Subjective binge eating with compensatory behaviors: A variant presentation of bulimia nervosa

Authors

  • Hunna J. Watson PhD,

    Corresponding author
    1. Center for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
    2. The Department of Health, Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
    3. The Faculty of Medicine, Dentistry and Health Sciences, School of Pediatrics and Child Health, The University of Western Australia, Australia
    • Center for Clinical Interventions, 223 James St, Northbridge, Western Australia 6003, Australia
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  • Anthea Fursland PhD,

    1. Center for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
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  • Cynthia M. Bulik,

    1. Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina
    2. Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina
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  • Paula Nathan MPsych(Clin)

    1. Center for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
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Abstract

Objectives:

To determine whether a variant bulimic-type presentation, whereby one meets criteria for bulimia nervosa (BN) except that binge eating episodes are not objectively large (i.e., “subjective bulimia nervosa,” SBN), has comparable clinical severity to established eating disorders, particularly BN.

Method:

Treatment-seeking adults with BN (N = 112), SBN (N = 28), anorexia nervosa restricting type (AN-R) (N = 45), and AN-binge/purge type (AN-B/P) (N = 24) were compared.

Results:

Overall, SBN could not be meaningfully distinguished from BN. SBN and BN had equivalent eating pathology, depression and anxiety symptoms, low quality of life, impulsivity, Axis I comorbidity, and lifetime psychiatric history, and comparable clinical severity to AN-R and AN-B/P.

Discussion:

Individuals with SBN, differing from BN only by the smaller size of their binge eating episodes, had a form of eating disorder comparable in clinical severity to threshold AN and BN and warranting clinical attention. Health professionals and the community require greater awareness of this variant to optimize detection, treatment-seeking, and outcomes. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)

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