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Bulimia nervosa and binge eating disorder in adults: Medical complications and their management

Authors
James E Mitchell, MD
Christie Zunker, PhD, CPH, CHES
Section Editor
Joel Yager, MD
Deputy Editor
David Solomon, MD

INTRODUCTION

Medical complications and symptoms of poor health are common in patients with bulimia nervosa and binge eating disorder [1,2]. As an example, somatic symptoms such as shortness of breath, chest pain, joint pain, gastrointestinal problems, menstrual problems, and headache occur in more individuals with either bulimia nervosa or binge eating disorder compared with individuals who have no psychiatric disorder.  

The medical complications of bulimia nervosa and binge eating disorder and their management are reviewed here. The epidemiology, clinical features, diagnosis, and treatment are discussed separately, as are the medical complications of anorexia nervosa.

(See "Eating disorders: Overview of epidemiology, clinical features, and diagnosis".)

(See "Bulimia nervosa in adults: Clinical features, course of illness, assessment, and diagnosis".)

(See "Eating disorders: Overview of treatment".)

                           

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Literature review current through: Nov 2016. | This topic last updated: Wed Jul 27 00:00:00 GMT+00:00 2016.
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References
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  1. Mitchell JE, Crow S. Medical complications of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry 2006; 19:438.
  2. Mehler PS, Birmingham LC, Crow SJ, Jahraus JP. Medical complications of eating disorders. In: The Treatment of Eating Disorders: A Clinical Handbook, Grilo CM, Mitchell JE (Eds), The Guilford Press, New York 2010. p.66.
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.
  4. Mitchell, JE, Crow, SJ. Medical comorbidities of eating disorders. In: The Oxford Handbook of Eating Disorders, Agras, WS (Eds), Oxford University Press, New York 2010. p.259.
  5. Eating Disorders: Core Interventions in the Treatment of and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. National Institute for Clinical Excellence, Clinical Guideline 9. http://guidance.nice.org.uk (Accessed on December 22, 2010).
  6. Mehler, PS, Anderson, AE. Eating Disorders: A guide to medical care and complications, 2nd ed, The Johns Hopkins University Press, Baltimore, MD 2010.
  7. Brown CA, Mehler PS. Medical complications of self-induced vomiting. Eat Disord 2013; 21:287.
  8. American Psychiatric Association. Treatment of patients with eating disorders,third edition. American Psychiatric Association. Am J Psychiatry 2006; 163:4.
  9. Forney KJ, Buchman-Schmitt JM, Keel PK, Frank GK. The medical complications associated with purging. Int J Eat Disord 2016; 49:249.
  10. Mascolo M, McBride J, Mehler PS. Effective medical treatment strategies to help cessation of purging behaviors. Int J Eat Disord 2016; 49:324.
  11. Pomeroy, C, Mitchell, JE, Roerig, J, Crow, S. Medical Complications of Psychiatric Illness, American Psychiatric Publishing, Inc., Washington, DC 2002.
  12. Denholm M, Jankowski J. Gastroesophageal reflux disease and bulimia nervosa--a review of the literature. Dis Esophagus 2011; 24:79.
  13. Dessureault S, Coppola D, Weitzner M, et al. Barrett's esophagus and squamous cell carcinoma in a patient with psychogenic vomiting. Int J Gastrointest Cancer 2002; 32:57.
  14. Brown CA, Mehler PS. Successful "detoxing" from commonly utilized modes of purging in bulimia nervosa. Eat Disord 2012; 20:312.
  15. Westmoreland P, Krantz MJ, Mehler PS. Medical Complications of Anorexia Nervosa and Bulimia. Am J Med 2016; 129:30.
  16. Dejong H, Perkins S, Grover M, Schmidt U. The prevalence of irritable bowel syndrome in outpatients with bulimia nervosa. Int J Eat Disord 2011; 44:661.
  17. Holderness CC, Brooks-Gunn J, Warren MP. Co-morbidity of eating disorders and substance abuse review of the literature. Int J Eat Disord 1994; 16:1.
  18. Morris LG, Stephenson KE, Herring S, Marti JL. Recurrent acute pancreatitis in anorexia and bulimia. JOP 2004; 5:231.
  19. Mehler PS, Walsh K. Electrolyte and acid-base abnormalities associated with purging behaviors. Int J Eat Disord 2016; 49:311.
  20. Greenfeld D, Mickley D, Quinlan DM, Roloff P. Ipecac abuse in a sample of eating disordered outpatients. Int J Eat Disord 1993; 13:411.
  21. Steffen KJ, Mitchell JE, Roerig JL, Lancaster KL. The eating disorders medicine cabinet revisited: a clinician's guide to ipecac and laxatives. Int J Eat Disord 2007; 40:360.
  22. Ipecac syrup: Drug information http://uptodate.com (Accessed on October 29, 2010).
  23. American Society of Health-System Pharmacists. AHFS Drug Information 2008, American Society of Helath-System Pharmacists, American Hospital Formulary Service, Bethesda, MD 2008. p.2990.
  24. Gendall KA, Bulik CM, Joyce PR, et al. Menstrual cycle irregularity in bulimia nervosa. Associated factors and changes with treatment. J Psychosom Res 2000; 49:409.
  25. Waller K, Swan SH, Windham GC, et al. Use of urine biomarkers to evaluate menstrual function in healthy premenopausal women. Am J Epidemiol 1998; 147:1071.
  26. Johnson JG, Spitzer RL, Williams JB. Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients. Psychol Med 2001; 31:1455.
  27. Mannucci E, Rotella F, Ricca V, et al. Eating disorders in patients with type 1 diabetes: a meta-analysis. J Endocrinol Invest 2005; 28:417.
  28. Wotton CJ, James A, Goldacre MJ. Coexistence of eating disorders and autoimmune diseases: Record linkage cohort study, UK. Int J Eat Disord 2016; 49:663.
  29. Raevuori A, Suokas J, Haukka J, et al. Highly increased risk of type 2 diabetes in patients with binge eating disorder and bulimia nervosa. Int J Eat Disord 2015; 48:555.
  30. de Jonge P, Alonso J, Stein DJ, et al. Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression. Diabetologia 2014; 57:699.
  31. Monteleone P, Santonastaso P, Pannuto M, et al. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134:267.
  32. Conviser JH, Fisher SD, Mitchell KB. Oral care behavior after purging in a sample of women with bulimia nervosa. J Am Dent Assoc 2014; 145:352.
  33. Hermont AP, Oliveira PA, Martins CC, et al. Tooth erosion and eating disorders: a systematic review and meta-analysis. PLoS One 2014; 9:e111123.
  34. Glorio R, Allevato M, De Pablo A, et al. Prevalence of cutaneous manifestations in 200 patients with eating disorders. Int J Dermatol 2000; 39:348.
  35. Strumia R. Dermatologic signs in patients with eating disorders. Am J Clin Dermatol 2005; 6:165.
  36. Hudson JI, Lalonde JK, Coit CE, et al. Longitudinal study of the diagnosis of components of the metabolic syndrome in individuals with binge-eating disorder. Am J Clin Nutr 2010; 91:1568.
  37. Bulik CM, Sullivan PF, Kendler KS. Medical and psychiatric morbidity in obese women with and without binge eating. Int J Eat Disord 2002; 32:72.
  38. Mitchell JE. Medical comorbidity and medical complications associated with binge-eating disorder. Int J Eat Disord 2016; 49:319.