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Nutrients Aug 2023More than any other mental illness, the course, prognosis, and therapy of anorexia nervosa are shaped by the physical changes associated with being underweight. This... (Review)
Review
More than any other mental illness, the course, prognosis, and therapy of anorexia nervosa are shaped by the physical changes associated with being underweight. This article provides an overview of the endocrine changes associated with malnutrition and underweight. This overview serves as a basis for understanding the other articles in this special issue, which deal with the health risks associated with being underweight. In this context, the differences between underweight in anorexia nervosa and in constitutional thinness are of particular importance in assessing the impact of intentional weight loss. In this context, the regulation of hunger and satiety deserves special interest, as this is the area in which the intentional influence on body weight comes into play. Clinical consequences on, for example, fertility, bone metabolism, the homeostasis of, for example, serum glucose levels, or body temperature have been observed for a long time; nonetheless, the medical responses, apart from vitamin supplementations and advice to gain weight, are still limited. Therefore, emphasis was placed on the potential improvement of outcomes through the administration of central or peripheral hormones. Studies were identified on PubMed via a selection of relevant keywords; original texts that were cited in reviews were studied where it was advantageous. This review found some promising data on bone health and the administration of transdermal oestrogen, which is not yet widely used, as well as distinct hormonal markers to differentiate between CT and AN. We concluded that the continuous efforts to investigate the role of endocrinology in underweight and/or anorexia nervosa lead to outcome benefits and that more and higher-powered studies are needed.
Topics: Humans; Thinness; Anorexia Nervosa; Endocrinology; Malnutrition; Body Temperature
PubMed: 37630700
DOI: 10.3390/nu15163509 -
Psychoneuroendocrinology Nov 2023Famine and starvation have punctuated the evolutionary past of the human species. As such, we have developed hormonal responses to undernutrition that minimize energy... (Review)
Review
Famine and starvation have punctuated the evolutionary past of the human species. As such, we have developed hormonal responses to undernutrition that minimize energy expenditure on processes that are not critical for the survival of the individual, such as reproduction. In this review, we discuss neuroendocrine adaptations to starvation including hypogonadotropic hypogonadism, growth hormone resistance, hypercortisolemia, and the downregulation of the hypothalamic-pituitary-thyroid axis. We review the time-course of these adaptations by describing studies involving the short-term fasting of healthy individuals as well as studies describing the hormonal changes in states of chronic undernutrition, using individuals with anorexia nervosa as a model of chronic starvation. Lastly, we review representative clinical effects of chronic undernutrition.
Topics: Humans; Anorexia Nervosa; Neurosecretory Systems; Hypogonadism; Human Growth Hormone; Malnutrition
PubMed: 37573628
DOI: 10.1016/j.psyneuen.2023.106365 -
Seminars in Musculoskeletal Radiology Aug 2023Anorexia nervosa is a feeding disorder involving intentional weight loss. Restricted dietary intake leads to disturbed bone metabolism due to various factors, notably...
Anorexia nervosa is a feeding disorder involving intentional weight loss. Restricted dietary intake leads to disturbed bone metabolism due to various factors, notably endocrine, that affect bone microarchitecture and incur risk of fracture. Mild to moderate anorexia shows a paradoxical increase in bone marrow adipose tissue, whereas severe forms show gelatinous transformation known as serous atrophy of bone marrow (SABM). Imaging assessment of the mineralized and adipose components uses several techniques: dual-energy X-ray absorptiometry, computed tomography, chemical shift magnetic resonance imaging (MRI), and single-voxel MR spectroscopy. SABM induces MRI bone signal disturbances that can be hard to interpret and may hinder visualization of the fracture line.
Topics: Humans; Anorexia; Bone Marrow; Anorexia Nervosa; Magnetic Resonance Imaging; Adipose Tissue; Fractures, Bone; Atrophy; Bone Density
PubMed: 37748469
DOI: 10.1055/s-0043-1768452 -
Nutrients Nov 2023Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their...
Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their association with social media addiction among youths. A descriptive cross-sectional study was conducted on 350 participants aged 14-25 years. Two pre-validated tools were used, i.e., the Eating Attitude Test and the Social Networking Addiction Scale. SPSS was used to analyze the data. Out of the 350 students, 42% had probable eating disorders, and 41.7% had social media addictions. The findings revealed that the chances of having eating disorders were significantly higher among youths who lived in separate places, smoked, and had a family history of eating disorders ( ≤ 0.05). Furthermore, the dieting domain displayed notably higher scores for youths living separately ( ≤ 0.05) and smokers ( ≤ 0.01). Moreover, the scores for bulimia and food preoccupation were significantly higher among participants who were married ( = 0.038), were smokers ( = 0.027), and had a family history of eating disorders ( = 0.001). Higher scores in the oral control domain were reported by females ( ≤ 0.05) and severely obese youths ( ≤ 0.01). Moreover, social media addiction was significantly higher among students aged 18-21 ( ≤ 0.01). Spearman's correlation revealed that social media addiction has a weak positive relationship with eating disorders ( = 0.133, ≤ 0.01), particularly bulimia and food preoccupation ( = 0.173, ≤ 0.001). This reflects the need to address the harmful consequences of social media addiction that might raise the likelihood of developing eating disorders, particularly bulimia nervosa.
