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Srpski Arhiv Za Celokupno Lekarstvo 2012Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the... (Review)
Review
Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient's health condition, associated with behavior and eating habits, the experience of one's own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.
Topics: Anorexia Nervosa; Bulimia Nervosa; Female; Humans
PubMed: 23289290
DOI: No ID Found -
BMJ Clinical Evidence Mar 2015Up to 1% of people in the community may have bulimia nervosa, characterised by an intense preoccupation with body weight, binge-eating episodes, and use of extreme... (Review)
Review
INTRODUCTION
Up to 1% of people in the community may have bulimia nervosa, characterised by an intense preoccupation with body weight, binge-eating episodes, and use of extreme measures to counteract the feared effects of overeating. People with bulimia nervosa are of normal weight or are overweight, making the condition distinct from anorexia nervosa. 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 question: What are the effects of online interventions for people with bulimia nervosa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (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 eight 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: applications (apps) or online programmes used as an adjunct to face-to-face therapy, delivery of self-help online, and delivery of therapy online.
Topics: Bulimia Nervosa; Humans; Internet; Psychology, Clinical; Psychotherapy; Treatment Outcome
PubMed: 25735611
DOI: No ID Found -
Periodontology 2000 Oct 2021People with eating disorders suffer from a mental disorder that negatively affects their physical and/or mental health. The three most frequent eating disorders are... (Review)
Review
People with eating disorders suffer from a mental disorder that negatively affects their physical and/or mental health. The three most frequent eating disorders are binge eating disorder, bulimia nervosa, and anorexia nervosa. Environmental and genetic factors are involved in the pathogenesis of eating disorders in vulnerable persons. Although treatment varies among different types of eating disorders, nutrition, medical care combined with psychotherapy and medications are standard of care. The aim of this review is to give an overview of the oral health impact of eating disorders with a special emphasis on the periodontium. Oral health professionals have a unique role to play in the early diagnosis of eating disorders because of the important impact that eating disorders have on the oral cavity. In vomiting-associated eating disorders, the risk of erosive tooth wear is mainly localized to the palatal surfaces of the incisors. Emerging evidence also indicates a high frequency of gingivitis and gingival recessions associated with compulsive toothbrushing. A holistic approach, including oral health and functional rehabilitation, should be promoted by physicians, psychiatrists, and dentists for people with eating disorders.
Topics: Anorexia Nervosa; Bulimia Nervosa; Feeding and Eating Disorders; Gingivitis; Humans; Oral Health
PubMed: 34463986
DOI: 10.1111/prd.12391 -
The International Journal of Eating... Jan 2022Preoccupation (excessive and constant thoughts) about shape/weight and food/eating is thought to be prominent in individuals with eating disorders but has received much...
OBJECTIVE
Preoccupation (excessive and constant thoughts) about shape/weight and food/eating is thought to be prominent in individuals with eating disorders but has received much less research than overt behavioral features. This study examined the significance and distinctiveness of different foci of preoccupation in individuals categorized with different forms of eating disorders and in individuals with higher weight.
METHOD
Participants (N = 1,363) completed a web-based survey with established measures of eating-disorder psychopathology and depression. The current study compared preoccupation among individuals with core features of bulimia nervosa (BN; n = 144), binge-eating disorder (BED; n = 576), anorexia nervosa (AN; n = 48), and higher body weight (body mass index [BMI] ≥ 25) without eating-disorder features (higher weight [HW]; n = 595). Associations of each type of preoccupation with other eating-disorder psychopathology and depression were examined both between and within study groups.
RESULTS
Preoccupation with shape/weight and with food/eating showed a graded pattern of statistically significant differences: AN and BN had higher preoccupation than BED, which was higher than HW. Within BN, BED, and AN study groups, correlation magnitudes of shape/weight and food/eating preoccupation with eating-disorder psychopathology and depression did not differ significantly. Within the HW group, shape/weight preoccupation was significantly more strongly correlated than food/eating preoccupation with overvaluation, body dissatisfaction, and depression.
