- A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- 1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
- 2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
- B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
- C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
- D. Self-evaluation is unduly influenced by body shape and weight.
- E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
- Dental enamel loss
- Scarring/erosions of dorsal fingers, hand from self-induced emesis
- Salivary gland hypertrophy (painless, bilateral)
- Arrhythmias secondary to hypokalemia, particularly with binge-purge subtype
- Metabolic alkalosis
- Dehydration, chronic contraction alkalosis
- Hypokalemia, hypochloremia
- GI complications
- Must avoid use of bupropion as it may lead to seizures in patients with eating disorders
|Laxatives||Nl to ↑||↓||Variable||Variable||Variable|
|Diuretics||↓ to nl||↓||↓||↑||↑|
- IVF volume replacement
- Potassium oral replacement 40-80 mEq/day
- Referral to psych for CBT
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Mehler PS. Bulimia nervosa. N Engl J Med 2003;349:876.
- Metabolic Abnormalities in Bulimia Nervosa. Am Fam Physician. 2004 Mar 15;69(6):1530-1532.