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Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa.
Arch Gen Psychiatry. 2007 Sep; 64(9):1058-66.AG

Abstract

CONTEXT

Recent data suggest that purging disorder, a recently characterized form of eating disorder not otherwise specified, may be worthy of specific delineation in nosological schemes. However, more data are needed to determine how purging disorder differs from bulimia nervosa.

OBJECTIVE

To examine clinical features and subjective as well as objective physiological responses to a standardized test meal in purging disorder compared with bulimia nervosa and controls.

DESIGN

Study visit 1 included psychological assessments with structured clinical interviews and questionnaires. Study visit 2 included assessment of test-meal responses.

SETTING

Participants recruited from the community completed test-meal studies in a General Clinical Research Center.

PARTICIPANTS

Women with DSM-IV bulimia nervosa-purging subtype (n = 37) and purging disorder (n = 20) and non-eating disorder controls (n = 33) with a body mass index (calculated as weight in kilograms divided by height in meters squared) between 18.5 and 26.5 who were free of psychotropic medications.

MAIN OUTCOME MEASURES

Assessments of eating disorder severity, postprandial cholecystokinin response, and subjective responses to test meals.

RESULTS

Eating abnormalities were significantly elevated in participants with purging disorder and bulimia nervosa compared with controls but did not differ between eating disorder groups. Participants with purging disorder demonstrated significantly greater postprandial cholecystokinin release compared with participants with bulimia nervosa (t(76.44) = 2.51; P = .01) and did not differ significantly from controls (t(75.93) = 0.03; P = .98). Participants with purging disorder reported significantly greater postprandial fullness and gastrointestinal distress compared with participants with bulimia nervosa and controls.

CONCLUSIONS

Purging disorder is a clinically significant disorder of eating that appears to be distinct from bulimia nervosa on subjective and physiological responses to a test meal. Findings support further consideration of purging disorder for inclusion in the classification of eating disorders. Future studies on the psychobiology of purging disorder are needed to understand the propensity to purge in the absence of binge eating.

Authors+Show Affiliations

Department of Psychology, The University of Iowa, Iowa City, IA 52242, USA. pamela-keel@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17768271

Citation

Keel, Pamela K., et al. "Clinical Features and Physiological Response to a Test Meal in Purging Disorder and Bulimia Nervosa." Archives of General Psychiatry, vol. 64, no. 9, 2007, pp. 1058-66.
Keel PK, Wolfe BE, Liddle RA, et al. Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. Arch Gen Psychiatry. 2007;64(9):1058-66.
Keel, P. K., Wolfe, B. E., Liddle, R. A., De Young, K. P., & Jimerson, D. C. (2007). Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. Archives of General Psychiatry, 64(9), 1058-66.
Keel PK, et al. Clinical Features and Physiological Response to a Test Meal in Purging Disorder and Bulimia Nervosa. Arch Gen Psychiatry. 2007;64(9):1058-66. PubMed PMID: 17768271.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. AU - Keel,Pamela K, AU - Wolfe,Barbara E, AU - Liddle,Rodger A, AU - De Young,Kyle P, AU - Jimerson,David C, PY - 2007/9/5/pubmed PY - 2007/9/29/medline PY - 2007/9/5/entrez SP - 1058 EP - 66 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 64 IS - 9 N2 - CONTEXT: Recent data suggest that purging disorder, a recently characterized form of eating disorder not otherwise specified, may be worthy of specific delineation in nosological schemes. However, more data are needed to determine how purging disorder differs from bulimia nervosa. OBJECTIVE: To examine clinical features and subjective as well as objective physiological responses to a standardized test meal in purging disorder compared with bulimia nervosa and controls. DESIGN: Study visit 1 included psychological assessments with structured clinical interviews and questionnaires. Study visit 2 included assessment of test-meal responses. SETTING: Participants recruited from the community completed test-meal studies in a General Clinical Research Center. PARTICIPANTS: Women with DSM-IV bulimia nervosa-purging subtype (n = 37) and purging disorder (n = 20) and non-eating disorder controls (n = 33) with a body mass index (calculated as weight in kilograms divided by height in meters squared) between 18.5 and 26.5 who were free of psychotropic medications. MAIN OUTCOME MEASURES: Assessments of eating disorder severity, postprandial cholecystokinin response, and subjective responses to test meals. RESULTS: Eating abnormalities were significantly elevated in participants with purging disorder and bulimia nervosa compared with controls but did not differ between eating disorder groups. Participants with purging disorder demonstrated significantly greater postprandial cholecystokinin release compared with participants with bulimia nervosa (t(76.44) = 2.51; P = .01) and did not differ significantly from controls (t(75.93) = 0.03; P = .98). Participants with purging disorder reported significantly greater postprandial fullness and gastrointestinal distress compared with participants with bulimia nervosa and controls. CONCLUSIONS: Purging disorder is a clinically significant disorder of eating that appears to be distinct from bulimia nervosa on subjective and physiological responses to a test meal. Findings support further consideration of purging disorder for inclusion in the classification of eating disorders. Future studies on the psychobiology of purging disorder are needed to understand the propensity to purge in the absence of binge eating. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/17768271/Clinical_features_and_physiological_response_to_a_test_meal_in_purging_disorder_and_bulimia_nervosa_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17768271.ui DB - PRIME DP - Unbound Medicine ER -