes dieting and having parental figures who fixate about weight are also risks.
This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause:

Chronic gastric reflux after eating, secondary to vomiting
Dehydration and hypokalemia due to renal potassium loss in the presence of alkalosis and frequent vomiting
Electrolyte imbalance, which can lead to abnormal heart rhythms, cardiac arrest, and even death
Esophagitis, or inflammation of the esophagus
Mallory-Weiss tears
Boerhaave syndrome, a rupture in the esophageal wall due to vomiting
Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to the lining of the mouth or throat
Russells sign: calluses on knuckles and back of hands due to repeated trauma from incisors
Perimolysis, or severe dental erosion of tooth enamel
Swollen salivary glands (for example, in the neck, under the jaw line)
Gastroparesis, or delayed gastric emptying
Constipation or diarrhea
Tachycardia or palpitations
Hypotension
Peptic ulcers
Infertility
Constant weight fluctuations are common
Elevated blood sugar, cholesterol, and amylase levels may occur
Hypoglycemia may occur after vomitingThese are some of the many signs that may indicate whether someone has bulimia nervosa:
A fixation on the number of calories consumed
A fixation on and extreme consciousness of ones weight
Low self-esteem and/or self-harming
Suicidal tendencies
An irregular menstrual cycle in women
Regular trips to the bathroom, especially soon after eating
Depression, anxiety disorders and sleep disorders
Frequent occurrences involving consumption of abnormally large portions of food
The use of laxatives, diuretics, and diet pills
Compulsive or excessive exercise
Unhealthy/dry skin, hair, nails, and lips
Fatigue, or exhaustionAs with many psychiatric illnesses, delusions can occur, in conjunction with other signs and symptoms, leaving the person with a false belief that is not ordinarily accepted by others.People with bulimia nervosa may also exercise to a point that excludes other activities.