Subjective binge eating with compensatory behaviors: a variant presentation of bulimia nervosa.
OBJECTIVE
To determine whether a variant bulimic-type presentation, whereby one meets criteria for bulimia nervosa (BN) except that binge eating episodes are not objectively large (i.e., "subjective bulimia nervosa," SBN), has comparable clinical severity to established eating disorders, particularly BN.


METHODS
Treatment-seeking adults with BN (N = 112), SBN (N = 28), anorexia nervosa restricting type (AN-R) (N = 45), and AN-binge/purge type (AN-B/P) (N = 24) were compared.


RESULTS
Overall, SBN could not be meaningfully distinguished from BN. SBN and BN had equivalent eating pathology, depression and anxiety symptoms, low quality of life, impulsivity, Axis I comorbidity, and lifetime psychiatric history, and comparable clinical severity to AN-R and AN-B/P.


CONCLUSIONS
Individuals with SBN, differing from BN only by the smaller size of their binge eating episodes, had a form of eating disorder comparable in clinical severity to threshold AN and BN and warranting clinical attention. Health professionals and the community require greater awareness of this variant to optimize detection, treatment-seeking, and outcomes.
Center for Clinical Interventions, Department of Health in Western Australia, Perth, Australia. hunna.watson@health.wa.gov.au
Hunna J
HJ
Watson
Anthea
A
Fursland
Cynthia M
CM
Bulik
Paula
P
Nathan
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000523:psychology; D002032:Bulimia / Q000175:diagnosis* / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index