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Physiology & Behavior Apr 2008Anorexia nervosa (AN) and bulimia nervosa (BN) are related disorders of unknown etiology that most commonly begin during adolescence in women. AN and BN have unique and... (Review)
Review
Anorexia nervosa (AN) and bulimia nervosa (BN) are related disorders of unknown etiology that most commonly begin during adolescence in women. AN and BN have unique and puzzling symptoms, such as restricted eating or binge-purge behaviors, body image distortions, denial of emaciation, and resistance to treatment. These are often chronic and relapsing disorders, and AN has the highest death rate of any psychiatric disorder. The lack of understanding of the pathogenesis of this illness has hindered the development of effective interventions, particularly for AN. Individuals with AN and BN are consistently characterized by perfectionism, obsessive-compulsiveness, and dysphoric mood. Individuals with AN tend to have high constraint, constriction of affect and emotional expressiveness, ahendonia and asceticism, whereas individuals with BN tend to be more impulsive and sensation seeking. Such symptoms often begin in childhood, before the onset of an eating disorder, and persist after recovery, suggesting they are traits that create a vulnerability for developing an ED. There is growing acknowledgement that neurobiological vulnerabilities make a substantial contribution to the pathogenesis of AN and BN. Considerable evidence suggests that altered brain serotonin (5-HT) function contributes to dysregulation of appetite, mood, and impulse control in AN and BN. Brain imaging studies, using 5-HT specific ligands, show that disturbances of 5-HT function occur when people are ill, and persist after recovery from AN and BN. It is possible that a trait-related disturbance of 5-HT neuronal modulation predates the onset of AN and contributes to premorbid symptoms of anxiety, obsessionality, and inhibition. This dysphoric temperament may involve an inherent dysregulation of emotional and reward pathways which also mediate the hedonic aspects of feeding, thus making these individuals vulnerable to disturbed appetitive behaviors. Restricting food intake may become powerfully reinforcing because it provides a temporary respite from dysphoric mood. Several factors may act on these vulnerabilities to cause AN to start in adolescence. First, puberty-related female gonadal steroids or age-related changes may exacerbate 5-HT dysregulation. Second, stress and/or cultural and societal pressures may contribute by increasing anxious and obsessional temperament. Individuals with AN may discover that reduced dietary intake, by reducing plasma tryptophan availability, is a means by which they can modulate brain 5-HT functional activity and anxious mood. People with AN enter a vicious cycle which accounts for the chronicity of this disorder because caloric restriction results in a brief respite from dysphoric mood. However, malnutrition and weight loss, in turn, produce alterations in many neuropeptides and monoamine function, perhaps in the service of conserving energy, but which also exaggerates dysphoric mood. In summary, this article reviews findings in brain chemistry and neuroimaging that shed new light on understanding the psychopathology of these difficult and frustrating disorders.
Topics: Adolescent; Adult; Affect; Aging; Anorexia; Appetite; Body Image; Brain; Brain Chemistry; Bulimia; Cognition; Disruptive, Impulse Control, and Conduct Disorders; Female; Humans; Male; Nervous System; Neuropeptides; Neurotransmitter Agents; Puberty; Radiography; Sex Characteristics
PubMed: 18164737
DOI: 10.1016/j.physbeh.2007.11.037 -
Anales Del Sistema Sanitario de Navarra Aug 2022Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the... (Review)
Review
Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portu-guese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.
Topics: Adolescent; Anorexia; Bulimia; Bulimia Nervosa; Female; Humans; Male; Social Networking; Thinness
PubMed: 35972299
DOI: 10.23938/ASSN.1009 -
Nutrients Nov 2017The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and... (Review)
Review
The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences (i.e., disappointment, being hurt or loneliness), seem to be particularly relevant. Individuals with BED have a tendency to suppress and ruminate on their unwanted emotions, which leads to increased psychopathological thoughts and symptoms. Compared to healthy controls, they use adaptive strategies, such as reappraisal, less frequently. Evidence concerning the causal relation between negative affect and binge eating is inconclusive and still very limited. While experimental studies in a laboratory setting lack ecological validity, ecological momentary assessment studies offer more promise at unraveling the causal relationship between emotions and binge eating. Increases in negative affect are found to be antecedents of binge eating in BED. However, there seems to be less support for the possibility that binge eating serves as a means to alleviate negative affect. Finally, BED seems to be related to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm.
