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Internal Medicine Journal Jan 2020This article presents current diagnostic conceptualisations of eating disorders, including new disorders such as binge eating disorder (BED) and avoidant/restrictive...
This article presents current diagnostic conceptualisations of eating disorders, including new disorders such as binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID). This is followed by contemporary findings in the epidemiology of eating disorders, their broad sociodemographic distribution and the increases in community prevalence. Advances and the current status of evidence-based treatment and outcomes for the main eating disorders, anorexia nervosa, bulimia nervosa and BED are discussed with focus on first-line psychological therapies. Deficits in knowledge and directions for further research are highlighted, particularly with regard to treatments for BED and ARFID, how to improve treatment engagement and the management of osteopenia.
Topics: Anorexia Nervosa; Avoidant Restrictive Food Intake Disorder; Binge-Eating Disorder; Bone Diseases, Metabolic; Bulimia Nervosa; Drug Therapy; Feeding and Eating Disorders; Humans; Prevalence; Psychotherapy; Refeeding Syndrome
PubMed: 31943622
DOI: 10.1111/imj.14691 -
Current Opinion in Psychiatry Nov 2021To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality. (Review)
Review
PURPOSE OF REVIEW
To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality.
RECENT FINDINGS
Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk.
SUMMARY
Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.
Topics: Anorexia Nervosa; Bulimia Nervosa; Feeding and Eating Disorders; Female; Humans; Incidence; Male; Prevalence
PubMed: 34419970
DOI: 10.1097/YCO.0000000000000739 -
Child and Adolescent Psychiatric... Oct 2019Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific... (Review)
Review
Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific neurobiology that contributes to onset and maintenance of those disorders. This article provides a state-of-the-art review of our current understanding of the neurobiology of anorexia nervosa and bulimia nervosa. This includes brain structure and function studies to understand food restriction, binge-eating or purging behaviors, cognitive and emotional factors, as well as interoception. Binge-eating disorder and avoidant restrictive food intake disorder are also discussed, but the literature is still very small.
Topics: Adolescent; Anorexia Nervosa; Binge-Eating Disorder; Brain; Bulimia Nervosa; Child; Feeding and Eating Disorders; Humans; Magnetic Resonance Imaging; Nerve Net; Neurobiology; Young Adult
PubMed: 31443880
DOI: 10.1016/j.chc.2019.05.007 -
Cleveland Clinic Journal of Medicine Jun 2021Bulimia nervosa, a mental illness 4 times more common than anorexia nervosa, is characterized by binge-eating followed by compensatory purging behaviors, which include... (Review)
Review
Bulimia nervosa, a mental illness 4 times more common than anorexia nervosa, is characterized by binge-eating followed by compensatory purging behaviors, which include self-induced vomiting, diuretic abuse, laxative abuse, and misuse of insulin. Patients with bulimia nervosa are at risk of developing medical complications that affect all body systems, especially the renal and electrolyte systems. Behavior cessation can reverse some, but not all, medical complications.
Topics: Anorexia Nervosa; Bulimia; Bulimia Nervosa; Humans; Vomiting
PubMed: 34078617
DOI: 10.3949/ccjm.88a.20168 -
Current Psychiatry Reports Jul 2022Identifying medications that may be used as therapeutic agents for eating disorders is a longstanding focus of research, with varying degrees of success. The present... (Review)
Review
PURPOSE OF REVIEW
Identifying medications that may be used as therapeutic agents for eating disorders is a longstanding focus of research, with varying degrees of success. The present review consolidates the most recent findings on pharmacological treatment of three eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).
RECENT FINDINGS
Recent research suggests that olanzapine demonstrates positive effects on weight gain among outpatients with AN. There are fewer recent advances in psychopharmacological treatment for BN and BED, likely due to the relative success of prior medication trials. Olanzapine is the first medication to safely promote weight gain among individuals with AN. Fluoxetine is FDA-approved for BN treatment, and lisdexamfetamine is FDA-approved for BED treatment. BN and BED also generally respond well to SSRIs prescribed off-label. Research on psychopharmacological treatments for other eating disorders, such as avoidant-restrictive food intake disorder and other specified feeding and eating disorders, are sorely needed.
Topics: Anorexia Nervosa; Binge-Eating Disorder; Bulimia Nervosa; Feeding and Eating Disorders; Humans; Olanzapine; Weight Gain
PubMed: 35576089
DOI: 10.1007/s11920-022-01340-5 -
American Family Physician Jan 2015Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical...
Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). In addition to the role of environmental triggers and societal expectations of body size and shape, research has suggested that genes and discrete biochemical signals contribute to the development of eating disorders. Anorexia nervosa and bulimia nervosa occur most often in adolescent females and are often accompanied by depression and other comorbid psychiatric disorders. For low-weight patients with anorexia nervosa, virtually all physiologic systems are affected, ranging from hypotension and osteopenia to life-threatening arrhythmias, often requiring emergent assessment and hospitalization for metabolic stabilization. In patients with frequent purging or laxative abuse, the presence of electrolyte abnormalities requires prompt intervention. Family-based treatment is helpful for adolescents with anorexia nervosa, whereas short-term psychotherapy, such as cognitive behavior therapy, is effective for most patients with bulimia nervosa. The use of psychotropic medications is limited for anorexia nervosa, whereas treatment studies have shown a benefit of antidepressant medications for patients with bulimia nervosa. Treatment is most effective when it includes a multidisciplinary, teambased approach.
