David Baxter PhD
Late Founder
Purging disorder distinct from bulimia nervosa
Purging disorder may be distinct from bulimia nervosa, say investigators who stress that more study is needed to characterize what appears to be a common condition.
Patients with purging disorder vomit frequently, but unlike individuals with bulimia, they do not binge eat.
The nature of the condition means that, according to current clinical criteria, purging disorder falls into the category of "eating disorder not otherwise specified." Thus, screens for anorexia and bulimia may miss such individuals because they are of normal weight and do not report binge-eating episodes.
However, Pamela Keel, from University of Iowa in Iowa City, Indiana, USA, and colleagues point out that purging disorder may be more common than both anorexia and bulimia nervosa combined.
To evaluate the clinical significance and distinctiveness of purging disorder, the researchers carried out clinical assessments on 37 women with purging disorder, 39 with bulimia, and 35 with no eating disorders. Of these, 23 women with purging disorder and 25 with bulimia also completed 6-month follow-up assessments.
Compared with women with no eating disorders, women in both groups of eating disorders reported significantly higher eating, and Axis I and Axis II pathology.
Moreover, women with purging disorder could be distinguished from those with bulimia due to having significantly lower eating concerns, and less disinhibition, hunger, and impulsivity.
There was no difference between the two groups in rates of remission at 6 months, and switching from one type of disorder to the other was rare.
Previous studies have suggested that binging in bulimia patients may be related to impairment in the neurotransmitter serotonin and the gastrointestinal peptide hormone cholecystokinin, which prevents individuals from feeling full, the researchers note in the International Journal of Eating Disorders.
This theory may explain the differences between purging disorder and bulimia, they suggest.
Int J Eat Disord 2005; 38: 191-199
Purging disorder may be distinct from bulimia nervosa, say investigators who stress that more study is needed to characterize what appears to be a common condition.
Patients with purging disorder vomit frequently, but unlike individuals with bulimia, they do not binge eat.
The nature of the condition means that, according to current clinical criteria, purging disorder falls into the category of "eating disorder not otherwise specified." Thus, screens for anorexia and bulimia may miss such individuals because they are of normal weight and do not report binge-eating episodes.
However, Pamela Keel, from University of Iowa in Iowa City, Indiana, USA, and colleagues point out that purging disorder may be more common than both anorexia and bulimia nervosa combined.
To evaluate the clinical significance and distinctiveness of purging disorder, the researchers carried out clinical assessments on 37 women with purging disorder, 39 with bulimia, and 35 with no eating disorders. Of these, 23 women with purging disorder and 25 with bulimia also completed 6-month follow-up assessments.
Compared with women with no eating disorders, women in both groups of eating disorders reported significantly higher eating, and Axis I and Axis II pathology.
Moreover, women with purging disorder could be distinguished from those with bulimia due to having significantly lower eating concerns, and less disinhibition, hunger, and impulsivity.
There was no difference between the two groups in rates of remission at 6 months, and switching from one type of disorder to the other was rare.
Previous studies have suggested that binging in bulimia patients may be related to impairment in the neurotransmitter serotonin and the gastrointestinal peptide hormone cholecystokinin, which prevents individuals from feeling full, the researchers note in the International Journal of Eating Disorders.
This theory may explain the differences between purging disorder and bulimia, they suggest.
Int J Eat Disord 2005; 38: 191-199
