Ramacciotti C E, Coli E, Paoli R, Gabriellini G, Schulte F, Castrogiovanni S, Dell'Osso L, Garfinkel P E
Department of Psychiatry, Pharmacology, Neurobiology and Biotechnologies, DPPhNB, Section of Psychiatry, University of Pisa, Italy.
Eat Weight Disord. 2005 Mar;10(1):8-12. doi: 10.1007/BF03353413.
To further investigate the differentiation between non-purging bulimia nervosa (BN-NP) and binge eating disorder (BED), particularly as concerns weight-shape overconcern affecting self-esteem, a core belief to both anorexia and bulimia nervosa.
Twenty-five female subjects with BN-NP and 25 female subjects with BED, consecutively referred to the Eating Disorder Unit of the DPPhNB, were administered the BEDCI, the EDI-2 and the BUT.
BED patients had a higher BMI (35.5 vs. 23.8 kg/m2, p<0.0001) and were slightly older than BN-NP ones. Weight-shape concerns as one of the main/the most important things influencing self-esteem were reported by 68% of BN-NP patients and 62.5% of BED ones. Age at onset of binge-eating, weight-cycling, overall impairment due to the eating behavior, sexual harassment, depressive and substance abuse comorbidity were equally represented in the two groups of patients. BN-NP patients scored higher than BED ones as regards EDI drive for thinness (p<0.05) and BUT weight phobia (p<0.05), with these scores significantly related to differences in BMI (p<0.0005 and p=0.012). Weight-shape overconcern influencing self-esteem was predictive of an earlier onset of binge-eating (p<0.05) and higher scores at the BUT weight phobia, and body image concerns (p<0.05).
Differences between BED and BN-NP seem to be more of degree than type and there seems little value in the separation between BED and BN-NP based on weight-shape concerns that substantially impair self-esteem. This construct seems core to both disorders and plays a substantial role in triggering and maintaining the binge-eating cycle.
进一步研究非清除型神经性贪食症（BN-NP）与暴饮暴食症（BED）之间的区别，特别是在体重-体型过度关注影响自尊方面，这是神经性厌食症和神经性贪食症的一个核心信念。
连续转诊至DPPhNB饮食失调科的25名患有BN-NP的女性受试者和25名患有BED的女性受试者接受了BEDCI、EDI-2和BUT测试。
BED患者的体重指数（BMI）更高（35.5 vs. 23.8 kg/m²，p<0.0001），且比BN-NP患者稍年长。68%的BN-NP患者和62.5%的BED患者报告称，体重-体型担忧是影响自尊的主要/最重要因素之一。两组患者在暴饮暴食发作年龄、体重波动、饮食行为导致的总体损害、性骚扰、抑郁和物质滥用共病方面的情况相当。在EDI的追求瘦身驱力方面（p<0.05）以及BUT的体重恐惧症方面（p<0.05），BN-NP患者的得分高于BED患者，这些得分与BMI差异显著相关（p<0.0005和p=0.012）。体重-体型过度关注影响自尊可预测暴饮暴食的更早发作（p<0.05）以及在BUT体重恐惧症和身体形象担忧方面的更高得分（p<0.05）。
BED和BN-NP之间的差异似乎更多是程度上的而非类型上的，基于严重损害自尊的体重-体型担忧来区分BED和BN-NP似乎价值不大。这种观念似乎是这两种疾病的核心，并且在触发和维持暴饮暴食循环中起重要作用。
