Eating - binge

The eating disorder bulimia is most common among female adolescents or young adults. People with bulimia typically consume large quantities of easily ingested high-calorie foods, usually in secrecy. This binge eating is usually followed by self-induced vomiting and accompanied by feelings of guilt or depression.

Complications resulting from prolonged bulimia include gastric dilatation, pancreatitis, dental decay, pharyngitis, esophagitis, pulmonary (lung) aspiration, and electrolyte abnormalities. Constipation and hemorrhoids are also common in people with bulimia.

Although death from bulimia is rare, the long-term outcome in severe bulimia can be worse than the outcome in anorexia nervosa, which suggests that the psychiatric disorder that causes bulimia is usually more severe.

While binge eating often begins during or after strict dieting, and may be caused by stress related to insufficient food intake, its cause remains unknown.

Take measures to reduce stress and improve overall health.

Medication is usually not necessary for this disorder. However, antidepressants, as prescribed by a doctor, are often helpful. Supportive care and counseling are recommended. Individual, group, family, and behavioral therapy may provide some help.

• bulimia is suspected

The health care provider will perform a physical examination. A history of the person's eating patterns may be sought from one or more family members because the person may not acknowledge that they are binge eating.

Medical history questions documenting binge eating in detail may include:

• How long has this been occurring?
• Are "purge" behaviors (such as self-induced vomiting or laxative abuse) also present?
• What other symptoms are also present?

Possible diagnostic tests include blood studies, such as electrolyte levels.

INTERVENTION

Behavior is usually controlled with counseling, biofeedback training (a process of monitoring body functions and altering these functions through relaxation), and individual or group psychotherapy.

Schmidt U, Lee S, Beecham J, et al. A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatry. 2007;164:591-598.