title: The relationship between binge eating disorder and non-purging bulimia nervosa.
abstract: OBJECTIVE
  To further investigate the differentiation between non-purging bulimia nervosa (BN-NP) and binge eating disorder (BED), particularly as concerns weight-shape overconcern affecting self-esteem, a core belief to both anorexia and bulimia nervosa.
  
  
  METHODS
  Twenty-five female subjects with BN-NP and 25 female subjects with BED, consecutively referred to the Eating Disorder Unit of the DPPhNB, were administered the BEDCI, the EDI-2 and the BUT.
  
  
  RESULTS
  BED patients had a higher BMI (35.5 vs. 23.8 kg/m2, p<0.0001) and were slightly older than BN-NP ones. Weight-shape concerns as one of the main/the most important things influencing self-esteem were reported by 68% of BN-NP patients and 62.5% of BED ones. Age at onset of binge-eating, weight-cycling, overall impairment due to the eating behavior, sexual harassment, depressive and substance abuse comorbidity were equally represented in the two groups of patients. BN-NP patients scored higher than BED ones as regards EDI drive for thinness (p<0.05) and BUT weight phobia (p<0.05), with these scores significantly related to differences in BMI (p<0.0005 and p=0.012). Weight-shape overconcern influencing self-esteem was predictive of an earlier onset of binge-eating (p<0.05) and higher scores at the BUT weight phobia, and body image concerns (p<0.05).
  
  
  CONCLUSIONS
  Differences between BED and BN-NP seem to be more of degree than type and there seems little value in the separation between BED and BN-NP based on weight-shape concerns that substantially impair self-esteem. This construct seems core to both disorders and plays a substantial role in triggering and maintaining the binge-eating cycle.
authors.affiliation: Department of Psychiatry, Pharmacology, Neurobiology and Biotechnologies, DPPhNB, Section of Psychiatry, University of Pisa, Italy. carlarama@hotmail.com
authors.forename: C E
authors.initials: CE
authors.lastname: Ramacciotti
authors.forename: E
authors.initials: E
authors.lastname: Coli
authors.forename: R
authors.initials: R
authors.lastname: Paoli
authors.forename: G
authors.initials: G
authors.lastname: Gabriellini
authors.forename: F
authors.initials: F
authors.lastname: Schulte
authors.forename: S
authors.initials: S
authors.lastname: Castrogiovanni
authors.forename: L
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: P E
authors.initials: PE
authors.lastname: Garfinkel
mesh_terms: D017668:Age of Onset; D001828:Body Image; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000523:psychology*; D005260:Female; D006801:Humans; D010698:Phobic Disorders / Q000523:psychology*; D012649:Self Concept; D014839:Vomiting / Q000523:psychology*