WorldWideScience

Sample records for anorexia

  1. Anorexia Nervosa

    Science.gov (United States)

    ... hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to ... job), can lead to the onset of anorexia. Personality traits. Someone with anorexia may not like her ...

  2. Anorexia nervosa

    OpenAIRE

    Lock, James; Fitzpatrick, Kathleen Kara

    2009-01-01

    Anorexia nervosa is characterised by a low BMI, fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea. Estimated prevalence is highest in teenage girls, and may affect up to 0.7% of this group.Anorexia nervosa is related to family, sociocultural, genetic, and other biological factors. Psychiatric and personality disorders such as depression, anxiety disorders, obsessive compulsive disorder, and perfectionism, are commonly found in people who have an...

  3. Anorexia nervosa

    OpenAIRE

    Fitzpatrick, Kathleen Kara; Lock, James

    2011-01-01

    Anorexia nervosa is characterised by a low body mass index (BMI), fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea. Estimated prevalence is highest in teenage girls, and the condition may affect up to 0.7% of this group.Anorexia nervosa is related to family, sociocultural, genetic, and other biological factors. Psychiatric and personality disorders such as depression, anxiety disorders, obsessive compulsive disorder, and perfectionism are commo...

  4. Anorexia Infantil.

    OpenAIRE

    Eva Rivas Cambronero

    2005-01-01

    Se reflexiona sobre las diferencias entre la anorexia infantil y la de la adolescencia constatando la ausencia de adscripción a ideales estéticos e intención de adelgazar en la anorexia de la infancia para poner de manifiesto el verdadero condicionante de ese síntoma: la confusión entre necesidad, demanda y deseo en la relación materno infantil. Se emite una hipótesis etiológica ilustrada con un caso clínico.

  5. Anorexia Nervosa.

    Science.gov (United States)

    Westerlage, Patricia A.

    The author traces the case histories of five anorexic female patients treated in the therapeutic milieu in a psychiatric inpatient unit. The history of anorexia nervosa is reviewed, incidence of the disorder is cited, and common characteristics are described. Case histories are presented in terms of events precipitating the weight loss, behavior…

  6. Anorexia of Aging.

    Science.gov (United States)

    Visvanathan, Renuka

    2015-08-01

    The anorexia of aging is common, leading to adverse health consequences. As populations age, the impacts from anorexia in the older population are set to increase. Only greater awareness will allow for prevention or early intervention. This article discusses the physiologic anorexia of aging, highlights contributing factors, and proposes management strategies, including screening, especially in primary care. Many neuroendocrine factors have been implicated in the pathophysiology; it is clear that further human research is necessary if there is to be a pharmacologic breakthrough. There are currently no approved pharmacologic treatment strategies to prevent or treat the anorexia of aging.

  7. Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Csapo, Marg

    1987-01-01

    The article reviews the literature on anorexia nervosa, with or without bulimia, and presents a comprehensive picture of this eating disorder, focusing on terminology, historical references, prevalence, prognosis, classification, diagnostic criteria, physical and psychological characteristics, evolution of the disability, etiology, treatment, and…

  8. Case 39: Anorexia nervosa

    Science.gov (United States)

    Anorexia nervosa is a disease affecting primarily young women who have distorted body images. Although their weight is less than 30 percent under ideal body weight, they see themselves as overweight. Anorectics often use diuretic and laxative agents to accomplish their weight loss. Patients with bul...

  9. Anorexia nervosa en adolescenten

    NARCIS (Netherlands)

    van Elburg, A A; Danner, U N

    2015-01-01

    BACKGROUND: Anorexia nervosa (AN), which is the most serious of the eating disorders, starts earlier in life and often continues into adulthood. AIM: To discuss the typical features of AN in adolescents. METHOD: We present an overview based on the literature about AN in adolescents and on analysis p

  10. Anorexia: The Cheating Disorder.

    Science.gov (United States)

    Murphy, Richard

    1990-01-01

    Tells two stories concerning the perversity of plagiarism. Discusses how one student's plagiarism was uncovered. Discusses how another student suspected of plagiarizing a personal account of anorexia denied the paper was about herself rather than admit that she was indeed anorexic. Notes that the student's journal entries indicate that she did not…

  11. Anorexia e melancolia

    OpenAIRE

    Mônica Assunção Costa Lima

    2012-01-01

    O texto desenvolve a proposição freudiana, que se encontra no Rascunho G, de que a anorexia é a neurose paralela à melancolia. Propõe que o elo entre melancolia e anorexia deve ser buscado no campo do narcisismo. Explora quatro aspectos da melancolia que permitem a aproximação destas duas afecções, entre elas, a inibição, a perspectiva de uma instância crítica que se diferencia do eu e se volta contra ele, o sadismo com que essa instância crítica trata o eu, e a identificação do eu ao objeto....

  12. Psychobiology of anorexia nervosa.

    Science.gov (United States)

    Ploog, D W; Pirke, K M

    1987-11-01

    The psychobiology of anorexia nervosa is described and explained under four headings; (1) the psychopathology as related to the motivation for fasting; (2) metabolic and somatic consequences of starvation, including brain morphology; (3) endocrine abnormalities in the hypothalamic-pituitary-adrenal and gonadal axis; and (4) the hunger drive and its possible perversions in terms of aspects of neuroethology and the reward system in the brain.

  13. Anorexia Nervosa and Bone

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors...

  14. Anorexia nervosa en adolescenten

    OpenAIRE

    van Elburg, A A; Danner, U N

    2015-01-01

    BACKGROUND: Anorexia nervosa (AN), which is the most serious of the eating disorders, starts earlier in life and often continues into adulthood. AIM: To discuss the typical features of AN in adolescents. METHOD: We present an overview based on the literature about AN in adolescents and on analysis performed by experts. RESULTS: Youngsters with AN run considerable physical risks because their bodies are less well developed and are more easily injured. These injuries can be a lifelong handicap ...

  15. Early onset anorexia nervosa.

    OpenAIRE

    Fosson, A; Knibbs, J; Bryant-Waugh, R; Lask, B

    1987-01-01

    This paper describes 48 children, aged 14 years or less, who met diagnostic criteria for anorexia nervosa modified from Morgan and Russell. The characteristics of the sample (13 boys and 35 girls) are described along with features of the illness, associated family characteristics, treatment in hospital, and a brief description of treatment. Difficulties in diagnosis are addressed, with reference in particular to the high incidence of depression in this group. Finally, the importance and diffi...

  16. Acrocyanosis in anorexia nervosa.

    OpenAIRE

    Bhanji, S; Mattingly, D

    1991-01-01

    Acrocyanosis, an uncommon disorder of the peripheral circulation, may occur in patients with anorexia nervosa. It is not known why this should be, nor whether acrocyanosis correlates with any other features of the disorder. The findings in an unselected series of 155 anorectics are reported. Acrocyanosis occurred in 32 and was more prevalent among the more severely ill. It was associated also with pallor of the face and trunk, slower pulse rates and higher fasting plasma glucose levels. Acroc...

  17. Dopamine and anorexia nervosa.

    Science.gov (United States)

    Södersten, P; Bergh, C; Leon, M; Zandian, M

    2016-01-01

    We have suggested that reduced food intake increases the risk for anorexia nervosa by engaging mesolimbic dopamine neurons, thereby initially rewarding dieting. Recent fMRI studies have confirmed that dopamine neurons are activated in anorexia nervosa, but it is not clear whether this response is due to the disorder or to its resulting nutritional deficit. When the body senses the shortage of nutrients, it rapidly shifts behavior toward foraging for food as a normal physiological response and the mesolimbic dopamine neurons may be involved in that process. On the other hand, the altered dopamine status of anorexics has been suggested to result from a brain abnormality that underlies their complex emotional disorder. We suggest that the outcomes of the treatments that emerge from that perspective remain poor because they target the mental symptoms that are actually the consequences of the food deprivation that accompanies anorexia. On the other hand, a method that normalizes the disordered eating behavior of anorexics results in much better physiological, behavioral, and emotional outcomes. PMID:26608248

  18. Adolescent Eating Disorder: Anorexia Nervosa.

    Science.gov (United States)

    Muuss, Rolf E.

    1985-01-01

    Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…

  19. Severe hypophosphataemia in anorexia nervosa.

    OpenAIRE

    Cariem, A. K.; Lemmer, E. R.; Adams, M. G.; Winter, T. A.; O'Keefe, S J

    1994-01-01

    In addition to well-described acid-base and electrolyte disturbances, anorexia nervosa may be complicated by severe hypophosphataemia. We report a case of anorexia nervosa complicated by life-threatening hypophosphataemia manifesting as generalized muscle weakness and bulbar muscle dysfunction, resulting in an aspiration pneumonia and cardiorespiratory arrest.

  20. Anorexia nervosa and necrotizing colitis.

    OpenAIRE

    Kaye, J. C.; Madden, M V; Leaper, D J

    1985-01-01

    Anorexia nervosa is associated with a mortality approaching 5% in patients severely enough affected to warrant hospital care (Hsu, 1980). The main causes of death are inanition, electrolyte disturbances or suicide. We report here a case of necrotizing colitis associated with anorexia nervosa, an association which has not been described previously.

  1. Anorexia Nervosa: Sociocultural Factors and Treatment.

    Science.gov (United States)

    Williams, Jennifer

    This paper examines how the epidemiological findings of anorexia nervosa lead theorists to speculate a correlation between sociocultural factors and the development of anorexia nervosa. A section on the essential features of anorexia nervosa identifies five primary characteristics of anorexia: (1) severe weight loss; (2) a disturbance of body…

  2. [Franz Kafka's anorexia nervosa].

    Science.gov (United States)

    Fichter, M M

    1988-07-01

    The evidence for the hypothesis that the poet Franz Kafka had suffered from an atypical anorexia nervosa is presented. Kafka was slim and underweight throughout his life and showed an ascetic attitude and abjuration of physical enjoyment and pleasure (fasting, vegetarianism, sexual abstinence, emphasis on physical fitness). The analysis is mainly based on Kafka's own descriptions in his letters, diaries, and literary work. Kafka was achievement oriented, reported many sadomasochistic fantasies, and had an anancastic (obsessive-compulsive) depressive personality. In addition there is evidence for a disturbed psychosexual and gender identity development. Our results concerning Kafka's psychopathology do not question his genius as a poet. PMID:3061914

  3. [Franz Kafka's anorexia nervosa].

    Science.gov (United States)

    Fichter, M M

    1988-07-01

    The evidence for the hypothesis that the poet Franz Kafka had suffered from an atypical anorexia nervosa is presented. Kafka was slim and underweight throughout his life and showed an ascetic attitude and abjuration of physical enjoyment and pleasure (fasting, vegetarianism, sexual abstinence, emphasis on physical fitness). The analysis is mainly based on Kafka's own descriptions in his letters, diaries, and literary work. Kafka was achievement oriented, reported many sadomasochistic fantasies, and had an anancastic (obsessive-compulsive) depressive personality. In addition there is evidence for a disturbed psychosexual and gender identity development. Our results concerning Kafka's psychopathology do not question his genius as a poet.

