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Purging disorder may be distinct from bulimia

December 4th, 2005

An article published in the November 2005 issue of International Journal of Eating Disorders suggests that purging disorder is a distinct eating disorder from bulimia nervosa. At present, the standard Diagnostic and Statistical Manual IV (DSM-IV) reference specifies bulimia nervosa as characterized by binge eating, while purging disorder falls into the category of “eating disorder not otherwise specified.” (ED-NOS)

The distinction between purging disorder and bulimia nervosa is that patients with purging disorder purge (vomit) frequently, but do not binge eat. Because of this difference in behavior it can be difficult to screen for purging disorder, as standard questionnaires are designed to identify potential anorexia or bulimia patients, and purging disorder patients are within normal weight ranges and do not report binge eating behaviors.

Pamela K. Keel of the University of Iowa suggests that purging disorder may actually be more common than anorexia nervosa and bulimia nervosa combined.

To evaluate whether purging disorder might be a distinct entity from bulimia nervosa, Keel and her colleagues assessed 37 women with purging disorder, 39 women with bulimia nervosa, and 35 women without an eating disorder. Twenty-three of the women with purging disorder and 25 of those with bulimia nervosa completed follow-up assessments six months later.

While women with purging disorder showed a similar degree of eating disorder severity, body image disturbance and dietary restraint as the women with bulimia nervosa, they showed less impulsivity about eating, less impulsivity overall, less hunger, and less eating disinhibition, the researchers found. There was no difference in remission rates between women with the two conditions at six months follow-up.


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