-
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 -
American Family Physician Jun 1998Bulimia nervosa is characterized by binge eating and inappropriate compensatory behaviors, such as vomiting, fasting, excessive exercise and the misuse of diuretics,... (Review)
Review
Bulimia nervosa is characterized by binge eating and inappropriate compensatory behaviors, such as vomiting, fasting, excessive exercise and the misuse of diuretics, laxatives or enemas. Although the etiology of this disorder is unknown, genetic and neurochemical factors have been implicated. Bulimia nervosa is 10 times more common in females than in males and affects up to 3 percent of young women. The condition usually becomes symptomatic between the ages of 13 and 20 years, and it has a chronic, sometimes episodic course. The long-term outcome has not been clarified. Other psychiatric conditions, including substance abuse, are frequently associated with bulimia nervosa and may compromise its diagnosis and treatment. Serious medical complications of bulimia nervosa are uncommon, but patients may suffer from dental erosion, swollen salivary glands, oral and hand trauma, gastrointestinal irritation and electrolyte imbalances (especially of potassium, calcium, sodium and hydrogen chloride). Treatment strategies are based on medication, psychotherapy or a combination of these modalities.
Topics: Behavior Therapy; Bulimia; Cognitive Behavioral Therapy; Diagnosis, Differential; Humans; Prevalence; Prognosis; Referral and Consultation
PubMed: 9636337
DOI: No ID Found -
Journal of Obstetric, Gynecologic, and... 1992Bulimia is a serious eating disorder that affects up to 19% of women in the United States. Research shows that bulimia may present a threat to the normal course of... (Review)
Review
Bulimia is a serious eating disorder that affects up to 19% of women in the United States. Research shows that bulimia may present a threat to the normal course of pregnancy. Nursing can play an important role in the prevention of maternal and neonatal morbidity through the early detection of bulimia. Bulimia and its impact on pregnancy are described to assist nurses in the early detection and referral of women with this disorder.
Topics: Bulimia; Female; Humans; Maternal-Child Nursing; Medical History Taking; Nursing Assessment; Physical Examination; Pregnancy; Pregnancy Complications; Pregnancy Outcome
PubMed: 1640276
DOI: 10.1111/j.1552-6909.1992.tb02256.x -
Appetite Jun 2009To examine the literature on binge eating to gain a better understanding of its biological foundations and their role in eating disorders. (Review)
Review
OBJECTIVE
To examine the literature on binge eating to gain a better understanding of its biological foundations and their role in eating disorders.
METHOD
Literature review and synthesis.
RESULTS
Research using animal models has revealed several factors that contribute to the development and maintenance of binge eating. These factors, including stress, food restriction, the presence of palatable foods, and environmental conditioning, parallel many of the precursory circumstances leading to binge eating in individuals with bulimia nervosa and binge eating disorder.
DISCUSSION
The animal literature has opened a new avenue to aid in the understanding of the neurobiological basis of binge eating. Future endeavors examining the genetic and environmental correlates of binge eating behavior will further contribute to the understanding of the biological foundations of binge eating and assist with establishing diagnostic criteria and the development of novel treatments for eating disorders marked by binge eating.