  4. Anorexia nervosa during pregnancy.

    OpenAIRE

    Goldman, Ran D.; Koren, Gideon

    2003-01-01

    QUESTION: A 22-year-old patient in my clinic was diagnosed with anorexia nervosa (AN) 7 years ago. She is now married and planning her first pregnancy. She is still underweight. What should she expect during pregnancy, and are there any implications for her unborn baby? ANSWER: Women with AN are at higher risk of complications during pregnancy, mainly because of low body weight. Apgar scores and birth weights of infants born to mothers with AN have been found to be significantly lower than th...

  5. Lengdevekst ved anorexia nervosa

    OpenAIRE

    Mortensen, Synnøve Gjelsten

    2012-01-01

    Bakgrunn:Normal pubertetsutvikling krever god ernæringsstatus og normale hormonelle forhold. Ved anorexia nervosa (AN) sees en rekke endokrine adaptasjonsresponser sekundært til sult, bl.a. hypogonadotrop hypogonadisme og en karakteristisk, høy GH-sekresjon med perifer GH-resistans og medfølgende lav produksjon av IGF-1 i lever og annet vev. Det er observert at mange som behandles for AN er små for alderen og forblir lave etter tilfriskning. Dette kan skyldes at den dysfunksjonelle regulering...

  6. Cachexia Syndrome, anorexia patient

    International Nuclear Information System (INIS)

    Introduction: Two thirds of patients (ptes) cancer present slimming recognized a negative prognostic factor. Anorexia cachexia syndrome (SCA) results from the interaction of multiple factors and causes death of 22% of these patients. Nutritional support produces a moderate recovery weight without affecting the underlying metabolic disorders. Objectives: Conduct a review of current knowledge of the underlying pathophysiology and management the cachexia-anorexia syndrome in cancer patients. Designing indications possible policy interventions in the management of these patients. Method: Performed an a literature review on SCA. Conclusions: We identify patients at risk for early implementation of non-pharmacological measures preventive. The control side effects to treatment oncospecific with particular attention to the need for antiemetics, laxatives / antidiarrheal control dental and proper pain management is fundamental. Keep track enteral is a priority. In those with swallowing disorders or dysphagia, nasogastric feeding tube should be considered early. Indications for gastrostomy / jejunostomy and total parenteral nutrition (TPN) are very limited. The NPT is a complementary treatment maneuver a temporary and reversible complication, in order to prevent deterioration

  7. Homeostasis in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Per eSodersten

    2014-08-01

    Full Text Available Brainstem and hypothalamic orexigenic/anorexigenic networks are thought to maintain body weight homeostasis in response to hormonal and metabolic feedback from peripheral sites. This approach has not been successful in managing over- and underweight patients. It is suggested that concept of homeostasis has been misinterpreted; rather than exerting control, the brain permits eating in proportion to the amount of physical activity necessary to obtain food. In support, animal experiments have shown that while a hypothalamic orexigen excites eating when food is abundant, it inhibits eating and stimulates foraging when food is in short supply. As the physical price of food approaches zero, eating and body weight increase without constraints. Conversely, in anorexia nervosa body weight is homeostatically regulated, the high level of physical activity in anorexia is displaced hoarding for food that keeps body weight constantly low. A treatment based on this point of view, providing patients with computerized mealtime support to re-establish normal eating behavior, has brought 75% of patients with eating disorders into remission, reduced the rate of relapse to 10%, and eliminated mortality.

  8. Anorexia nervosa: an Indian perspective.

    Science.gov (United States)

    Mendhekar, D N; Arora, K; Lohia, D; Aggarwal, A; Jiloha, R C

    2009-01-01

    Anorexia nervosa is a condition thought to be associated with the western culture. However, the recent publication of a case series from Asia suggests that it is a syndrome related to a changing culture. We present a detailed clinical form of this syndrome based on descriptive analysis of 2 cases of anorexia nervosa. Both these patients were adolescent, school-going girls from middle socioeconomic class of urban background. They were pre-morbidly non-obese and did not have any pressures to pursue slimness for beauty. However, there was an identifiable psychosocial stressor as a precipitant in both of them. Both the patients had symptoms of refusal to eat followed by weight loss. We could not identify any risk factor in our patients for anorexia nervosa. Our report illustrates the differences in developmental and psychodynamic issues related to the development of anorexia nervosa, though the clinical symptoms may be similar. PMID:20120991

  9. Acrodermatitis enteropathica with anorexia nervosa.

    Science.gov (United States)

    Kim, Sang Tae; Kang, Jin Seuk; Baek, Jae Woo; Kim, Tae Kwon; Lee, Jin Woo; Jeon, Young Seung; Suh, Kee Suck

    2010-08-01

    Acrodermatitis enteropathica is a rare hereditary or acquired disorder of hypozincemia. It is characterized by acral and periorificial dermatitis, alopecia, diarrhea and growth retardation. Anorexia nervosa is characterized by low body weight, body image distortion with an obsessive fear and is also associated with various cutaneous findings including acrodermatitis enteropathica. We report a 37-year-old female with acrodermatitis enteropathica showing acquired zinc deficiency with anorexia nervosa. PMID:20649716

  10. Neurobiologische Faktoren bei Anorexia nervosa

    OpenAIRE

    Schott, Regina

    2013-01-01

    Central serotonergic pathways may play an important role in the aetiology of anorexia nervosa (AN). This thesis aimed to investigate the serotonergic system in acute patients with anorexia nervosa (acAN), weight-recovered patients (recAN) and healthy controls (HCW). Platelets served as a validated model for peripheral serotonergic neurons. We investigated functional characteristics of the platelet 5-HT transporter, platelet 5-HT content, MAO-B activity and the relationship between MAO-B activ...

  11. Chronic Anorexia Nervosa: Medical Mimic

    OpenAIRE

    Borson, Soo; Katon, Wayne

    1981-01-01

    While anorexia nervosa is typically construed as an acute, dramatic disorder of younger women, long-term follow-up studies indicate that morbidity is chronic or relapsing in 30 percent to 50 percent of cases and sometimes leads to death. In older patients or those with atypical clinical features or obscure complications, chronic starvation may mimic other diseases, and rigid adherence to current diagnostic criteria may impede recognition and appropriate treatment. Anorexia nervosa should be v...

  12. Executive functions in anorexia nervosa

    OpenAIRE

    Ignacio Jauregui-Lobera

    2014-01-01

    Introduction: The pathophysiologic mechanisms that account for the development and persistence of anorexia nervosa (AN) remain unclear. With respect to the neuropsychological functioning, the executive functions have been reported to be altered, especially cognitive flexibility and decision-making processes. Objectives: The aim of this study was to review the current state of the neuropsychological studies focused on anorexia nervosa, especially those highlighting the executive functions. Met...

  13. Reproductive issues in anorexia nervosa

    OpenAIRE

    Hoffman, Elizabeth R.; Zerwas, Stephanie C; Bulik, Cynthia M.

    2011-01-01

    Despite a high prevalence of menstrual irregularities, women with anorexia nervosa are becoming pregnant. The physical and psychological demands of pregnancy and motherhood can represent an immense challenge for women already struggling with the medical and psychological stress of an eating disorder. This article summarizes key issues related to reproduction in women with anorexia nervosa, highlighting the importance of preconception counseling, adequate gestational weight gain, and sufficien...

  14. Anorexia nervosa presenting as reversible hypoglycaemic coma.

    OpenAIRE

    Zalin, A. M.; Lant, A F

    1984-01-01

    Hypoglycaemic coma was the presenting feature in two patients with anorexia nervosa, both of whom rapidly regained consciousness following intravenous administration of glucose. This uncommon complication of malnutrition does not appear to have been reported previously in anorexia nervosa.

  15. Anorexia Nervosa or Not? A Case Presentation

    OpenAIRE

    Swanson, Richard W.; Haight, Kenneth R.

    1989-01-01

    The authors of this article present a case of diabetic gastroparesis, initially diagnosed as anorexia nervosa. They compare the symptoms and signs of diabetic gastroparesis with the diagnostic criteria for anorexia nervosa and discuss treatment with domperidone.

  16. Spontaneous pneumomediastinum: a complication of anorexia nervosa?

    OpenAIRE

    Fergusson, R J; Shaw, T R; Turnbull, C M

    1985-01-01

    We describe a patient with anorexia nervosa who developed a spontaneous pneumomediastinum. Five other patients have been reported with this association, suggesting that tissue changes in anorexia nervosa may predispose to this condition.

  17. Measuring Severity and Change in Anorexia Nervosa.

    Science.gov (United States)

    Piazza, Eugene; And Others

    1983-01-01

    Describes the State of Mind (SOM) Questionnaire, which measures severity and change of clinical state in anorexia nervosa. A study of 42 anorexia patients and 4 control groups showed a strong correlation between depression as measured by the Beck Depression Inventory and the Anorexia Scale, which comprise the SOM. (JAC)

  18. The incidence of anorexia nervosa on Curacao

    NARCIS (Netherlands)

    Hoek, HW; van Harten, PN; Hermans, KME; Katzman, MA; Matroos, GE; Susser, ES

    2005-01-01

    Objective: Although anorexia nervosa was once thought to occur only in affluent societies, cases have now been documented across the globe. To examine whether anorexia nervosa emerges in societies undergoing socioeconomic transition, the authors studied the incidence of anorexia nervosa on the Carib

  19. Anorexia nervosa e retardo mental

    OpenAIRE

    Adriana Trejger Kachani; Táki Athanássios Cordás

    2011-01-01

    OBJETIVO: Revisar a literatura pertinente, observando a prevalência, etiopatogenia, aspectos nutricionais, diagnóstico e tratamento da anorexia nervosa (AN) em pacientes com retardo mental (RM). MÉTODO: Revisão bibliográfica realizada nos sistemas Medline, SciELO e PubMed usando os descritores "transtornos alimentares", "anorexia nervosa" e "retardo mental". RESULTADOS: A AN pode se manifestar de formas atípicas em indivíduos com RM, exigindo critérios diagnósticos específicos. O mais utiliza...

  20. [Caring for teenagers with anorexia].

    Science.gov (United States)

    Lapp, Aymeric

    2015-04-01

    Anorexia mainly affects young girls, although more and more boys and adults are also concerned. The consequences of eating disorders have a significant impact on young people's health. Nurses play a key role in the therapeutic contract set up during the hospital treatment.

  1. Adolescent Boys and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia

    1994-01-01

    Notes that there has been steady increase in reported incidence of male adolescents with anorexia nervosa, from approximately 5% in 1985 to as much as 10% in 1987. Considers role of educators and counselors in early identification of this disorder, noting that young anorectic males have better prognosis for recovery if they receive treatment in…

  2. Hypoglycaemia associated with anorexia nervosa.

    OpenAIRE

    Fonseca, V; Ball, S; Marks, V; Havard, C W

    1991-01-01

    A 41 year old woman with severe emaciation due to longstanding anorexia nervosa presented with recurrent hypoglycaemia. During an episode of hypoglycaemia, serum insulin and C peptide were undetectable and plasma beta hydroxybutyrate, free fatty acids and lactate were inappropriately low. Response to intravenous glucagon was poor. Muscle enzymes were grossly elevated until she gained weight. Hypoglycaemia was abolished by weight gain.

