Recent genetic and brain imaging studies have found that patients with Bulimia often have problems in their satiety system. Satiety refers to all of the signals from your body that tell your brain to stop eating after starting a meal. The most famous example of a satiety signal are the stretch receptors in your stomach that monitor the distension of the muscles in your stomach wall during a meal and literally signal that the stomach is “full.” There are many other less well known signals as well including the physical sensations of chewing and swallowing in your mouth, nutrient receptors in your GI track, and satiety hormones that are released after meals, including glucagon-like peptide 1 (GLP-1), protein YY (PYY), and cholecystokinin (CKK). These hormones are released from the intestines in response to food and help with digestion by slowing the emptying of the stomach, promoting the storage of nutrients in the muscle, liver, and adipose tissue by insulin, and going to the brain to shut of the appetite. Many patients with Bulimia have either decreased production or release of these hormones causing them to always feel hungry even they are uncomfortably full. This disconnect between the physical discomfort of overeating while the brain still feels hungry produces intense anxiety that can only be relieved by the act of purging in an attempt to align mind and body again.