Bulimia

Question 1

What is bulimia?

Answer 1

An eating disorder marked by recurrent episodes of binge eaeting followed by compensatory behaviour such as self infuced vomiting or laxative abuse

Question 2

What population is bulimia most common in?

Answer 2

Women in their 20s and 30s

Question 3

What are the risk factors for bulimia?

Answer 3

Female sex
Young age
Perfectionism
History of sexual abuse
Personal history of depression or anxiety
Family history of depression, anxiety or eating disorders

Question 4

What is the presentation of bulimia?

Answer 4

Recurrent episodes of binge eating
Purging - self induced vomiting, laxative use
Body image distortion
Dental erosion
Parotid gland swelling
Russell’s sign

Question 5

What is Russell’s sign?

Answer 5

Scarring on the back of the hands or knuckles, by repeatedly inducing vomiting

Question 6

What blood abnormalities may be seen in bulimia?

Answer 6

Alkalosis from vomiting hydrochloric acid
Hypokalaemia

Question 7

What physical signs of bulimia may be seen?

Answer 7

Erosion of teeth
Russell’s sign
Parotid gland swelling
GORD
Mouth ulcers

Question 8

What are the differentials of bulimia?

Answer 8

Binge eating disorder
Anorexia nervosa
Rumination-regurgitation disorder
Other psychiatric disorders

Question 9

What is the management of bulimia?

Answer 9

Referral to a specialist
CBT
Nutrition and meal support
SSRIs