Bulimic episodes are frequently planned, with food purchased or prepared in order to be consumed without interruption. The individual may also avoid situations in which they are likely to be exposed to food or will find it difficult to control their eating, such as when eating out with others. This avoidance behavior tends to add to any social and relationship difficulties that may be present. People with bulimic nervosa feel of panic, disgust, guilt, or depression will set in and the individual soon recognizes the need to purge, often minutes after binge. Individuals who participate in these behaviors will usually experience low self-esteem, shame, and self-deprecation (Mizock & Lewis,
