Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstrasse 5, 72076, Tübingen, Germany,
Eat Weight Disord. 2013 Mar;18(1):99-101. doi: 10.1007/s40519-013-0013-3. Epub 2013 Mar 29.
A case of a 25-year-old woman with bulimia nervosa and Graves' disease is presented. Graves' disease is the cause of 50-80 % of hyperthyroidism. The disease is characterized by increases of thyroid hormone production, activation of the metabolism, and successive weight loss. Bulimia nervosa is characterized by purging behavior after binge eating episodes.
We report a patient suffering from both entities. A pronounced non-compliance to the intake of antithyroid drugs (Carbimazole) correlated with eating disorder symptoms like negative evaluation of the body and fear of weight gain. Thus, elevated hyperthyroidism due to Graves' disease served as a purging method. During 8 weeks of inpatient psychotherapy, the patient adapted to a structured eating behavior. Self-esteem was less influenced by body shape and body weight, and compliance to endocrinological recommendations improved.
Non-compliance to antithyroid drugs may be a symptom of an eating disorder. A careful and primarily non-confronting interdisciplinary diagnostic and treatment approach is required.
报告 1 例 25 岁女性同时患有神经性贪食症和格雷夫斯病（Graves 病）。格雷夫斯病是导致 50-80%甲状腺功能亢进的原因。该疾病的特征是甲状腺激素产生增加、代谢激活和持续体重减轻。神经性贪食症的特征是暴食发作后出现清除行为。
我们报告了 1 例同时患有这两种疾病的患者。对抗甲状腺药物（甲巯咪唑）的明显不依从与饮食失调症状相关，如对身体的负面评价和对体重增加的恐惧。因此，由于格雷夫斯病导致的甲状腺功能亢进症升高可作为清除方法。在 8 周的住院心理治疗期间，患者适应了结构化的饮食行为。自尊心较少受到体型和体重的影响，对内分泌学建议的依从性也有所提高。
对甲状腺药物的不依从可能是饮食失调的一种症状。需要进行仔细且主要是非对抗性的跨学科诊断和治疗方法。