  3. What People with Anorexia Nervosa Need to Know about Osteoporosis

    Science.gov (United States)

    ... Osteoporosis Osteoporosis and Other Conditions What People With Anorexia Nervosa Need to Know About Osteoporosis Publication available ... focus(); */ } //--> Print-Friendly Page April 2016 What Is Anorexia Nervosa? Anorexia nervosa is an eating disorder characterized ...

  4. Anorexia mental e feminilidade Mental anorexia and femininity

    OpenAIRE

    Simone Pencak; Angélica Bastos

    2009-01-01

    Pretende-se discutir a anorexia e sua incidência preponderante em jovens mulheres, extraindo da teorização da experiência indicações para a direção do tratamento psicanalítico. Discute-se a anorexia como sintoma contemporâneo e examina-se a hipótese de uma estratégia de paridade entre os sexos. A resposta anoréxica é articulada à problemática da sexuação no ensino de Jacques Lacan, sendo tal resposta circunscrita ao impasse relativo à inexistência do universal das mulheres. Com um fragmento d...

  5. Anorexia mental e feminilidade Mental anorexia and femininity

    Directory of Open Access Journals (Sweden)

    Simone Pencak

    2009-12-01

    Full Text Available Pretende-se discutir a anorexia e sua incidência preponderante em jovens mulheres, extraindo da teorização da experiência indicações para a direção do tratamento psicanalítico. Discute-se a anorexia como sintoma contemporâneo e examina-se a hipótese de uma estratégia de paridade entre os sexos. A resposta anoréxica é articulada à problemática da sexuação no ensino de Jacques Lacan, sendo tal resposta circunscrita ao impasse relativo à inexistência do universal das mulheres. Com um fragmento de caso, interroga-se a manobra de instituir uma exceção no lado mulher da partilha sexual e aponta-se a função da angústia nesta clínica.This paper aims at discussing anorexia and its predominant incidence among young women, drawing out some indications for psychoanalytical treatment from the experience theorization. Anorexia as a contemporary symptom is discussed and the hypothesis of a parity strategy between the genders is examined. The anorectic response is articulated to the problematic of sexuation in Jacques Lacan's teaching. Such response is circumscribed in the impasse related to the nonexistence of the women's universality. Based on a case fragment, an interrogation is made upon the maneuver to establish an exception on the woman's side of the gender division and the anguish function in this clinic is indicated.

  6. Does Anorexia Nervosa Resemble an Addiction?

    OpenAIRE

    Barbarich-Marsteller, Nicole C.; Foltin, Richard W.; Walsh, B. Timothy

    2011-01-01

    Anorexia nervosa is a severe psychiatric disorder characterized by unrelenting self-starvation and life-threatening weight loss. The relentlessness with which individuals with anorexia nervosa pursue starvation and in some cases exercise despite the negative physical, emotional, and social consequences parallels features of addictive disorders. From a clinical perspective, individuals with anorexia nervosa behave similarly to individuals with substance abuse by narrowing their behavioral repe...

  7. Preservation of macronutrient preferences in cancer anorexia.

    OpenAIRE

    Levine, J A; Morgan, M. Y.

    1998-01-01

    Indirect evidence suggests that cancer anorexia is associated with specific aversions to macronutrients. To investigate this, patients with cancer anorexia and hospitalized control subjects devised 3-day menus comprising foods that they wished to eat. These foods were then provided for 3 days and the intakes of each food carefully measured. As expected, patients with cancer anorexia consumed substantially less energy than hospitalized control subjects (6.0 +/- 0.9 MJ vs 9.5 +/- 0.5 MJ, P < 0....

  8. Treating Anorexia Nervosa in the Couple Context

    OpenAIRE

    Bulik, Cynthia M.; BAUCOM, DONALD H.; Kirby, Jennifer S.

    2012-01-01

    Anorexia nervosa is a serious mental illness that affects women and men of all ages. Despite the gravity of its chronic morbidity, risk of premature death, and societal burden, the evidence base for its treatment—especially in adults—is weak. Guided by the finding that family-based interventions confer benefit in the treatment of anorexia nervosa in adolescents, we developed a cognitive-behavioral couple-based intervention for adults with anorexia nervosa who are in committed relationships th...

  9. The issues of anorexia nervosa in childhood

    OpenAIRE

    ROUBÍKOVÁ, Alice

    2013-01-01

    Anorexia Nervosa is being described as an extreme starving. According to the International Statistical Classification of Diseases and Related Health Problems, it is a disease caused by an intentional weight loss, when the patient avoids most of the meals and uses other ways to lose his weight, for example induced vomiting, using laxatives, diuretics, excessive physical activity. Anorexia Nervosa means not only a physical illness, mostly a psychological disease. Anorexia Nervosa starts usually...

  10. Anorexia Nervosa, Obesity and Bone Metabolism

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Anorexia nervosa and obesity are conditions at the extreme ends of the nutritional spectrum, associated with marked reductions versus increases respectively in body fat content. Both conditions are also associated with an increased risk for fractures. In anorexia nervosa, body composition and hormones secreted or regulated by body fat content are important determinants of low bone density, impaired bone structure and reduced bone strength. In addition, anorexia nervosa is characterized by inc...

  11. Methionine sulfoximine intensifies cancer anorexia.

    Science.gov (United States)

    Chance, W T; Zhang, F S; Fischer, J E

    1991-05-01

    Consistent anorexia was first observed 33 days after inoculating Fischer 344 rats with methylcholanthrene-induced sarcoma. Daily treatment of a similar group of rats with the glutamine synthetase inhibitor, methionine sulfoximine, elicited significant reductions of feeding by day 29 at a dose that had no effect on nontumor-bearing rats. Blood concentrations of ammonia were elevated in both groups of tumor-bearing rats and brain ammonia level was increased in the methionine sulfoximine-treated tumor-bearing rats. Forebrain concentrations of tyrosine, tryptophan, DOPAC and 5-HIAA were elevated in both groups of tumor-bearing rats. Since ammonia is detoxified through the glutamine synthetase reaction, these results suggest that blood and brain ammonia concentrations are more important than the neurochemical consequences of ammonia detoxification for the etiology of cancer anorexia.

  12. Medical Complications of Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Westmoreland, Patricia; Krantz, Mori J; Mehler, Philip S

    2016-01-01

    Anorexia nervosa and bulimia nervosa are serious psychiatric illnesses related to disordered eating and distorted body images. They both have significant medical complications associated with the weight loss and malnutrition of anorexia nervosa, as well as from the purging behaviors that characterize bulimia nervosa. No body system is spared from the adverse sequelae of these illnesses, especially as anorexia nervosa and bulimia nervosa become more severe and chronic. We review the medical complications that are associated with anorexia nervosa and bulimia nervosa, as well as the treatment for the complications. We also discuss the epidemiology and psychiatric comorbidities of these eating disorders.

  13. Endocrine Consequences of Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is prevalent in adolescents and young adults, and endocrine changes include hypothalamic amenorrhea, a nutritionally acquired growth hormone resistance with low insulin like growth factor-1 (IGF-1), relative hypercortisolemia, decreases in leptin, insulin, amylin and incretins, and increases in ghrelin, PYY and adiponectin. These changes in turn have deleterious effects on bone, and may affect neurocognition, anxiety, depression and eating disorder psychopathology. Low b...

  14. Anorexia nervosa and bulimia nervosa.

    OpenAIRE

    Goldbloom, D S; Kennedy, S H; Kaplan, A S; Woodside, D. B.

    1989-01-01

    No definitive therapy exists for anorexia nervosa (AN) or bulimia nervosa (BN). Nevertheless, biologic and psychologic research into these disorders has increased over the last decade. We examine the various drugs available for treatment. Advances in pharmacotherapy for AN have been modest and have reflected efforts either to stimulate hunger and weight gain or to control complications of the starvation process. Food remains the "drug" of choice. Antidepressants have been found to be benefici...

  15. Anorexia nervosa and bone metabolism

    OpenAIRE

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a psychiatric disorder characterized by self-induced starvation with a lifetime prevalence of 2.2% in women. The most common medical co-morbidity in women with AN is bone loss, with over 85% of women having bone mineral density values more than one standard deviation below an age comparable mean. The low bone mass in AN is due to multiple hormonal adaptations to under nutrition, including hypothalamic amenorrhea and growth hormone resistance. Importa...

  16. Anorexia nervosa and pancreatic ascites.

    OpenAIRE

    Isaacs, P.; Saunders, A J; Rosen, B. K.; Sladen, G E

    1986-01-01

    Acute alcoholic pancreatitis was undiagnosed in a patient with anorexia nervosa who subsequently developed pancreatic ascites and oedema, wrongly attributed to protein malnutrition alone. She became hyperphagic in an attempt to reverse the malnutrition and hence the abdominal swelling, indicating that the goal of attaining a thin shape was the major determinant of the eating disorder in this patient. Measurement of ascitic fluid amylase concentration should be carried out in all patients with...

  17. Anorexia nervosa – medical complications

    OpenAIRE

    Mehler, Philip S; Brown, Carrie

    2015-01-01

    In contrast to other mental health disorders, eating disorders have a high prevalence of concomitant medical complications. Specifically, patients suffering from anorexia nervosa (AN) have a litany of medical complications which are commonly present as part of their eating disorders. Almost every body system can be adversely, affected by this state of progressive malnutrition. Moreover, some of the complications can have permanent adverse effects even after there is a successful program of nu...

  18. Psychosomatic syndromes and anorexia nervosa

    OpenAIRE

    Abbate-Daga Giovanni; Delsedime Nadia; Nicotra Barbara; Giovannone Cristina; Marzola Enrica; Amianto Federico; Fassino Secondo

    2013-01-01

    Abstract Background In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. Methods 108 AN inp...

  19. Bone Metabolism in Anorexia Nervosa

    OpenAIRE

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN), a psychiatric disorder predominantly affecting young women, is characterized by self-imposed chronic nutritional deprivation and distorted body image. AN is associated with a number of medical co-morbidities including low bone mass. The low bone mass in AN is due to an uncoupling of bone formation and bone resorption, which is the result of hormonal adaptations aimed at decreasing energy expenditure during periods of low energy intake. Importantly, the low bone mass in ...

  20. Anorexia nervosa und Down Syndrom

    OpenAIRE

    Räder, Klaus; Specht, Friedrich; Reister, Monika

    1989-01-01

    Es wird über eine 24jährige Patientin mit einer Anorexia nervosa (AN) und einem Down-Syndrom (DS) berichtet. Nach Sichtung bisheriger Fallberichte zum gemeinsamen Auftreten beider Krankheiten wird versucht, einen weiteren Beitrag zur kontrovers diskutierten Frage zu leisten, ob bei geistig Retardierten eine primäre Anorexie auftreten kann, oder ob es sich vielmehr um anorektische Reaktionen bei anderweitigen Störungen z.B. im Rahmen depressiver Verstimmung handelt.

  1. QT interval in anorexia nervosa.

    OpenAIRE

    Cooke, R. A.; Chambers, J. B.; Singh, R.; Todd, G J; Smeeton, N C; Treasure, J; Treasure, T.

