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Bulimia Nervosa

Umer Farooq, MD, MBBS and Saeed Ahmed, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A pattern of discrete periods of binge eating (within 2-hour period) along with lack of control over eating, followed by compensatory behaviors such as self-induced vomiting, misuse ...

DIAGNOSIS

HISTORY

  • Patients unlikely to self-identify binge eating or purging behaviors; corroborate with parent/relative.

  • Unhappiness and/or preoccupation with weight and diet attempts

  • Pattern of binge e...

TREATMENT

  • Cognitive-behavioral therapy (CBT) should be considered as first-line treatment (2,3)[A].

  • Interpersonal therapies and group therapies have been found to be helpful.

GENERAL MEASURES

  • Multidiscip...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Binge–purge activity, including antecedents and consequences

  • Level of exercise activity

  • Self-esteem, comfort with body and self

  • Ruminations and dep...

REFERENCES

1
1 Cotton MA, Ball C, Robinson P. Four simple questions can help screen for eating disorders. J Gen Intern Med.  2003;18(1):53–56. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 H...

ADDITIONAL READING

  • American Psychiatric Association. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 2006. http://ww...

CODES

ICD10

F50.2 Bulimia nervosa 

ICD9

307.51 Bulimia nervosa 

SNOMED

  • 78004001 Bulimia nervosa (disorder)

  • 32721004 Bulimia nervosa, purging type

  • 59645001 Bulimia nervosa, nonpurging type

  • 231523004 Atypical b...

CLINICAL PEARLS

  • Asking “Are you satisfied with your eating patterns?” and/or “Do you worry that you have lost control over how much you eat?” may help to screen for an eating problem.

  • Weight is not sev...

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