[Nasogastric tube feeding in bulimia. Controlled study with follow-up at 3 months].
OBJECTIVE
Few effective treatments are available for severe forms of bulimia nervosa, which are accompanied by malnutrition, anxiety, and depressive mood. We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa.


METHODS
This prospective randomized trial compared bulimia patients in two treatment groups: one group received TF at home, together with psychotherapy, nutritional counseling and a support group while the control group received only psychotherapy, nutritional counseling, and a support group. Patients in the first group underwent TF for 8 weeks (exclusively for 10 days and associated with meals thereafter). Assessment was based on clinical examination, laboratory results, and a variety of questionnaires (our in-house instrument for measuring binge and vomiting episodes, eating disorder inventory, Beck's depression inventory and the Hamilton rating scale for anxiety), all performed at the onset of treatment and at 8 days, 8 weeks (i.e., the end of TF), and 3 months after treatment began.


RESULTS
Binges and vomiting disappeared faster and more frequently in TF patients than in the control group: 65% versus 29% (p<0.01). Three months later, these remained less frequent in the TF group than among controls (52% versus 33%, p=0.064). Nutritional status, depression, and anxiety improved more among the TF than control subjects (p<0.05).


CONCLUSIONS
Tube feeding was effective in these patients with bulimia nervosa, reducing the number of binge and vomiting episodes and improving nutritional status and mood.
Rigaud
Daniel
D
CHU Le Bocage, Dijon. daniel.rigaud@chu-dijon.fr
Brayer
Véronique
V
Biton-Jélic
Violaine
V
Païs
Vanessa
V
Pennacchio
Hélène
H
Brun
Jean-Marcel
JM
D001007:Anxiety / Q000175:diagnosis; D002032:Bulimia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003376:Counseling; D003627:Data Interpretation, Statistical; D003863:Depression / Q000175:diagnosis; D004750:Enteral Nutrition; D005500:Follow-Up Studies; D006801:Humans; D009752:Nutritional Status; D011446:Prospective Studies; D011613:Psychotherapy; D012657:Self-Help Groups; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome