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April 1987

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

Author Affiliations

From the Lipid Research Laboratory, Department of Medicine B (Drs Gavish, Eisenberg, Berry, Kleinman, and Leitersdorf and Ms Norman) and the Department of Psychiatry (Dr Witztum), Hadassah University Hospital, Jerusalem.

Arch Intern Med. 1987;147(4):705-708. doi:10.1001/archinte.1987.00370040087015

• 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)