When a girl enters puberty, her body changes. It begins to look like a woman's body, rather than a girl's. Fat begins to appear. Breasts develop and hips widen as the girl grows. For some young woman, these changes are greeted with excitement. For other young women, these changes may cause sadness and spark self-doubt. A young woman feeling uncomfortable in her body may wish for a girl's body without curves. She may project her fear onto food. Now, when she eats, she eats too much food. She binges. This may fill her with guilt and shame and vomit up the food. She purges. This is the story of a young woman has bulimia.

Bulimia is not exclusively caused by the changes of puberty, nor is it exclusive to women. Although 90 percent of bulimia cases occur in women, and most of these women begin to eat and vomit in their mid- to late-teens, bulimia nervosa can stem from diverse causes. Some people with bulimia are perfectionists. Some feel their weight reflects their self-worth. Being too heavy is a sign of failure. Some may be depressed, or unable to cope with the world. Vomiting may represent the person's desire to purge his or her being of the qualities they most despise. A person with bulimia may be unhappy inside and feel lost, and comforted by controlling his or her food intake and weight. But there is no single known cause of bulimia.

The disorder is not limited to teens. Roughly 10 percent of college women are bulimic, four percent of the population is estimated to have bulimia. Most people with bulimia start with a normal weight, but as they attempt to lose weight, they lose adequate nutrition. When people with bulimia binge, they tend to eat comfort foods like potato chips, ice cream, or cookies" ?foods with little nutritional value. The purging removes any food in the body, nutritionally sound or not. Some people suffering from bulimia abuse diuretics or laxatives instead of (or in addition to) vomiting.

Repeated vomiting often erodes the enamel of a person with bulimia's teeth and causes cavities. Stomach ulcers, constipation, bloating, and heartburn are other symptoms of bulimia. People with bulimia often go to the bathroom after meals, are preoccupied with weight, and are sensitive to temperature changes. Women with bulimia may have irregular periods from the nutritionally sparse diet.

Bulimia nervosa became an officially diagnosed eating disorder in the 1980s. Ten percent of people with bulimia will die from its complications. Though people with bulimia may deny their eating disorder, they should see a doctor immediately, with support from those who love them. Bulimia is completely treatable.