[…] in 80-90% of individuals who present for treatment,7 and therefore this section describes the health state of an individual with bulimia nervosa, purging type. [acronymattic.com]

Case presentation We present as our main case a 20-year-old Japanese woman with anorexia nervosa who engaged in “tube vomiting.” [ncbi.nlm.nih.gov]

A diagnosis might then be allocated that specifies a specific reason why the presentation does not meet the specifics of another disorder (e.g. Bulimia Nervosa- low frequency). [freedeatingdisorders.org]

• Shivering

  I would sit in the icy water for at least an hour, shivering like mad and delighted that I was burning off fat. It usually took me ages to get to sleep after that, because I'd be lying in bed still shivering. But at least shivering used energy! [stillhopingstilleating.blogspot.com]

• Vomiting

  The baselines of both groups were comparable with regard to key features, including binge and vomiting frequency, and carbohydrate and lipid intake. [ncbi.nlm.nih.gov]

  […] uses other methods of compensation, such as fasting or excessive exercise, but does not regularly engage in self-induced vomiting or the use of laxatives, diuretics, or enemas. 7- Self-induced vomiting is the most common method to compensate for binge [acronymattic.com]

  (Somerset and Wessex Eating Disorders Association) Vomiting and Your Health (PDF) – Fact sheet on the dangers of chronic vomiting. Includes myths about self-induced vomiting. (Centre for Clinical Interventions) [soulutionscounselling.com]

• Nausea

  […] non-draft ICD-10-CM) 2017 (effective 10/1/2016) : No change 2018 (effective 10/1/2017) : No change 2019 (effective 10/1/2018) : No change Code annotations containing back-references to F50.2 : Type 1 Excludes: R11, R63, F50.02 ICD-10-CM Diagnosis Code R11 Nausea [icd10data.com]

  Self-induced vomiting, misuse of laxatives, diuretics, and enemas Excessive exercising, fasting, or dieting Eating so much that it results in stomach pain Fluctuating weight – going up and down Gastrointestinal problems – diarrhea, gas, constipation, nausea [psycom.net]

  Gastric rupture, the most serious complication, is uncommon. 17 More often, patients describe nausea, abdominal pain and distention, prolonged digestion and weight gain. [aafp.org]

  When the patient is regurgitating previous swallowed food this might be partially digested and patient is not having nausea or involuntary retching. [clevelandclinicmeded.com]

• Hematemesis

  ) hematemesis ( K92.0 ) neonatal hematemesis ( P54.0 ) newborn vomiting ( P92.0- ) psychogenic vomiting ( F50.89 ) vomiting associated with bulimia nervosa ( F50.2 ) vomiting following gastrointestinal surgery ( K91.0 ) ICD-10-CM Diagnosis Code R63 [icd10data.com]

  10% Refusal to eat Failure to respond to outpatient treatment Bulimia nervosa Syncope Serum potassium < 3.2 mmol/L Serum chloride < 88 mmol/L Esophageal tears Cardiac arrhythmias including prolonged QTc Hypothermia Suicide risk Intractable vomiting Hematemesis [aafp.org]

  […] in oral intake or weight despite maximally intensive outpatient interventions Prior knowledge of weight at which physical instability is likely to occur in the particular patient Serious physical abnormalities Electrolyte or metabolic abnormalities Hematemesis [clevelandclinicmeded.com]

• Eating Frequently

  […] vomiting Broken blood vessels in the eyes Electrolyte imbalances Weakening of tooth enamel due to repeated vomiting Enlarged glands in the neck or cheeks, resulting in a “chipmunk” cheeks Chronic gastric re-flux after eating Frequent use of the bathroom [amyboyers.com]

  Frequently, but not always, people with eating disorders have been victims of sexual, physical or emotional abuse as children. [consumer.healthday.com]

• Recurrent Vomiting

  Moreover, the acid can aggravate or tear the esophagus, which can cause an individual to vomit blood. The circulatory system is affected in that recurrent vomiting, which can cause dehydration, weak muscles or fatigue. [therecoveryvillage.com]

  Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse oflaxatives, diuretics, or other medications; fasting; or excessive exercise. C. [aafp.org]

• Dental Caries

  caries Electrolyte abnormalities Gastrointestinal irritation, bleeding, or reflux Parotid abnormalities Secondary renal failure Based on information from references 35-38. [clevelandclinicmeded.com]

• Orthostatic Hypotension

  Consider admission for persistent and recurrent emesis alone (10 to 20 times a day), especially in the face of bradycardia or orthostatic hypotension. [acphospitalist.org]

