Purging disorder

Signs, Symptoms and Causes

Signs

Some of the signs of this disorder include inappropriate influence of body shape and weight, recurrent purging to influence body weight or shape and Russell's sign.

Symptoms

The symptoms include the absence of binging episodes as well as purging behaviours occurring at least once per week for at minimum 3 months

Causes

Risk factors

Some of the risk factors include dieting, thin-ideal internalization and body dissatisfaction.

Genetic

The heritability of some eating disorders has been well established, but to date there are no documented family studies of purging disorder to understand the familial nature of purging disorder.

Diagnosis

The DSM-5 is used as a reference to diagnose Purging Disorder. A patient with Purging disorder will be diagnosed with other specified feeding or eating disorder.

Complications

Purging behaviors, specifically self-induced vomiting and laxative use are associated with the following medical complications:

• Subconjunctival hemorrhages (small bleeds in the eyes)
• Cuts or scars on the top of the hands (Russell's sign)
• Dental abnormalities such as enamel erosion
• Swelling of the parotid gland
• Mild esophagitis, heartburn, or acid reflux
• Renal (kidney) inflammation Purging disorder progressing into bulimia nervosa has been observed. However, it is extremely rare for the reverse situation. Bulimia nervosa progressing into purging disorder. This was observed once in a transgender patient with a severe history of bulimia nervosa but presented with symptoms of purging disorder to an eating disorder treatment facility in New Zealand.

Treatment

Treatment for purging disorder can be multidisciplinary. One approach to treatment is cognitive behavioral therapy.

Prognosis

Children and teenagers with purging disorder have been found to have poorer health-related quality of life than their healthy peers. A small review of 11 cases of purging disorder where death occurred found that only 5 of the 11 deaths could be attributed to the purging disorder. The remaining 6 deaths were a result of suicide.

References

References

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12. Stice, Eric. (2016). "Interactive and Mediational Etiologic Models of Eating Disorder Onset: Evidence from Prospective Studies". Annual Review of Clinical Psychology.
13. (2013). "A critique of the literature on etiology of eating disorders". Annals of Neurosciences.
14. (2011). "The Heritability of Eating Disorders: Methods and Current Findings".
15. (2014-03-01). "Purging disorder: a pathway to death? A review of 11 cases". Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity.
16. (2019). "The association between disordered eating and health-related quality of life among children and adolescents: A systematic review of population-based studies". PLOS ONE.