    1994-01-01

    OBJECTIVES--To determine the incidence of a long QT interval as a marker for sudden death in patients with anorexia nervosa and to assess the effect of refeeding. To define a long QT interval by linear regression analysis and estimation of the upper limit of the confidence interval (95% CI) and to compare this with the commonly used Bazett rate correction formula. DESIGN--Prospective case control study. SETTING--Tertiary referral unit for eating disorders. SUBJECTS--41 consecutive patients wi...

  2. Skin signs in anorexia nervosa

    OpenAIRE

    Strumia, Renata

    2009-01-01

    Anorexia nervosa (AN) is a significant cause of morbidity and mortality among adolescent females and young women. AN is associated with severe medical and psychological consequences, including death, osteoporosis, growth delay, and developmental delay. Skin signs are almost always detectable in severe AN and awareness of them may help in the early diagnosis of hidden AN. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and di...

  3. The paternal function in anorexia

    OpenAIRE

    Giuseppe Nucara

    2012-01-01

    In this work, the problem of anorexia is taken up by giving preference, as the high point of observation, to the area of the so-called relationship with the Other, with particular reference to the unconscious vicissitudes of the Self, mother and father triangulation, in the context of two original psychoanalytical concepts: namely, A. Ferrari's oedipal constellation, and J. Lacan's oedipal significance of the “Name of the Father”. The deepening of these concepts, together with their relation ...

  4. Leptin treatment in activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; Koeners, Maarten P; de Rijke, Corine E; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    BACKGROUND: Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa (AN). In ABA, scheduled feeding together with voluntary access to a running wheel results in increased running wheel activity (RWA), hypophagia, and body weight loss. Previously it was shown that leptin treat

  5. Anorexia Nervosa: Treatment in the Family Context.

    Science.gov (United States)

    Levitt, Dana Heller

    2001-01-01

    One form of treatment for anorexia nervosa that continues to be developed is family therapy. In the following article, anorexia nervosa and its prevalence are defined, theories of its development are discussed, and family therapy interventions that have been applied to the treatment of the disorder are outlined. (Contains 15 references.) (GCP)

  6. Anorexia Nervosa/Bulimia: The Teenager's Dilemma.

    Science.gov (United States)

    Thompson, G. Sue

    Anorexia nervosa and bulimia are currently being studied with great intensity by the medical profession. Anorexia nervosa was first described in the medical literature in 1868, but was considered a rarity until the late 1930's. Bulimia was not identified in the medical literature until 1979. Recent studies suggest that approximately five percent…

  7. Action Monitoring and Perfectionism in Anorexia Nervosa

    Science.gov (United States)

    Pieters, Guido L. M.; de Bruijn, Ellen R. A.; Maas, Yvonne; Hulstijn, Wouter; Vandereycken, Walter; Peuskens, Joseph; Sabbe, Bernard G.

    2007-01-01

    To study action monitoring in anorexia nervosa, behavioral and EEG measures were obtained in underweight anorexia nervosa patients (n=17) and matched healthy controls (n=19) while performing a speeded choice-reaction task. Our main measures of interest were questionnaire outcomes, reaction times, error rates, and the error-related negativity ERP…

  8. Action monitoring and perfectionism in anorexia nervosa

    NARCIS (Netherlands)

    Pieters, G.L.M.; Bruijn, E.R.A. de; Maas, Y.J.; Hulstijn, W.; Eycken, W. van der; Peuskens, J.; Sabbe, B.G.C.C.

    2006-01-01

    To study action monitoring in anorexia nervosa, behavioral and EEG measures were obtained in underweight anorexia nervosa patients (n = 17) and matched healthy controls (n = 19) while performing a speeded choice-reaction task. Our main measures of interest were questionnaire outcomes, reaction times

  9. ANOREXIA FOLLOWING TERMINATION OF PREGNANCY AND LAPROSCOPIC STERILIZATION

    OpenAIRE

    Velayudhan, Ajay; Raghu, T.M.; Sudarshan, B.; Chandra, Prabha S.

    2001-01-01

    Presentations of Anorexia Nervosa in India are usually atypical and anorexia is more commonly a symptom rather than a syndrome. This report highlights a case of anorexia following medical termination of pregnancy and laproscopic sterilisation, its association with conflicts regarding childbirth and motherhood in a 34 year old woman and the impact of anorexia on child rearing.

  10. Executive functions in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Ignacio Jauregui-Lobera

    2014-03-01

    Full Text Available Introduction: The pathophysiologic mechanisms that account for the development and persistence of anorexia nervosa (AN remain unclear. With respect to the neuropsychological functioning, the executive functions have been reported to be altered, especially cognitive flexibility and decision-making processes. Objectives: The aim of this study was to review the current state of the neuropsychological studies focused on anorexia nervosa, especially those highlighting the executive functions. Methods: This was done by means of a searching process covering three relevant electronic databases, as well as an additional search on references included in the analysed papers. Eventually we have to mention other published reviews and a hand-search. Results and discussion: Comparing AN patients and healthy controls the results remain controversial and so remains the comparison of different eating disorders with respect to the neuropsychological dysfunction. The role of variables such as depression, anxiety and obsessionality needs to be clarified. There seems to be some base to state that some commonalities exist in the so-called extreme weight conditions (anorexia, obesity. The link between neuropsychological dysfunction in AN and biomarkers remains unclear. The role of neuropsychological deficits in AN, as initial factors or simply as mere consequences, remains unclear too. The link between the body image disturbances and the neuropsychological dysfunction needs to be clarified. The similarities between the AN neuropsychological dysfunction and that found in other mental disorders may be considered up to date as a mere approach. The same applies to the relationship between the AN patients´ neuropsychological performance and personality or gender.

  11. Case Report on Anorexia Nervosa

    OpenAIRE

    Preeti Srinivasa; Chandrashekar, M; Nikitha Harish; Gowda, Mahesh R.; Sumit Durgoji

    2015-01-01

    Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10 th standard, a homemaker, hailing from an upper social class Hindu (Marvadi) family, living with husband′s family i...

  12. Anorexia Nervosa: A Lifestyle Disorder

    OpenAIRE

    Talbot, Yves

    1983-01-01

    Anorexia nervosa is a real lifestyle disorder. The apparent increase in frequency has been linked to the change of position of women in society. If families have an important role to play in the maintenance of the drama, they also hold the key to its resolution. The family physician in early contact with the anorectic patient is in an important position to involve the family in therapy and maximize the chances of recovery. The steps required are reframing, preparing the family involved for fa...

  13. Krank durch Sport: Anorexia athletica

    OpenAIRE

    Friedmann-Bette B

    2012-01-01

    Sportler aus Sportarten, in denen ein geringes Körpergewicht vorteilhaft für die Leistungsfähigkeit ist, gehen oft durch Reduktion der Kalorienzufuhr bei gleichzeitig hohem Energieverbrauch ein erhebliches Energiedefizit ein. Dabei kommt es häufig zu Essstörungen, für die in besonders gefährdeten Sportarten eine Prävalenz von bis zu 80 % berichtet wird und die sich zur Anorexia nervosa oder Bulimia nervosa entwickeln können. Als Folge des Energiedefizits können Konzentrationsänderun...

  14. Anorexia e bulimia em odontopediatria

    OpenAIRE

    Bezerra, Fernanda Barros

    2015-01-01

    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária Introdução: A procura de um ideal de beleza e a obsessão pela estética imposta pela sociedade moderna em que se vive têm promovido o aumento do número de pessoas com transtornos alimentares, como por exemplo, a anorexia nervosa e a bulimia nervosa. Esses transtornos contribuem para o aumento de pacientes com prejuízos, diretos e indi...

  15. Case report on anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Preeti Srinivasa

    2015-01-01

    Full Text Available Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10 th standard, a homemaker, hailing from an upper social class Hindu (Marvadi family, living with husband′s family in Urban Bangalore; presented to our tertiary care centre with complaints of gradual loss of weight, recurrent episodes of vomiting, from a period of two years, menstrual irregularities from 1 year and amenorrhea since 6 months, with a probable precipitating factor being husband′s critical comment on her weight. Diagnosis of atypical anorexia nervosa was made, with the body mass index (BMI being 15.6. A multidisciplinary therapeutic approach was employed to facilitate remission. Through this case report the authors call for the attention of general practitioners and other medical practitioners to be aware of the symptomatology of eating disorders as most patients would overtly express somatic conditions similar to the reported case so as to facilitate early psychiatric intervention.

  16. Young Women With Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Elisabeth Dahlborg Lyckhage

    2015-03-01

    Full Text Available The aim of this study was to describe how young women living with self-identified anorexia narrate about their lives by blogging. Thirteen Swedish blogs were chosen and analyzed by means of qualitative content analysis. The results described falling ill, the illness itself, and the path to recovery. Low self-esteem, depressed state of mind, and self-destructive behavior were typical signs at the start of the illness. The women’s lives were characterized by a need for controlling their body by tormenting it and by the illness demanding all their concentration and energy. The women suffered from the feeling of being a disappointment to their family members. The illness was like an enemy that had to be defeated with the help of family members, health care professionals, and by means of therapy. A turning point occurred when the women felt at their worst or had tired of the illness and could concentrate on something other than their body and the eating disorder. Suffering from self-identified anorexia was described as experiencing low self-esteem. The illness took all of the women’s time and energy. For a turning point to be reached, the women needed support from family, friends, and health care professionals, including the use of distractions.

  17. Anorexia nervosa: un estudio de casos

    Directory of Open Access Journals (Sweden)

    Lillyana Zusman Tinman

    2013-09-01

    Full Text Available La Anorexia Nervosa es un trastorno de alimentación que se define (etimológicamente como una "pérdida nerviosa del apetito". Se caracteriza por la actitud consciente, voluntaria y rotunda de los sujetos  de tener un exceso de peso que intentan modificar por vía de la inanición. A partir del estudio de casos, se propone la distinción entre una Anorexia Nervosa Estructural -aquella en la que predomina el conflicto intrapsíquico primario y arcaico, y que manifiesta una conducta aislada y retraída- y una Anorexia Nervosa Reactiva, aquella en la que predomina un conflicto intrafamiliar algo más posterior y, por lo tanto, una personalidad más abierta y compatible con el medio. Anorexia Nervosa is an Eating Disorder defined (etimoligacally as a "nervouse loss of apetite". It is characterized by a conscious, voluntary and categoric attitude of the sick patient to refrain from eating. He/she has a firm conviction of having excess weight which they try to modify by starvation. Through a case study, a distinction between two types of Anorexia Nervosa is proposed: a Structural Anorexia Nervosa -in which an intrapsyhic, primary, arcaic conflic prevails, leading to an isolated, withdrawal conduct- and a Reactive Anorexia Nervosa, in which a later intrafamilial conflict prevails leading, therefore, to a more open personality, compatible with the enviroment.

  18. Anorexia Nervosa and Bulimia: A Research Review.

    Science.gov (United States)

    Sweeten, Mary K.