Topics: Female; Humans; Adolescent; Bulimia; Internet Addiction Disorder; Prevalence; Cross-Sectional Studies; Anorexia Nervosa; Feeding and Eating Disorders; Bulimia Nervosa
PubMed: 37960340
DOI: 10.3390/nu15214687 -
Zeitschrift Fur Psychosomatische... Feb 2024To investigate macular and peripapillary vascular density (VD) in patients with anorexia nervosa (AN) compared to healthy controls. :Whole face scans of the superficial...
To investigate macular and peripapillary vascular density (VD) in patients with anorexia nervosa (AN) compared to healthy controls. :Whole face scans of the superficial and deep macular layers and whole face and peripapillary scans of the radial peripapillary capillaries (RPC) were obtained using optical coherence tomography angiography (OCTA, AngioVueR, Optovue) in ten patients with AN and ten age-matched controls.The primary objective was to determine whether there was a difference between the vessel density (VD) in the above areas in AN and controls. P-values ≤ 0.0125 were considered statistically significant. : VD in the superficialmacular en-face OCTA image was significantly lower in the study group compared to the control group. Neither the deepmacula nor the radial peripapillary capillary (RPC) in the whole-face image nor the RPC-peripapillary imaging appeared to be significantly different. : Patients with AN showed reduced VD in the superficialmacular layers compared to healthy controls, which can be discussed as a consequence of the malnutrition. OCTA could be a useful non- invasive tool to detect reduced peripheral blood supply to show vascular changes that occur before ocular symptoms.
Topics: Humans; Optic Disk; Fluorescein Angiography; Retinal Vessels; Microvascular Density; Pilot Projects; Tomography, Optical Coherence; Anorexia Nervosa
PubMed: 38598705
DOI: 10.13109/zptm.2024.70.1.24 -
Soins. Psychiatrie 2024Addictions are invading our daily lives. Eating and body image have become major preoccupations. Anorexia nervosa and bulimia nervosa are eating disorders with a high...
Addictions are invading our daily lives. Eating and body image have become major preoccupations. Anorexia nervosa and bulimia nervosa are eating disorders with a high risk of chronicity and death. Curing them and preventing their recurrence requires a solid therapeutic alliance that aims to work around individual symptoms. The low self-esteem associated with these disorders may contribute to their maintenance, despite their negative impact on quality of life. One of the challenges of treating these disorders is to help patients find the motivation to seek treatment.
Topics: Humans; Food Addiction; Quality of Life; Bulimia Nervosa; Anorexia Nervosa; Feeding and Eating Disorders
PubMed: 38527872
DOI: 10.1016/j.spsy.2024.01.011 -
Psychiatria Danubina Oct 2023Psychiatric comorbidity is present in more than 70% of people with an Eating Disorders (ED), before or during the acute state of illness or in the long-term course....
Psychiatric comorbidity is present in more than 70% of people with an Eating Disorders (ED), before or during the acute state of illness or in the long-term course. These comorbidities include personality disorders (>53%), anxiety disorders (>50%), mood disorders (>40%) and substance abuse (>10%). This work aims to analyse the different treatments available for patients affected by eating disorders and other psychiatric comorbidity.
Topics: Humans; Anorexia Nervosa; Feeding and Eating Disorders; Personality Disorders; Anxiety Disorders; Comorbidity; Bulimia Nervosa
PubMed: 37800230
DOI: No ID Found -
Soins; La Revue de Reference Infirmiere Dec 2023Supporting people suffering from anorexia nervosa remains a challenge. While traditional treatment focuses more on speech and its emergence for the patient and family,...
Supporting people suffering from anorexia nervosa remains a challenge. While traditional treatment focuses more on speech and its emergence for the patient and family, non-medicinal and non-verbal therapies are used more systematically, sometimes as a last resort. Yet, as a non-verbal mediated therapy, music therapy can find a legitimate place and complement all the psychiatric, psychotherapeutic, somatic, dietetic and nursing areas where speech already circulates.
Topics: Humans; Anorexia Nervosa; Music Therapy
PubMed: 38070983
DOI: 10.1016/j.soin.2023.10.012 -
Psychiatry Research Sep 2023Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their...
Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered.
Topics: Adult; Humans; Child; Anorexia Nervosa; Bulimia Nervosa; Isotretinoin; Iatrogenic Disease; World Health Organization
PubMed: 37611327
DOI: 10.1016/j.psychres.2023.115415 -
Soins; La Revue de Reference Infirmiere Dec 2023Due to intensive physical training, and the pressure exerted by coaches, parents and the athlete him/herself during pre-competitive and competitive periods, a large...
Due to intensive physical training, and the pressure exerted by coaches, parents and the athlete him/herself during pre-competitive and competitive periods, a large number of high-level sporting activities can trigger or participate in anorexia nervosa. That said, some of these activities are more likely than others to promote this eating disorder. It is worth highlighting the sports most at risk for the onset or development of anorexia nervosa, and then addressing the means of prevention and regulation adapted to these circumstances.
Topics: Humans; Male; Anorexia Nervosa; Parents
PubMed: 38070981
DOI: 10.1016/j.soin.2023.10.010