DISCUSSION
The preoccupation cognitive style, as well as focus, appears associated with other facets of eating-disorder psychopathology and depression. If results are confirmed among individuals with formal diagnoses, clinicians addressing maladaptive cognitions in cognitive-behavioral therapy should consider the role of preoccupation. Future research should investigate whether preoccupation predicts or moderates eating disorder treatment outcomes.
Topics: Anorexia Nervosa; Binge-Eating Disorder; Body Image; Bulimia Nervosa; Humans; Overweight
PubMed: 34713460
DOI: 10.1002/eat.23630 -
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 -
Eating Behaviors Aug 2021Previous research has failed to find differences in eating disorder and general psychopathology and impairment between people with sub- and full-threshold bulimia...
Previous research has failed to find differences in eating disorder and general psychopathology and impairment between people with sub- and full-threshold bulimia nervosa (BN). The purpose of the current study was to test the validity of the distinction between sub- and full-threshold BN and to determine the frequency of objective binge episodes and inappropriate compensatory behaviors that would best distinguish between sub- and full-BN. Community-recruited adults (83.5% female) with current sub-threshold (n = 105) or full-threshold BN (n = 99) completed assessments of eating-disorder psychopathology, clinical impairment, internalizing problems, and drug and alcohol misuse. Receiver operating characteristic curve analysis was used to evaluate whether eating-disorder psychopathology, clinical impairment, internalizing problems, and drug and alcohol misuse could empirically discriminate between sub- and full-threshold BN. The frequency of binge episodes and inappropriate compensatory behaviors (AUC = 0.94) was "highly accurate" in discriminating between sub- and full-threshold BN; however, only objective binge episodes was a significant predictor of BN status. Internalizing symptoms (AUC = 0.71) were "moderately accurate" at distinguishing between sub- and full-BN. Neither clinical impairment (AUC = 0.60) nor drug (AUC = 0.56) or alcohol misuse (AUC = 0.52) discriminated between groups. Results suggested that 11 episodes of binge eating and 17 episodes of inappropriate compensatory behaviors optimally distinguished between sub- and full-BN. Overall, results provided mixed support for the distinction between sub- and full-threshold BN. Future research to clarify the most meaningful way to discriminate between sub- and full-threshold is warranted to improve the criterion-related validity of the diagnostic system.
Topics: Adult; Binge-Eating Disorder; Bulimia; Bulimia Nervosa; Feeding and Eating Disorders; Female; Humans; Male; Psychopathology
PubMed: 34315120
DOI: 10.1016/j.eatbeh.2021.101540 -
The Primary Care Companion For CNS... Dec 2020Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa. These outcomes may be a consequence of late detection... (Review)
Review
Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa. These outcomes may be a consequence of late detection and subsequent management. The combination of these disorders has been referred to as diabulimia; however, this is not an official diagnosis and is a colloquial term used by patients and the media to describe the associated maladaptive pattern of compensatory behaviors. Early intervention is required to prevent short- and longer-term complications, with intensive treatment approaches having the best current evidence. Collaboration is required between specialist services for patients to receive optimal care. This narrative review summarizes the latest published evidence in the formulation, detection, and subsequent management of bulimia nervosa in type 1 diabetes, while highlighting the need for higher-quality research in the assessment and treatment of these comorbidities.
Topics: Bulimia Nervosa; Comorbidity; Diabetes Mellitus, Type 1; Early Diagnosis; Humans; Treatment Outcome
PubMed: 33351292
DOI: 10.4088/PCC.20nr02707 -
The Psychiatric Clinics of North America Jun 2019The authors present the theoretic model, structure of treatment, and preliminary evidence for several emerging treatments that are increasingly being used and studied in... (Review)
Review
The authors present the theoretic model, structure of treatment, and preliminary evidence for several emerging treatments that are increasingly being used and studied in eating disorders treatment, including dialectical behavior therapy, acceptance and commitment therapy, integrative cognitive-affective therapy, and neuromodulation. In addition, the article discusses treatments that address mindfulness, interpersonal factors, and habit.