    1985-01-01

    The eating disorders called anorexia nervosa and bulimia are examined in terms of their symptomatology, etiology, and treatment, and in terms of how the extension home economist or teacher can help. Resources for additional information or help are listed. (CT)

  19. Anorexia nervosa: aetiology, assessment, and treatment.

    Science.gov (United States)

    Zipfel, Stephan; Giel, Katrin E; Bulik, Cynthia M; Hay, Phillipa; Schmidt, Ulrike

    2015-12-01

    Anorexia nervosa is an important cause of physical and psychosocial morbidity. Recent years have brought advances in understanding of the underlying psychobiology that contributes to illness onset and maintenance. Genetic factors influence risk, psychosocial and interpersonal factors can trigger onset, and changes in neural networks can sustain the illness. Substantial advances in treatment, particularly for adolescent patients with anorexia nervosa, point to the benefits of specialised family-based interventions. Adults with anorexia nervosa too have a realistic chance of achieving recovery or at least substantial improvement, but no specific approach has shown clear superiority, suggesting a combination of re-nourishment and anorexia nervosa-specific psychotherapy is most effective. To successfully fight this enigmatic illness, we have to enhance understanding of the underlying biological and psychosocial mechanisms, improve strategies for prevention and early intervention, and better target our treatments through improved understanding of specific disease mechanisms. PMID:26514083

  20. Treatment of Adolescents with Anorexia Nervosa.

    Science.gov (United States)

    Patel, Dilip R.; Pratt, Helen D.; Greydanus, Donald E.

    2003-01-01

    Reviews research on the treatment of adolescents with anorexia nervosa, including the general approach, treatment setting, treatment of medical complications, nutritional management, psychopharmacotherapy, psychotherapy, treatment efficacy and outcome studies, comparison studies, and prevention programs. (EV)

  1. New Insights in Anorexia Nervosa.

    Science.gov (United States)

    Gorwood, Philip; Blanchet-Collet, Corinne; Chartrel, Nicolas; Duclos, Jeanne; Dechelotte, Pierre; Hanachi, Mouna; Fetissov, Serguei; Godart, Nathalie; Melchior, Jean-Claude; Ramoz, Nicolas; Rovere-Jovene, Carole; Tolle, Virginie; Viltart, Odile; Epelbaum, Jacques

    2016-01-01

    Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors-the "pondero-nutritional-feeding basements"- are also discussed. PMID:27445651

  2. New Insights in Anorexia Nervosa

    Science.gov (United States)

    Gorwood, Philip; Blanchet-Collet, Corinne; Chartrel, Nicolas; Duclos, Jeanne; Dechelotte, Pierre; Hanachi, Mouna; Fetissov, Serguei; Godart, Nathalie; Melchior, Jean-Claude; Ramoz, Nicolas; Rovere-Jovene, Carole; Tolle, Virginie; Viltart, Odile; Epelbaum, Jacques

    2016-01-01

    Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors—the “pondero-nutritional-feeding basements”- are also discussed. PMID:27445651

  3. Anorexia nervosa: a mistaken diagnosis.

    Science.gov (United States)

    Nicholls, Katie; Boggis, Nicola; Pandya, Nikila

    2016-01-01

    Eating disorders in the form of anorexia and bulimia are becoming increasingly common in young adults and children. Most of the patients are initially seen by their general practitioner (GP) and it may take several months before the facts are pieced together and an underlying eating disorder is identified. However, other medical conditions, albeit rare, should be considered when assessing these young adults as potentially missing them can lead to devastating consequences. This case highlights how a 15-year-old girl who presented to her GP with a history suggestive of an eating disorder and had a body mass index below the 0.4th centile, in fact had classical symptoms and clinical signs of primary adrenal failure, or Addison's disease. PMID:27005795

  4. Update on endocrine disturbances in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Hagen, C

    2001-01-01

    The marked endocrine changes that occur in anorexia nervosa have aroused a great deal of interest, and over the last decade much research has been conducted in this field. The endocrine disturbances are not specific to this disorder, as they also occur in starvation states secondary to other causes...... of the large body of literature concerning endocrine aspects of anorexia nervosa with the main focus on the latest results, which provide leads for potential etiological theories....

  5. Ödipale Konstellationen bei Anorexia nervosa

    OpenAIRE

    Deegener, Günther

    1982-01-01

    Es wird davon ausgegangen, daß ödipale Konflikte bei der Therapie von Patienten mit Anorexia nervosa oft nicht genügend beachtet werden. Nach allgemeinen theoretischen Einführungen zum ödipalen Konflikt sowie der psychosexuellen Entwicklung im Rahmen verschiedener Modellvorstellungen werden diese Probleme dann speziell in den Zusammenhang der Psychodynamik und Pathogenese der Anorexia nervosa integriert. Die Darstellungen werden anhand eines Fallbeispiels verdeutlicht.

  6. Anorexia nervosa e retardo mental

    Directory of Open Access Journals (Sweden)

    Adriana Trejger Kachani

    2011-01-01

    Full Text Available OBJETIVO: Revisar a literatura pertinente, observando a prevalência, etiopatogenia, aspectos nutricionais, diagnóstico e tratamento da anorexia nervosa (AN em pacientes com retardo mental (RM. MÉTODO: Revisão bibliográfica realizada nos sistemas Medline, SciELO e PubMed usando os descritores "transtornos alimentares", "anorexia nervosa" e "retardo mental". RESULTADOS: A AN pode se manifestar de formas atípicas em indivíduos com RM, exigindo critérios diagnósticos específicos. O mais utilizado atualmente é o Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation, conhecido por DC-LC. A prevalência é incerta e o tratamento ainda não está estabelecido, apesar de exigir treinamento específico da equipe. A alimentação costuma ser "pobre" e alimentos que engordam normalmente são evitados. Na maioria das vezes, é difícil acessar a complexa psicopatologia da AN nesses pacientes, em virtude das dificuldades de obter o relato de insatisfação e/ou distorção da imagem corporal, baixa autoestima e crenças alimentares. CONCLUSÃO: Muitos fatores indicam a necessidade de maiores estudos de AN no RM, entre eles a falta de critérios diagnósticos próprios validados e diretrizes para tratamento. Paralelamente, o debate da forma de acesso à conceitualização e ao tratamento dos distúrbios da imagem corporal nessa população deve ser intensificado.

  7. Anorexia

    Science.gov (United States)

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Kreipe RE. Eating disorders. In: Kliegman RM, Stanton BF, St Geme ...

  8. Understanding anorexia: an hermeneutic approach as a methodological alternative for the field of contemporary anorexia research

    Directory of Open Access Journals (Sweden)

    Anne Puuronen

    1999-01-01

    Full Text Available Theories of anorexia nervosa have mainly been dominated by psychiatry and concentrate upon its physiological aspects, both in diagnosis and treatment. This has led to a search for organic causes behind anorectic conditions, instead of seeing it as molded and shaped both by the individual and the socio-cultural context. This "medicalisation" has been an impediment to a more complete conceptualisation of the experience of discipline and of the ascetic modes of action in anorexia. The intension is to approach anorexia as lived process. The focus is not in explaining what cause anorexia, but is centered on the contents of living experience as such. Thus, the author proposes a phenomenological approach to anorexia as a methodological alternative compared to the dominant medico-psychological approaches to anorexia of today. If we consider the body of an anorectic person as an intersection in which the subject's relationship to social reality will be materialized and verified, we are able to see first how accurate a picture of the dual meanings, double bindings and paradoxical commitments of our present culture and its relation to a woman's body anorexia will draw up. Also, because the fact is that anorexia is a predominantly "women's" illness we have to take in account that the construction of subjectivity and in this context the construction of a lived anorectic experience of discipline, is not a gender-neutral process.

  9. Krank durch Sport: Anorexia athletica

    Directory of Open Access Journals (Sweden)

    Friedmann-Bette B

    2012-01-01

    Full Text Available Sportler aus Sportarten, in denen ein geringes Körpergewicht vorteilhaft für die Leistungsfähigkeit ist, gehen oft durch Reduktion der Kalorienzufuhr bei gleichzeitig hohem Energieverbrauch ein erhebliches Energiedefizit ein. Dabei kommt es häufig zu Essstörungen, für die in besonders gefährdeten Sportarten eine Prävalenz von bis zu 80 % berichtet wird und die sich zur Anorexia nervosa oder Bulimia nervosa entwickeln können. Als Folge des Energiedefizits können Konzentrationsänderungen von Stoffwechselhormonen, Störungen der Hypothalamus- Hypophysen-Gonaden-Achse und des Knochenstoffwechsels mit Abnahme der Knochendichte bis hin zur Osteoporose und einem erhöhten Risiko für Stressfrakturen beobachtet werden. Der Symptomkomplex aus Essstörung, sekundärer Amenorrhö und verminderter Knochendichte wird auch als „Female Athlete Triad“ bezeichnet, wobei in den vergangenen Jahren als viertes Symptom eine endotheliale Dysfunktion beschrieben wurde. Die effektivste Therapie ist das Herstellen eines dauerhaften Energiegleichgewichts, wofür eine tägliche Energieverfügbarkeit von mindestens 30 kcal/kg Magergewicht erforderlich ist. Eine hierdurch bedingte Gewichtszunahme kann den Sportlern nicht immer vermittelt werden, weshalb durch eine sorgfältig zusammengestellte Ernährung zumindest auf eine ausreichende Zufuhr von Kalzium, Vitamin D und Eiweiß geachtet werden muss. Oftmals ist die zusätzliche Verabreichung von Kalzium- und Vitamin-D-Präparaten angezeigt sowie eine Östrogensubstitution. Allerdings ist ein orales Kontrazeptivum als einzige Therapie – anders als früher angenommen – nicht ausreichend zur Behandlung oder Vermeidung einer Knochendichteminderung. Zur Prävention der Anorexia athletica sind die Aufklärung der Sportler, Trainer und Betreuer und ein Screening im Rahmen von Sporttauglichkeitsuntersuchungen, vor allem aber auch strukturelle Maßnahmen durch die Sportfachverbände erforderlich (wie zum Beispiel im

  10. The diet of an individual diagnosed with anorexia nervosa

    OpenAIRE

    SRBOVÁ, Martina

    2015-01-01

    The aim of this Bachelor thesis entitled "A diet of individual with a diagnosis of anorexia nervosa" was to monitor the content and quality of the diet of people with a diagnosis of anorexia nervosa. Anorexia nervosa is a very serious disease belonging to the group of eating disorders. The prevalence of this disease increases, to which primarily affect media and requirements of today's society excessively slender figure, other factors that influence the formation of anorexia nervosa include b...

  11. Normal gastric antral myoelectrical activity in early onset anorexia nervosa.

    OpenAIRE

    Ravelli, A M; Helps, B A; Devane, S P; Lask, B D; Milla, P J

    1993-01-01

    Anorexia, epigastric discomfort, nausea, and vomiting may result from disordered gastric motility and emptying. These features have been found in many adults with anorexia nervosa, but have never been investigated in early onset anorexia nervosa. In 14 patients with early onset anorexia nervosa (eight of whom had upper gastrointestinal tract symptoms), six children with other eating disorders, four children with non-ulcer dyspepsia, and 10 controls matched for age and sex, the non-invasive te...

  12. Recovery from adolescent onset anorexia nervosa : a longitudinal study

    OpenAIRE

    Nilsson, Karin

    2007-01-01

    Anorexia Nervosa is a psychiatric illness with peak onset in ages 14-17. Most cases recover within a few years, but the illness can have a fatal outcome or long duration. Multifactor causes of anorexia nervosa include genetics, personality, family, and socio-cultural factors. This study measures mortality, recovery from anorexia nervosa, and psychosocial outcome of patients with adolescent onset anorexia nervosa that were treated in Child and Adolescent Psychiatry in northern Sweden from 1980...

