We report the long-term clinical course of a female patient of bipolar disorder who had chronic binge eating and self-induced vomiting in depressive state or normal mood but had no abnormal eating behavior in manic state. A female patient in the early 30's with a 12-years history of binge eating and self-induced vomiting visited our hospital. She exhibited a fat phobia and a distorted view of her bodyweight and shape and was diagnosed with eating disorder. Two years after first visit, her mood was suddenly uplifted and exhibited sever manic state with hallucination and delusion. At the same time, her long-term abnormal eating behaviors disappeared. However, as her mood shifted to depressive or normal, her abnormal eating behaviors recurred. After that, her abnormal eating behaviors disappeared in manic or hypomanic state and recurred in depressive state. Early 40's, her mood changed to hypomanic state. After her hypomanic condition improved, her mood fluctuation disappeared and her abnormal eating behaviors did not recurred again and cognitive distortion of her body weight and shape also disappeared. In this case, the symptom of eating disorder was linked to the mood change of bipolar disorder, and it was thought that the treatment of bipolar disorder might help the remission of eating disorder.
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