REPEATED BINGE PURGE CYCLES IN BULIMIA-NERVOSA - ROLE OF GLUCOSE AND INSULIN

The available data indicate that over half of patients with bulimia ne rvosa binge and purge daily with repetitions of the binge/purge cycle being common. An understanding of the biobehavioral mechanisms associa ted with frequent binge/purge cycles may aid the general conceptualiza tion of bulimia nervosa including its development and maintenance. Bin ging and purging have demonstrable physiological effects that may be p artially responsible for the repetition of binge/purge episodes. In th e present study, the cephalic phase oversecretion of insulin and high insulin levels subsequent to purging were investigated as possible med iators of repeated binging and purging. Insulin and glucose levels of bulimic and nonbulimic women were measured in response to: thinking ab out food, the presence of food, while eating, and for the bulimic grou p, after purging. Bulimic subjects displayed a dramatic reduction in b oth insulin and glucose after purging the test meal. When these same s ubjects ate a subsequent meal that was not purged, they displayed elev ations in insulin and glucose similar to those of the normal controls. The hypoglycemia resulting from purging appears to be partially respo nsible for the continuation of repeated binge/purge episodes. (C) 1994 by John Wiley & Sons, Inc.