Eating disorders (ED) have become an important focus of research interest in recent decades, due to the increase in cases in recent decades.
At present they are considered of multifactorial etiology, in addition multiple possible factors are involved.
They are generally associated with a certain degree of neurological and psychological dysfunction accompanied by neuronal abnormalities. These disorders are debilitating psychiatric illnesses that present with persistent alteration of eating habits and weight control behaviors.
According to the Foundation for the Treatment of Bulimia and Anorexia, cases have increased fivefold in the past decade.
For its part, bulimia nervosa is considered "nervous" because it is the product of mental discomfort. This differs from the other eating disorders because it occurs with constant episodes of high food intake accompanied by excessive concern about weight gain, which leads to the adoption of extreme behaviors to reduce weight gain.
It is produced from multiple factors: emotional and personality disorders, family pressure, possible genetic or biological sensitivity and influence of a modern society obsessed with thinness as a unique concept of beauty.
Diagnosis of bulimia
There are certain basic mandatory criteria that must be present for a person to be diagnosed with bulimia nervosa:
• Recurring bouts of binge eating, at least 2 times a week in the past 3 months.
• Feeling of uncontrolled eating behavior during bingeing.
• Self-induced vomiting, use of laxatives or diuretics, or exercise aimed at losing weight.
• Persistent and excessive preoccupation with gaining weight and body shape.
Symptoms of bulimin nervosa
There are different symptoms and signs that occur in bulimia nervosa, and its manifestations occur in different systems and organs of the body, and can be grouped as follows:
Head, neck and throat
• Caries and erosions on the inside of the teeth due to the effect of gastric acid.
• Puffy face (swollen or swollen) and enlargement of the parotid gland and, to a lesser extent, other salivary glands.
• Petechiae on the face and neck.
• Enlargement of the tonsils may occur.
Vital signs
• Tachypnea as a consequence of diarrhea, use of laxatives or due to effort in induced vomiting, including hypothermia.
Skin
They can be divided into three categories:
1. Complications associated with malnutrition: brittle and brittle hair, as well as brittle nails and dry skin.
2. Complications associated with self-induced vomiting: Russell's sign, characterized by elongated and superficial ulcerations or hyperpigmented calluses or scars with an average dimension of 6 x 10 mm on the back of the hands. Although these lesions may not be found in those who self-induce vomiting with an object.
3. Complications associated with a concomitant psychiatric pathology: Some people with psychiatric pathology tend to produce cutting wounds, generally in the upper and lower limbs, they are recognized by the typical linear scars.
Pulmonary
They are uncommon, but chest pain may develop that is accentuated when breathing or coughing, and may radiate to the back, neck, and shoulders.
Gastrointestinal
Generally, there are several intestinal disorders, but not all present in the same person.
• After a binge, abdominal discomfort or pain, nausea, bloating and pain can occur. The symptoms will depend on the amount and type of food eaten.
• The induction of vomiting produces lesions in the oropharynx and the passage of gastric acid through these damaged areas can cause alterations in the perception of taste and food temperature. It can also promote the appearance of granulomas and ulcers at the oral level.
• Gastric reflux.
• The colon is affected by laxative abuse.
Renal
The kidney may be affected as a result of dehydration, loss of potassium, and chronic use of diuretics.
• Higher incidence of urinary infections.
• Increased urea.
• Decreased urinary density.
Endocrinological manifestations
Bulimia causes hormonal alterations with the consequent alteration and irregularity of menstrual cycles
Bony manifestations
The bulimia nervosa is strongly related to restrictive diets, malnutrition, irregular menstrual periods, poor nutritional intake and low estrogen levels. All of these factors act as risk factors for osteoporosis.

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