The effect of bulimia nervosa on plasma glucose and lipids

This analysis examined changes in plasma lipids and glucose after 3 years in women treated for bulimia nervosa (BN). One hundred and thirty-five women aged 17-45 years with DSM-III-R BN entered a 12-week cognitive behavioral therapy treatment programme. Prior to and 3 years after treatment, patients completed psychiatric and behavioral assessments and fasting blood samples were drawn. At 3-year follow-up, 105 women were available, 67.6% of whom had no eating disorder and 32.4% of whom had any eating disorder (16.2% with eating disorder not otherwise specified and 16.2% with BN). Women with no eating disorder diagnosis at 3-year follow-up experienced a significant mean decrease in plasma glucose from pretreatment to 3-year follow-up compared to those with any eating disorder diagnosis. Eating disorder diagnosis at 3-year follow-up was independently associated with change in plasma glucose when potential confounders were adjusted for. Plasma triglyceride concentrations did not change in the group as a whole. Plasma HDL-cholesterol increased and total cholesterol decreased significantly from pretreatment to 3-year follow-up in the group as a whole. The decrease in serum cholesterol was significant in women with no eating disorder, but not in the women with any eating disorder diagnosis at 3-year follow-up. We conclude that a protracted course of BN may result in clinically insignificant increases in glucose concentrations and may attenuate the decrease in total cholesterol that is observed in women who recover from BN.