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Bulimia Nervosa

Updated : December 2, 2022





Background

Teenage females are more likely than boys to develop bulimia nervosa, which is characterized by binge eating & improper compensating behaviors.

The current diagnostic standards for bulimia nervosa are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V):

Binge eating episodes:

  • Patients consume quantities that are larger than what most individuals would typically consume in a comparable time frame (generally fewer than two hours) under similar circumstances.
  • The patient is unable to regulate his eating during eating episodes and loses all self-control.

Following bingeing events, unhealthy compensating behavior is used to avoid gaining weight:

  • Usage of diuretics
  • Self-induced nausea
  • Extreme exercise
  • Overuse of laxatives
  • Fasting

To confirm a diagnosis, the episodes must occur at least once each week for 3 months.

Epidemiology

Any sex can be impacted by bulimia nervosa; however, women are disproportionately affected. The average onset age is 12.4 years old. According to estimates, there is 0.9 percent of teenagers have bulimia nervosa, 1.5 percent of women overall, & 0.5 percent of males overall have the disorder in the United States.

It is unknown how common bulimia nervosa is in developing nations, although estimates of prevalence from Europe, North America, & Australia range from 0.1 percent to 1.3 percent for men and 0.5 percent to 2.0 percent for women.

Anatomy

Pathophysiology

Etiology

Although the exact cause of bulimia nervosa is unknown, it is most likely complex. The binge-like behavior connected to this illness may be influenced by anomalies in interoceptive activity, notably of the insula.

According to a 2016 survey, individuals with anorexia or bulimia nervosa exhibit broad abnormalities and diffuse changes in the structural and functional connectivity of their white matter, notably in the circuits that control their hunger and reward their taste buds.

Other research has suggested that the intrinsic functioning brain structure may function differently.

Genetics

Prognostic Factors

Bulimia nervosa individuals typically recover from their disease. According to DSM-IV, the estimated 5-year relapse frequency for bulimia nervosa is 74 percent; however, 47 percent of those individuals also experienced a relapse during that time.

A different study using DSM-V standards reported a 5-year survival rate for bulimia nervosa in the general population of 55 percent. At two decades, 52 percent of bulimia nervosa patients receiving placebo therapy had totally recovered. It has been established that bulimia nervosa raises the overall mortality rate.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

fluoxetine 

Initially, 60 mg orally each day for several days
The maintenance dose can be titrated



 
 

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References

https://www.ncbi.nlm.nih.gov/books/NBK562178/

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Bulimia Nervosa

Updated : December 2, 2022




Teenage females are more likely than boys to develop bulimia nervosa, which is characterized by binge eating & improper compensating behaviors.

The current diagnostic standards for bulimia nervosa are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V):

Binge eating episodes:

  • Patients consume quantities that are larger than what most individuals would typically consume in a comparable time frame (generally fewer than two hours) under similar circumstances.
  • The patient is unable to regulate his eating during eating episodes and loses all self-control.

Following bingeing events, unhealthy compensating behavior is used to avoid gaining weight:

  • Usage of diuretics
  • Self-induced nausea
  • Extreme exercise
  • Overuse of laxatives
  • Fasting

To confirm a diagnosis, the episodes must occur at least once each week for 3 months.

Any sex can be impacted by bulimia nervosa; however, women are disproportionately affected. The average onset age is 12.4 years old. According to estimates, there is 0.9 percent of teenagers have bulimia nervosa, 1.5 percent of women overall, & 0.5 percent of males overall have the disorder in the United States.

It is unknown how common bulimia nervosa is in developing nations, although estimates of prevalence from Europe, North America, & Australia range from 0.1 percent to 1.3 percent for men and 0.5 percent to 2.0 percent for women.

Although the exact cause of bulimia nervosa is unknown, it is most likely complex. The binge-like behavior connected to this illness may be influenced by anomalies in interoceptive activity, notably of the insula.

According to a 2016 survey, individuals with anorexia or bulimia nervosa exhibit broad abnormalities and diffuse changes in the structural and functional connectivity of their white matter, notably in the circuits that control their hunger and reward their taste buds.

Other research has suggested that the intrinsic functioning brain structure may function differently.

Bulimia nervosa individuals typically recover from their disease. According to DSM-IV, the estimated 5-year relapse frequency for bulimia nervosa is 74 percent; however, 47 percent of those individuals also experienced a relapse during that time.

A different study using DSM-V standards reported a 5-year survival rate for bulimia nervosa in the general population of 55 percent. At two decades, 52 percent of bulimia nervosa patients receiving placebo therapy had totally recovered. It has been established that bulimia nervosa raises the overall mortality rate.

fluoxetine 

Initially, 60 mg orally each day for several days
The maintenance dose can be titrated



https://www.ncbi.nlm.nih.gov/books/NBK562178/

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