  Bradycardia, orthostatic hypotension, and palpitations may progress to potentially fatal arrhythmias. Epigastric pain and a bloating sensation are common. Laxative abuse causes hemorrhoids and rectal prolapse. [aafp.org]

  hypotension and heart rate less than 40 beats per minute or greater than 110 beats per minute Inability to sustain body core temperature Comorbid psychiatric illness (suicidal, depressed, unable to care for self) Based on information from references [clevelandclinicmeded.com]

• Low Self-Esteem

  Low self-esteem: Women or men who think of themselves as useless, worthless, and unattractive are at risk for bulimia. Things that can contribute to low self-esteem include depression, perfectionism, childhood abuse, and a critical home environment. [soulutionscounselling.com]

  Left unchecked, it can to lead to metabolic disorders, low self-esteem, depression, or even death. It is therefore, important to seek treatment for this complex and dangerous form of bulimia, and the emotional issues that accompany it. [eatingdisorders.com]

  Often times individuals will have emotional trauma, low self esteem, mental health disorders, a history of self-harm or substance abuse disorders that are driving them to engage in self-induced purging. [centerfordiscovery.com]

  They may also be preoccupied with and secretive around food, and feel self-conscious about eating around others. Low self-esteem, irritability and mood swings, and feelings of guilt, shame, and anxiety, especially after a binge, are also common. [beateatingdisorders.org.uk]

  Psychotherapy : Some forms of treatment are psychotherapy, which uses counseling to uncover the reason for bulimia and to help boost self-esteem. [belmarrahealth.com]

• Preoccupation with Food

  Their preoccupation with food and weight may become an obsession that severely impacts what and how they eat. They will create extreme rules and restrictions about their diets, and some people with anorexia may binge eat and then purge. [healthdirect.gov.au]

  Warning Signs of Anorexia Nervosa Preoccupation with body shape, weight and/or appearance Intense fear of gaining weight Preoccupation with food or food related activities Negative or distorted body image; perceiving self to be fat when at a healthy weight [eatingdisorders.org.au]

  Anorexia nervosa and bulimia are psychiatric illnesses that center on food and its consumption and are usually characterized by: Excessive preoccupation with food and dissatisfaction with one’s body shape or weight A compulsion to engage in extreme eating [hopkinsmedicine.org]

  An eating disorder is an unhealthy preoccupation with food, weight, or appearance that interferes with everyday life. [eatingdisorderfoundation.org]

  […] or fasting Peculiar eating habits or rituals Inappropriate use of laxatives, diuretics, or other cathartics Irregular or absence of menstruation Anxiety Discouragement related to dissatisfaction with themselves and their bodily appearance Depression Preoccupation [stanfordchildrens.org]

• Seizure

  In addition to anorexia, a number of disorders may mimic bulimia, including: borderline personality disorder brain tumors depression epileptic seizures Klein-Levin syndrome (a rare condition more common in men that causes excessive eating) Kluver-Bucy [psychiatric-disorders.com]

  Paresthesias, tetany, seizures or cardiac arrhythmias are potential metabolic complications that require acute care. 17 Chemistry profiles should be obtained regularly in patients who continue to vomit or abuse purgatives on a regular basis. [aafp.org]

  Malnutrition (can lead to loss of muscle and bone density [osteoporosis] resulting in dry, brittle bones) Severe dehydration, which can result in kidney failure and chemical imbalances (can lead to seizures, irregular heartbeats and possibly heart failure [disabled-world.com]

  Doses of tricyclic antidepressants and monoamine oxidase inhibitors parallel those used to treat depression, but higher doses of fluoxetine (≤80 mg/day) may be needed to treat bulimia nervosa. 51 Bupropion (Wellbutrin) has been associated with seizures [clevelandclinicmeded.com]

• Screaming

  Truly and honestly, it's as if a thousand people were screaming, crying, begging to be fed and nothing you can ever give them will be enough. And then comes the guilt and shame. It is devastating and all consuming. [fatpagan.blogspot.com]

Psychoeducational principles in treatment. In: Garner D.M., Garfinkel P.E. (Eds.) Handbook of treatment for Eating Disorders. New York, Guilford, 1997, pp. 145–174. Google Scholar 6. [link.springer.com]

Bulimia treatment and therapyTo stop the cycle of bingeing and purging, it’s important to seek professional help early, follow through with treatment, and resolve the underlying emotional issues that caused the bulimia in the first place. [soulutionscounselling.com]

With its emphasis on treatment strategies, this text can be used by practitioners as well as by professors in the classroom in introductory courses in addictions or in subsequent courses that focus on treatment strategies. [books.google.com]

Treatment for bulimia The severity of the bulimia nervosa is what will determine the level of treatment required. Many treatments may be conducted simultaneously for the most effective recovery. [belmarrahealth.com]

[…] and eating disorder treatment centers [mental-health-matters.com]

