Bulimia Nervosa
Bulimia Nervosa was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.

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Basics

Description

  • A pattern of discrete periods of uncontrolled eating, followed by compensatory behaviors
  • System(s) affected: Oropharyngeal; Endocrine/metabolic; Gastrointestinal; Dermatologic; Cardiovascular; Nervous

Epidemiology

  • Predominant age: Adolescents and young adults
  • Mean age of onset: 18–21 years
  • Predominant sex: Female > Male (10–20:1)

Incidence
28.8 women, 0.8 men per 100,000 per year

Prevalence
  • 1–3% in women age 16–35 years
  • 0.5% in young men (higher among gay and bisexual men)

Risk Factors

  • Female gender
  • History of obesity and dieting
  • Body dissatisfaction
  • Critical comments by family or others about weight, body shape, or eating
  • Severe life stressor
  • Low self-esteem
  • Perceived pressure to be thin
  • Perfectionist or obsessive thinking
  • Poor impulse control, alcohol misuse
  • History of anorexia nervosa (AN)
  • Environment stressing high achievement, competition, thinness, or physical fitness (e.g., armed forces, ballet, cheerleading, gymnastics, or modeling)
  • Family history of substance abuse, affective disorders, eating disorder, or obesity
  • Early feeding problems
  • Low birthweight for gestational age
  • Hyporeactivity at birth
  • Type I diabetes
  • Sexual abuse is not causally related to bulimia.

General Prevention

  • Prevention programs can reduce risk factors and future onset of eating disorders (1)[C].
  • Target adolescents and young women ≥15 years.
  • Encourage realistic and healthy weight management strategies and attitudes.
  • Decrease body dissatisfaction and promote self-esteem.
  • Reduce focus on thin as ideal.
  • Moderate overly high self-expectations.
  • Decrease anxiety/depressive symptoms and improve stress management.

Etiology

Combination of biological, psychological, environmental, and social factors. Unique contribution of any specific factor remains unclear.

Commonly Associated Conditions

  • Major depression and dysthymia
  • Anxiety disorders
  • Substance abuse/dependence
  • Bipolar disorder
  • Obsessive-compulsive disorder
  • Borderline personality disorder
  • Schizophrenic disorder

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