Question
A 16-year-old girl has intense craving for food after eating large amount of food followed by recurrent vomiting. Girl was also on anti-appetite drugs. What is the most probable diagnosis
| A. |
Anorexia nervosa |
| B. |
Bulimia nervosa |
| C. |
Binge eating disorder |
| D. |
Anxiety disorder |
|
Correct Answer � B Explanation |
 |
Core Features:
– Recurrent binge eating: Uncontrolled intake of large food amounts.
– Compensatory behaviors: Vomiting, laxatives, diuretics, fasting, or excessive exercise.
– Persistent concern with body shape and weight.
– Typically maintain normal body weight or may be slightly overweight.
– Associated Findings:
– Electrolyte abnormalities: Hypokalemia, hypochloremic metabolic alkalosis.
– Dental erosion from gastric acid due to frequent vomiting.
– Parotid gland swelling, calluses on knuckles (Russell’s sign).
– Age and Gender:
– Common in adolescent females.
– Usually starts in late teens or early 20s.
– Treatment:
– Cognitive Behavioral Therapy (CBT) is first-line.
– SSRIs (e.g., fluoxetine) can help ↓ binge-purge cycles.
Incorrect Options:
– Anorexia Nervosa:
– Characterized by low body weight due to restricted energy intake.
– May have binge/purge subtype, but weight is markedly low.
– Binge Eating Disorder (BED):
– Involves binge eating without compensatory behaviors.
– Patients usually overweight or obese.
– Anxiety Disorder:
– May cause appetite changes but lacks binge-purge cycles. Use of appetite suppression drugs & vomiting indicates an eating disorder.