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The Western Journal of Medicine Dec 1992Anorexia nervosa and bulimia nervosa are prevalent illnesses affecting between 1% and 10% of adolescent and college age women. Developmental, family dynamic, and... (Review)
Review
Anorexia nervosa and bulimia nervosa are prevalent illnesses affecting between 1% and 10% of adolescent and college age women. Developmental, family dynamic, and biologic factors are all important in the cause of this disorder. Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea. A diagnosis of bulimia nervosa is made when a person has recurrent episodes of binge eating, a feeling of lack of control over behavior during binges, regular use of self-induced vomiting, laxatives, diuretics, strict dieting, or vigorous exercise to prevent weight gain, a minimum of 2 binge episodes a week for at least 3 months, and persistent overconcern with body shape and weight. Patients with eating disorders are usually secretive and often come to the attention of physicians only at the insistence of others. Practitioners also should be alert for medical complications including hypothermia, edema, hypotension, bradycardia, infertility, and osteoporosis in patients with anorexia nervosa and fluid or electrolyte imbalance, hyperamylasemia, gastritis, esophagitis, gastric dilation, edema, dental erosion, swollen parotid glands, and gingivitis in patients with bulimia nervosa. Treatment involves combining individual, behavioral, group, and family therapy with, possibly, psychopharmaceuticals. Primary care professionals are frequently the first to evaluate these patients, and their encouragement and support may help patients accept treatment. The treatment proceeds most smoothly if the primary care physician and psychiatrist work collaboratively with clear and frequent communication.
Topics: Adolescent; Adult; Anorexia Nervosa; Behavior Therapy; Bulimia; Feeding and Eating Disorders; Female; Humans; Prognosis
PubMed: 1475950
DOI: No ID Found -
Eating and Weight Disorders : EWD Mar 2022The association of bulimic symptoms with sensation seeking is uncertain; however, both behaviors have been linked to alcohol problems. We assessed in a longitudinal,...
PURPOSE
The association of bulimic symptoms with sensation seeking is uncertain; however, both behaviors have been linked to alcohol problems. We assessed in a longitudinal, community-based setting whether sensation seeking in adolescence is associated with bulimic symptoms in early adulthood, also accounting for alcohol problems.
METHODS
Finnish men (N = 2000) and women (N = 2467) born between 1974-1979 completed Zuckerman's sensation seeking scale (SSS) at age 18. Alcohol problems (Malmö-modified Michigan alcoholism screening test (Mm-MAST) and bulimic symptoms [eating disorder inventory-2, bulimia subscale (EDI-Bulimia), population and clinical scoring systems] were defined at age 22-27. We examined relationships between SSS, Mm-MAST, and EDI-Bulimia using Pearson's correlation coefficient (r) and linear regression.
RESULTS
Alcohol problems were moderately correlated with sensation seeking and bulimic symptoms (population scoring) among women and men (r = 0.21-0.31). The correlation between sensation seeking and bulimic symptoms (population scoring) was weak among men (r = 0.06, p = 0.006) and even weaker and non-significant among women (r = 0.03, p = 0.214). Adjustment for alcohol problems removed the association between sensation seeking and bulimic symptoms among men. Furthermore, there were no significant correlations between sensation seeking and bulimic symptoms when assessing EDI-Bulimia clinical scoring.
CONCLUSION
Sensation seeking and bulimic symptoms were not associated among women. The association between sensation seeking and bulimic symptoms among men was entirely attributable to increased alcohol problems among those with higher sensation seeking. While this association may be important on the population level, its clinical significance may be minor.
LEVEL OF EVIDENCE
Level III, well-designed cohort study.
Topics: Adolescent; Adult; Alcohol-Related Disorders; Bulimia; Cohort Studies; Female; Humans; Longitudinal Studies; Male; Sensation; Young Adult
PubMed: 33900563
DOI: 10.1007/s40519-021-01193-6 -
Revista Da Associacao Medica Brasileira... Dec 2020The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological... (Review)
Review
INTRODUCTION
The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report.
METHODS
The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms "anorexia nervosa", "bulimia nervosa", "comorbidity" and "psychotic disorders".
RESULTS
The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms.
CONCLUSIONS
The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.
