Eating Disorder: Bulimia Nervosa

Abstract

A 30 year old female medical undergraduate presented with the poor eating habits of insidious onset for 9 years. During her 11 th class, she developed liking for a boy in her class who rejected her calling fat. Though, she managed to move on; however, developed dissatisfaction for her body image, and would consider herself fat in front of the mirror and started looking for means to reduce weight. With gradually increasing concern over growing fat, she started skipping two meals and would take only one meal and salads in class 12th. She tried to induce vomiting also once or twice. She started exercising for 1-2 hours in order to compensate weight gain out of binging. Though she knew that her Body Mass Index (BMI) was well within normal range, she started taking one tablet of Orlistat daily secretly along with skipping meals and rejoining gymnasium At the time of consultation in the Psychiatry out-patient department, her BMI was 22.5, which is within normal range. Her laboratory investigations including, complete hemogram, liver, and renal function tests, serum electrolytes, plasma blood glucose levels were normal. She was put on Fluoxetine 40 mg and Cognitive Behavior Therapy. She is under regular OPD follow-up with sustained improvement since last 16 weeks.