How do patients typically engage in behavior associated with bulimia nervosa?

Patients with bulimia nervosa typically engage in recurrent binge eating followed by compensatory behaviors to avoid weight gain. This pattern forms the core of the disorder. Binge eating involves consuming an unusually large amount of food within a discrete period, often accompanied by a sense of loss of control. Following these episodes, individuals commonly engage in compensatory behaviors such as self-induced vomiting, excessive exercise, fasting, or misuse of laxatives or diuretics to counteract the effects of the binge eating. This cycle of behavior is driven by intense feelings of guilt and shame associated with eating, as well as a preoccupation with body image.

The other options do not align with the characteristics of bulimia nervosa. While regular exercise can be part of a healthy routine, in the context of bulimia, it often becomes excessive and compulsive, rather than typical or balanced. Maintaining a balanced diet at all times contradicts the definition of bulimia, where individuals struggle with control over their eating habits and often engage in bingeing. Similarly, intermittent fasting is not a behavioral hallmark of bulimia; while it may be used by individuals to try to control weight, it does not represent the compensatory mechanisms classically associated with the disorder. Therefore, the focus on binge