Self-harm and bulimia nervosa: a complex connection.

There is some evidence to suggest that eating disordered individuals are unusually likely to engage in self-harm behavior. However, the nature of the relationship among self-harm, bulimia nervosa, and related constructs such as borderline personality disorder and multi-impulsive bulimia nervosa remains unclear. This article briefly addresses the nature of this relationship and discusses two possible mechanisms for self-harm behavior in bulimia nervosa. Additionally, a protocol for managing such behavior in the treatment of eating disordered individuals is presented.