Topics: Acceptance and Commitment Therapy; Anorexia Nervosa; Binge-Eating Disorder; Bulimia Nervosa; Humans; Mindfulness; Psychotherapy
PubMed: 31046924
DOI: 10.1016/j.psc.2019.01.005 -
Revista de Neurologia Nov 2018Eating disorders are severe mental disorders that appear in different diagnostic forms, such as anorexia nervosa and bulimia nervosa. In recent years, a number of... (Review)
Review
INTRODUCTION
Eating disorders are severe mental disorders that appear in different diagnostic forms, such as anorexia nervosa and bulimia nervosa. In recent years, a number of studies have highlighted the involvement of neuropsychological processes in anorexia and bulimia nervosa.
AIM
To review the evidence on the deficits in the executive functions, attentional biases and central coherence in anorexia and bulimia nervosa in relation to a neuropsychological risk profile, a different neuropsychological profile associated with the aforementioned eating pathologies and the role of variables (body mass index, age, anxiety, impulsiveness, alexithymia, mood, body image) in the presence of neuropsychological deficits.
DEVELOPMENT
We reviewed the empirical studies conducted in the last seven years found in the Medline and PsycINFO databases for English, and Dialnet and Psicodoc for Spanish. Twenty-eight articles were selected as suitable for the purposes of this study. The documents were chosen on the basis of a set of pre-established criteria.
CONCLUSIONS
According to the evidence available, there seems to be a risk profile characterised by cognitive rigidity and weak central coherence. The results appear to be more consistent as regards the risk profile in anorexia nervosa. Furthermore, in both anorexia and bulimia nervosa there are attentional biases related to the recognition of emotions and social aspects, and the alexithymia trait is a modulating variable in this difficulty.
Topics: Anorexia Nervosa; Bulimia Nervosa; Humans; Neuropsychology; Risk Factors
PubMed: 30350847
DOI: No ID Found -
The International Journal of Eating... Nov 2023Food-cue-reactivity entails neural and experiential responses to the sight and smell of attractive foods. Negative emotions can modulate such cue-reactivity and this...
OBJECTIVE
Food-cue-reactivity entails neural and experiential responses to the sight and smell of attractive foods. Negative emotions can modulate such cue-reactivity and this might be central to the balance between restrictive versus bulimic symptomatology in Anorexia Nervosa (AN) and Bulimia Nervosa (BN).
METHOD
Pleasantness ratings and electrocortical responses to food images were measured in patients with AN (n = 35), BN (n = 32) and matched healthy controls (HC, n = 35) in a neutral state and after idiosyncratic negative emotion induction while electroencephalography (EEG) was recorded. The EEG data were analyzed using a mass testing approach.
RESULTS
Individuals with AN showed reduced pleasantness for foods compared to objects alongside elevated widespread occipito-central food-object discrimination between 170 and 535 ms, indicative of strong neural cue-reactivity. Food-object discrimination was further increased in the negative emotional condition between 690 and 1200 ms over centroparietal regions. Neither of these effects was seen in individuals with BN.
DISCUSSION
Emotion modulated food-cue-reactivity in AN might reflect a decreased appetitive response in negative mood. Such specific (emotion-)regulatory strategies require more theoretical work and clinical attention. The absence of any marked effects in BN suggests that emotional cue-reactivity might be less prominent in this group or quite specific to certain emotional contexts or food types.
PUBLIC SIGNIFICANCE
Negative affectivity is a risk factor for the development of eating disorders and individuals with eating disorders experience problems with emotion regulation. To better understand the effects of negative emotions, the present study investigated how they affected neural correlates of food perception in anorexia nervosa and bulimia nervosa.
Topics: Humans; Anorexia Nervosa; Bulimia Nervosa; Cues; Emotions; Electroencephalography
PubMed: 37565581
DOI: 10.1002/eat.24028