A multi-faceted issue
The term Multi-impulsive Bulimia describes a distinct subgroup of individuals, with multiple self-harming behaviours in addition to their bulimic behaviour. It suggests that the combined behaviours be treated as a single impulse control issue. It was first used by J. H. Lacey and C. Evans in their article The Impulsivist: A multi-impulsive personality disorder, published in The British Journal of Addiction in 1986.
Multi-impulsive Bulimia is gaining recognition
Multi-impulsive Bulimia is not a formal diagnosis and has been challenged, but is recognised by some agencies and clinics. It may also be worth noting that it is not unknown for additional self-harming behaviours to be used by individuals with Bulimia Nervosa as a way of coping with the distress of their condition. It should be observed that both DSM-IV and ICD-10 consider eating disorders to be a category in their own right and not impulse control disorders.
Multi-impulsive Bulimia is a complex area and much information can be found on the Internet, both positive and negative. As always, this should be regarded with caution.