بولیمیا در زنان دارای اضافه وزن و با وزن طبیعی

The aim of the present study was to examine overweight bulimia nervosa (BN) in a community sample of women. Volunteers (n = 1964) completed self-report questionnaires of weight, binge eating, purging, and cognitive features. Participants were classified as overweight (body mass index ≥25) or normal weight (body mass index <25). Rates of BN within the overweight and normal-weight classes did not differ (6.4% vs 7.9%). Of the 131 participants identified as BN, 64% (n = 84) were classified as overweight BN and 36% (n = 47) as normal-weight BN. The overweight BN group had a greater proportion of ethnic minorities and reported significantly less restraint than the normal-weight BN group. Otherwise, the 2 groups reported similarly, even in terms of purging and depression. In summary, rates of BN did not differ between overweight and normal-weight women. Among BN participants, the majority (two thirds) were overweight. Differences in ethnicity and restraint, but little else, were found between overweight and normal-weight BN. Findings from the present study should serve to increase awareness of the weight range and ethnic diversity of BN, and highlight the need to address weight and cultural sensitivity in the identification and treatment of eating disorders.

According to the Diagnostic and Statistical Manual Of Mental Disorders, Fourth Edition (DSM-IV) and the DSM-IV-Text Revision (DSM-IV-TR), the two prominent behavioral features of bulimia nervosa (BN) include recurrent episodes of binge eating and recurrent episodes of inappropriate compensatory behavior to prevent weight gain (eg, self-induced vomiting; fasting; excessive exercise; or misuse of laxatives, diuretics, enemas, or other medications). Although weight status is not a diagnostic criterion for BN, the DSM-IV states that moderate obesity and morbid obesity are uncommon comorbid conditions within this diagnostic group. There is a substantial body of eating disorder literature in which investigators have examined subgroups of, or groups with many similarities to, patients with BN. This has included comparisons of behavioral and eating disorder–related functioning for individuals with BN and differing histories of anorexia nervosa [1], [2] and [3], for individuals with BN who use different methods of compensatory behaviors [4], for individuals who have recurrent episodes of binge eating but not compensatory behaviors (binge eating disorder [5]), for individuals who do not binge eat but do engage in recurrent compensatory behaviors (purging disorder [6]), and for individuals with BN who have personality disorder or substance abuse comorbidities [7] and [8]. Thus, much has been learned about the behavioral and eating disorder pathology of individuals with BN or behaviorally similar eating disorders in relation to eating disorder history, method and presence of compensatory behaviors, and presence of binge eating and other comorbidities. Despite the rapid escalation in rates of overweight and obesity in the general population since the publications of DSM-IV and DSM-IV-TR, only one study to date has examined comorbid overweight or obesity among individuals with BN [9]. In 1990, Mitchell and colleagues [9] found that only a small percentage (4.2%) of clinic patients with BN were also overweight and that this subgroup differed considerably from patients with normal-weight BN. The aim of the present study was to examine overweight in a community sample of women with BN. Overweight and normal-weight community volunteers who self-reported symptoms consistent with a diagnosis of BN were compared on rates of diagnosis, demography, diagnostic criteria, and associated clinical features. We hypothesized that an overweight subgroup of women with BN would be well represented and that this group would report greater levels of binge eating, lower levels of purging, and similar levels of severity for the clinical eating disorder features in comparison to a normal-weight group of women with BN.