  13. Do girls with anorexia nervosa have elevated autistic traits?

    OpenAIRE

    Baron-Cohen, Simon; Jaffa, Tony; Davies, Sarah; Auyeung, Bonnie; Allison, Carrie; Wheelwright, Sally

    2013-01-01

    Background Patients with anorexia may have elevated autistic traits. In this study, we tested test whether patients with anorexia nervosa (anorexia) have an elevated score on a dimensional measure of autistic traits, the Autism Spectrum Quotient (AQ), as well as on trait measures relevant to the autism spectrum: the Empathy Quotient (EQ), and the Systemizing Quotient (SQ). Methods Two groups were tested: (1) female adolescents with anorexia: n = 66, aged 12 to 18 years; and (2) female adolesc...

  14. The paternal function in anorexia

    Directory of Open Access Journals (Sweden)

    Giuseppe Nucara

    2012-12-01

    Full Text Available In this work, the problem of anorexia is taken up by giving preference, as the high point of observation, to the area of the so-called relationship with the Other, with particular reference to the unconscious vicissitudes of the Self, mother and father triangulation, in the context of two original psychoanalytical concepts: namely, A. Ferrari's oedipal constellation, and J. Lacan's oedipal significance of the “Name of the Father”. The deepening of these concepts, together with their relation to the problem of the space (or its lack between the self and the Other, leads to the conclusion that a “deficit” of the paternal, oedipal function-which leaves the individual exposed to the unbearable anguish of being fused with a dangerous, absorbing maternal Other-may lead this individual to save him/herself from the danger of being nullified in the Other by making an extreme attempt to flee into the withdrawal of the“anorexic choice”. From this viewpoint, one crucial moment in the analytical process is referred to recovering the paternal oedipal function in order to redress the previously destabilized oedipal order. The crucial stages in the treatment of a female patient are gone over again in order to visualize how the dynamics of the space between the self and the Other are reflected on the anorexic person„s experience of her body.

  15. Anorexia Nervosa in Chinese Adolescents: Does Culture Make a Difference?

    Science.gov (United States)

    Lai, Kelly Y. C.

    2000-01-01

    Reports on clinical and psychosocial characteristics of 16 Chinese adolescents from Hong Kong with anorexia nervosa. Over 80% of these patients expressed a fear of fatness. Against the background of increasing Westernization of Hong Kong society, anorexia is taking on a Western pattern, in congruence with the notion that anorexia nervosa is a…

  16. Clínica del objeto: la anorexia

    OpenAIRE

    GLORIA GOMEZ

    2003-01-01

    La anorexia como falta de apetito no es enteramente nueva, mas, ¿qué hace de ella una patología moderna? se trata de pensar que representan las anorexias de la época del discurso capitalista, que ordena hoy en mundo. arrancando la anorexia del abordaje qu

  17. Clínica del objeto: la anorexia

    Directory of Open Access Journals (Sweden)

    GLORIA GOMEZ

    2003-01-01

    Full Text Available La anorexia como falta de apetito no es enteramente nueva, mas, ¿qué hace de ella una patología moderna? se trata de pensar que representan las anorexias de la época del discurso capitalista, que ordena hoy en mundo. arrancando la anorexia del abordaje qu

  18. "Fasting Girls": Reflections on Writing the History of Anorexia Nervosa

    Science.gov (United States)

    Brumberg, Joan Jacobs

    1986-01-01

    Reflects on the history of anorexia nervosa among adolescent ("fasting") girls, suggesting that its psychodynamics have changed over time. Focuses on the social and cultural processes by which anorexia nervosa became a disease. Argues for a conception of anorexia nervosa that incorporates culture as well as biomedical and psychological models.…

  19. Pro-Anorexia and Anti-Pro-Anorexia Videos on YouTube: Sentiment Analysis of User Responses

    OpenAIRE

    Oksanen, Atte; Garcia, David; Sirola, Anu; Näsi, Matti; Kaakinen, Markus; Keipi, Teo; Räsänen, Pekka

    2015-01-01

    Background Pro-anorexia communities exist online and encourage harmful weight loss and weight control practices, often through emotional content that enforces social ties within these communities. User-generated responses to videos that directly oppose pro-anorexia communities have not yet been researched in depth. Objective The aim was to study emotional reactions to pro-anorexia and anti-pro-anorexia online content on YouTube using sentiment analysis. Methods Using the 50 most popular YouTu...

  20. Neurobiology of inflammation-associated anorexia

    Directory of Open Access Journals (Sweden)

    Laurent Gautron

    2010-01-01

    Full Text Available Compelling data demonstrate that inflammation-associated anorexia directly results from the action of pro-inflammatory factors, primarily cytokines and prostaglandins E2, on the nervous system. For instance, the aforementioned pro-inflammatory factors can stimulate the activity of peripheral sensory neurons, and induce their own de novo synthesis and release into the brain parenchyma and cerebrospinal fluid. Ultimately, it results in the mobilization of a specific neural circuit that shuts down appetite. The present article describes the different cell groups and neurotransmitters involved in inflammation-associated anorexia and examines how they interact with neural systems regulating feeding such as the melanocortin system. A better understanding of the neurobiological mechanisms underlying inflammation-associated anorexia will help to develop appetite stimulants for cancer and AIDS patients.

  1. [Pharmacotherapy for anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Greetfeld, M; Cuntz, U; Voderholzer, U

    2012-01-01

    Psychotherapy is the treatment of choice for both anorexia nervosa and for bulimia nervosa. However, many patients are also treated by pharmaceutical drugs. For the clinician it is difficult to choose pharmacotherapy, because the drugs may not be licensed, because of pharmacodynamic problems due to underweight or purging behaviour, or because of comorbidity. The present review summarises the current knowledge on pharmacotherapy for anorexia nervosa and bulimia nervosa considering the available guidelines. In general, the knowledge based on studies is insufficient for anorexia nervosa. Up to now, there is no proof of efficacy for any antidepressant or atypical antipsychotic with respect to weight gain; atypical antipsychotics may be helpful for ruminating or excessive motor hyperactivity. For bulimia nervosa antidepressants are the pharmacotherapy of first choice. Long-term effects, however, are still unknown.

  2. Rodent model of activity-based anorexia.

    Science.gov (United States)

    Carrera, Olaia; Fraga, Ángela; Pellón, Ricardo; Gutiérrez, Emilio

    2014-04-10

    Activity-based anorexia (ABA) consists of a procedure that involves the simultaneous exposure of animals to a restricted feeding schedule, while free access is allowed to an activity wheel. Under these conditions, animals show a progressive increase in wheel running, a reduced efficiency in food intake to compensate for their increased activity, and a severe progression of weight loss. Due to the parallelism with the clinical manifestations of anorexia nervosa including increased activity, reduced food intake and severe weight loss, the ABA procedure has been proposed as the best analog of human anorexia nervosa (AN). Thus, ABA research could both allow a better understanding of the mechanisms underlying AN and generate useful leads for treatment development in AN.

  3. [Impaired theory of mind in anorexia nervosa].

    Science.gov (United States)

    Gál, Zita; Egyed, Katalin; Pászthy, Bea; Németh, Dezsö

    2011-01-01

    Anorexia nervosa (AN) is a severe mental illness, which is characterized by a continuously growing occurrence in the population and by the shift of the onset for earlier ages. The understanding of factors playing role in AN and the importance of effective prevention is an essential issue in science as well as in the society. AN also affects the social domain of life, patients with AN may exhibit impaired social interaction, social isolation, difficulties in emotion recognition and egocentric thinking in cognitive processing. Therefore, the aim of present study was to investigate the theory of mind (ToM) deficits is anorexia nervosa. Although previous studies have reported ToM deficits in autism and in schizophrenia, the number of studies investigating ToM functioning in eating disorders are particularly low. Even though ToM difficulties, such as the affective ToM impairments were found in AN, however, the evidence of cognitive ToM deficits in anorexia patients is still lacking. Twenty anorexia nervosa patients and 20 healthy control adolescent girls participated in the experiment. EDI, BAT, Fallon-Rozin Test and Anamoprhic Micro Body Image Assesment Programme questionnaires and body-image tests were applied to discriminate anorexia nervosa group from healthy control group. The Hungarian version of Faux Pas Recognition Test was applied to evaluate ToM functioning. Compared to healthy control group, impairment in ToM functioning was found in AN group, especially in affective mental state attribution. Our results can raise new aspects for research, therapy and prevention of anorexia nervosa.

  4. [Zinc in patients with anorexia nervosa].

    Science.gov (United States)

    Røijen, S B; Worsaae, U; Zlotnik, G

    1991-03-01

    In a multicenter study, the relation between zinc status and anorexia nervosa was studied in 18 patients (15 females and 3 males in the age range of 11 to 25 years). Analysis of plasma zinc (by atomic absorption), plasma albumin (by electro-immuno diffusion method) and sense of taste (comparing quinine, zinc sulfate and water solutions), showed no significant abnormalities. Thus, the investigation does not support the hypothesis, that zinc status plays a significant role in the symptomatology of anorexia nervosa. PMID:2008719

  5. Anorexia nervosa: un estudio de casos

    OpenAIRE

    Lillyana Zusman Tinman

    2013-01-01

    La Anorexia Nervosa es un trastorno de alimentación que se define (etimológicamente) como una "pérdida nerviosa del apetito". Se caracteriza por la actitud consciente, voluntaria y rotunda de los sujetos  de tener un exceso de peso que intentan modificar por vía de la inanición. A partir del estudio de casos, se propone la distinción entre una Anorexia Nervosa Estructural -aquella en la que predomina el conflicto intrapsíquico primario y arcaico, y que manifiesta una conducta aislada y retraí...

  6. Reward processing in anorexia nervosa.

    Science.gov (United States)

    Keating, Charlotte; Tilbrook, Alan J; Rossell, Susan L; Enticott, Peter G; Fitzgerald, Paul B

    2012-04-01

    Individuals with anorexia nervosa (AN) demonstrate a relentless engagement in behaviors aimed to reduce their weight, which leads to severe underweight status, and occasionally death. Neurobiological abnormalities, as a consequence of starvation are controversial: evidence, however, demonstrates abnormalities in the reward system of patients, and recovered individuals. Despite this, a unifying explanation for reward abnormalities observed in AN and their relevance to symptoms of the illness, remains incompletely understood. Theories explaining reward dysfunction have conventionally focused on anhedonia, describing that patients have an impaired ability to experience reward or pleasure. We review taste reward literature and propose that patients' reduced responses to conventional taste-reward tasks may reflect a fear of weight gain associated with the caloric nature of the tasks, rather than an impaired ability to experience reward. Consistent with this, we propose that patients are capable of 'liking' hedonic taste stimuli (e.g., identifying them), however, they do not 'want' or feel motivated for the stimuli in the same way that healthy controls report. Recent brain imaging data on more complex reward processing tasks provide insights into fronto-striatal neural circuit dysfunction related to altered reward processing in AN that challenges the relevance of anhedonia in explaining reward dysfunction in AN. In this way, altered activity of the anterior cingulate cortex and striatum could explain patients' pathological engagement in behaviors they consider rewarding (e.g., self-starvation) that are otherwise aversive or punishing, to those without the eating disorder. Such evidence for altered patterns of brain activity associated with reward processing tasks in patients and recovered individuals may provide important information about mechanisms underlying symptoms of AN, their future investigation, and the development of treatment approaches. PMID:22349445

  7. Psychosomatic syndromes and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Abbate-Daga Giovanni

    2013-01-01

    Full Text Available Abstract Background In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN, few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. Methods 108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory–2, and Temperament and Character Inventory. Data were submitted to cluster analysis. Results Illness denial (63% and alexithymia (54.6% resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%, somatization group (26%, and severe psychosomatic group (25%. The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome. Conclusions These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.

