Ox hunger: Psychoanalytic explorations of bulimia nervosa

Bulimia, a term derived from Greek words meaning "ox" and "hunger," is a food obsession characterized by repeated overeating binges followed by purges of forced vomiting, prolonged fasting, or abuse of laxatives, enemas, diuretics and amphetamines. It provides temporary relief to emotional pain. If untreated, bulimia causes serious medical and dental problems. In this paper, I first present an overview of the historical development of bulimia nervosa as a clinical entity and then explore the syndrome from a psychoanalytic perspective, focusing on the Freudian drive-conflict model, the pathology of early object relations, and attachment theory. A case is presented and treatment implications are discussed.