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Alexithymia is a syndrome which has been characterized as difficulty in recognizing and describing affective feelings as distinct from bodily sensations, combined with a lack of imagination and symbolic thinking. Past studies have linked alexithymia to anorexia nervosa and to depression. Although it has also been linked to bulimia nervosa, previous studies did not control for a depressive component. This study compared normal-weight female bulimics without symptoms of anorexia nervosa or major depression to age- and weight-matched controls on a variety of depression, anxiety, and personality scales. Of particular interest were subjects' scores on the Toronto Alexithymia Scale (TAS), which indicated a significant difference between patients and controls on the ability to differentiate between bodily sensations and other feelings and on the ability to express these other feelings, but there were no differences between patients and controls on fantasy or metaphorical thinking. Results suggest affective dysregulation in bulimic patients, without a disruption of creativity. Patient scores on the TAS were lower than those of previous unscreened bulimic studies, indicating a component of alexithymia secondary to depression contributing to previous results. The authors note that bulimics' affective deficits may have impact on the efficacy of psychodynamic therapy, making them better candidates for cognitive behavioral therapy, in which they may concentrate on identifying and resolving these cognitions and affects.