Bulimia nervosa and resting metabolic rate

This study investigated the relationship between bulimia nervosa and resting metabolic rate. It was hypothesized that severe levels of bulimia, characterized by purging through self‐induced vomiting as well as restrictive eating patterns, would be associated with a decrease in the rate of energy utilization and thus a lower resting metabolic rate. Forty‐two female subjects participated in the metabolic assessment. Twenty‐six were given the diagnosis of bulimia nervosa, and only those subjects purging through self‐induced vomiting were included. Sixteen nonbulimic women of comparable age, height, and weight were included as a control group. Resting metabolic rate was measured by continuous monitoring of expired oxygen and carbon dioxide fractions by indirect calorimetry via open‐circuit spirometry. Mean values of kilocalories per hour per kilogram were utilized as the dependent variable in the statistical analysis. Bulimic subjects were divided into severe and less severe groups using a median split on the Bulimia Test (BULIT) and compared with normals. Results showed a negative correlation between severity of bulimia, as measured by the BULIT, and resting metabolic rate. It was found that severe bulimics had lower resting metabolic rates than less severe bulimics and normals, who did not differ. These data indicate that severe levels of bulimia are associated with lower resting metabolism, although the correlational nature of the data prohibits a direct causal statement regarding bulimic behavior and its effects on metabolism.