New Research Links Bulimia to Testosterone

Since it was first identified in 1977 bulimia has been thought of as having psychological causes. However, new research has shown that, at least in some cases, it may be metabolic and fairly easy to treat.

Background
Bulimia, like anorexia nervosa, is an eating disorder. It manifests as a pattern of overeating - "bingeing" - followed by a period of "purging," in which the person vomits or uses laxatives in an effort to remove the food from their system.

Eating disorders have traditionally been regarded as forms of mental illness and blamed on problems with self-esteem, stress, or depression. As a result, they've been treated mainly with psychiatric and psychological methods like antidepressants and cognitive therapy, which tries to help the person see their condition more rationally so they can make needed changes to their behavior. But this treatment isn't always effective.

Interestingly, about 90% of the people who have bulimia are women. This has led to theories about the possibility of a hormonal connection that is now being investigated.

Recent research
A study at the Karolinska Institute in Sweden involved 136 women, of whom 77 had bulimia. Initial tests showed that the women with bulimia had much higher levels of testosterone - and lower levels of estrogen - than the women without the eating disorder. Estrogen is a well-known female hormone. Testosterone is also well known as a male hormone that is normally found only in small quantities in women.

Testosterone can influence appetite, so it was theorized that reducing the bulimic women's levels might affect their hunger levels. These women were treated for three months with estrogen, in the form of oral contraceptives. Three months isn't a very long period for hormonal treatment, but it did significantly reduce the women's hunger and cravings for fat and sugar. And three of the women lost all symptoms of the bulimia they'd had at the beginning of the study.

Conclusions and considerations
It does seem that many cases of bulimia in women may be associated with increased levels of testosterone, and therefore treatable with estrogen. But experts in the treatment of eating disorders stress that this research isn't enough to assume that contraceptives will completely erase the symptoms of bulimia in all women. They do feel that traditional psychological methods may still be needed in many cases. And even among women with high testosterone levels, oral contraceptives may not be the answer. Some women may not be able to tolerate them, so alternative forms of treatment may be needed.

Still, this research provides direction for the study of a complicated and confusing condition. And in that way it can give hope to many women suffering from bulimia who have not been helped by current psychological methods.