Bulimia nervosa is the episodic uncontrolled ingestion of large quantities of food followed by recurrent inappropriate compensatory behavior to prevent weight gain such as self-induced vomiting, diuretic or cathartic use, or a regime that calls for strict dieting or overly vigorous exercise. Gastric dilatation and pancreatitis have been reported after binges. Moreover, vomiting can result in poor dentition, pharyngitis, esophagitis, aspiration, and electrolyte abnormalities. Treatment requires supportive care and psychotherapy. Individual, group, family, and behavioral therapy have all been used. On occasion, prescription of fluoxetine hydrochloride and other SSRIs may be helpful. All cases should be co-managed with a psychiatrist.