- Usually normal BMI or slightly overweight
- Pattern of binging and purging with vomiting, laxative/diuretic abuse
- Purges from as often as 1-2/wk to 10x/day
- Most commonly late adolescent females
- Associated with borderline, narcissistic personality disorders
- A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- 1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
- 2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
- B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
- C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
- D. Self-evaluation is unduly influenced by body shape and weight.
- E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
- Dental enamel loss
- Scarring of dorsal fingers, hand
- Salivary gland swelling
- Anorexia nervosa, binge eating/purging type
- Binge-eating disorder
- Klein-Levin syndrome
- Major depressive disorder, with atypical features
- Borderline personality disorder
- Dependent on type of purging
|Laxatives||Nl to ↑||↓||Variable||Variable||Variable|
|Diuretics||↓ to nl||↓||↓||↑||↑|
- IVF volume replacement
- Potassium oral replacement 40-80 mEq/day
- Referral to psych for CBT
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Mehler PS. Bulimia nervosa. N Engl J Med 2003;349:876.
- Metabolic Abnormalities in Bulimia Nervosa. Am Fam Physician. 2004 Mar 15;69(6):1530-1532.