Accessible summary
• Bulimia nervosa, if not treated or if treated unsuccessfully, can develop into a
severe and enduring eating disorder.
• Analysis of self-management of Seed-BN indicates that individuals frequently
experience significant negative mental health issues and a complex relationship
with medication management.
• Two discrete patterns of coping strategies to prevent deterioration in distressing
symptoms were in evidence, controlled vomiting, which was related to the management
of anxiety, and uncontrolled vomiting due to more dominant selfmanagement
of compulsive acts.
• The implications for nursing revolve around accurate assessment of vomiting and
subsequent engagement by the individual with their coping strategies in relation to
perceived deterioration in distressing symptoms.