Bulimia represents a major health problem in the United States, especially in high schools, colleges, and universities. This paper reviews literature on the definition, etiology, and therapeutic approaches for bulimia. The literature points to potential physiological bases for the disorder since some researchers reported similarities between it and the physiological aspects of major affective disorders. Some of this research is supported by the relative efficacy of treatment models for both conditions with include antidepressants, especially the tricyclics. But much of the literature is flawed, with some researchers relying only on self-report data to determine compliance with medication. Improved methodology would allow use of validated paper-and-pencil measures with the examination of the bulimic's blood plasma level of the drug. Research using these techniques plus self-reports, clinical and behavioral observations, and chemical and urine analyses may help determine the efficacy of antidepressant, psychotherapeutic, or behavior management strategies on bulimic behavior. The research surveyed here suggests that when clinicians are either assessing or treating bulimic clients, they should also investigate for any major affective disorder. Once the presence of other mental disorders is detected, clinicians can begin to design more effective treatment modalities for bulimia. Contains 43 references. (RJM)