An examination of subtype criteria for bulimia nervosa

We examined the new subtyping criteria for bulimia nervosa by comparing purging and nonpurging bulimia nervosa patients with two similar subgroups: binge eating disorder patients and an eating disorder not otherwise specified (ED-NOS) group who compensates but does not binge eat or meet weight criteria for anorexia, which we labeled compensatory eating disorder (CED). Of particular interest was whether purging could differentiate a more "disturbed" group of patients, bulimic or otherwise.

We compared these four subgroups on the Eating Disorders Inventory (EDI), the Hopkins Symptom Checklist (SCL-90R), and rates of hospitalization.

There were few differences between either the purging or nonpurging bulimic patients, or the CED patients. All three groups showed more comorbid disturbance than the binge eating patients.

The findings failed to support the current subgrouping criteria for purging and nonpurging bulimia nervosa but indicated the need for further revision in the Diagnostic and statistical manual of mental disorders and the possible creation of a subgroup based on compensatory behaviors.