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Bulimia Nervosa

Umer Farooq, MD and Ayesha Fatima, MBBS Reviewed 06/2020
 


BASICS

DESCRIPTION

Bulimia nervosa is an eating disorder that includes binge eating and inappropriate compensatory behaviors. 
  • Binge eating is characterized by eating, in a discrete period of time (with...

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]. 

GENERAL MEASURES

  • Multidisciplinary team

    • Primary care physician, behavioral health provider, nutritio...

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 d...

REFERENCES

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. [View Abstract on OvidMedline]
2
Hay PP, Bacaltchuk J, St...

ADDITIONAL READING

Harrington BC, Jimerson M, Haxton Cet al. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. Am Fam Physician.  2015;91(1):46–52. [View Abstr...

CODES

ICD10

F50.2 Bulimia nervosa 

ICD9

307.51 Bulimia nervosa 

SNOMED

  • 32721004 Bulimia nervosa, purging type

  • 78004001 Bulimia nervosa

  • 231523004 Atypical bulimia nervosa

  • 59645001 Bulimia nervosa, nonpurging t...

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.

  • Consider multidis...

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