Bulimia nervosa-nonpurging subtype: Closer to the bulimia nervosa-purging subtype or to binge eating disorder?

Jennifer Jordan*, Virginia V. W. McIntosh, Janet D. Carter, Sarah Rowe, Kathryn Taylor, Christopher M. A. Frampton, Janice M. McKenzie, Janet Latner, Peter R. Joyce

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Objective

DSM-5 has dropped subtyping of bulimia nervosa (BN), opting to continue inclusion of the somewhat contentious diagnosis of BN-nonpurging subtype (BN-NP) within a broad BN category. Some contend however that BN-NP is more like binge eating disorder (BED) than BN-P. This study examines clinical characteristics, eating disorder symptomatology, and Axis I comorbidity in BN-NP, BN-P, and BED groups to establish whether BN-NP more closely resembles BN-P or BED.

Method

Women with BN-P (n = 29), BN-NP (n = 29), and BED (n = 54) were assessed at baseline in an outpatient psychotherapy trial for those with binge eating. Measures included the Structured Clinical Interviews for DSM-IV, Eating Disorder Examination, and Eating Disorder Inventory-2.

Results

The BN-NP subtype had BMIs between those with BN-P and BED. Both BN subtypes had higher Restraint and Drive for Thinness scores than BED. Body Dissatisfaction was highest in BN-NP and predicted BN-NP compared to BN-P. Higher Restraint and lower BMI predicted BN-NP relative to BED. BN-NP resembled BED with higher lifetime BMIs; and weight-loss clinic than eating disorder clinic attendances relative to the BN-P subtype. Psychiatric comorbidity was comparable except for higher lifetime cannabis use disorder in the BN-NP than BN-P subtype

Discussion

These results suggest that BN-NP sits between BN-P and BED however the high distress driving inappropriate compensatory behaviors in BN-P requires specialist eating disorder treatment. These results support retaining the BN-NP group within the BN category. Further research is needed to determine whether there are meaningful differences in outcome over follow-up.

Original languageEnglish
Article numberN/A
Pages (from-to)231-238
Number of pages8
JournalInternational Journal of Eating Disorders
Volume47
Issue number3
DOIs
Publication statusPublished - Apr 2014

Keywords

  • classification
  • binge eating disorder
  • bulimia nervosa nonpurging
  • DSM-5
  • bulimia nervosa
  • subtype
  • COMMUNITY SAMPLE
  • DIAGNOSTIC CROSSOVER
  • ANOREXIA-NERVOSA
  • DSM-V
  • OBESITY
  • PREVALENCE
  • CRITERIA
  • WEIGHT
  • WOMEN
  • CLASSIFICATION

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