Bulimia nervosa

doi:10.1136/bmj.327.7411.380

BMJ 2003;327:380-381 (16 August), doi:10.1136/bmj.327.7411.380

Clinical review

Extracts from "BestTreatments"

Bulimia nervosa

Regina Z Lilly, medical writer¹

¹ BMJ Unified, London WC1H 9JR rzlilly@netscape.net

The first 150 words of the full text of this article appear below.

Description

Bulimia nervosa is an eating disorder that affects women 9-10times more often than men. It has three key features:

Intense preoccupation with body weight and shape
Repetitiveepisodes of binge eating (uncontrollably eating alarge quantity of food in a defined period—usually lessthan two hours)
Routinely taking extreme measures to prevent weight gain,includingself induced vomiting, fasting, excessive exercise,and misuseof laxatives and diuretics.

The condition is characterised by the patient's inability tocontrol the urge to indulge in binge eating. Medical complicationsare caused by the weight reducing behaviours, particularlyvomiting and laxative misuse. The frequency of these behavioursis, on average, at least twice a week for three months. Episodesmay be spontaneous or planned and can be triggered by stress, intense hunger, or dysphoria. Patients are usually in the normalweight range.

Treatment

Despite the availability of effective treatments, few peoplewith bulimia nervosa . . . [Full text of this article]

Treatments that are likely to work
Antidepressants
Cognitive behaviour therapy
Combination treatment with antidepressants and psychotherapy
Other psychotherapies
Treatments that need further study
Antidepressants as maintenance
Newer antidepressants
Selective serotonin reuptake inhibitors other than fluoxetine

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