Bulimia nervosa and misuse of orlistat: two case reports.

OBJECTIVE: Orlistat (tetrahydrolipstatin) is an intestinal lipase inhibitor that was approved recently for the management and treatment of obesity. This is the first report of the misuse of orlistat in two normal-weight purging bulimia nervosa (BN) patients. METHOD AND RESULTS We report two diagnosed cases of BN in two Spanish women who used orlistat as a purging mechanism after binge episodes. In both cases, the onset of the eating disorder was in adolescence. From the beginning, a restrictive diet, binging, and purging behavior (vomiting and using laxatives) were present. Both patients misused this substance as their only purging mechanism after every binge episode. CONCLUSION: BN patients have used many substances and bizarre behaviors as purging mechanisms. Nevertheless, to the authors' knowledge, these are the first reported cases of orlistat misuse as the only purging mechanism in two BN patients.