overview

Who gets Bulimia Nervosa?

Bulimia Nervosa can affect many different populations including women and men, as well as people of different racial and ethnic backgrounds. While many different types of people may have bulimia nervosa, it primarily affects women (approximately 90%). Most individuals with the disorder develop it in early adulthood, though onset may occur earlier or later.

Diagnostic Criteria for Bulimia Nervosa*

  1. Recurrent episodes of binge eating at least twice a week for three months. The binge episodes are characterized by:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time under similar circumstances
    • A sense of loss of control over eating during these episodes (e.g. a feeling that one cannot stop eating or control what or how much one is eating)
  2. Regular inappropriate compensatory behavior (at least twice weekly for three months) such as self-induced vomiting, laxative or diuretic abuse, enemas, fasting or excessive exercise.
  3. Undue influence of body weight or shape on self-evaluation
  4. Anorexia nervosa is not present (i.e. weight is greater than 85% of expected body weight)

Subtypes
Purging Type: During the current episode of bulimia the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics or enemas.

Nonpurging Type: During the current episode of bulimia nervosa the person has used other inappropriate compensatory behaviors such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting, laxative, diuretic or enema misuse.

*These criteria are established by the American Psychiatric Association and published in the Diagnostic Manual of Mental Disorders, Fourth Edition.

What Treatment is Available for Bulimia Nervosa?

We offer treatment for adolescents and adult women with bulimia nervosa who are interested in participating in research. Differing treatment options are available depending on a patient's eligibility for particular studies. Treatment possibilities include cognitive-behavioral therapy (CBT), supportive psychotherapy and medication, as well as inpatient treatment if needed.

Outpatient Psychotherapy
Research has found outpatient Cognitive-Behavioral Therapy (CBT) to be useful in treating Bulimia Nervosa. CBT is a structured psychotherapy aimed at helping patients develop a regular pattern of eating and providing psychoeducation about binge eating and purging. In addition, CBT focuses on increasing interpersonal functioning, targeting body image disturbances as well as issues of control and mood intolerance.

Inpatient Treatment
Inpatient treatment is most helpful for those individuals unable to reduce binge eating and purging without the help of a highly structured setting. Typically, these programs have a multidisciplinary team approach that incorporates individual, family and group psychotherapy and are geared at normalizing eating habits and addressing disturbed thoughts about body shape and weight. Our clinic provides both inpatient and outpatient treatment for patients interested and eligible in the ongoing research studies.

Medication
Research indicates that medications are often a helpful component of treatment for Bulimia Nervosa. We are currently conducting medication trials for this disorder and can provide medication management for those individuals receiving therapy at our clinic.

For additional information, please call 212-543-5151 or email EDRU@pi.cpmc.columbia.edu