A variant of anorexia, bulimia ranges from excessive food intake, to an out-of-control compulsive cycle of binge eating in which extraordinary quantities of any available food, usually high in of carbohydrates. Once gorged, victims are overwhelmed by the need to rid themselves of what they hate by eating by purging themselves, usually with vomiting and sometimes with massive doses of laxatives. In between these obsessive bouts, most are able to accept a little nourishment. While the anorexic person fears the fat resulting from the anticipated loss of eating control and, unlike the anorexic person, the typical bulimic individual is not emaciated, but usually maintains a normal body weight and appears to be fit and healthy. However, the obsessive cycle of binging and purging causes them deep distress, shame, guilt, self-loathing and social isolation, and many will go to great lengths to hide their “shameful” secret from family and friends. Typical sufferers Anorexic or bulimic can be of both sexes, but the smallest percentage is in males. However, the male percentage is increasing. Most sufferers come from middle- and upper-income families and are usually very intelligent. Anorexic and bulimic people are often perfectionists, with unrealistically high expectations. They often lack self-esteem, experience feelings of ineffectiveness and a strong need for approval from others. Causes There is currently no generally accepted view on the causes of anorexia and bulimia. Most authorities believe the problem has a psychological basis, possibly resulting from family and social pressures or other forms of stress in our modern environment. Where a high value is placed on thinness, women are more likely to be judged on their appearance, against a backdrop of heavy promotion of high-carbohydrate junk food. Often the disease is triggered by a major change in the person's life. Age and Scope Anorexia tends to begin in the early adolescent years, while bulimia usually occurs in late adolescence and older age groups. Sometimes bulimia develops from anorexia, but it can occur without a previous history of anorexia. It often persists for many years. Girls as young as 8 have been known to show an unhealthy preoccupation with diet. The true extent of the problem is not known, but it is estimated that it ranges from one in a hundred schoolgirls with anorexia to 6% of Australian women with bulimia. Since bulimia is not a physically noticeable condition, the numbers could be much higher. Social Isolation People who suffer from anorexia or bulimia have probably felt isolated and friendless for a long time. This may have been one factor contributing to their belief that they were essentially unacceptable people. However, the condition itself increases social isolation. Sick people don't dare let people get too close to them so as not to risk their true selves, which is them