Topics: Adolescent; Adult; Anorexia Nervosa; Body Mass Index; Bulimia Nervosa; Depression; Diagnostic and Statistical Manual of Mental Disorders; Disease Management; Family Practice; Female; Hospitalization; Humans; Male; Mass Screening; Practice Guidelines as Topic; Psychotherapy; Social Environment; Social Support; Symptom Assessment
PubMed: 25591200
DOI: No ID Found -
Nutricion Hospitalaria Aug 2022Background: eating disorders are a group of conditions in which negative beliefs about food, body shape, and body weight together with behaviors such as restricted food...
Background: eating disorders are a group of conditions in which negative beliefs about food, body shape, and body weight together with behaviors such as restricted food intake, binge eating, excessive exercise, self-induced vomiting, and use of laxatives. They can become serious, affect quality of life, and lead to multiple physical and even psychiatric complications with a fatal outcome. The purpose of this chapter is to describe the characteristics, epidemiology, and trends of eating disorders with updated information based on the most recent publications. Methods: we conducted a systematic literature search in Medline, EMBASE, Cochrane, and Web of Science. The search terms were "anorexia nervosa", "bulimia nervosa", "binge eating disorders" and "epidemiology" both in titles and in abstracts. Results and conclusions: EDs generally occur in adolescents and young adults. The best characterized TCAs are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (TA). Prevalence studies indicate wide differences by age group and sex, much higher in young women (NA, 0.1-2 %; BN, 0.37-2.98 %; BED, 0.62-4.45 %). The prevalence of EDs is 2.2 % (0.2-13.1 %) in Europe, 3.5 % (0.6-7.8 %) in Asia, and 4.6 % (2.0-13.5 %) in America. Comorbidity is high with psychiatric problems such as depression, anxiety, attention deficit/hyperactivity disorder, obsessive-compulsive disorder, and personality disorders.
Topics: Adolescent; Anorexia; Binge-Eating Disorder; Bulimia; Bulimia Nervosa; Feeding and Eating Disorders; Female; Humans; Male; Quality of Life; Young Adult
PubMed: 35748385
DOI: 10.20960/nh.04173 -
Molecular and Cellular Endocrinology Nov 2019The pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN) are still poorly understood, but psychobiological models have proposed a key role for disturbances... (Review)
Review
The pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN) are still poorly understood, but psychobiological models have proposed a key role for disturbances in the neuroendocrines that signal hunger and satiety and maintain energy homeostasis. Mounting evidence suggests that many neuroendocrines involved in the regulation of homeostasis and body weight also play integral roles in food reward valuation and learning via their interactions with the mesolimbic dopamine system. Neuroimaging data have associated altered brain reward responses in this system with the dietary restriction and binge eating and purging characteristic of AN and BN. Thus, neuroendocrine dysfunction may contribute to or perpetuate eating disorder symptoms via effects on reward circuitry. This narrative review focuses on reward-related neuroendocrines that are altered in eating disorder populations, including peptide YY, insulin, stress and gonadal hormones, and orexins. We provide an overview of the animal and human literature implicating these neuroendocrines in dopaminergic reward processes and discuss their potential relevance to eating disorder symptomatology and treatment.
Topics: Animals; Anorexia Nervosa; Bulimia Nervosa; Ghrelin; Humans; Leptin; Neuroendocrinology; Reward
PubMed: 30395874
DOI: 10.1016/j.mce.2018.10.018 -
Child and Adolescent Psychiatric... Oct 2019There are few systematic studies of treatment of bulimia nervosa (BN) in adolescents. Although family-based treatment has demonstrated preliminary evidence to support... (Review)
Review
There are few systematic studies of treatment of bulimia nervosa (BN) in adolescents. Although family-based treatment has demonstrated preliminary evidence to support involvement of caregivers in treatment, there is significant opportunity for improvement in mitigating binge-eating and purging symptoms among adolescents afflicted with BN. When caregivers are unable to participate in treatment, there is evidence that BN-specific cognitive behavioral therapy approaches are helpful for some adolescents. Further research is needed to determine for whom, and under what conditions certain types of family involvement might be most effective in adolescent treatment of BN.
Topics: Adolescent; Adolescent Psychiatry; Binge-Eating Disorder; Bulimia Nervosa; Cognitive Behavioral Therapy; Family Therapy; Humans
PubMed: 31443872
DOI: 10.1016/j.chc.2019.05.002 -
The Psychiatric Clinics of North America Mar 2019Anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) are heritable conditions that are influenced by both genetic and environmental factors.... (Review)
Review
Anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) are heritable conditions that are influenced by both genetic and environmental factors. Recent genome-wide association studies (GWAS) of AN have identified specific genetic loci implicated in AN, and genetic correlations have implicated both psychiatric and metabolic factors in its origin. No GWAS have been performed for BN or BED. Genetic counseling is an important tool and can aid families and patients in understanding risk for these illnesses.
Topics: Anorexia Nervosa; Binge-Eating Disorder; Bulimia Nervosa; Genome-Wide Association Study; Humans
PubMed: 30704640
DOI: 10.1016/j.psc.2018.10.007