Dr. Paul Jenkins, Clinical Psychologist and Community Team Manager at the Cotswold House Eating Disorders Service, Oxford Health NHS FT, has led a study to assess the severity indicator published in the most recent ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM-5). This indicator assigns a severity rating (Mild, Moderate, Severe, or Extreme) based on the frequency of certain weight control behaviours, such as self-induced vomiting, laxative use, and excessive exercise.

The study, which will be published in the journal Psychiatry Research, was an audit, reviewing data that was routinely collected over a period of around three-and-a-half years within Oxford Health NHS Foundation Trust’s Eating Disorder Service, a specialist service for adults in Oxfordshire and Buckinghamshire.

Dr Paul Jenkins says: “We were not expecting such a relatively low proportion (fewer than 4%) classified as Extreme.  We hope that the results presented here might stimulate further work evaluating classification of bulimia nervosa severity according to frequency of compensatory behaviours, and also greater scrutiny of patient-reported impairment.”

In summary, the results highlight that:

• Weight control behaviours are associated with significant psychosocial impairment, particularly so when occurring at least four times per week.
• There is significant morbidity and impairment associated with bulimia nervosa, and that individuals experiencing such symptoms should seek support with recovery.

Dr Paul Jenkins comments: “More work is required to establish the validity of this classification and whether this is the best way of defining ‘severity’ in bulimia nervosa.  It is often the case that there is a long delay from symptom onset to the point of seeking treatment. We hope highlighting that even ‘mild’ cases are associated with significant impairment might encourage more of those suffering from disordered eating to present for support.”

Bulimia nervosa is a serious mental health disorder but outcomes are good the earlier people seek help.  If somebody needs help they should speak to their GP who will refer them to a local specialist eating disorders service.

To read the report in full, visit the Science Direct website.

See here for further information on research into eating disorders at Oxford Health.

Visit Cotswold House website and the national eating disorder charity b-eat for help or further information.