Changes in self-reported food intake in bulimics as a consequence of antidepressant treatment

Abstract

Twenty females with bulimia nervosa over the age of 18 monitored their eating behavior and purge frequency for 1 week before and after 16 weeks of treatment with imipramine or placebo using a standard diary. There was a significantly greater decrease in purged calories for subjects in the imipramine group once pretreatment group differences were covaried out, confirming the action of imipramine on binge eating. Subjects in both groups consumed approximately 1000 kcal/day excluding purged calories with no significant difference between groups on this measure. Nonpurged caloric intake did not increase over time, indicating continuation of a highly restricted eating pattern following medication treatment. During binges subjects in both groups combined, before and after treatment, consumed an average of 1485 kcal, although there was considerable variability associated with this mean.

Does the size of a binge matter?

“…However, Rossiter and Agras (1990) found that nearly one third (28%) of all binges in bulimics consisted of fewer than 500 kcal. This replicated findings of an earlier study (Rossiter, Agras, & Losch, 1986). Other researchers found that some of the variability in the amount of calories consumed in a binge could be explained by the type of food eaten and subjective feelings of loss of control (Rosen, Leitenberg, Fisher, & Khazam, 1986;Gleaves, Williamson, & Barker, 1993;Telch & Agras, 1996).…”

Psychotherapy and Bulimia Nervosa

“…However, the ex¬ treme dieting that is also a feature seems not to be affected. 5 The other promising treatment is a specific form of CBT.6·7 It appears to be at least as effective as anti¬ depressant drug treatment at reducing both the frequency of overeating and vomiting and the level of general psychiatric symp¬ toms. In addition, dietary restraint is eroded and the disturbed attitudes to shape and weight lessen in intensity.…”

Cognitive-Behavioural Treatment of Bulimia Nervosa

“…Rossiter , Agras, Losch, & Telch (1988) reported that patients with bulimia nervosa who decrease their purging behaviour in response to antidepressant medication nevertheless continue to eat in a restricted fashion. In contrast, patients who received cognitivebehaviour therapy increased their nonpurged energy intake.…”