title: Women's experiences of bulimia nervosa.
abstract: OBJECTIVE
  This paper reports a study to interpret and understand bulimia nervosa as women experience it.
  
  
  BACKGROUND
  Research into bulimia nervosa has focused on prevalence rates, health complications, comorbidity, neurochemical dysregulation, and cultural influences. Despite a multitude of investigations, little published research appraised bulimic women's personal experiences and understanding of this disorder. Such an understanding would assist health care professionals in providing sensitive, empathetic care.
  
  
  METHODS
  The principles of Heideggerian phenomenology guided the study. Participants were 13 actively bulimic women, aged 18-36 years, with lengths of illness from 1 to 23 years. Data were obtained through interviews, personal diaries, and demographic questionnaires.
  
  
  RESULTS
  Participants' narratives revealed four themes that characterized the experience of living with bulimia: isolating self, living in fear, being at war with the mind, and pacifying the brain. The practices bulimic women engage in are carried out in secret, and hence participants experienced isolation. Binge eating and self-induced vomiting are considered abnormal behaviours; therefore, participants believed that they were subjected to negative public perceptions, which led to the experience of living in fear. The women feared being judged if others knew about the disorder. Several feared living without bulimia because it had become a significant part of their identity. In addition, these women were terrified of gaining weight or becoming fat. They experienced an internal struggle with the mind. In order to pacify the inner voice, many fed the compulsion to eat, and this resulted in guilt. The women subsequently balanced the experience by getting rid of fullness and erasing guilt, which was primarily achieved through self-induced vomiting.
  
  
  CONCLUSIONS
  Understanding the experience of bulimia for women who suffer from this disorder is important. Bulimia often presents as a chronic and potentially lifelong health issue. Awareness of bulimic women's perspectives could promote a comprehensive appreciation of bulimia, its aetiology, and directions for treatment alternatives.
authors.affiliation: Department of Family and Child Nursing, University of Washington, Seattle, Washington 98195, USA. bbroussa@u.washington.edu <bbroussa@u.washington.edu>
authors.forename: Brenda B
authors.initials: BB
authors.lastname: Broussard
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001828:Body Image; D001835:Body Weight; D002032:Bulimia / Q000523:psychology*; D005260:Female; D006801:Humans; D012649:Self Concept; D016387:Women's Health