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Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder?
Int J Eat Disord. 2014 Apr; 47(3):231-8.IJ

Abstract

OBJECTIVE

DSM-5 has dropped subtyping of bulimia nervosa (BN), opting to continue inclusion of the somewhat contentious diagnosis of BN-nonpurging subtype (BN-NP) within a broad BN category. Some contend however that BN-NP is more like binge eating disorder (BED) than BN-P. This study examines clinical characteristics, eating disorder symptomatology, and Axis I comorbidity in BN-NP, BN-P, and BED groups to establish whether BN-NP more closely resembles BN-P or BED.

METHOD

Women with BN-P (n = 29), BN-NP (n = 29), and BED (n = 54) were assessed at baseline in an outpatient psychotherapy trial for those with binge eating. Measures included the Structured Clinical Interviews for DSM-IV, Eating Disorder Examination, and Eating Disorder Inventory-2.

RESULTS

The BN-NP subtype had BMIs between those with BN-P and BED. Both BN subtypes had higher Restraint and Drive for Thinness scores than BED. Body Dissatisfaction was highest in BN-NP and predicted BN-NP compared to BN-P. Higher Restraint and lower BMI predicted BN-NP relative to BED. BN-NP resembled BED with higher lifetime BMIs; and weight-loss clinic than eating disorder clinic attendances relative to the BN-P subtype. Psychiatric comorbidity was comparable except for higher lifetime cannabis use disorder in the BN-NP than BN-P subtype

DISCUSSION

These results suggest that BN-NP sits between BN-P and BED however the high distress driving inappropriate compensatory behaviors in BN-P requires specialist eating disorder treatment. These results support retaining the BN-NP group within the BN category. Further research is needed to determine whether there are meaningful differences in outcome over follow-up.

Authors+Show Affiliations

Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, Christchurch, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24282157

Citation

Jordan, Jennifer, et al. "Bulimia Nervosa-nonpurging Subtype: Closer to the Bulimia Nervosa-purging Subtype or to Binge Eating Disorder?" The International Journal of Eating Disorders, vol. 47, no. 3, 2014, pp. 231-8.
Jordan J, McIntosh VV, Carter JD, et al. Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder? Int J Eat Disord. 2014;47(3):231-8.
Jordan, J., McIntosh, V. V., Carter, J. D., Rowe, S., Taylor, K., Frampton, C. M., McKenzie, J. M., Latner, J., & Joyce, P. R. (2014). Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder? The International Journal of Eating Disorders, 47(3), 231-8. https://doi.org/10.1002/eat.22218
Jordan J, et al. Bulimia Nervosa-nonpurging Subtype: Closer to the Bulimia Nervosa-purging Subtype or to Binge Eating Disorder. Int J Eat Disord. 2014;47(3):231-8. PubMed PMID: 24282157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder? AU - Jordan,Jennifer, AU - McIntosh,Virginia V W, AU - Carter,Janet D, AU - Rowe,Sarah, AU - Taylor,Kathryn, AU - Frampton,Christopher M A, AU - McKenzie,Janice M, AU - Latner,Janet, AU - Joyce,Peter R, Y1 - 2013/11/26/ PY - 2013/04/16/received PY - 2013/09/30/revised PY - 2013/10/05/accepted PY - 2013/11/28/entrez PY - 2013/11/28/pubmed PY - 2014/5/23/medline KW - DSM-5 KW - binge eating disorder KW - bulimia nervosa KW - bulimia nervosa nonpurging KW - classification KW - subtype SP - 231 EP - 8 JF - The International journal of eating disorders JO - Int J Eat Disord VL - 47 IS - 3 N2 - OBJECTIVE: DSM-5 has dropped subtyping of bulimia nervosa (BN), opting to continue inclusion of the somewhat contentious diagnosis of BN-nonpurging subtype (BN-NP) within a broad BN category. Some contend however that BN-NP is more like binge eating disorder (BED) than BN-P. This study examines clinical characteristics, eating disorder symptomatology, and Axis I comorbidity in BN-NP, BN-P, and BED groups to establish whether BN-NP more closely resembles BN-P or BED. METHOD: Women with BN-P (n = 29), BN-NP (n = 29), and BED (n = 54) were assessed at baseline in an outpatient psychotherapy trial for those with binge eating. Measures included the Structured Clinical Interviews for DSM-IV, Eating Disorder Examination, and Eating Disorder Inventory-2. RESULTS: The BN-NP subtype had BMIs between those with BN-P and BED. Both BN subtypes had higher Restraint and Drive for Thinness scores than BED. Body Dissatisfaction was highest in BN-NP and predicted BN-NP compared to BN-P. Higher Restraint and lower BMI predicted BN-NP relative to BED. BN-NP resembled BED with higher lifetime BMIs; and weight-loss clinic than eating disorder clinic attendances relative to the BN-P subtype. Psychiatric comorbidity was comparable except for higher lifetime cannabis use disorder in the BN-NP than BN-P subtype DISCUSSION: These results suggest that BN-NP sits between BN-P and BED however the high distress driving inappropriate compensatory behaviors in BN-P requires specialist eating disorder treatment. These results support retaining the BN-NP group within the BN category. Further research is needed to determine whether there are meaningful differences in outcome over follow-up. SN - 1098-108X UR - https://www.unboundmedicine.com/medline/citation/24282157/Bulimia_nervosa_nonpurging_subtype:_closer_to_the_bulimia_nervosa_purging_subtype_or_to_binge_eating_disorder L2 - https://doi.org/10.1002/eat.22218 DB - PRIME DP - Unbound Medicine ER -