More threads by David Baxter PhD

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


personally, I think ed's are an area where with more research more diagnostic criteria and more ed classifications will be added or at least seriously considered as it has been done so with some. as much as a term can shine light onto a person or a problem, I think it can also be confining and restricting to the person's experiences....

I was actually just reading about a possible purging type of bulimia...

Adolescents with Bulimia Nervosa and Eating Disorder Not Otherwise Specified-Purging Only

Abstract: Objective: The purpose of the study was to better understand the phenomenology of bulimic symptomatology in an adolescent clinic sample. Method: Adolescents with bulimia nervosa (BN; n = 36) and eating disorders not otherwise specified-purging but no objective bulimic episodes (EDNOS-P; n = 20) were compared on the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), the Rosenberg Self- Esteem Scale (RSES), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). Results: Subjects with EDNOS-P and BN were equivalent in terms of age and weight, but were less likely to have intact families. Nearly one half of EDNOS-P subjects purged exclusively outside of eating episodes in which they experienced a sense of loss of control. Although still at clinically significant levels, EDNOS-P subjects reported less concerns regarding weight, shape, and eating relative to BN. Groups were not significantly different on psychiatric comorbidity, but differed on self-esteem. Discussion: Results prompt reappraisal of current criteria of BN to encompass those who purge without binge eating.

Intl. Journal of Eating Disorders 2005;38:157-161

- should be able to click on "pdf" for the full article once you open the link
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