Editing Bulimia nervosa (section)

===Related disorders===
People with bulimia are at a higher risk to have an affective disorder, such as depression or general anxiety disorder. One study found 70% had depression at some time in their lives (as opposed to 26% for adult females in the general population), rising to 88% for all affective disorders combined.<ref>{{cite journal | vauthors = Walsh BT, Roose SP, Glassman AH, Gladis M, Sadik C | title = Bulimia and depression | journal = Psychosomatic Medicine | volume = 47 | issue = 2 | pages = 123–31 | year = 1985 | pmid = 3863157 | doi = 10.1097/00006842-198503000-00003 | s2cid = 12748691 }}</ref> Another study in the Journal of Affective Disorders found that of the population of patients that were diagnosed with an eating disorder according to the DSM-V guidelines about 27% also suffered from bipolar disorder. Within this article, the majority of the patients were diagnosed with bulimia nervosa, the second most common condition reported was binge-eating disorder.<ref>{{Cite journal |last1=McElroy |first1=Susan L. |last2=Crow |first2=Scott |last3=Blom |first3=Thomas J. |last4=Biernacka |first4=Joanna M. |last5=Winham |first5=Stacey J. |last6=Geske |first6=Jennifer |last7=Cuellar-Barboza |first7=Alfredo B. |last8=Bobo |first8=William V. |last9=Prieto |first9=Miguel L. |last10=Veldic |first10=Marin |last11=Mori |first11=Nicole |last12=Seymour |first12=Lisa R. |last13=Bond |first13=David J. |last14=Frye |first14=Mark A. |date=February 2016 |title=Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder |url=https://linkinghub.elsevier.com/retrieve/pii/S016503271530519X |journal=Journal of Affective Disorders |language=en |volume=191 |pages=216–221 |doi=10.1016/j.jad.2015.11.010|pmid=26682490 }}</ref> Some individuals with anorexia nervosa exhibit episodes of bulimic tendencies through purging (either through self-induced vomiting or laxatives) as a way to quickly remove food in their system.<ref>Carlson, N.R., et al. (2007). Psychology: The Science of Behaviour – 4th Canadian ed. Toronto, ON: Pearson Education Canada.{{page needed|date=August 2013}}</ref> There may be an increased risk for [[diabetes mellitus type 2]].<ref>{{cite journal | vauthors = Nieto-Martínez R, González-Rivas JP, Medina-Inojosa JR, Florez H | title = Are Eating Disorders Risk Factors for Type 2 Diabetes? A Systematic Review and Meta-analysis | journal = Current Diabetes Reports | volume = 17 | issue = 12 | pages = 138 | date = November 2017 | pmid = 29168047 | doi = 10.1007/s11892-017-0949-1 | s2cid = 3688434 }}</ref> Bulimia also has negative effects on a person's teeth due to the acid passed through the mouth from frequent vomiting causing acid erosion, mainly on the posterior dental surface.

Research has shown that there is a relationship between bulimia and [[narcissism]].<ref name="pmid21184981">{{cite journal | vauthors = Maples J, Collins B, Miller JD, Fischer S, Seibert A | title = Differences between grandiose and vulnerable narcissism and bulimic symptoms in young women | journal = Eat Behav | volume = 12 | issue = 1 | pages = 83–5 | date = January 2011 | pmid = 21184981 | doi = 10.1016/j.eatbeh.2010.10.001 }}</ref><ref name="pmid9261656">{{cite journal | vauthors = Steiger H, Jabalpurwala S, Champagne J, Stotland S | title = A controlled study of trait narcissism in anorexia and bulimia nervosa | journal = Int J Eat Disord | volume = 22 | issue = 2 | pages = 173–8 | date = September 1997 | pmid = 9261656 | doi = 10.1002/(sici)1098-108x(199709)22:2<173::aid-eat9>3.0.co;2-c }}</ref><ref name="pmid9347071">{{cite journal | vauthors = Steinberg BE, Shaw RJ | title = Bulimia as a disturbance of narcissism: self-esteem and the capacity to self-soothe | journal = Addict Behav | volume = 22 | issue = 5 | pages = 699–710 | date = 1997 | pmid = 9347071 | doi = 10.1016/s0306-4603(97)00009-9 | s2cid = 25050604 }}</ref> According to a study by the [[Australian National University]], eating disorders are more susceptible among [[Vulnerable narcissism|vulnerable narcissists]]. This can be caused by a childhood in which inner feelings and thoughts were minimized by parents, leading to "a high focus on receiving validation from others to maintain a positive sense of self".<ref name="Sivanathan et al 2019">{{cite journal |vauthors=Sivanathan D, Bizumic B, Rieger E, Huxley E |date=December 2019 |title=Vulnerable narcissism as a mediator of the relationship between perceived parental invalidation and eating disorder pathology |journal=Eat Weight Disord |volume=24 |issue=6 |pages=1071–1077 |doi=10.1007/s40519-019-00647-2 |pmid=30725304 |s2cid=73416090}}