Topics: Binge-Eating Disorder; Bulimia; Emotions; Empirical Research; Humans; Meta-Analysis as Topic
PubMed: 29165348
DOI: 10.3390/nu9111274 -
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 -
BMJ Clinical Evidence Jul 2010Up to 1% of young women may have bulimia nervosa, characterised by an intense preoccupation with body weight, uncontrolled binge-eating episodes, and use of extreme... (Review)
Review
INTRODUCTION
Up to 1% of young women may have bulimia nervosa, characterised by an intense preoccupation with body weight, uncontrolled binge-eating episodes, and use of extreme measures to counteract the feared effects of overeating. People with bulimia nervosa may be of normal weight, making it difficult to diagnose. After 10 years, about half of people with bulimia nervosa will have recovered fully, one third will have made a partial recovery, and 10% to 20% will still have symptoms.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for bulimia nervosa in adults? What are the effects of discontinuing treatment in people with bulimia nervosa in remission? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: cognitive behavioural therapy (CBT; alone or plus exposure/response prevention enhancement), cognitive orientation therapy, dialectical behavioural therapy, discontinuing fluoxetine in people with remission, guided self-help cognitive behavioural therapy, hypnobehavioural therapy, interpersonal psychotherapy, mirtazapine, monoamine oxidase inhibitors (MAOIs), motivational enhancement therapy, pharmacotherapy plus psychotherapy, pure or unguided self-help cognitive behavioural therapy, reboxetine, selective serotonin reuptake inhibitors (SSRIs), topiramate, tricyclic antidepressants (TCAs), and venlafaxine.
Topics: Administration, Oral; Bulimia; Bulimia Nervosa; Cognitive Behavioral Therapy; Evidence-Based Medicine; Fluoxetine; Humans; Psychotherapy
PubMed: 21418667
DOI: No ID Found -
BMJ Open Nov 2019Little is known about the applicability of mindfulness-based interventions in Spanish adults with overweight/obesity. The objective of the present study protocol is to...
Efficacy of a mindful-eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol.
INTRODUCTION
Little is known about the applicability of mindfulness-based interventions in Spanish adults with overweight/obesity. The objective of the present study protocol is to describe the methods that will be used in a cluster randomised trial (CRT) that aims to evaluate the effectiveness of a mindfulness eating (ME) programme to reduce emotional eating (EE) in adults with overweight/obesity in primary care (PC) settings.
METHODS AND ANALYSIS
A CRT will be conducted with approximately 76 adults with overweight/obesity from four PC health centres (clusters) in the city of Zaragoza, Spain. Health centres matched to the average per capita income of the assigned population will be randomly allocated into two groups: 'ME +treatment as usual (TAU)' and 'TAU alone'. The ME programme will be composed of seven sessions delivered by a clinical psychologist, and TAU will be offered by general practitioners. The primary outcome will be EE measured by the Dutch Eating Behaviour Questionnaire (DEBQ) at post test as primary endpoint. Other outcomes will be external and restrained eating (DEBQ), binge eating (Bulimic Investigatory Test Edinburgh), eating disorder (Eating Attitude Test), anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), mindful eating (Mindful Eating Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and self-compassion (Self-Compassion Scale). Anthropometric measures, vital signs and blood tests will be taken. A primary intention-to-treat analysis on EE will be conducted using linear mixed models. Supplementary analyses will include secondary outcomes and 1-year follow-up measures; adjusted models controlling for sex, weight status and levels of anxiety and depression; the complier average causal effect of treatment; and the clinical significance of improvements.
ETHICS AND DISSEMINATION
Positive results of this study may have a significant impact on one of the most important current health-related problems. Approval was obtained from the Ethics Committee of the Regional Authority. The results will be submitted to peer-reviewed journals, and reports will be sent to participants.
TRIAL REGISTRATION NUMBER
NCT03927534 (5/2019).
Topics: Aged; Humans; Middle Aged; Bulimia; Emotions; Feeding Behavior; Mindfulness; Obesity; Overweight; Primary Health Care; Spain; Randomized Controlled Trials as Topic
PubMed: 31753880
DOI: 10.1136/bmjopen-2019-031327 -
BMJ (Clinical Research Ed.) Dec 1999
Topics: Adolescent; Adult; Anorexia Nervosa; Bulimia; Feeding and Eating Disorders; Female; Humans; Mass Screening; Surveys and Questionnaires
PubMed: 10582927
DOI: 10.1136/bmj.319.7223.1467 -
Australian Family Physician Sep 2007Bulimia nervosa (BN) and related eating disorders such as binge eating disorder are common. General practitioners can play a key role in the identification and... (Review)
Review
BACKGROUND
Bulimia nervosa (BN) and related eating disorders such as binge eating disorder are common. General practitioners can play a key role in the identification and management of BN and related eating disorders.
