Bulimarexia and related serious eating disorders with medical complications

Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating disorders--anorexia nervosa, pica, rumination disorder of infancy, and bulimia/bulimarexia--are discussed. Detailed attention is given to the potential medical hazards of bulimarexia. These hazards may be categorized according to the organ system affected or the individual behavioral components of bulimarexia. Because bulimarexia is commonly practiced in secrecy, its presentation may be in the form of one of its medical complications. Therefore, physicians must know the behavioral components of bulimarexia and its potential medical hazards. Optimal care of these patients requires collaborative efforts from a physician and behavioral therapist.