Bulimia Nervosa Differential Diagnoses

  • Author: Christine I Osterhout, MD; Chief Editor: David Bienenfeld, MD   more...
 
Updated: Nov 15, 2011
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Christine I Osterhout, MD  Resident Physician, Department of Psychiatry and Behavioral Sciences, University of California, Davis Health System

Christine I Osterhout, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Child and Adolescent Psychiatry, American Academy of Psychiatry and the Law, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Coauthor(s)

Lorin M Scher, MD  Health Sciences Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis, School of Medicine

Lorin M Scher, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, Alpha Omega Alpha, American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Donald M Hilty, MD  Professor of Clinical Psychiatry, Vice-Chair of Faculty Development, Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine

Donald M Hilty, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Technology in Psychiatry, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Joel Yager  MD, Professor of Psychiatry, University of Colorado Health Sciences Center; Professor of Psychiatry Emeritus, University of California, Los Angeles, David Geffen School of Medicine; Professor of Psychiatry Emeritus, University of New Mexico School of Medicine

Joel Yager is a member of the following medical societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Gurze publishers Salary editing; Massachusetts Medical Society Salary Writing

Specialty Editor Board

Sarah C Aronson, MD  Associate Professor, Departments of Psychiatry and Medicine, Case Western Reserve School of Medicine/University Hospitals of Cleveland

Sarah C Aronson, MD is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD  Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

David Bienenfeld, MD  Professor of Psychiatry, Vice-Chair and Director of Residency Training, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Gabriel I Uwaifo, MBBS and Robert C Daly, MB, ChB, MPH to the development and writing of this article.

The authors would also like to acknowledge the contributions of Rebecca Davis, Librarian at the University of California (UC), Davis and Dr. Eric Rickin, Director for the Center for Overcoming Problem Eating (COPE) at the Western Psychiatric Institute and Clinic, University of Pittsburgh, Medical Center. Finally, the authors thank the Department of Psychiatry and Behavioral Sciences at UC Davis.

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Parotid hypertrophy. Reprinted with permission from Mandel, L and Siamak, A. Diagnosing bulimia nervosa with parotid gland swelling. J Am Dent Assoc 2004, Vol 135, No 5, 613-616.
Dental caries. Reprinted with permission from Wolcott, RB, Yager, J, Gordon, G. Dental sequelae to the binge-purge syndrome (bulimia): report of cases. JADA. 1984; 109:723-725.
Russell sign. Reprinted with permission from Glorio R, et al. Prevalence of cutaneous manifestations in 200 patients with eating disorders. Int J Derm, 2000, 39(5), 348-353.
This chest radiograph demonstrates pneumomediastinum, which can occur in association with esophageal rupture from forceful vomiting.
Water-soluble contrast esophagram from a patient with esophageal perforation after esophageal dilation shows contrast leak (arrowheads) and normal esophageal lumen (arrows).
Mallory-Weiss tear. Typical longitudinal mucosal tear with overlying fibrinous exudate extending from the distal esophagus to the gastric cardia. Courtesy of C.J. Gostout, MD.
Table. Self-Help Books and Internet Resources on Eating Disorders
CBT-oriented workbooksAgras WS, Apple RF: Overcoming Eating Disorders: A Cognitive-Behavioral Treatment for Bulimia Nervosa and Binge-Eating Disorder. New York, Oxford University Press, 1997 (client workbook)
Agras WS, Apple RF: Overcoming Eating Disorders: A Cognitive-Behavioral Treatment for Bulimia Nervosa and Binge-Eating Disorder. New York, Oxford University Press, 1997 (therapist workbook)
Cash TF: The Body Image Workbook: An 8-Step Program for Learning to Like Your Looks. Oakland, CA, New Harbinger, 1997
Fairburn C: Overcoming Binge Eating. New York, Guilford, 1995
Goodman LJ, Villapiano M: Eating Disorders:The Journey to Recovery Workbook. New York, Brunner-Routledge, 2001 (client workbook)
Goodman LJ, Villapiano M: Eating Disorders: Time for Change. Plans, Strategies, and Worksheets. New York, Brunner-Routledge, 2001 (therapist workbook)
Schmidt U, Treasure J: Getting Better Bit(e) by Bit(e): A Survival Kit for Sufferers of Bulimia Nervosa and Binge Eating Disorder. East Sussex, UK, Psychology Press, 1993
Other books reported to be helpful by patients/familiesBulik CM, Taylor N: Runaway Eating: The 8-Point Plan to Conquer Adult Food and Weight Obsessions. New York, Rodale Books, 2005
Ellis A, Abrams M, Dengelegi L: The Art and Science of Rational Eating. Fort Lee, NJ, Barricade Books, 1992
Goodman LJ, Villapiano M: Eating Disorders: The Journey to Recovery Workbook. New York, Brunner-Routledge, 2001 (client workbook)
Hall L: Full Lives: Women Who Have Freed Themselves From Food and Weight Obsessions. Carlsbad, CA, Gürze Books, 1993
Lock J, le Grange D: Help Your Teenager Beat an Eating Disorder. New York, Guilford, 2005
Michel DM, Willard SG: When Dieting Becomes Dangerous. New Haven, CT, Yale University Press, 2003
Walsh BT, Cameron VL: If Your Child Has an Eating Disorder: An Essential Resource for Parents. New York, Guilford, 2005
Zerbe K: The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment. Carlsbad, CA, Gürze Books, 1995
Books reported to be helpful for male patientsAndersen AE, Cohn L, Holbrook T: Making Weight: Men's Conflicts With Food, Weight, Shape and Appearance. Carlsbad, CA, Gürze Books, 2000
Internet resources for health care professionalsAcademy for Eating Disorders (http://www.aedweb.org)
Internet resources for patients, families, and professionalsNational Eating Disorders Association (http://www.nationaleatingdisorders.org)National Association of Anorexia Nervosa and Associated Disorders (http://www.anad.org/site/anadweb/)
Eating Disorder Referral and Information Center (http://www.edreferral.com)
Something Fishy (http://www.something-fishy.org; a well-monitored advocacy site)
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