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For further information, see CMDT Part 29-06: Bulimia Nervosa

Key Features

  • Uncontrolled episodes of binge eating at least twice weekly for 3 months

  • Recurrent inappropriate compensation to prevent weight gain

    • Self-induced vomiting

    • Laxatives

    • Diuretics

    • Fasting

    • Excessive exercise

  • Overconcern with weight and body shape

  • Occurs predominantly in young, white, middle- and upper-class women

Clinical Findings

  • Consuming large quantities of easily ingested high-calorie foods, usually in secrecy, followed by vomiting, cathartics, or diuretics accompanied by feelings of guilt or depression

  • Body weight fluctuates but generally within 20% of desirable weight

  • Menstruation is typically preserved

  • Differential diagnosis

    • Anorexia nervosa

    • Depression

    • Obsessive-compulsive disorder

    • Personality disorder

    • Substance abuse

Diagnosis

  • History and identification of behavioral features

Treatment

  • Antidepressant medications such as fluoxetine and other selective serotonin reuptake inhibitors

  • Psychotherapy (individual, group, family, and behavioral)

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