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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent psychotherapy studies for bulimia nervosa are reviewed and it is concluded that many interventions lead to statistically and clinically significant reductions in the frequency of bingeing and vomiting and other associated symptoms; however, the results are more variable if success is defined as abstinence from symptomatic behavior. Treatment and patient variables which seem to be associated with positive response to treatment are reviewed and serious methodological concerns are raised. Carefully controlled dismantling trials are recommended in order to isolate factors which are critical for symptom change.
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PMID:Psychotherapy outcome research with bulimia nervosa. 333 87

Bulimia nervosa is an eating disorder characterized by secretive binge eating and purging with induced vomiting, laxatives, and diuretics. The disorder primarily afflicts young white women between 18-35 years of age. We report the case of a 30-year-old pregnant woman with a 17-year history of bulimia that involved up to six episodes of binging and purging daily. A multidisciplinary approach enabled outpatient management throughout gestation. The pregnancy resulted in the delivery of a normal 3000-g female infant at term. The ramifications for maternal and fetal well-being and the goals of therapeutic management are discussed.
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PMID:Bulimia nervosa in pregnancy: a case report. 337 14

Bulimia nervosa is an eating disorder syndrome characterized by frequent binge-eating episodes followed by self-induced vomiting, fasting, excessive exercise, or the use of laxatives or diuretics. In addition to the psychological manifestations of this disorder, the patient may exhibit an array of physical symptoms. The major otolaryngologic finding is the presence of benign, persistent enlargement of the parotid and/or submandibular salivary glands in some patients with more severe bingeing and purging behavior. Recent reports in the otolaryngology literature have advocated superficial parotidectomy for correction of the cosmetic deformity of this sialadenomegaly. A detailed description of the psychological and behavioral manifestations and natural history of this illness is presented. The authors believe that surgical management of parotid enlargement in patients with bulimia nervosa is contraindicated by the surgical risks, the natural history of the disorder, and the patient's psychological state.
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PMID:Parotidectomy for bulimia: a dissenting view. 343 75

There have been reports of a high prevalence of bulimic episodes and the syndromes of bulimia nervosa and DSM-III bulimia in community samples. A group of American authors recently compared the findings of a contemporary survey with those of a survey they had conducted previously and reported a three-fold increase in the prevalence of DSM-III bulimia. The present study replicates a community survey conducted four years ago in Britain. The prevalence of bulimic episodes, self-induced vomiting and bulimia nervosa found in the present survey was very similar to that found in the earlier study.
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PMID:The prevalence of bulimia nervosa. A replication study. 344 13

This study examines the impact of pregnancy on the reported eating behaviour of 20 untreated normal body weight bulimia nervosa women; it also reports foetal and obstetric abnormalities and indicates the initial eating habits of the infants. The prevalence of binge-eating and self-induced vomiting reduced sequentially during each trimester of pregnancy. By the third trimester 15 women (75%) had stopped all bulimic behaviour and in the remainder the disturbed eating was less severe. Symptoms tended to return in the puerperium and in nearly half the sample abnormal eating was more disturbed after delivery than before conception. However, the improvement associated with the pregnancy described by seven patients was maintained and for five it appears to have been curative. The common fear among pregnant bulimics that their abnormal eating behaviour may damage their unborn child cannot be dispelled by this study; the incidence of foetal abnormality (including cleft palate and cleft lip), multiple pregnancies and obstetric complications (including breech presentation and surgical intervention) was high. The nutrition and development of the infants was good although three mothers (15%) reported slimming their babies down within the first year.
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PMID:Bulimia nervosa. The impact of pregnancy on mother and baby. 365 30

