An eating disorder in which binge eating is followed by depression and guilt, self-induced vomiting and purging, and painful or difficult swallowing, is called?

Appeared in: DSSSB - 29 August 2019 (Shift-2)

Explanation

Bulimia nervosa is defined by recurrent episodes of binge eating, which involves consuming a large quantity of food while feeling a lack of control.
These binge episodes are followed by recurrent inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, use of laxatives, fasting, or excessive exercise.
The cycle is driven by an overvaluation of body shape and weight and is often accompanied by feelings of guilt, depression, and self-disgust.
The symptom of painful swallowing (dysphagia) mentioned in the question is a direct consequence of repeated vomiting, which irritates the esophagus.

Option A: Dysphagia is the medical term for difficulty swallowing. It is a symptom, not a primary diagnosis of an eating disorder. In this context, it is a potential complication of the purging behaviors seen in bulimia.
Option C: Asphyxia refers to suffocation due to a lack of oxygen. It is an acute medical emergency and is entirely unrelated to the chronic psychiatric condition described.
Option D: Malnutrition is a condition resulting from an imbalanced diet, either deficient or excessive in nutrients. While it can be a consequence of an eating disorder, it is not the disorder itself. Individuals with bulimia nervosa often maintain a normal body weight and may not appear malnourished.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnosis of eating disorders based on clinical features as background academic context rather than a clinical decision trigger.
Nurses must assess for both physical and psychological signs of bulimia. Physical signs include Russell's sign (calluses on knuckles from inducing vomiting), dental enamel erosion, and parotid gland swelling.
A critical nursing intervention is monitoring for electrolyte imbalances, especially hypokalemia (low potassium), which can result from vomiting and laxative abuse and lead to life-threatening cardiac arrhythmias.
Management involves a multidisciplinary approach, including nutritional rehabilitation, cognitive-behavioral therapy (CBT), and often SSRI medications like fluoxetine. Nurses play a key role in creating a therapeutic, non-judgmental environment and supervising meals.

How to Approach the Question

First, break down the question stem into its core components: 1) Binge eating, 2) Feelings of depression and guilt, 3) Compensatory behaviors (vomiting/purging), and 4) A physical symptom (difficulty swallowing).
Analyze the options to see which term best encompasses this entire clinical picture.
Recognize that 'dysphagia' is only one symptom listed, not the overall disorder.
Eliminate 'asphyxia' and 'malnutrition' as they do not describe the specific behavioral pattern of an eating disorder.
Match the classic binge-and-purge cycle described in the question to the definition of Bulimia nervosa.
Conclude that Bulimia nervosa is the correct diagnosis as it is the only option that describes this specific syndrome of behaviors and psychological distress.

Concept Tested & Keywords

Concept Tested: Diagnosis of eating disorders based on clinical features.
Stem keywords: eating disorder, binge eating, depression and guilt, self-induced vomiting, purging, painful or difficult swallowing
Lead-in keywords: is called
Negative lead-in flag: false

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1496-1498

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Practise the full DSSSB - 29 August 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.