Topics: Analgesics, Opioid; Animals; Behavior, Addictive; Bulimia; Bulimia Nervosa; Disease Models, Animal; Dopamine; Environment; Food Deprivation; Food Preferences; Humans; Hyperphagia; Stress, Psychological; Taste
PubMed: 19501749
DOI: 10.1016/j.appet.2009.03.005 -
Pharmacology, Biochemistry, and Behavior Feb 2017This review examines the merits of 'food addiction' as an explanation of excessive eating (i.e., eating in excess of what is required to maintain a healthy body weight).... (Review)
Review
This review examines the merits of 'food addiction' as an explanation of excessive eating (i.e., eating in excess of what is required to maintain a healthy body weight). It describes various apparent similarities in appetites for foods and drugs. For example, conditioned environmental cues can arouse food and drug-seeking behaviour, 'craving' is an experience reported to precede eating and drug taking, 'bingeing' is associated with both eating and drug use, and conditioned and unconditioned tolerance occurs to food and drug ingestion. This is to be expected, as addictive drugs tap into the same processes and systems that evolved to motivate and control adaptive behaviours, including eating. The evidence, however, shows that drugs of abuse have more potent effects than foods, particularly in respect of their neuroadaptive effects that make them 'wanted.' While binge eating has been conceptualised as form of addictive behaviour, it is not a major cause of excessive eating, because binge eating has a far lower prevalence than obesity. Rather, it is proposed that obesity results from recurrent overconsumption of energy dense foods. Such foods are, relatedly, both attractive and (calorie for calorie) weakly satiating. Limiting their availability could partially decrease excessive eating and consequently decrease obesity. Arguably, persuading policy makers that these foods are addictive could support such action. However, blaming excessive eating on food addiction could be counterproductive, because it risks trivialising serious addictions, and because the attribution of excessive eating to food addiction implies an inability to control one's eating. Therefore, attributing everyday excessive eating to food addiction may neither explain nor significantly help reduce this problem.
Topics: Appetite; Bulimia; Craving; Drug Tolerance; Drug-Seeking Behavior; Humans; Motivation; Obesity; Reward; Substance Withdrawal Syndrome; Substance-Related Disorders
PubMed: 28063947
DOI: 10.1016/j.pbb.2017.01.001 -
Physiology & Behavior 1987Binge-eating episodes in bulimia often involve sweet or fat-containing foods. Sensory perceptions and preferences for sweetness and fat content were examined in 16...
Binge-eating episodes in bulimia often involve sweet or fat-containing foods. Sensory perceptions and preferences for sweetness and fat content were examined in 16 normal-weight women with a diagnosis of DSM IIIR bulimia and in 16 normal-weight volunteer controls. Taste stimuli were 15 semi-liquid mixtures of dessert-type soft white cheese ("fromage blanc") containing 0, 3 or 7 grams of fat per 100 g, and sweetened with 1, 5, 10, 20, or 40% sucrose (wt./wt.). The subjects used 9-point category scales to rate the perceived sweetness and fat content of the stimuli, and assigned a pleasantness (hedonic) rating to each sample. Taste preferences were modelled using the Response Surface Method (RSM). Mean estimates of sweetness intensity and fat content were generally similar for bulimic patients and controls. In contrast, profiles of taste preference differed significantly between groups. Optimal stimulus sweetness was 15% sucrose wt./wt. for bulimic patients and only 9% for controls, while optimal fat levels were lower for bulimic patients relative to controls. The present data are consistent with previous reports that patients with eating disorders crave sweetness but show reduced sensory preferences for fat-containing foods.
Topics: Adult; Bulimia; Dietary Carbohydrates; Dietary Fats; Female; Food Preferences; Humans; Taste
PubMed: 3441532
DOI: 10.1016/0031-9384(87)90320-9 -
Revista de Saude Publica Aug 2009A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia... (Review)
Review
A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia nervosa patients. Articles were critically reviewed and a meta-synthesis analysis was carried out based on a meta-ethnographic method to analyze and summarize data. Of a total of 3,415 studies, nine met the study inclusion and exclusion criteria. Reciprocal translation was used for data interpretation allowing to identifying two concepts: disease awareness and disease impacts. Feelings of impotence were often described in family reorganization. The study results point to distortions in the concept of disease associated with family involvement, resulting in changes in communication, attitudes, and behaviors in a context of impotence.
