Lifetime prevalence is 1.0% (higher than anorexia nervosia)
Like anorexia, it is more common in females
Recurrent episodes of binge eating
Inappropriate compensatory behavior to prevent weight gain
Excess worry about body shape and weight
Patients find their symptoms ego-dystonic, in contrast with anorexia nervosa
Binge-eating is done every 2 hours with a lack of self-control
Self-evaluation unduly influenced by body shape and weight
Recurrent inappropriate compensatory behavior following binge-eating to avoid weight gain
The finding of hypokalemia is consistent with self-induced vomiting. Other typical clinical findings include:
Erosion of dental enamel
Cognitive behavioral therapy (CBT)
SSRIs first-line (e.g. fluoxetine)
Fluoxetine has the best evidence for reducing the frequency of bingeing and purging episodes. It can be used alone, but is most effective as part of a multimodal therapy that includes nutritional rehabilitation (e.g. establishing a structured and consistent meal pattern) and CBT.
Avoid buproprion in patients with active symptoms of bulimia nervosa due to an increased risk of seizures.