Eructophilia in bulimia nervosa: A clinical feature

Authors

  • William R. Jones MBChB, MRCPsych,

    Corresponding author
    1. Yorkshire Centre for Eating Disorders, Leeds Partnership NHS Foundation Trust, Leeds, United Kingdom
    • ST5 in Psychiatry, Yorkshire Centre for Eating Disorders, Newsam Centre, Seacroft Hospital, York Road, Leeds LS14 6WB, United Kingdom.
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  • John F. Morgan MA (Cantab), MB, BChir, MD, FRCPsych

    1. Yorkshire Centre for Eating Disorders, Leeds Partnership NHS Foundation Trust, Leeds, United Kingdom
    2. Division of Mental Health, St. George's University London, London, United Kingdom
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Abstract

This report offers the first detailed description of repetitive eructation (belching) in a patient with bulimia nervosa. The case was a man in his 30's with bulimia nervosa characterized by daily bingeing and purging behavior. Detailed assessment revealed repetitive eructation which was construed as a learned behavior precipitated and maintained by aerophagia (air swallowing) secondary to regular binge-eating. Eructation was associated with a strong sense of “relief” that shared a common phenomenology with other purging behaviors. Repetitive eructation was addressed as part of outpatient treatment using a cognitive-therapy approach. Eructation became less frequent during outpatient treatment but the patient disengaged after six sessions. We define a new term “eructophilia” where repetitive eructation takes on an ego-syntonic, self-contained, and autonomous quality which serves as a reinforcing stimulus in itself. Issues of phenomenology and motivating factors are further discussed. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)

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