Self-induced vomiting has been associated with the psychiatric diagnosis of anorexia nervosa and a newly proposed disorder named bulimia. Two patients with a self-induced vomiting compulsion did not fulfill criteria for either of these diagnoses. One patient had an affective disorder, and the other had no psychiatric illness, but the habit had developed as a weight-control measure. Systematic studies of these symptoms are not available. Clinical diagnostic decisions should not be based on one outstanding sign or symptom, eg, self-induced vomiting, unless research clearly relates the sign or symptom to only one disorder.
(JAMA 239:2688-2689, 1978)
Rich CL. Self-induced VomitingPsychiatric Considerations. JAMA. 1978;239(25):2688–2689. doi:10.1001/jama.1978.03280520060021