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Bulimia nervosa is an eating disorder also known as the "binge and purge syndrome."

One long-term treatment facility estimates as many as 25 million people suffer from binge-eating disorder. It's common among high school and college girls, athletes, dancers, and models. About 90% of those with eating disorders are women.

About 35% of people who go on severe diets fall into the trap of eating disorders. Without treatment or intervention, about 10% die from starvation, cardiac problems or suicide. The earlier the diagnosis is made and treatment is begun, the higher the rate of success. Up to 50% of bulimics fully recover with help; another 35% have some bulimic episodes; 15% don't recover.

Bulimics are usually secretive; they feel ashamed about their bingeing - up to 11,500 calories at one sitting. Self-induced vomiting keeps them within normal weight limits. Consequently, bulimics can often conceal the disorder until it becomes life-threatening.

Bulimics will overuse laxatives, diuretics, and diet pills, and participate in extreme physical exercises, diets and fasts to prevent weight gain, causing dehydration and malnutrition.

For bulimics, food becomes the "drug of choice" for daily stressors. Self-image problems, boredom, extreme dieting, relationship stressors, and anxious/depressed/uneasy feelings act as triggers, resulting in an addictive binge/purge cycle.

The binger recognizes she is losing control over eating; she is obsessively concerned with her body shape and weight. After gorging, she becomes intensely self-critical and depressed. She will obsess about her personal appearance, and how she appears to others, especially sexually. Her scale-weight determines how she feels about herself that day.

Excessive vomiting leads to dehydration, an electrolyte imbalance, esophageal tears, cardiac arrhythmias, gastro-intestinal problems, and erosion of tooth enamel (because of the gastric acid in the vomit).

Once recognized, an interdisciplinary team of counselors, nurses, dietitians, etc. (often including recovered bulimics) work together for successful intervention and behavior modification for this disease.

The short-term goal is to get the patient to gain a specified amount of weight per week; the long-term goal is for the patient to show no signs of malnutrition by discharge. She must also understand and verbalize - her unhealthy relationship between emotions and food.

Trained professionals recognize the needs, "excuses" and "tricks" a patient might try, but they

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