sodes of binge eating, but this is seldom th e sole compensatory method employed. Individ-
uals with this disorder may take thyroid ho rmone in an attempt to avoid weight gain.
Individuals with diabetes mellitus and bulimia nervosa may omit or reduce insulin doses in
order to reduce the metabolism of food cons umed during eating bi nges. Individuals with
bulimia nervosa may fast for a da y or more or exercise excessive ly in an attempt to prevent
weight gain. Exercise may be considered excessi ve when it significantly interferes with im-
portant activities, when it occurs at inappr opria te times or in i nappropriate settings, or
when the individual continues to exercise despite injury or  other medical complications.
Individuals with bulimia nervosa place an ex cessive emphasis on body shape or weight
in their self-evaluation, and these factors ar e typically extremely important in determining