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

Choice A reason: Bulimia nervosa involves recurrent binge eating followed by purging behaviors, such as vomiting or laxative use, often done secretively. The statement about binging and purging for years without others knowing directly describes this pattern, a core diagnostic criterion, making this a correct choice. Choice B reason: Using laxatives only for constipation does not indicate bulimia nervosa, which involves purging to prevent weight gain after binging. This statement reflects a medical or situational use of laxatives, not the compulsive behavior of bulimia, making it incorrect. Choice C reason: Bulimia nervosa can involve an emotional high during binge-purge cycles due to endorphin release or temporary relief from anxiety. This statement captures the psychological reinforcement of these episodes, aligning with bulimia’s behavioral patterns, making it a correct choice. Choice D reason: Feeling power from restricting food intake is characteristic of anorexia nervosa, not bulimia. Bulimia involves binging and purging, not sustained restriction, making this statement incorrect as it does not reflect the typical behavior of bulimia nervosa.