Bulimia Nervosa
Definition
Specific Type
Clinical Features
SCOFF tool:
S ick: Do you make yourself sick because you feel uncomfortably full?
C ontrol: Do you worry you have lost control over how much you eat?
O ne stone/6.5kg: Have you recently lost more than one stone (6.5kg) in a 3 month period?
F at: Do you believe yourself to be fat when other people say you are thin?
F ood: Would you say that food dominates your life?
Management
Non-Pharmacological
Pharmacological
Source
Toronto Notes 2012
Dr Megan Corp 2014
- For paediatric BN, click here
- Recurrent episodes of binge eating.
- An episode of binge eating is characterized by both of the following
- Eating more than a normal amount of food
- Inappropriate compensatory behaviour
- ≥ 2 times a week for 3 months
Specific Type
- Purging
- Non-purging
Clinical Features
- Fatigue and muscle weakness
- Tooth decay
- Swollen appearance around angle of jaw
- Puffiness of eye sockets due to fluid retention
- Reddened knuckles, Russell's sign (knuckle callus from self-induced vomiting)
- Trouble concentrating
- Weight fluctuation over time (usually normal weight)
SCOFF tool:
S ick: Do you make yourself sick because you feel uncomfortably full?
C ontrol: Do you worry you have lost control over how much you eat?
O ne stone/6.5kg: Have you recently lost more than one stone (6.5kg) in a 3 month period?
F at: Do you believe yourself to be fat when other people say you are thin?
F ood: Would you say that food dominates your life?
Management
- Admission for significant electrolyte abnormalities
Non-Pharmacological
- CBT (1st line), family therapy
Pharmacological
- Treatment of starvation effects
- SSRIs (2nd line - only fluoxetine approved)
Source
Toronto Notes 2012
Dr Megan Corp 2014