Bulimia Nervosa

21/12/2013 by admin | Psychiatry

Diagnosis

Diagnosis requires all three of the following:

  1. Binge eating
  2. Methods to prevent weight gain (vomiting, purging, laxatives)
  3. Morbid fear of fatness (overvalued idea, not a delusion)

 

Features:

Individuals tend to be of a normal or above normal weight

 

Complications

Caused by starvation and vomiting:

  • Hypokalaemia
  • Dehydration
  • Enlargement of the parotid glands
  • Dental caries (due to stomach acid erosion)
  • Mallory Weiss tear (tear in the mucosa at the gastro-oesophageal junction due to vomiting)
  • Osteoporosis
  • Russell’s sign (thick skin on back of hands due to repeated induced vomiting)

 

Epidemiology

12 per 100,000. Ten times more common in females.

 

Treatment

CBT/ supportive therapy

SSRI’s may improve bingeing behavior.

Prognosis

70% of cases recover within 5 years and there is no increase in mortality.

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