Nonpurging bulimia: A distinct subtype of bulimia nervosa

Bulimics whose primary method of purgation was self‐induced vomiting (purgers) were compared to bulimics who did not purge (nonpurgers), using standardized diagnostic instruments. Differences in eating patterns, demographic characteristics, past and present DSM‐III‐R diagnoses, mood and personality traits were found. Purgers were younger, more likely to be single, and binged more frequently than nonpurgers. More purgers had Major Depression, Panic Disorder, or past Anorexia Nervosa than did nonpurgers. Purgers scored higher on the narcissistic, masochistic (self‐defeating), and borderline scales of the Personality Disorders Examination. In contrast, nonpurgers were more likely to be overweight and have history of substance abuse than purgers. These findings support the view that nonpurging bulimics constitute a distinct clinical group, and suggest that differences between purging and nonpurging bulimics may reflect differences in core pathology.