Metabolic and endocrine investigations in women of normal weight with the bulimia syndrome.

Bulimia is a disorder characterized by episodes of binge-eating. Patients with this problem consume large amounts of food when binge-eating and, subsequently, to avoid weight gain, usually self-induce vomiting or induce diarrhea with laxatives. Metabolic and endocrine investigations in six bulimic subjects of normal weight are reported. Normal fasting plasma glucose concentrations and glucose tolerance were present in all. Five subjects had normal serum T4 and T3 concentrations. Only one subject had depressed serum T4 and T3 concentrations and this subject had a normal serum TSH level. Menstrual irregularities were present in all patients and, in three, were associated with modestly elevated serum prolactin levels. In four subjects there was an abnormal increase in serum growth hormone following TRH administration and in three, growth hormone failed to suppress normally after oral glucose. Two subjects were found to have a hypokalimic metabolic alkalosis, presumably due to vomiting. Urinary 17-OH steroid excretion and urinary concentrating ability were normal or nearly so in all subjects.