* {{lay source|template=cite news|url=https://health.anu.edu.au/news-events/news/vulnerable-narcissists-more-susceptible-eating-disorders|title=Vulnerable narcissists more susceptible to eating disorders|website=ANU College of Health & Medicine}}</ref>

The medical journal ''Borderline Personality Disorder and Emotion Dysregulation'' notes that a "substantial rate of patients with bulimia nervosa" also have [[borderline personality disorder]].<ref name="bpded.biomedcentral.com">{{cite journal |last1=Hessler |first1=Johannes Baltasar |last2=Heuser |first2=Jörg |last3=Schlegl |first3=Sandra |last4=Bauman |first4=Tabea |last5=Greetfeld |first5=Martin |last6=Voderholzer |first6=Ulrich |year=2019 |title=Impact of comorbid borderline personality disorder on inpatient treatment for bulimia nervosa: Analysis of routine data |journal=Borderline Personality Disorder and Emotion Dysregulation |volume=6 |page=1 |doi=10.1186/s40479-018-0098-4 |pmc=6335811 |pmid=30680217 |doi-access=free}}</ref>

A study by the Psychopharmacology Research Program of the [[University of Cincinnati College of Medicine]] "leaves little doubt that [[Bipolar disorder|bipolar]] and eating disorders—particularly bulimia nervosa and bipolar II disorder—are related." The research shows that most clinical studies indicate that patients with bipolar disorder have higher rates of eating disorders, and vice versa. There is overlap in phenomenology, course, comorbidity, family history, and pharmacologic treatment response of these disorders. This is especially true of "eating dysregulation, mood dysregulation, impulsivity and compulsivity, craving for activity and/or exercise."<ref name="McElroy et al 2005">{{cite journal |vauthors=McElroy SL, Kotwal R, Keck PE, Akiskal HS |date=June 2005 |title=Comorbidity of bipolar and eating disorders: distinct or related disorders with shared dysregulations? |journal=J Affect Disord |volume=86 |issue=2–3 |pages=107–27 |doi=10.1016/j.jad.2004.11.008 |pmid=15935230}}</ref>

Studies have shown a relationship between bulimia's effect on metabolic rate and caloric intake with [[thyroid dysfunction]].<ref name="pmid8817724">{{cite journal | vauthors = Altemus M, Hetherington M, Kennedy B, Licinio J, Gold PW | title = Thyroid function in bulimia nervosa | journal = Psychoneuroendocrinology | volume = 21 | issue = 3 | pages = 249–61 | date = April 1996 | pmid = 8817724 | doi = 10.1016/0306-4530(96)00002-9 | s2cid=24919021 }}</ref>

Scientific research has shown that people suffering from bulimia have decreased volumes of brain matter, and that the abnormalities are reversible after long-term recovery.<ref>{{Cite journal |last1=Wagner |first1=Angela |last2=Greer |first2=Phil |last3=Bailer |first3=Ursula F. |last4=Frank |first4=Guido K. |last5=Henry |first5=Shannan E. |last6=Putnam |first6=Karen |last7=Meltzer |first7=Carolyn C. |last8=Ziolko |first8=Scott K. |last9=Hoge |first9=Jessica |last10=McConaha |first10=Claire |last11=Kaye |first11=Walter H. |date=2006-02-01 |title=Normal Brain Tissue Volumes after Long-Term Recovery in Anorexia and Bulimia Nervosa |url=https://linkinghub.elsevier.com/retrieve/pii/S0006322305007651 |journal=Biological Psychiatry |language=en |volume=59 |issue=3 |pages=291–293 |doi=10.1016/j.biopsych.2005.06.014|pmid=16139807 }}</ref>