Topics: Anorexia Nervosa; Bulimia; Family; Family Relations; Health Knowledge, Attitudes, Practice; Humans; Qualitative Research
PubMed: 19503976
DOI: 10.1590/s0034-89102009005000035 -
Journal of the American Academy of... Apr 1998To critically review the research in juvenile anorexia nervosa and bulimia nervosa over the past 10 years and highlight recent advances in normal development as it... (Review)
Review
OBJECTIVE
To critically review the research in juvenile anorexia nervosa and bulimia nervosa over the past 10 years and highlight recent advances in normal development as it pertains to these disorders and their diagnosis, prevention, and treatment.
METHOD
Computerized search methods were combined with manual searches of the literature. A detailed review of the most salient articles is provided. Preference was given to studies involving children and adolescents that approached the subject from a developmental perspective.
RESULTS
The information from these studies is presented in a developmental framework. Research in eating disorders has progressed, but definitive longitudinal data are still absent from the literature. Research specific to treatment of child and adolescent eating disorders remains rare.
CONCLUSIONS
Data approaching eating disorders from a developmental perspective are available in only a few studies. Research is needed addressing normative data on the development of eating behavior and specific risk and resilience factors for pathology in specific developmental periods. Especially lacking are studies regarding the continuities and discontinuities of eating disturbances across the life span. Best documented are epidemiological studies of prevalence and incidence, long-term outcome in anorexia nervosa, and short-term treatment response in bulimia.
Topics: Adolescent; Anorexia Nervosa; Bulimia; Child; Disease Progression; Female; Humans; Male; Risk Factors; Treatment Outcome
PubMed: 9549954
DOI: 10.1097/00004583-199804000-00011 -
Nutrients Jun 2023Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED... (Review)
Review
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
Topics: Humans; Adolescent; Child; Binge-Eating Disorder; Food, Processed; Bulimia; Brain; Neuroimaging
PubMed: 37447320
DOI: 10.3390/nu15132994 -
Journal of Psychiatry & Neuroscience :... May 2018Frontostriatal and frontoparietal abnormalities likely contribute to deficits in control and attentional processes in individuals with bulimia nervosa and to the...
BACKGROUND
Frontostriatal and frontoparietal abnormalities likely contribute to deficits in control and attentional processes in individuals with bulimia nervosa and to the persistence of dysregulated eating across development. This study assessed these processes and cortical thickness in a large sample of adolescent girls and women with bulimia nervosa compared with healthy controls.
METHODS
We collected anatomical MRI data from adolescent girls and women (ages 12-38 yr) with full or subthreshold bulimia nervosa and age-matched healthy controls who also completed the Conners Continuous Performance Test-II (CPT-II). Groups were compared on task performance and cortical thickness. Mediation analyses explored associations among cortical thickness, CPT-II variables, bulimia nervosa symptoms and age.
RESULTS
We included 60 girls and women with bulimia nervosa and 54 controls in the analyses. Compared with healthy participants, those with bulimia nervosa showed increased impulsivity and inattention on the CPT-II, along with reduced thickness of the right pars triangularis, right superior parietal and left dorsal posterior cingulate cortices. In the bulimia nervosa group, exploratory analyses revealed that binge eating frequency correlated inversely with cortical thickness of frontoparietal and insular regions and that reduced frontoparietal thickness mediated the association between age and increased symptom severity and inattention. Binge eating frequency also mediated the association between age and lower prefrontal cortical thickness.
LIMITATIONS
These findings are applicable to only girls and women with bulimia nervosa, and our cross-sectional design precludes understanding of whether cortical thickness alterations precede or result from bulimia nervosa symptoms.
CONCLUSION
Structural abnormalities in the frontoparietal and posterior cingulate regions comprising circuits that support control and attentional processes should be investigated as potential contributors to the maintenance of bulimia nervosa and useful targets for novel interventions.
Topics: Adolescent; Adult; Age Factors; Atrophy; Attention; Bulimia; Bulimia Nervosa; Case-Control Studies; Cerebral Cortex; Child; Cross-Sectional Studies; Female; Humans; Impulsive Behavior; Magnetic Resonance Imaging; Young Adult
PubMed: 29688871
DOI: 10.1503/jpn.170070