Treatment interventions may speed eventual recovery but do not appear to alter outcome more than 5 years following presentation. Long-term outcome for women diagnosed with bulimia nervosa remains unclear. However, this disorder may be chronic for at least a subset of women.
Full Answer
Does duration of follow-up affect the prevalence of bulimia nervosa?
Conclusions: The findings suggest that the number of women who continue to meet full criteria for bulimia nervosa declines as the duration of follow-up increases; approximately 30%, however, continued to engage in recurrent binge eating or purging behaviors (incidence rate, 0.026 cases per person-years).
Is bulimia nervosa treatable?
CONCLUSIONS Bulimia nervosa is a common and treatable condition that often presents in the primary care setting. The hallmark sign for bulimia nervosa is a distorted view of food and eating. Patients with this condition often maintain a normal or above-normal weight.
What is the clinical presentation of bulimia nervosa?
CLINICAL PRESENTATION. The diagnosis and long-term treatment of bulimia nervosa require the practitioner to have insight into the patient's thoughts regarding weight, food, and eating rituals. The cardinal symptoms of bulimia nervosa include only inappropriate bingeing and compensatory behavior, not low body weight.
What is the prognosis of bulimia and anorexia?
During Wave 1, 31.4% of participants with anorexia nervosa and 68.2% with bulimia nervosa recovered. Individuals with anorexia nervosa were slower to recover than those with bulimia nervosa during Wave 1 (χ21= 38.2, P< .001) (Figure 1).
How many people with bulimia nervosa recovered?
At 22-year follow-up, 62.8% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa recovered, compared to 31.4% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa by 9-year follow-up. Approximately half of those with anorexia nervosa who had not recovered by 9 years progressed to recovery at 22 years. Early recovery was associated with increased likelihood of long-term recovery in anorexia nervosa (odds ratio [OR] = 10.5; 95% CI, 3.77–29.28; McNemar χ21= 31.39; P< .01) but not in bulimia nervosa (OR = 1.0; 95% CI, 0.49–2.05; McNemar χ21= 0; P= 1.0).
How long does it take to recover from bulimia nervosa?
In contrast, the relationship between recovery and follow-up duration in bulimia nervosa appears nonlinear; bulimia nervosa recovery rates peaked between 4 to 9 years of follow-up and did not increase substantially beyond 10 years.4,16,17Only 1 report18followed the long-term course of bulimia nervosa in a small college sample assessed at 10 and 20 years of follow-up. At 20-year follow-up, 76% of women with bulimia nervosa had recovered, and in contrast to the other studies, recovery rates increased between the 10- and 20-year follow-ups.
How many people recovered from anorexia nervosa wave 1?
During Wave 1, 31. 4% of participants with anorexia nervosa and 68.2% with bulimia nervosa recovered. Individuals with anorexia nervosa were slower to recover than those with bulimia nervosa during Wave 1 (χ21= 38.2, P< .001) (Figure 1). The median time to recovery for anorexia nervosa could not be calculated because fewer than 50% recovered. For bulimia nervosa, the median time to recovery was estimated at 3.8 years.
How many participants recovered from wave 2 of bulimia?
Among participants with bulimia nervosa who were not recovered at Wave 1, 44.1% were recovered by Wave 2, and 20.5% who were recovered at Wave 1 were no longer recovered at Wave 2.
How long is the follow up period for a wave 1 study?
In the second wave (Wave 2) of data collection (initiated in 2011), surviving participants were re-contacted between 20 to 25 years after study entry for a 1-time follow-up. Among the 176 participants, the mean (SD) length of follow-up was 22.1 (1.1) years.
Does binge purge cause cognitive symptoms?
No binge/purge behaviors; fights urges to binge/purge; cognitive symptoms may be present
Do eating disorders respond to treatment?
Despite recent treatment advances, a sizable minority of patients with eating disorders do not respond to evidence-based treatments, experience multiple treatment failures, and are reluctant or challenging to engage in treatment.6,9,10Approximately half of patients will not recover following an adequate treatment course, and longer duration of illness is among the identified predictors of poor outcomes.9As a result of repeated treatment failures, Hay and colleagues suggested that “both the clinician and [chronically ill] patient often share the experience of hopelessness and despair about the likelihood of meaningful change.”7(p996)For these patients with severe and enduring illness, Robinson5and others proposed a paradigmatic shift in therapeutic approach focused on harm reduction rather than recovery. Similarly, Strober and Johnson6and Wonderlich and colleagues9suggested that rather than prioritizing behavioral change (eg, weight restoration and binge/purge abstinence), treatment should match the patient’s goals—which may be quite different from behavioral change—in order to minimize risk of dropout. Preliminary data adopting a specialist supportive clinical management approach for patients with severe and enduring illness suggested that quality of life improvements are sizable and that improvement in symptoms of eating disorders were also observed in some patients but were not substantial when not the focus of treatment.8
What are the short term effects of bulimia?
The short-term effects of bulimia are numerous. 4 People may experience amenorrhea, which is the absence of menstruation, or anemia, which can lead to fatigue. Severe dehydration, constipation, and irregular heart rhythms known as arrhythmias can also occur. They may also suffer from changes in their electrolyte levels which can affect organ health. Other effects can include cavities, gum disease, intestinal problems, hair loss, dry skin, sleep problems, stroke, and organ failure. Due to this intense damage to the body, people with bulimia are at risk of death if they do not seek treatment.