OBJECTIVE
This article describes the presenting and associated features of BN and overviews evidence based treatment approaches.
DISCUSSION
Key features are recurrent episodes of binge eating, extreme weight control behaviours and over concern about weight and shape issues. By definition people are not underweight. Risk factors include being from a western culture, obesity, exposure to a restrictive dieting environment and low self esteem. People are more likely to present asking for help in weight control or a physical problem secondary to the eating disorder. Evidenced based therapies with good outcomes in current use are cognitive behaviour therapy (in full or guided self help forms), high dose fluoxetine, and interpersonal psychotherapy. It is important to convey optimism about treatment efficacy and outcomes.
Topics: Adult; Antidepressive Agents; Bulimia; Cognitive Behavioral Therapy; Evidence-Based Medicine; Family Practice; Female; Fluoxetine; Humans
PubMed: 17885703
DOI: No ID Found -
Deutsches Arzteblatt International Feb 2024Eating disorders are seen mainly as a problem affecting women, not just by the public at large, but also in specialized circles. Although it is true that more women than... (Review)
Review
BACKGROUND
Eating disorders are seen mainly as a problem affecting women, not just by the public at large, but also in specialized circles. Although it is true that more women than men suffer from all types of eating disorder, pertinent reviews have clearly shown that they do indeed occur in men, and that the available evidence on the matter is limited. The stigmatization of men with eating disorders makes it harder for these men, and for the relevant professionals, to recognize the symptoms and to seek or provide help.
METHODS
This review is based on publications retrieved by a selective search in PubMed on the epidemiological, diagnostic, clinical, and therapeutic aspects of eating disorders in men.
RESULTS
Current estimated lifetime prevalences in men are 0.2% for anorexia nervosa, 0.6% for bulimia nervosa, and 1% for bingeeating disorder; the corresponding figures for women are 1.4%, 1.9%, and 2.8%. Men and women may display different manifestations. Women are thought to be mainly seeking a slim figure and weight reduction; men, a muscular build. The established Germanlanguage screening and diagnostic tools, however, do not cover the types of symptoms that are more common in men. Little is known about whether treatment yields comparable results in men and women.
CONCLUSION
It is important to combat the stigmati - zation of men with eating disorders and to remove the obstacles to their appropriate diagnosis and treatment. The current methods of screening and diagnosis need to be adapted to take account of the special aspects of abnormal eating behavior in men. It remains unclear whether and how the disorderspecific treatment of these conditions in men should differ from their treatment in women.
Topics: Male; Female; Humans; Bulimia; Feeding and Eating Disorders; Anorexia Nervosa
PubMed: 38019152
DOI: 10.3238/arztebl.m2023.0246 -
Nutrients Nov 2014Obesity presents a major health hazard of the 21st century. It promotes co-morbid diseases such as heart disease, type 2 diabetes, obstructive sleep apnea, certain types... (Review)
Review
Obesity presents a major health hazard of the 21st century. It promotes co-morbid diseases such as heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. Excessive energy intake, physical inactivity, and genetic susceptibility are main causal factors for obesity, while gene mutations, endocrine disorders, medication, or psychiatric illnesses may be underlying causes in some cases. The development and maintenance of obesity may involve central pathophysiological mechanisms such as impaired brain circuit regulation and neuroendocrine hormone dysfunction. Dieting and physical exercise offer the mainstays of obesity treatment, and anti-obesity drugs may be taken in conjunction to reduce appetite or fat absorption. Bariatric surgeries may be performed in overtly obese patients to lessen stomach volume and nutrient absorption, and induce faster satiety. This review provides a summary of literature on the pathophysiological studies of obesity and discusses relevant therapeutic strategies for managing obesity.
Topics: Anti-Obesity Agents; Bariatric Surgery; Bulimia; Comorbidity; Craving; Diabetes Mellitus, Type 2; Gastrointestinal Hormones; Heart Diseases; Humans; Obesity; Sleep Apnea, Obstructive
PubMed: 25412152
DOI: 10.3390/nu6115153