Described by Russell in 1979, bulimia nervosa is an eating disorder characterised by lack of control. Abnormal eating behaviour including dieting, vomiting, purging and particularly bingeing may be associated with normal weight or obesity. The syndrome is associated with guilt, depressed mood, low self-esteem and sometimes with childhood sexual abuse, alcoholism and promiscuity. May be asociated with oesophageal ulceration and parotid swelling (Green's chubby chops sign).