What is bulimia nervosa?
Bulimia nervosa is a serious eating disorder whose long-term effects should not be overlooked. Persons with bulimia will eat a large among of food and then rid their body of the food through self-induced vomiting or the use of laxatives or diuretics.
How many women will have bulimia in their lifetime?
They may also restrict calories through fasting or excessive exercise to make up for the periods of binging. 1. Researchers estimate that roughly 1.5% of women will develop bulimia in their lifetime, but men can develop the disorder as well. 2 Roughly 50% of women will recover from bulimia within ten years of their diagnosis, ...
How to help someone with bulimia?
Recovery includes a combination of medical attention and nutritional planning to counter the effects of poor nutrition and purging. Mental health treatment is also vital component, to address potential co-occurring illness like depression or anxiety and to help a person identify and challenge negative thought patterns and environmental influences that contributed to the eating disorder behaviors.
Why is it important to talk to your doctor about bulimia?
If you have a history of bulimia, it’s important to talk to your doctor so that they can help you monitor for long-term health risks. Physicians can help you evaluate whether you’re at risk for osteoporosis, diabetes, high cholesterol, or other conditions. If you’re planning to conceive, it’s important to talk to your OB-GYN about the risk of relapse as you gain weight during the pregnancy. Because relapse is common among people with bulimia, the more informed people you have on your medical team, the better your long-term health will be.
Is bulimia nervosa a long term illness?
Bulimia nervosa is a serious eating disorder that not only has significant short-term repercussions, but can also have severe long-term effects on both physical and mental health. Bulimia nervosa is a serious eating disorder whose long-term effects should not be overlooked. Persons with bulimia will eat a large among of food ...
Can bulimia affect fertility?
Women with bulimia are at risk for infrequent menstrual periods, known as oligomenorrhea, due to poor nutrition. This can affect fertility. It may take some time, but after recovering from bulimia, women will begin to see their menstrual cycle return to normal and they can conceive. 7 However, during pregnancy women with a history of bulimia are at risk for relapse as they begin to focus on their weight.Other long-term effects of bulimia can include dental problems, high cholesterol, and damage to the esophagus.
What is bulimia nervosa?
Abstract. Bulimia nervosa is a psychiatric condition that affects many adolescent and young adult women. The disorder is characterized by bingeing and purging behavior and can lead to medical complications. Thus, patients with bulimia nervosa commonly present in the primary care setting. Physical and laboratory examinations reveal markers ...
What is the diagnosis of bulimia nervosa?
The diagnosis and long-term treatment of bulimia nervosa require the practitioner to have insight into the patient's thoughts regarding weight, food, and eating rituals. The cardinal symptoms of bulimia nervosa include only inappropriate bingeing and compensatory behavior, not low body weight.
What is eating attitude test?
The Eating Attitudes Test has been widely used in epidemiologic studies, particularly to assess for symptoms of anorexia nervosa.22–25The instrument has been validated for bulimia nervosa and modified for use in patients with diabetes mellitus.26–28We recommend starting with the Eating Disorder Screen for Primary Care or the SCOFF for screening purposes in primary care.
What is the bulimia investigatory test?
The Bulimic Investigatory Test, Edinburgh (BITE) questionnaire is a brief test for the detection and description of bulimia nervosa.21The BITE consists of a set of 33 questions (30 yes/no type and 3 graded-response) that simultaneously assess the presence and relative severity of a binge-eating disorder. The BITE is divided into 2 sections: the symptom scale and the severity scale. The symptom scale consists of the 30 yes/no questions; 1 point is assigned for every “yes” answer, and a score of 20 or greater indicates a binge-eating disorder. The 3 graded-response questions make up the severity scale and ask the patient to score the frequency of their actions. A score of 5 or more on this section is considered clinically significant, and a score of 10 or more is considered severe. The BITE takes an average of 10 minutes to complete and can be immediately scored by the practitioner. Although not intended for screening in primary care, this instrument could be used to track disease severity in patients with known disease.
How many white women have bulimia nervosa?
However, most patients begin experiencing bulimic symptoms during adolescence.7Bulimia nervosa occurs in 2.3% of white women but in only 0.40% of black women.8. Risk factors for bulimia nervosa include, but are not limited to, ...
What is the purging subtype of bulimia nervosa?
Bulimia nervosa is also delineated into 2 distinct subtypes: purging and nonpurging. With the purging subtype, patients engage in some method to remove the binged food from their bodies. This is most often accomplished by self-induced vomiting but can include the misuse of laxatives, enemas, or diuretics.
How many people have eating disorders?
In the United States, eating disorders affect 5 to 10 million people, primarily young women between the ages of 14 and 40 years.1Much attention has been paid to the identification and treatment of anorexia nervosa in this age group.2,3However, bulimia nervosa is a more prevalent disorder that is more difficult to identify in the primary care setting. It is imperative that primary care physicians are aware of the presentation and subsequent interventions available to treat patients with bulimia nervosa, considering the relatively silent presentation of the disease. In this article, we provide an overview of bulimia nervosa, associated physical and laboratory examination findings, and diagnostic strategies pertinent to primary care practice.