Purging Disorder Different from Bulimia Nervosa

Purging disorder may be distinct from bulimia nervosa, investigators say. They 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 purging disorder falls into the category of “eating disorder not otherwise specified”, according to current clinical criteria. This means that screens for anorexia and bulimia may not catch such individuals because they are of normal weight and do not report binge-eating episodes.

However, Pamela Keel of the University of Iowa in Iowa City, Indiana and colleagues point out that purging disorders may be more common than both anorexia and bulimia nervosa combined.

To evaluate the clinical significance and distinctiveness of purging disorder, the researchers undertook 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 having no eating disorders, women in both groups of eating disorders reported significantly higher eating, and Axis I and Axis II pathology. As well, women with purging disorder were distinguishable from those with bulimia due to having significantly lower eating concerns, 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 proved rare.

Previous studies suggest 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. They suggest this theory may explain the differences between purging disorder and bulimia.

© Copyright 2007 Insight Journal Online Magazine.

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