Which statement best describes the typical presentation of Bulimia Nervosa?

• A. Underweight BMI
• B. Normal or overweight; binge eating with compensatory behaviors such as vomiting; teeth pitting/enamel erosion; Russell's sign
• C. Severe malnutrition due to purging
• D. Anorexia nervosa with fear of gaining weight

Answer: (B)

Bulimia nervosa typically presents in someone who is normal weight or slightly overweight and who engages in episodes of binge eating followed by compensatory behaviors to prevent weight gain, such as self-induced vomiting. The physical signs commonly seen are dental enamel erosion from stomach acid exposure and Russell’s sign, which are calluses on the knuckles from repeated vomiting. This pattern differs from anorexia nervosa, where individuals are underweight and have a fear of gaining weight with restrictive eating. Severe malnutrition from purging is not the hallmark of bulimia, as weight is usually preserved despite purging efforts.