The binge subsequently should trigger a perceived loss of control, promoting the individual to purge in hope of counteracting the binge. However, Fairburn et al. assert the cycle repeats itself, and thus consider the binge-purge cycle to be self-perpetuating.In contrast, Byrne and Mcleans findings differed slightly from Fairburn et al.s cognitive-behavioral model of bulimia nervosa in that the drive for thinness was the major cause of purging as a way of controlling weight. In turn, Byrne and Mclean argued that this makes the individual vulnerable to binging, indicating that it is not a binge-purge cycle but rather a purge-binge cycle in that purging comes before bingeing. Similarly, Fairburn et al.s cognitive-behavioral model of bulimia nervosa is not necessarily applicable to every individual and is certainly reductionist. Every one differs from another, and taking such a complex behavior like bulimia and applying the same one theory to everyone would certainly be invalid. In addition, the cognitive-behavioral model of bulimia nervosa is very culturally bound in that it may not be necessarily applicable to cultures outside of Western society. To evaluate, Fairburn et al..s model and more generally the cognitive explanation of bulimia nervosa is more descriptive than explanatory, as it does not necessarily explain how bulimia arises. Furthermore, it is difficult to ascertain cause and effect, because it may be that distorted eating leads to distorted cognition rather than vice versa.A considerable amount of literature has identified a correlation between sexual abuse and the development of bulimia nervosa.
In 1981, the steering committee for the United Nations International Drinking Water Supply and Sanitation Decade (a program to improve global drinking water during the decade from 1981 to 1990) adopted the goal of eradicating dracunculiasis as part of their efforts. The following June, an international meeting termed "Workshop on Opportunities for Control of Dracunculiasis" concluded that dracunculiasis could be eradicated through public education, drinking water improvement, and larvicide treatments. In response, India began its national eradication program in 1983. In 1986, the 39th World Health Assembly issued a statement endorsing dracunculiasis eradication and calling on member states to craft eradication plans. The same year,  The Carter Center began collaborating with the government of Pakistan to initiate its national program, which then launched in 1988. By 1996, national eradication programs had been launched in every country with endemic dracunculiasis: Ghana and Nigeria in 1989; Cameroon in 1991; Togo, Burkina Faso, Senegal, and Uganda in 1992;  Benin, Mauritania, Niger, Mali, and Côte dIvoire in 1993; Sudan, Kenya, Chad, and Ethiopia in 1994; Yemen and the Central African Republic in 1995.Each national eradication program had three phases. The first phase consisted of a nationwide search to identify the extent of dracunculiasis transmission and develop national and regional plans of action. The second phase involved the training and distribution of staff and volunteers to provide public education village-by-village, surveil for cases, and deliver water filters. This continued and evolved as needed until the national burden of disease was very low.