Topics: Anorexia Nervosa; Bulimia; Comorbidity; Feeding and Eating Disorders; Female; Humans; Psychotic Disorders
PubMed: 33331586
DOI: 10.1590/1806-9282.66.12.1736 -
Physiology & Behavior Sep 2019Recent research indicates that weight suppression (WS: defined as the difference between highest lifetime and current weight) prospectively predicts illness trajectory... (Review)
Review
Recent research indicates that weight suppression (WS: defined as the difference between highest lifetime and current weight) prospectively predicts illness trajectory across eating disorders characterized by binge eating, including AN binge-purge subtype (ANbp), bulimia nervosa (BN), and binge eating disorder (BED), collectively referred to as bulimic eating disorders. Through a series of studies, we have developed a model to explain the link between WS and illness trajectory in bulimic eating disorders. Our model posits that WS contributes to reduced circulating leptin, which leads to reduced postprandial glucagon-like peptide 1 (GLP-1) response. Diminished leptin and GLP-1 function contribute to alterations in two reward-related constructs in the Research Domain Criteria (RDoC): reward value/effort and reward satiation. Respectively, these changes increase drive/motivation to consume food and decrease ability for food consumption to lead to a state of satiation/satisfaction. Combined, these alterations increase risk for experiencing large, out-of-control binge-eating episodes. The following review presents evidence that contributed to the development of this model as well as preliminary findings from an on-going project funded to test this model.
Topics: Binge-Eating Disorder; Body-Weight Trajectory; Bulimia; Bulimia Nervosa; Humans; Models, Psychological; Reward
PubMed: 31153878
DOI: 10.1016/j.physbeh.2019.112565 -
BMC Psychiatry Jun 2020The Binge Eating Genetics Initiative (BEGIN) is a multipronged investigation examining the interplay of genomic, gut microbiota, and behavioral factors in bulimia...
BACKGROUND
The Binge Eating Genetics Initiative (BEGIN) is a multipronged investigation examining the interplay of genomic, gut microbiota, and behavioral factors in bulimia nervosa and binge-eating disorder.
METHODS
1000 individuals who meet current diagnostic criteria for bulimia nervosa or binge-eating disorder are being recruited to collect saliva samples for genotyping, fecal sampling for microbiota characterization, and recording of 30 days of passive data and behavioral phenotyping related to eating disorders using the app Recovery Record adapted for the Apple Watch.
DISCUSSION
BEGIN examines the interplay of genomic, gut microbiota, and behavioral factors to explore etiology and develop predictors of risk, course of illness, and response to treatment in bulimia nervosa and binge-eating disorder. We will optimize the richness and longitudinal structure of deep passive and active phenotypic data to lay the foundation for a personalized precision medicine approach enabling just-in-time interventions that will allow individuals to disrupt eating disorder behaviors in real time before they occur.
TRIAL REGISTRATION
The ClinicalTrials.gov identifier is NCT04162574. November 14, 2019, Retrospectively Registered.
Topics: Binge-Eating Disorder; Bulimia; Bulimia Nervosa; Feeding Behavior; Feeding and Eating Disorders; Humans
PubMed: 32546136
DOI: 10.1186/s12888-020-02698-7 -
Obesity Reviews : An Official Journal... Feb 2016According to learning-based models of behavior, food cue reactivity and craving are conditioned responses that lead to increased eating and subsequent weight gain.... (Meta-Analysis)
Meta-Analysis Review
According to learning-based models of behavior, food cue reactivity and craving are conditioned responses that lead to increased eating and subsequent weight gain. However, evidence supporting this relationship has been mixed. We conducted a quantitative meta-analysis to assess the predictive effects of food cue reactivity and craving on eating and weight-related outcomes. Across 69 reported statistics from 45 published reports representing 3,292 participants, we found an overall medium effect of food cue reactivity and craving on outcomes (r = 0.33, p < 0.001; approximately 11% of variance), suggesting that cue exposure and the experience of craving significantly influence and contribute to eating behavior and weight gain. Follow-up tests revealed a medium effect size for the effect of both tonic and cue-induced craving on eating behavior (r = 0.33). We did not find significant differences in effect sizes based on body mass index, age, or dietary restraint. However, we did find that visual food cues (e.g. pictures and videos) were associated with a similar effect size to real food exposure and a stronger effect size than olfactory cues. Overall, the present findings suggest that food cue reactivity, cue-induced craving and tonic craving systematically and prospectively predict food-related outcomes. These results have theoretical, methodological, public health and clinical implications.
