A nurse is observing a group therapy session. Which of the following client statements should the nurse identify as an indication of bulimia nervosa?

A. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise. The statement, “I have binged and purged for years without my family or friends knowing,” reflects secretive binge-purge behavior, which is a hallmark of bulimia nervosa. B. Feeling a sense of power by restricting food intake is more characteristic of anorexia nervosa, particularly the restricting subtype, rather than bulimia nervosa. C. Using laxatives only for constipation does not indicate a disorder. In bulimia nervosa, laxatives are used to compensate for binge eating, not for routine bowel regulation. D. While some individuals may report emotional relief after binge-purge episodes, describing an “emotional high” is less specific than secretive behaviors. The key diagnostic feature is the cycle of bingeing and compensatory behavior, often done in secrecy.