Bulimia Nervosa

Question 1

What are the diagnostic criteria for bulimia nervosa?

Answer 1

Persistent preoccupation with eating
Irresistible craving for food
Binges
Compensatory behaviour - purging, vomiting, excessive exercise, use of laxatives, use of appetite suppressants, failure to take insulin in diabetics

Question 2

What is the epidemiology for bulimia nervosa?

Answer 2

Most common in women in their early 20s

Question 3

What are the causes of bulimia nervosa?

Answer 3

Thought to be linked to family/personal history if obesity and substance misuse

Question 4

Other than the diagnostic criteria what are the other symptoms associated with bulimia nervosa?

Answer 4

Parotid hypertrophy
Erosion of teeth
Russel’s sign
Menstrual irregularity
Drug seeking behaviour
Self injurious behaviour

Question 5

What are the differential diagnoses of bulimia nervosa?

Answer 5

Upper GI disorders (same physical presentations but no psychopathology)
General personality disorder
Depression

Question 6

What are the physical signs of bulimia nervosa?

Answer 6

Arrhythmias
 Cardiac failure
Electrolytes disturbances
Oesophageal erosions/perforation
Gastric/duodenal ulcers
Pancreatitis
Constipation
Dental erosion
Leukopenia

Question 7

What are the risk fa tors for bulimia nervosa?

Answer 7

Females more at risk
Personality disorders
Family history of alcoholism
Body dissatisfaction
Impulsivity
History of sexual abuse
Depression
Past obesity
Past anorexia nervosa
Exposure to media pressure

Question 8

What are the treatments for bulimia nervosa?

Answer 8

Cognitive behavioural therapy
SSRIs
Psychotherapy
Structured eating plans
Potassium, calcium, magnesium, sodium replention