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Atypical purging behaviors in a patient with anorexia nervosa: consumption of raw red kidney beans as an emetic

  • Weronika Micula-GondekEmail author
  • Ye Tao
  • Angela S. Guarda
Case Report
  • 114 Downloads

Anorexia nervosa has the highest mortality rate of any psychiatric disorder with over half of deaths resulting from medical complications related to physiological effects of starvation and purging behaviors [1]. Purging is a defining feature of bulimia nervosa, purging disorder and anorexia nervosa binge-eating/purging type. Well-recognized purging behaviors include laxative or diuretic abuse as well as omission or underdosing of insulin in individuals with comorbid Type I diabetes mellitus. The most common method of purging, however, is self-induced vomiting with rates as high as 56.6–86.4% in clinical patient cohorts whereas the prevalence of laxative abuse ranges from 26.4 to 56.3%. Amongst patients with eating disorders who purge, almost half employ multiple methods, consistent with greater eating disorder severity and more extreme methods of weight control [2].

Vomiting is usually mechanically induced by stimulating the gag reflex. Individuals who vomit frequently may do so by...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Fichter MM, Quadflieg N (2016) Mortality in eating disorders—results of a large prospective clinical longitudinal study. Int J Eat Disord 49:391–401. doi: 10.1002/eat.22501 CrossRefPubMedGoogle Scholar
  2. 2.
    Forney KJ, Buchman-Schmitt JM, Keel PK, Frank GK (2016) The medical complications associated with purging. Int J Eat Disord 49:249–259. doi: 10.1002/eat.22504 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Grewal S, Birmingham CL (2003) Self-phlebotomy in eating disorders. Eat Weight Disord 8:336–340CrossRefGoogle Scholar
  4. 4.
    Rodhouse JC, Haugh CA, Roberts D, Gilbert RJ (1990) Red kidney bean poisoning in the UK: an analysis of 50 suspected incidents between 1976 and 1989. Epidemiol Infect 105:485–491CrossRefGoogle Scholar
  5. 5.
    Kumar S, Verma AK, Das M, Jain SK, Dwivedi PD (2013) Clinical complications of kidney bean (Phaseolus vulgaris L.) consumption. Nutrition 29:821–827. doi: 10.1016/j.nut.2012.11.010 CrossRefPubMedGoogle Scholar
  6. 6.
    Bulik CM, Sullivan PF, Fear JL, Pickering A (1996) A case of comorbid anorexia nervosa, bulimia nervosa, and Munchausen’s syndrome. Int J Eat Disord 20:215–218. doi: 10.1002/(SICI)1098-108X(199609)20:2<215:AID-EAT14>3.0.CO;2-1 CrossRefPubMedGoogle Scholar
  7. 7.
    Tozzi F, Thornton LM, Mitchell J, Fichter MM, Klump KL, Lilenfeld LR, Reba L, Strober M, Kaye WH, Bulik CM, Price Foundation Collaborative G (2006) Features associated with laxative abuse in individuals with eating disorders. Psychosom Med 68:470–477. doi: 10.1097/01.psy.0000221359.35034.e7 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral Sciences, The Johns Hopkins HospitalJohns Hopkins University School of MedicineBaltimoreUSA

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