  8. Anorexia nervosa: Divergent validity of a prototype narrative among anorexia relatives

    OpenAIRE

    Bárbara C. Machado; Óscar F. Gonçalves; Machado, Paulo P. P.; Margarida R. Henriques; António Roma-Torres; Isabel Brandão

    2006-01-01

    The objective of this ex post facto study was to test the divergent validity (degree of discrimination) of anorexia prototype narrative according to anorectic close confidents (relatives), as well as explore different characteristics of the participants which may be associated with the degree of prototype discrimination. Sixty-four relatives of individuals with anorexia nervosa participated in the study and were asked to indicate their degree of identification, according to their rel...

  9. Compulsory Treatment in Anorexia Nervosa : A Review

    NARCIS (Netherlands)

    Elzakkers, Isis F. F. M.; Danner, Unna N.; Hoek, Hans W.; Schmidt, Ulrike; van Elburg, Annemarie A.

    2014-01-01

    ObjectiveCompulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN.

  10. Compulsory treatment in anorexia nervosa : A review

    NARCIS (Netherlands)

    Elzakkers, Isis F F M; Danner, Unna N; Hoek, Hans W; Schmidt, Ulrike; van Elburg, Annemarie A

    2014-01-01

    OBJECTIVE: Compulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN

  11. Behavioral neuroendocrinology and treatment of anorexia nervosa

    NARCIS (Netherlands)

    Sodersten, P.; Nergardh, R.; Bergh, C.; Zandian, M.; Scheurink, A.

    2008-01-01

    Outcome in anorexia nervosa remains poor and a new way of looking at this condition is therefore needed. To this aim, we review the effects of food restriction and starvation in humans. It is suggested that body weight remains stable and relatively low when the access to food requires a considerable

  12. Male Anorexia Nervosa: A New Focus.

    Science.gov (United States)

    Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

    2000-01-01

    Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better…

  13. The Physical Educator and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia F.

    1984-01-01

    The physical education teacher is in an advantageous position to observe a student who may have anorexia nervosa. Severe weight loss, hyperactivity, body image delusion, and amenorrhea are symptoms of this behavior disorder. Implications for the physical education teacher and athletic coach are offered. (DF)

  14. Anorexia Nervosa--A Teacher's Perspective.

    Science.gov (United States)

    Rittner, Max

    The paper describes the physical and psychological symptoms of anorexia nervosa, treatment methods, and implications for the classroom. A rationale is offered for the predominance of upper-middle and upper class female adolescents in the anorectic population. Four models of treatment for the anorectic individual are considered: medical,…

  15. THE ANOREXIA OF AGING IN HUMANS

    Science.gov (United States)

    Energy intake is reduced in older individuals, with several lines of evidence suggesting that both physiological impairment of food intake regulation and non-physiological mechanisms are important. Non-physiological causes of the anorexia of aging include social (e.g. poverty, isolation), psycholog...

  16. Cisplatin-induced anorexia and ghrelin.

    Science.gov (United States)

    Hattori, Tomohisa; Yakabi, Koji; Takeda, Hiroshi

    2013-01-01

    Cisplatin, a formidable anticancer treatment, is used for several varieties of cancer. There are, however, many cases in which treatment must be abandoned due to a decrease in the patient's quality of life from loss of appetite associated with vomiting and nausea. There is a moderate degree of improvement in prevention of cisplatin-induced nausea and vomiting when serotonin (5-HT) 3 receptor antagonists, neurokinin 1 receptor antagonists, and steroids-either alone or in combination-are administered. The mechanism of action for anorexia, which continues during or after treatment, is, however, still unclear. This anorexia is, similar to the onset of vomiting and nausea, caused by the action of large amounts of 5-HT released as a result of cisplatin administration on tissue 5-HT receptors. Among the 5-HT receptors, the activation of 5-HT2b and 5-HT2c receptors, in particular, seems to play a major role in cisplatin-induced anorexia. Following activation of these two receptors, there is reduced gastric and hypothalamic secretion of the appetite-stimulating hormone ghrelin. There is ample evidence of the usefulness of exogenous ghrelin, synthetic ghrelin agonists, and the endogenous ghrelin signal-enhancer rikkunshito, which are expected to play significant roles in the clinical treatment and prevention of anorexia in future.

  17. Juvenile Anorexia Nervosa: Family Therapy's Natural Niche

    Science.gov (United States)

    Fishman, H. Charles

    2006-01-01

    Juvenile Anorexia Nervosa (AN) is a severe problem both in terms of presenting symptomatology and its tendency toward chronicity. Researchers have consistently shown that family-based approaches are superior to individual approaches for the treatment of juvenile AN. This article addresses the capacity deficit of trained family therapists to treat…

  18. Anorexia Nervosa with Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Pani, Adyapad; Santra, Gouranga; Biswas, Kali Das

    2015-09-01

    We report the case of an adolescent female, previously nonobese, belonging to educated average socioeconomic Muslim family. She stopped taking food, developed a perception of distorted body image with occasional episodes of binge eating and forced vomiting. She became amenorrheic and emaciated with loss of secondary sexual characters. She satisfied the criteria for anorexia nervosa with obsessive-compulsive disorder. PMID:27608877

  19. Body representation disturbances in anorexia nervosa

    NARCIS (Netherlands)

    Keizer, A.

    2014-01-01

    One of the main symptoms of anorexia nervosa (AN) is a disturbed experience of body size and shape. Although patients are underweight, they experience their body as bigger than it in reality is. Previous studies were mainly conducted by (clinical) psychologists and psychiatrists, and almost exclusiv

  20. A Developmental View of Anorexia Nervosa.

    Science.gov (United States)

    Akeroyd-Guillory, Denise

    1988-01-01

    Conducted research, based on Erikson's theory of identity development, to examine anorexic's progression through early stages of development. Results support the view that the negative aspects of development are clearly present in the anorexic. Findings have implications for school counselors. Introductory questionnaire on anorexia is appended.…

  1. Anorexia Nervosa: Its Symptoms and Possible Cures.

    Science.gov (United States)

    Bingaman, David E.

    This document presents a definition and description of anorexia nervosa as a disorder that occurs predominantly in girls and that can affect 1 out of every 250 girls between the ages of 12 and 18 years. The existence of a distorted mental body image among anorexics is discussed and symptoms of the disorder are described, including amenorrhea…

  2. Family Patterns Associated with Anorexia Nervosa.

    Science.gov (United States)

    Grigg, Darryl N.; And Others

    1989-01-01

    Used family systems perspective to explore familial transactional patterns related to anorexia nervosa among 22 families with an anorexic child and 22 matched control families. Identified 7 family groups with unique family dynamics differentiating one from another. With no single family pattern characterizing families of anorexics, results…

  3. Eco-Systemic Analysis of Anorexia Nervosa.

    Science.gov (United States)

    Sheppy, Margarette I.; And Others

    1988-01-01

    Tested eco-systemic approach to understanding of anorexia nervosa. Compared 30 anorexics and parents to 34 matched control subjects and parents. Found that, compared to controls, families of anorexics were less supportive, helpful, and committed to each other. Family interactions perceived by anorexics were characterized by overprotective,…

  4. Recovery from anorexia nervosa: a Durkheimian interpretation.

    Science.gov (United States)

    Garrett, C J

    1996-11-01

    Attempts to explain "eating disorders" in contemporary western society have concentrated on aetiology at the expense of resolution. Most "recovered" anorectics, however, question medical definitions of "anorexia nervosa" and clinical criteria for recovery. This article refers to a study of 32 people at different stages of the recovery process, to reconceptualize the problem in sociological terms. Durkheim's account of asceticism offers a fresh interpretive framework in which anorexia and recovery are understood as the negative and positive phases respectively of a ritual of self-transformation. In western culture, where appropriate myths and rituals of re-incorporation are not readily available following a period of symbolic fasting, it is not surprising that recovery from anorexia is not automatic. Participants in this study referred to anorexia as a spiritual quest and for them recovery involved a re-discovery (or creation) of a threefold connection: inner, with others and with "nature". These connections are, for them, the defining features of spirituality. The negative phase of the ritualistic quest (anorexia) involves a confrontation with the inevitability of death as a condition of the positive phase (recovery) in which people actively choose life. This new theoretical approach provides a non-medicalized understanding of anorexia and simultaneously enables a re-interpretation of the fasting of medieval women saints. Recent scholarship in this area is re-evaluated to demonstrate that the continuity between asceticism and anorexia lies in the use of food as a metaphorical attempt to confront the universal problem of one's own mortality. In certain historical situations, asceticism served a socially valuable symbolic purpose. In contemporary society, however, this meaning is no longer available. Instead, it is recovery which constitutes the active and metaphorical "rebellion" against forces of social control. Finally, the work of Van Gennep is used to explore

  5. [Pharmacological therapy of cancer anorexia-cachexia].

    Science.gov (United States)

    Cardona, D

    2006-05-01

    Anorexia is one of the most common symptoms of patients with advanced cancer and it presents as loss of appetite due to satiety. On the other hand, cachexia is described in those patients with unwanted weight loss. Cancerous processes produce an energy unbalance by decreased food intake and increased catabolism, resulting in a clearly negative balance. Several factors determining cachexia are observed, from metabolic unbalances produced by tumoral products and endocrine impairments or the inflammatory response produced by cytokines, all of them leading to higher lipolysis, loss of muscle protein, and anorexia. Besides, causes of anorexia are multiple, from chemotherapy agents, radiotherapy, or immunotherapy, which may produce different degrees of nausea, vomiting, diarrhea, and also leading to impairments of taste and smell, to obstruction of the digestive tract, pain, depression, constipation, etc. From the knowledge of the different mechanisms producing the anorexia-cachexia syndrome, hypercaloric diets for artificial nutrition have been studied with varying success, and different drugs with a positive effect on appetite gain such as progestogens, steroids, and with lesser clinical evidence cannabinoids, cyproheptadine, mirtazapine (antidepressant), and olanzapine (antipsychotic). Other drugs have been studied because of their anti-inflammatory properties, anti-cytokine, such as melatonin, polyunsaturated omega-3 fatty acids, pentoxifylline, and thalidomide; with the exception of the latter, clinical data are still scant for daily usage. Similarly happens with testosterone-derived anabolic drugs or with metabolism inhibitors such as hydrazine sulfate. With no doubt, progestogens, especially megestrol, and corticosteroids will be first-line therapies for anorexia-cachexia syndrome to stimulate the appetite and increase weight (megestrol), and have an effect on quality of life improvement and comfort in patients with advanced cancer.