Topics: Behavior, Addictive; Bulimia; Craving; Cues; Evidence-Based Practice; Feeding Behavior; Food; Humans; Impulsive Behavior; Obesity; Weight Gain
PubMed: 26644270
DOI: 10.1111/obr.12354 -
International Journal of Environmental... Aug 2020The objective of this study is to assess the effect of alcohol consumption, anxiety, and food restriction before and after consuming alcohol and body image on the risk...
The objective of this study is to assess the effect of alcohol consumption, anxiety, and food restriction before and after consuming alcohol and body image on the risk of anorexia and bulimia in college students from Tijuana, Baja California, through predictive statistical models. A quantitative, descriptive, and cross-sectional design and a non-probabilistic sample of 526 college students from Tijuana, Baja California, México were used. Application of the scales (with acceptable psychometric properties) was conducted in classrooms. Through path analyses, four models were found with adequate indicators of goodness of fit: (1) risk of anorexia in women [Chi Square (X) = 5.34, = 0.376, Adjusted Determination Coefficient (R)= 0.250]; (2) anorexia risk for men (X = 13.067, = 0.192, R = 0.058); (3) risk of bulimia in women (X = 3.358, = 0.645, R = 0.202); and bulimia risk for men (X = 14.256, = 0.075, R = 0.284). The findings provide empirical evidence for the food and alcohol disturbance model.
Topics: Alcohol Drinking; Anorexia; Anorexia Nervosa; Anxiety; Bulimia; Cross-Sectional Studies; Female; Humans; Male; Mexico
PubMed: 32872410
DOI: 10.3390/ijerph17176293 -
Journal of General Internal Medicine Aug 2000To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications. (Review)
Review
OBJECTIVE
To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications.
DESIGN
A review of literature from 1994 to 1999 identified by a MEDLINE search on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa.
MEASUREMENTS AND MAIN RESULTS
Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia).
CONCLUSION
Primary care providers have an important role in detecting and managing eating disorders.
Topics: Anorexia Nervosa; Antidepressive Agents; Bulimia; Diabetes Complications; Feeding and Eating Disorders; Female; Humans; Male; Patient Care Team; Primary Health Care; Prognosis; Psychotherapy; Risk Factors; Sex Factors; Sports
PubMed: 10940151
DOI: 10.1046/j.1525-1497.2000.02439.x -
BMC Psychiatry May 2023Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be... (Observational Study)
Observational Study
BACKGROUND
Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN.
METHODS
This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175).
RESULTS
Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia.
CONCLUSION
Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.
Topics: Humans; Young Adult; Bulimia Nervosa; Bulimia; Emotional Regulation; Mental Health; Cross-Sectional Studies; Binge-Eating Disorder
PubMed: 37173734
DOI: 10.1186/s12888-023-04847-0 -
Nutrients Jan 2018The feeding process is required for basic life, influenced by environment cues and tightly regulated according to demands of the internal milieu by regulatory brain... (Review)
Review
The feeding process is required for basic life, influenced by environment cues and tightly regulated according to demands of the internal milieu by regulatory brain circuits. Although eating behaviour cannot be considered "addictive" under normal circumstances, people can become "addicted" to this behaviour, similarly to how some people are addicted to drugs. The symptoms, cravings and causes of "eating addiction" are remarkably similar to those experienced by drug addicts, and both drug-seeking behaviour as eating addiction share the same neural pathways. However, while the drug addiction process has been highly characterised, eating addiction is a nascent field. In fact, there is still a great controversy over the concept of "food addiction". This review aims to summarize the most relevant animal models of "eating addictive behaviour", emphasising binge eating disorder, that could help us to understand the neurobiological mechanisms hidden under this behaviour, and to improve the psychotherapy and pharmacological treatment in patients suffering from these pathologies.
Topics: Animals; Behavior, Animal; Brain; Bulimia; Cues; Disease Models, Animal; Dopamine; Environment; Feeding Behavior; Food Addiction; Genetic Predisposition to Disease; Humans; Neural Pathways; Opioid Peptides; Risk Factors; Signal Transduction
PubMed: 29324652
DOI: 10.3390/nu10010071