A nurse is collecting data from a client who has bulimia nervosa. Which of the following client statements should the nurse expect?

A. Clients with bulimia nervosa are typically preoccupied with body shape and weight, which drives the cycle of binge-eating and purging. This distorted body image is a hallmark of the disorder and contributes to feelings of guilt, shame, and low self-esteem. Statements expressing concern or obsession about body shape are common and expected during assessment. B. Clients may experience temporary relief or reduction of anxiety during binge-purge episodes, but they rarely describe feeling “energized.” Instead, these behaviors are often followed by shame, guilt, and physical discomfort. C. Bulimia nervosa is often associated with low self-esteem and self-doubt, so statements of confidence are inconsistent with the disorder’s characteristic psychological patterns. D. Although some clients perceive bingeing and purging as a way to control weight, overall, bulimia nervosa is associated with feelings of loss of control—especially over eating behaviors. The disorder typically reflects an attempt to manage emotional distress rather than actual control over life circumstances.