Purging disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Purging disorder is an eating disorder characterized by recurrent purging (self-induced vomiting, misuse of laxatives, diuretics, or enemas) to control weight or shape in the absence of binge eating episodes that occurs in people with normal or near-normal weight. Purging disorder differs from anorexia nervosa (AN) because individuals with purging disorder are not underweight, and purging disorder differs from bulimia nervosa (BN) because individuals with purging disorder do not consume a large amount of food before they purge. In current diagnostic systems, purging disorder is a form of Eating disorder not otherwise specified (EDNOS). Research indicates that purging disorder may be as common as bulimia nervosa or anorexia nervosa in women, that the syndrome is associated with clinically significant levels of distress, and that it appears to be distinct from bulimia nervosa on measures of hunger and ability to control food intake.

References

• Binford RB, le Grange D [2]: Adolescents with bulimia nervosa and eating disorder not otherwise specified-purging only. Int J Eat Disord 2005; 38:157-61.
• Favaro A, Ferrara S, Santonastaso P [3]: The spectrum of eating disorders in young women: a prevalence study in a general population sample. Psychosom Med 2003; 65:701-8.
• Keel PK, Haedt A, Edler C [4]: Purging disorder: an ominous variant of bulimia nervosa? Int J Eat Disord 2005; 38:191-9.
• Keel PK, Mayer SA, Harnden-Fischer JH [5]: Importance of size in defining binge eating episodes in bulimia nervosa. Int J Eat Disord 2001; 29:294-301.
• Keel PK, Wolfe BE, Liddle RA, De Young KP, Jimerson [6]:

Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. Arch Gen Psychiatry 2007; 64:1058-1066.

• le Grange D, Binford RB, Peterson CB, Crow SJ, Crosby RD, Klein MH, Bardone-Cone AM, Joiner TE, Mitchell JE, Wonderlich SA [7]: DSM-IV threshold versus subthreshold bulimia nervosa. Int J Eat Disord 2006; 39:462-7.
• Machado PP, Machado BC, Goncalves S, Hoek HW [8]: The prevalence of eating disorders not otherwise specified. Int J Eat Disord 2007; 40:212-217.
• Wade TD, Bergin JL, Tiggemann M, Bulik CM, Fairburn CG [9]: Prevalence and long-term course of lifetime eating disorders in an adult Australian twin cohort. Aust N Z J Psychiatry 2006; 40:121-8.
• Wade TD [10]: A retrospective comparison of purging type disorders: Eating disorder not otherwise specified and bulimia nervosa. Int J Eat Disord 2007; 40:1-6.