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

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...


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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.


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© 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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