Diagnosis and treatment of purging disorder

Diagnosis of purging disorder (technically as an EDNOS)

As purging disorder has not been specifically defined as an eating disorder in its own right it is difficult to outline a set of diagnostic criteria specifically aimed at purging disorder. However the following is taken from the diagnostic criteria for eating disorder not otherwise specified (EDNOS) and applies to one suffering purging disorder.

•An individual of normal body weight who regularly engages in inappropriate compensatory behaviour after eating small amounts of food (e.g. self-induced vomiting after the consumption of a slice of toast)

 Physiologically, the health risks of purging disorder are similar to bulimia and anorexia (based on malnutrition and effects of purging), therefore following diagnosis a doctor will be clear on the health implications that need treating.

Treatment of purging disorder

Currently there are no evidence-based treatments for purging disorder because no controlled treatment trials have been conducted for this relatively new eating disorder. Doctors should therefore consider adopting an individual-case-approach when treating patients with purging disorder. This means conducting careful assessments of symptoms as a baseline before starting any treatment. Symptom levels should be reassessed during different phases of treatment, this helps examine whether certain interventions are associated with reductions in specific symptom features.

 Among patients with higher weight, clinicians are likely to encounter greater resistance to interventions if reductions in restrictive diet and purging lead to rapid weight gain.

Researchers are working on a ‘follow-up studies’ which are aimed to explore why some women feel the need to purge after eating what most is generally regarded a normal or even small amount of food. This information can provide an insight as to what types of treatments may be effective for purging disorder. It would be naive and wrong to provide a basis bulimia or anorexia treatment for this disorder as the psychological aspects involved are different. Though the underlying reasons may be similar the mechanisms behind each disorder need to be treated individually.

Although purging disorder is classified as an EDNOS, diagnosis of this does not make it any less serious or less critical as one suffering bulimia nervosa or anorexia nervosa. The implications and health risks can be just as detrimental to their health and well being. The problem with the diagnosis of an EDNOS makes treatment a little more difficult and not as specialised. Being aware that eating disorders of any kind predominantly stem from psychological disturbance means that psychological treatment such as counselling can be very effective in treatment.

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