This study examines the daily food intake and eating habits of 30 bulimia nervosa patients of normal weight; 20 vomited daily and 10 purged daily. The aim was to measure and compare food intakes and to examine the belief that laxative abuse is an effective means of controlling body weight. The results indicate that the purgers control their weight by overall dietary restraint, not by the pharmacological action of the laxatives. The purgers' eating patterns were bulimic, but not gross: mean daily energy intake being in a normal range (2210 +/- 210 kcal/day). Binge-eating by the vomiters was of a different order: mean energy intake was very large (6025 kcal/day), nearly three times that recommended and significantly greater (P less than 0.01) than that eaten by the purgers. There was major daily variation (s.d. = 3605) and, on occasions, huge amounts were recorded, up to 30 000 kcal in a day. Despite this, vomiting was highly effective in preventing weight gain, the mean weights of the vomiters being similar (mean = 98 per cent) to their matched population mean weight (MPMW). In contrast, purging was relatively ineffective, for despite smaller energy intakes, all the purgers were above (mean = 114 per cent)--and some markedly above--their MPMW. This difference between the two groups was significant (P less than 0.01). Reasons for persisting with laxative abuse are discussed.
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PMID:Does laxative abuse control body weight? A comparative study of purging and vomiting bulimics. 386 Apr 94

Two adolescent patients with eating disorders and severe weight loss presented with neuromyopathy. The first was female and had a twenty months' history of bulimia nervosa with weight loss and episodic gorging and vomiting. The second was male with a two-year history of anorexia nervosa characterised by vegetarianism and increasing food restriction. Both had severe wasting and asymmetrical weakness of proximal limb muscles. The first patient deteriorated on refeeding and became temporarily paralysed. Both had a purpuric rash and haematological abnormalities. They made a complete recovery on a mixed diet: vitamin supplements were given to the first but not to the second patient.
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PMID:Neuropathy and myopathy in two patients with anorexia and bulimia nervosa. 386 93

Eight patients with bulimia nervosa were given methylamphetamine or placebo intravenously under double blind controlled conditions. In every patient, methylamphetamine reduced self-ratings of hunger and amount of food eaten as measured under laboratory conditions. This shows that the food intake of patients with bulimia nervosa can be modified by experimental drugs. The symptom of bulimia (rapid, excessive and distressing eating) which may be followed by self-induced vomiting or purgation was seen in four patients after receiving placebo but in none after receiving methylamphetamine. These findings suggest that the severe symptom of bulimia may be amenable to drug treatment. Further studies are needed to explore the mechanism by which methylamphetamine appears to prevent bulimia.
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PMID:Suppression of bulimic symptoms with methylamphetamine. 635 41

An "epidemic" prevalence of binge eating and vomiting (bulimia nervosa) has been reported, and treatment has been claimed to be difficult. This paper describes a short term outpatient treatment programme of eclectic orientation capable of being conducted by non-specialist staff, under medical supervision, in local centres. The treatment programme was evaluated in a controlled trial and in long term follow up. In 30 women with severe bulimia the treatment programme significantly reduced their incidence of dietary manipulation without producing weight gain, weight disorder, or neurotic illness. After treatment all the women had fewer symptoms; 24 stopped binge eating and vomiting at the end of treatment, and a further four stopped shortly afterwards. During formal follow up 20 showed no dietary abuse and a further eight reduced their attacks to an average of three episodes a year: all judged treatment to be a success. Pretreatment indicators of poorer prognosis include alcohol abuse and a history of anorexia nervosa. Married patients experienced marital difficulties or illness in the spouse.
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PMID:Bulimia nervosa, binge eating, and psychogenic vomiting: a controlled treatment study and long term outcome. 640 8

This study examined by questionnaire the prevalence of binge-eating and self-induced vomiting among a sample of 369 consecutive attenders at a family planning clinic. 20.9 per cent reported current episodes of uncontrollable and excessive eating ('binges'), 2.9 per cent currently induced vomiting as a means of weight control; and 4.9 per cent reported using laxatives. Binge-eating and self-induced vomiting were strongly associated with disturbed attitudes to food, eating, body weight and shape; and with psychiatric disturbance. Menstrual dysfunction was not associated with either body weight or binge-eating; it was however associated with psychiatric state. Applying conservative rules, 1.9 per cent appeared to fulfil diagnostic criteria for the recently described syndrome bulimia nervosa.
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PMID:Binge-eating and self-induced vomiting in the community. A preliminary study. 657 25


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