Bulimia is an eating disorder compels people to binge on food and then purge through self-induced vomiting, diuretics or laxative abuse, or excessive exercise. People with bulimia tend to feel guilty and disgusted about food and fat. Even though most people with bulimia begin at normal weights, they think of themselves as fat. Roughly 90 percent of the people with bulimia are women, and the disorder usually begins a few years after puberty. Genetics, social pressures, and emotional problems like depression, low self-esteem, and extreme perfectionism contribute to bulimia’s development. Without bulimia treatment, people with bulimia become dehydrated and malnourished. This causes mineral and vitamin deficiencies, resulting in dry skin, nails, and hair. Many people with bulimia are constipated from laxative abuse. Constant vomiting brings up stomach acid that irritates the throat and mouth. Many people with bulimia have heartburn, gum infections, swollen salivary glands, and cavities from the acid eroding tooth enamel. Without treatment, some of side effects, like kidney failure, can become fatal. Dehydration can lower the body’s electrolyte levels, causing heart problems or even death. About 10 percent of people with bulimia will die from it. Bulimia, however, is completely treatable. The sooner a person begins bulimia treatment, the sooner the recovery. Successful recovery depends on the work of psychiatrists, doctors, dieticians, and the patient. Psychiatrists work with the patient to break the binge-and-purge cycles and to educate the patient about what she is doing to her body and mind. The psychiatrist and patient must identify the triggers of a binging-and-purging episode, as well as help the patient cope with an unhealthy body image. The patient must learn to communicate openly and must increase his or her self-esteem. Doctors work with the patient to treat the effects of bulimia’s dehydration and malnutrition on the body. A dietician helps the patient develop healthy eating habits. Group therapy and support groups are also helpful for people recovering from bulimia. Information about many support groups can be found online.