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Bulimia nervosa overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yashasvi Aryaputra[2]

Overview

Overview

Bulimia is an eating disorder in which an individual purges after they eat large quantities of food in a short period of time. Bulimia is linked with many mental disorders, one of the most prominent of which is depression. Those with this disorder fear gaining weight as a result of the binge eating episodes they go on, so they resort to extreme ways to counteract that such as forcing themselves to vomit.[1]

Historical Perspective

Historical Perspective

Bulimia is a Greek term that translates to “ravenous hunger”. Gerald Russell became the first person to publish a description of bulimia nervosa in 1979.

Pathophysiology

Pathophysiology

Bulimia is related to deep psychological issues and feelings of lack of control. They may feel a loss of control during a binge, and consume great quantities of food (over 20,000 calories). There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, dance and cheerleading, figure skating.

Classification

Classification

Bulimia nervosa may be classified in to two types on the basis of purging behavior into purging and non-purging types.

Causes

Causes

Screening

Screening

Differential Diagnosis

Differential Diagnosis

Epidemiology and Demographics

Epidemiology and Demographics

Very few studies regarding bulimia nervosa have been conducted on the general population, and thus, very little data is available. Bulimia nervosa is more prominent in females than in males. 0.1% to 1.4% of males are affected whereas 0.3% to 9.4% of females are affected.

Risk Factors

Risk Factors

The risk for Bulimia nervosa may be increased due to possible genetic predisposition, hormonal imbalances, and poor body image and self esteem.

Natural History, Complications and Prognosis

Natural History, Complications and Prognosis

Bulimia typically tends to start in late teens or early 20s. Bulimics go through cycles of over-eating and purging, that may be severe and devastating to the body. This cycle may be repeated several times a week or, in serious cases, several times a day. Bulimics may appear underweight, normal weight or overweight. Bulimia may cause several complications including malnutrition, dehydration, electrolyte imbalance, and vitamin and mineral deficiencies. The Eating Disorders Association of UK estimates it at 10%. An 18% mortality rate has been suggested for anorexia.

Diagnosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-effectiveness of Therapy

Future or Investigational Therapies

References

References

  1. Hay PJ, Claudino AM (2010). “Bulimia nervosa”. BMJ Clin Evid. 2010. PMC 3275326. PMID 21418667.

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