Personality variables ( i.e., perfectionism) may influence or be a consequence of anorexia nervosa. 109 Prognosis is improved with early detection and intervention. [www150.statcan.gc.ca]

Both are illnesses of the lung with cough and fever, but each will have a slightly different natural history, treatment, and, sometimes, prognosis. [kartiniclinic.com]

[…] changes in nerve & muscle function � Low blood pressure � Slow heart rate � Kidney & gastrointestinal problems � Bone mass declines � Skin dry & nails brittle � Hair loss � Death from life-threatening illness or suicide Eating Disorders - Anorexia Nervosa Prognosis [www2.hawaii.edu]

Prognosis: 1. The expected course of a disease. 2. The patient's chance of recovery. The prognosis predicts the outcome of a disease and therefore the future for the patient. His prognosis is grim, for example, while hers is good. [psychologistanywhereanytime.com]

Prognosis The outcome for individuals with eating disorders can be described by the rule of thirds. One-third of individuals improve, do well, and lead normal lives. [acphospitalist.org]

Often accompanied by: depressed mood, anxiety, substance abuse (esp. stimulants), suicide, illegal behavior (esp. stealing) � Physical consequences of purging i.e. electrolytes, irritation of stomach and intestines, loss of dental enamel, amenorrhea Etiology [www2.hawaii.edu]

Etiology of Binge Eating: Biological mechanisms. In: Fairburn C.G., Wilson G.T. (Eds.) Binge Eating. Nature, Assessment and Treatment. New York, Guilford, 1993, pp. 206–224. Google Scholar 18. [link.springer.com]

Frequent vomiting has been reported to cause swelling of the salivary glands in approximately 8 percent of patients with bulimia nervosa. 20 The exact etiology is unknown. [aafp.org]

Definition and Etiology Eating disorders are syndromes characterized by severe disturbances in eating behavior and by distress or ex-cessive concern about body shape or weight and often occur with severe medical or psychiatric comorbidities. [clevelandclinicmeded.com]

"Epidemiological studies on adverse dieting behaviours and eating disorders among young people in Hungary". Social Psychiatry and Psychiatric Epidemiology. 39 (8): 647–54. doi : 10.1007/s00127-004-0783-z. [en.wikipedia.org]

In disease epidemiology, the incidence is the number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence which refers to the number of cases alive on a certain date. [psychologistanywhereanytime.com]

Smink FR, van Hoeken D, Hoek HW. epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14:406–414. Carter JC, Mercer-Lynn KB, Norwood SJ, et al. [clevelandclinicmeded.com]

Child sexual abuse and later disordered eating: a New Zealand epidemiological study. Int J Eat Disord, Vol. 29(4):380-92. Raffi AR, et al. Life events and prodromal symptoms in bulimia nervosa. Psychol Med, vol. 30(3):727-31. Webster JJ, et al. [consumer.healthday.com]

The inclusion of BED as a formal diagnosis in DSM-5, along with reference to its epidemiology in the accompanying text, will, it is hoped, go some way to redressing this problem. [jeatdisord.biomedcentral.com]

The “pathophysiologic model” suggests that brain chemistry causes the disorder. [bulimiaguide.org]

The research in this field is continuously evolving, as is the current knowledge of pathophysiology, clinical recognition and inpatient management of NI and eating disorders. [acphospitalist.org]

Back to Top Pathophysiology and Natural History Biologic and psychosocial factors are implicated in the pathophysiology of eating disorders, but the underlying causes and mechanisms remain unknown. 7,18,19 Biologic Factors First–degree female relatives [clevelandclinicmeded.com]

“Eating disorders: clinical features and pathophysiology”. Physiol. Behav. 81 (2): 359–74.doi:10.1016/j.physbeh.2004.02.009. PMID 15159176 6. Douglas Harper (November 2001). “ Online Etymology Dictionary: bulimia “.Online Etymology Dictionary. [mirror-mirror.org]

Selected Clinical Signs of Eating Disorders Sign Underlying pathophysiology Anorexia nervosa Amenorrhea Hypothalamic dysfunction, low fat stores, malnutrition Arrhythmia Electrolyte disorders, heart failure, prolonged corrected QT interval Bradycardia [aafp.org]

He or she may be in a good position to identify early indicators of an eating disorder and help prevent its development. [mayoclinic.org]

Laxative and enema abuse Laxatives are medications used to treat or prevent constipation and are often inappropriately used to rid the body of calories of food. [centerfordiscovery.com]

Nonpurging bulimics use other compensatory behaviors including fasting and excessive exercise to prevent weight gain. The causes of bulimia nervosa are unclear. [ohioline.osu.edu]

Prevention of bulimia Preventive measures to reduce the incidence of bulimia are not known at this time. [stanfordchildrens.org]