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Bulimia: An Underlying Behavioral Disorder in Hyperlipidemic Pancreatitis: A Prospective Multidisciplinary Approach

Bulimia: An Underlying Behavioral Disorder in Hyperlipidemic Pancreatitis: A Prospective... Abstract • Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy. (Arch Intern Med 1987;147:705-708) References 1. Klatskin G, Gordon M: Relationship between relapsing pancreatitis and essential hyperlipemia. Am J Med 1952;12:3-22.Crossref 2. Greenberger NJ, Hathich FT, Drummey GD, et al: Pancreatitis and hyperlipemia. Medicine 1966;45:161-174.Crossref 3. Cameron JL, Capuzzi DM, Zuidema GD, et al: Acute pancreatitis with hyperlipemia: The incidence of lipid abnormalities in acute pancreatitis. Ann Surg 1973;177:483-499.Crossref 4. Buch A, Buch J, Carlsen A, et al: Hyperlipidaemia and pancreatitis. World J Surg 1980;4:307-314.Crossref 5. Lenariot JP, Fournier F, Brun P, et al: Primary acute pancreatitis and hyperlipoproteinemia: A severe reality. Digestion 1982;9:49-53. 6. Dickson AP, O'Neill J, Imrie CW: Hyperlipidaemia, alcohol abuse and acute pancreatitis. Br J Surg 1984;37:685-688.Crossref 7. Ranson JHC: Etiological and prognostic factors in human acute pancreatitis: A review. Am J Gastroenterol 1982;77:633-638. 8. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980, pp 69-71. 9. Fairburn C: A cognitive behavioural approach to the treatment of bulimia. Psychol Med 1981;252:520-523. 10. Lipid Research Clinic Program: Manual of Laboratory Operations, vol 1: Lipid and Lipoprotein Analysis , US Dept of Health, Education, and Welfare publication 76-62B. National Institutes of Health, 1976. 11. Huttunen JKC, Enholm PJ, Kinnunen A, et al: An immunochemical method for selective measurement of two triglyceride lipases in human post heparin plasma. Clin Chim Acta 1975;65:335-349.Crossref 12. Hill AB: Principles of Medical Statistics , ed 9. London, Lancet Ltd, 1971, pp 371, 376. 13. Herzog DG, Copeland PM: Eating disorders. N Engl J Med 1985;313: 295-303.Crossref 14. Cooper PJ, Fairburn CG: Binge eating and self induced vomiting in the community: A preliminary study. Br J Psychiatry 1983;142:139-144.Crossref 15. Pope HG Jr, Yurge WN, Tudd D: Anorexia nervosa and bulimia among 300 women shoppers. Am J Psychiatry 1984;141:292-294. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Bulimia: An Underlying Behavioral Disorder in Hyperlipidemic Pancreatitis: A Prospective Multidisciplinary Approach

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1987.00370040087015
Publisher site
See Article on Publisher Site

Abstract

Abstract • Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy. (Arch Intern Med 1987;147:705-708) References 1. Klatskin G, Gordon M: Relationship between relapsing pancreatitis and essential hyperlipemia. Am J Med 1952;12:3-22.Crossref 2. Greenberger NJ, Hathich FT, Drummey GD, et al: Pancreatitis and hyperlipemia. Medicine 1966;45:161-174.Crossref 3. Cameron JL, Capuzzi DM, Zuidema GD, et al: Acute pancreatitis with hyperlipemia: The incidence of lipid abnormalities in acute pancreatitis. Ann Surg 1973;177:483-499.Crossref 4. Buch A, Buch J, Carlsen A, et al: Hyperlipidaemia and pancreatitis. World J Surg 1980;4:307-314.Crossref 5. Lenariot JP, Fournier F, Brun P, et al: Primary acute pancreatitis and hyperlipoproteinemia: A severe reality. Digestion 1982;9:49-53. 6. Dickson AP, O'Neill J, Imrie CW: Hyperlipidaemia, alcohol abuse and acute pancreatitis. Br J Surg 1984;37:685-688.Crossref 7. Ranson JHC: Etiological and prognostic factors in human acute pancreatitis: A review. Am J Gastroenterol 1982;77:633-638. 8. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980, pp 69-71. 9. Fairburn C: A cognitive behavioural approach to the treatment of bulimia. Psychol Med 1981;252:520-523. 10. Lipid Research Clinic Program: Manual of Laboratory Operations, vol 1: Lipid and Lipoprotein Analysis , US Dept of Health, Education, and Welfare publication 76-62B. National Institutes of Health, 1976. 11. Huttunen JKC, Enholm PJ, Kinnunen A, et al: An immunochemical method for selective measurement of two triglyceride lipases in human post heparin plasma. Clin Chim Acta 1975;65:335-349.Crossref 12. Hill AB: Principles of Medical Statistics , ed 9. London, Lancet Ltd, 1971, pp 371, 376. 13. Herzog DG, Copeland PM: Eating disorders. N Engl J Med 1985;313: 295-303.Crossref 14. Cooper PJ, Fairburn CG: Binge eating and self induced vomiting in the community: A preliminary study. Br J Psychiatry 1983;142:139-144.Crossref 15. Pope HG Jr, Yurge WN, Tudd D: Anorexia nervosa and bulimia among 300 women shoppers. Am J Psychiatry 1984;141:292-294.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1987

References

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