Bulimia nervosa and misuse of orlistat: Two case reports

Objective: Orlistat (tetrahydrolipstatin) is an intestinal lipase inhibitor that was approved recently for the management and treatment of obesity. Th is is the first report of the misuse of orlistat in two normal-weight purgi ng bulimia nervosa (BN) patients. Method and Results: We report two diagnos ed cases of BN in two Spanish women who used orlistat as a purging mechanis m after binge episodes. In both cases, the onset of the eating disorder was in adolescence. From the beginning, a restrictive diet, binging, and purgi ng behavior (vomiting and using laxatives) were present. Both patients misu sed this substance as their only purging mechanism after every binge episod e. Conclusion: BN patients have used many substances and bizarre behaviors as purging mechanisms. Nevertheless, to the authors' knowledge, these are t he first reported cases of orlistat misuse as the only purging mechanism in two BN patients. (C) 2001 by John Wiley & Sons, Inc.