Bulmia

Question 1

What purgative behaviours occur in bulimia?

Answer 1

laxatives

diuretics

exercising

Question 2

What is Russell’s sign?

Answer 2

calluses on the knuckles or back of the hand due to repeated self induced vomiting

Question 3

over what period of time does this occur

Answer 3

once a week for 3 months

Question 4

what is the management?

Answer 4

referral for specialist care is appropriate in all cases

NICE recommend bulimia-nervosa-focused guided self-help for adults

If bulimia-nervosa-focused guided self-help is unacceptable, contraindicated, or ineffective after 4 weeks of treatment, NICE recommend:

• that we consider individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

-children should be offered bulimia-nervosa-focused family therapy (FT-BN)

pharmacological treatments have a limited role:
- a trial of high-dose fluoxetine is currently licensed for bulimia but long-term data is lacking