Bulimia

   In an economy of scarcity, where the population is chronically undernourished, frenzied episodes of overeating wax and wane like the moon. Thus, the symptom of bulimia, which according to its Greek roots means hungry enough to eat an ox ("bous"_ox; "limos"_hunger), goes back to the Ancients. Yet the syndrome of what Gerald F. M. Russell (1928–) of the Maudsley Hospital called "bulimia nervosa" in a 1979 article in Psychological Medicine seems of relatively recent date. Russell argued that bulimia nervosa grew out of anorexia nervosa, a demonstrably recent illness. In bulimia nervosa, episodes of gorging alternate with periods of anorexia, and the patients maintain a normal weight through induced vomiting and laxatives. Russell’s bulimia nervosa became simple "bulimia" in DSM-III in 1980, an eating disorder that was insisted to be separate from anorexia nervosa (anorexia being a body-image disorder; bulimia an inability to control food cravings) in the pages of the Manual. (See Body Image: Disturbances of: anorexia nervosa.) By DSM-III-R in 1987, the term "bulimia nervosa" was accepted in the Manual and gone was the belief that it was separate from anorexia nervosa. In 1994, the disease-designers of DSM-IV shifted bulimia and anorexia entirely from the childhood–adolescence part of the Manual to a newly created section on "eating disorders." Here, a bulimic subtype of anorexia nervosa was accepted, yet bulimia nervosa remained an independent diagnosis as well, with "purging" and "nonpurging" subtypes.