Bulimia nervosa increases CVD and mortality risk in women, finds study

Canada: Bulimia nervosa, a serious eating disorder, increases the risk of cardiovascular disease and death in women, finds a recent study published in the JAMA Psychiatry journal.

The findings suggest that women having a history of bulimia nervosa should undergo regular screening of ischemic cardiovascular disease. In this way, women may benefit from prevention of and treatment for cardiovascular risk factors.

According to Mayo Clinic, bulimia nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food with a loss of control over the eating — and then purge, trying to get rid of the extra calories in an unhealthy way.

Bulimia nervosa is associated with short-term cardiovascular complications in women, but its long-term consequences on cardiovascular health are unknown. Nathalie Auger, Institut National de Santé Publique du Québec, Montreal, QC, Canada, and colleagues determined the of bulimia nervosa with the long-term risk of cardiovascular disease and mortality in women.

The study involved 818 women who were hospitalized for bulimia nervosa (mean age, 28.3 years) and 415 891 hospitalized for pregnancy-related events (mean age, 28.3 years). They were were followed up for 12 years from 2006 to 2018 to identify incidences of cardiovascular disease and death to identify future incidences of cardiovascular disease and deaths.

Key findings of the study include:

• The women hospitalized for bulimia nervosa had a greater incidence of cardiovascular disease compared with those hospitalized for pregnancy-related events (10.34 vs 1.02 per 1000 person-years).


• Incidence of future cardiovascular disease was even higher for women with 3 or more bulimia admissions (25.13 per 1000 person-years).


• Women hospitalized for bulimia nervosa had 4.25 times the risk of any cardiovascular disease and 4.72 times the risk of death compared with women hospitalized for pregnancy-related events.


• Bulimia nervosa was found to be associated with ischemic heart disease, atherosclerosis, and cardiac conduction defects.


• Bulimia was also associated with 21.93 times the risk of myocardial infarction at 2 years of follow-up and 14.13 times the risk at 5 years of follow-up.

"Bulimia nervosa is associated with the long-term risk of any cardiovascular disease, such as ischemic cardiac events and conduction disorders, as well as with death among women," wrote the authors.

"Our findings suggest that women with a history of bulimia nervosa should be informed of an increased risk of cardiovascular disease and death in the first decade after the index admission for bulimia. These women may benefit from screening for prevention and treatment of cardiovascular risk factors," they concluded.

More Information: "Association of Bulimia Nervosa With Long-term Risk of Cardiovascular Disease and Mortality Among Women" published in the JAMA Psychiatry journal.

DOI: 10.1001/jamapsychiatry.2019.2914

Journal Information: JAMA Psychiatry