Eating disorders have long been associated with an increased risk of suicide, but a new study suggests women who binge and purge may be at particular risk.
Swiss researchers found that among 288 women diagnosed with an eating disorder, such as anorexia or bulimia, those who purged were more likely to have attempted suicide in the past.
Both eating disorders involve a distorted body image and intense fear of gaining weight, and each frequently co-exists with other psychiatric conditions such as depression, anxiety or substance abuse. People with eating disorders also have a risk of suicide that is several times greater than that of the general population.
In the new study, researchers at the University Hospital Zurich found that more than one third of anorexic women who also binged and purged said they had attempted suicide in the past. That compares with about 11 percent of anorexics whose disorder was marked by food restriction alone.
Similarly, 30 percent of bulimic women who binged and purged had tried to take their own lives.
According to the study authors, led by Dr. Gabriella Milos, understanding which eating disorder patients are most likely to attempt suicide will help get high-risk individuals the treatment they need.
They report the findings in the journal General Hospital Psychiatry.
The study involved adult women being treated for an eating disorder, anorexia or bulimia in most cases, though some women were diagnosed with an unspecified eating disorder.
In interviews, 26 percent said they had tried to commit suicide at some time in their lives, with 31 percent of women who binged and purged reporting a suicide attempt, versus 12 percent of women who did not purge. Most women in the study had an additional disorder, such as anxiety or depression, and the majority of those who had attempted suicide had more than one co-existing psychiatric condition.
Binging and purging signifies problems with impulse control, Milos and her colleagues point out, and the current findings confirm the idea that impulsivity is an “important precursor” to suicide attempts.
The researchers also found that when it came to suicidal thoughts, rather than actions, women with anorexia were more likely than those with bulimia to contemplate suicide.
Anorexics’ starvation, the authors note, is a form of continuous self-injury, and the high level of stress this generates may explain their higher rate of suicidal thoughts.
SOURCE: General Hospital Psychiatry
Revision date: June 18, 2011
Last revised: by Sebastian Scheller, MD, ScD