Bulimia nervosa, mostly known as bulimia is an eating disorder in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation. The sufferer will then engage in compensatory behaviors to make up for the excessive eating, which are referred to as “purging”. Purging can take the form of vomiting, fasting, the use of laxatives, enemas, diuretics or other medications, or overexercising. Bulimia is related to deep psychological issues and feelings of lack of control. Sufferers often use the destructive eating pattern to feel in control over their lives. They may hide or hoard food and overeat when stressed or upset. They may feel a loss of control during a binge, and consume great quantities of food (over 20,000 calories.) After a length of time, the sufferer of bulimia will find that they no longer have control over their binging and purging. The binging becomes an addiction that seems impossible to break. Recovery is very hard and often in the early stages of recovery the patient will gain weight as they are still binging but no longer purging, causing anxiety which will in turn cause the patient to revert back to bulimia. There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, dance, cheerleading, acting and figure skating. Bulimia is more prevalent among Caucasians. In one study, diagnosis of this disease was correlated with high testosterone and low estrogen levels, and normalizing these levels with combined oral contraceptive pills reduced cravings for fat and sugar.