  6. Anorexia nervosa: Divergent validity of a prototype narrative among anorexia relatives

    Directory of Open Access Journals (Sweden)

    Bárbara C. Machado

    2006-01-01

    Full Text Available El objetivo de este estudio ex post facto fue analizar la validez divergente (grado de discriminación de la narrativa prototipo de la anorexia nerviosa de acuerdo a los familiares significativos de los pacientes anoréxicos y explorar distintas características de los participantes que pueden estar asociadas con el grado de discriminación de la narrativa prototipo. Participaron 64 personas significativas de los individuos con anorexia nerviosa, a los que se les pidió que indicasen el grado de identificación, de acuerdo con su familiar, con cinco narrativas prototipo distintas (depresión, agorafobia, anorexia, alcoholismo y tóxico-dependencia. Los resultados no confirmaron la validez divergente de la narrativa prototipo de la anorexia. Los participantes mostraron tendencia a identificar en primer lugar a sus familiares con el prototipo de la agorafobia. Además, no se encontraron diferencias significativas entre la identificación con el prototipo de la anorexia y el de la depresión, de la agorafobia y del alcoholismo. La única diferencia significativa encontrada fue en la comparación entre el prototipo de la anorexia y el de la tóxico-dependencia. No obstante, las madres de las anoréxicas y la duración del trastorno se asocian al grado de identificación con la narrativa prototipo de la anorexia. Se discuten los resultados en términos de una aproximación sistémica versus prototipo de las perturbaciones del comportamiento alimentario.

  7. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  8. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  9. Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa

    DEFF Research Database (Denmark)

    Meier, Sandra M; Bulik, Cynthia M; Thornton, Laura M;

    2015-01-01

    Anxiety disorders and anorexia nervosa are frequently acknowledged to be highly comorbid conditions, but still, little is known about the clinical and aetiological cohesion of specific anxiety diagnoses and anorexia nervosa. Using the comprehensive Danish population registers, we aimed to determine...... the risk of anorexia nervosa in patients with register-detected severe anxiety disorders. We also explored whether parental psychopathology was associated with offspring's anorexia nervosa. Anxiety disorders increased the risk of subsequent anorexia nervosa, with the highest risk observed in obsessive......-compulsive disorder. Especially, male anxiety patients were at an increased risk for anorexia nervosa. Furthermore, an increased risk was observed in offspring of fathers with panic disorder. A diagnosis of an anxiety disorder, specifically obsessive-compulsive disorder, constitutes a risk factor for subsequent...

  10. [Change of peripheral blood appetite regulation factor of anorexia children and infect of child anorexia granule].

    Science.gov (United States)

    Hu, Ai-Hua; Xu, Hui-Min; Hu, Guo-Hua; Jin, Fang; Li, Zhong; Fang, Guo-Xing

    2014-12-01

    Study the infect of child anorexia granule on serum ghrelin and leptin of anorexia children and its clinical efficacy. Selected 81 cases of anorexia children aged 1-6 years old into treatment group (42 cases) and control group (39 cases), in addition, 30 case healthy children as healthy control group. The control group children were treated with domperidone suspension 0.3 mg x kg(-1) x d(-1), tid, orally 30 minutes before meals. Treatment group were treated with child anorexia granule, 1-3 years 1 package, bid; 4-6 years 1 package, tid; po, 4 weeks as a course of treatment. Study the change of serum ghrelin and leptin before and after therapy. The study demonstrates that before treatment, the serum ghrelin level of disease group was lower than healthy group (P anorexia granule can facilitate secretion of ghrelin, and inhibit secretion of leptin, so as to work up an appetite. And the molecular mechanism is its infect on serum ghrelin, leptin.

  11. [Anorexia nervosa as differential diagnosis in underweight patients].

    Science.gov (United States)

    Rapps, Nora; Skoda, Eva; Zipfel, Stephan

    2016-02-01

    Anorexia nervosa is a differential diagnosis in underweight patients, especially in young underweight women. Diagnostic criteria for anorexia nervosa are self-induced weight loss due to restrictive eating or purging behaviour, intense fear of gaining weight and disturbance in the way in which one`s shape is experienced, undue influence of body weight on self-evaluation and persistent lack of recognition of the seriousness of the current low body weight. Anorexia nervosa is associated with numerous medical complications. PMID:26886039

  12. Anorexia of Aging: A Modifiable Risk Factor for Frailty

    OpenAIRE

    Francesco Landi; Emanuele Marzetti; Matteo Tosato; Elena Ortolani; Graziano Onder; Davide Liborio Vetrano; Anna Maria Martone

    2013-01-01

    Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social factors. Given the interconnection between weight loss, sarcopenia and frailty, anorexia is a powerful, independent predictor of poor quality of life, morbidity and mortality in older persons. One of the...

  13. Social Cognition in Child and Adolescents with Anorexia Nervosa

    OpenAIRE

    ipek Percinel; Kemal Utku Yazici; Oznur Bilac; Sezen Kose; Burcu Ozbaran

    2015-01-01

    Social cognition represents the mental processes of social interaction between oneself and others. In recent years, the interest in social cognition skills has increased in cases with eating disorders. Anorexia nervosa is an eating disorder that is associated with the multiple factors in etiology. Treatment of anorexia nervosa is still controversial. The youths diagnosed with anorexia nervosa are known to be as the most difficult group in eating disorders for building therapeutic relations...

  14. Leptin in Anorexia and Cachexia Syndrome

    Directory of Open Access Journals (Sweden)

    Diana R. Engineer

    2012-01-01

    Full Text Available Leptin is a product of the obese (OB gene secreted by adipocytes in proportion to fat mass. It decreases food intake and increases energy expenditure by affecting the balance between orexigenic and anorexigenic hypothalamic pathways. Low leptin levels are responsible for the compensatory increase in appetite and body weight and decreased energy expenditure (EE following caloric deprivation. The anorexia-cachexia syndrome is a complication of many chronic conditions including cancer, chronic obstructive pulmonary disease, congestive heart failure, chronic kidney disease, and aging, where the decrease in body weight and food intake is not followed by a compensatory increase in appetite or decreased EE. Crosstalk between leptin and inflammatory signaling known to be activated in these conditions may be responsible for this paradox. This manuscript will review the evidence and potential mechanisms mediating changes in the leptin pathway in the setting of anorexia and cachexia associated with chronic diseases.

  15. Effectiveness of psychopharmacology in Anorexia Nervosa treatment

    Directory of Open Access Journals (Sweden)

    Zadka Lukasz

    2015-06-01

    Full Text Available The eating disorder that generates the highest death rate is that of anorexia nervosa, and current treatment is a combination of equalization of somatic state and patient education. Moreover, psychical symptoms occurring in the course of anorexia nervosa are thought to have a crucial influence on the course of the disease. Hence, in medical literature, the effectiveness of psychotherapeutic interventions is also widely described. Still, the implementation of appropriate psychopharmacology is now considered an additional method of treatment, rather than a therapy of choice. Yet, in spite of many years of research, there are no absolute recommendations given, nor are instructions within the scope of psychopharmacological treatment proffered, although the selection of psychopharmacological items must respect both the patient’s psychic and somatic states. In recent years, the popularity of psychopharmacological treatment has increased; therefore, we feel that it is justified to present the latest scientific information in this respect.

  16. Treatment of anorexia nervosa with antidepressants.

    Science.gov (United States)

    Hudson, J I; Pope, H G; Jonas, J M; Yurgelun-Todd, D

    1985-02-01

    Nine patients with anorexia nervosa were treated with antidepressant medications from three classes: tricyclics, monoamine oxidase inhibitors, and triazolopyridines. A tenth patient was treated with the combination of lithium carbonate and carbamazepine. With either the initial or a subsequent medication trial, four patients had displayed significant improvement in weight and in other anorexic and bulimic symptoms. Three additional patients had a marked or moderate improvement in bulimic symptoms, one with moderate and two without any weight gain. Two other patients had moderate weight gain. Side effects were a significant problem in many of the patients. These preliminary results suggest that antidepressants may be of benefit in the treatment of some patients with anorexia nervosa. PMID:3919068

  17. Anorexia nervosa: uma revisão

    OpenAIRE

    Eder Schmidt; Gustavo Ferreira da Mata

    2008-01-01

    Os autores apresentam uma revisão de alguns pontos de vista com relação à anorexia nervosa. Alinham-se aspectos classificatórios, históricos, clínicos e terapêuticos. Reconhecida como a base para ocorrências místicas na Idade Média, foi entendida como uma apresentação histérica no século XVII, para tornar-se, logo em seguida, objeto das indagações freudianas. Discute-se a anorexia como uma apresentação da estrutura histérica, aqui abordada a partir dos conceitos freudianos sobre histeria, Édi...

  18. The role of zinc in anorexia nervosa: etiology and treatment.

    Science.gov (United States)

    Bakan, R

    1979-07-01

    Zinc deficiency may play a role in the etiology of anorexia nervosa. The symptoms of anorexia nervosa and zinc deficiency are similar in a number of respects, e.g., weight loss, loss of appetite, amenorrhea in females, impotence in males, nausea and skin lesions. In both conditions females under 25 are most at risk. Stress, estrogen and dietary habits may also be involved in the complex of factors which create or exacerbate a zinc deficiency and result in anorexia nervosa. It is proposed that effectiveness in the treatment of anorexia nervosa. PMID:514114

  19. Olfactory identification ability in anorexia nervosa.

    OpenAIRE

    Kopala, L C; Good, K; Goldner, E M; Birmingham, C L

    1995-01-01

    OBJECTIVE: The hypothesis tested was that patients with severe eating disorders would demonstrate olfactory identification deficits as a result of zinc deficiency or malnutrition. METHOD: The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 27 hospitalized female patients with anorexia nervosa and 50 normal control female subjects. For a subgroup of patients, serum zinc levels and body mass indices were obtained at pre- and post-nutritional repletion phases. RE...

  20. [Role of leptin in anorexia nervosa].

    Science.gov (United States)

    Riccioni, G; D'Orazio, N; Menna, V; Lambo, M S; Guagnano, M T; Di Ilio, C

    2003-01-01

    Anorexia and bulimia nervosa are the main psychiatric disorders characterised by abnormal models of feeding and perception of people's personal physical appearance and weight. These symptoms are associated with a severe psychosocial uneasiness that leads to severe medical complications and this, to its turn, has a big impact on morbidity and sick rate of general population. Although researchers have made big improvements in individualising some likely pathogenic mechanisms that include different factors (genetic, neurochemical and sociocultural) and psychological development, the pathogenesis of these kinds of feeding disorders is still unknown. Leptina is a neurochemical factor particularly relevant. It is a 17 KD hormone, produced by adipocytes. At hypothalamic level, it is essential for regulating body weight and body development. Recent studies have identified some factors responsible for the production and the secretion of leptina. They are micro and macronurishing factors, hormones and the sympatic neurotic system that is the most important among them. It plays a very important role for some disorders of feeding behaviour, specifically for the anorexia nervosa, where we notice a reduction of leptina levels strictly correlated to a reduction of the fat component. Since anorexia nervosa is associated to medical, nourishing and psychological components, it involves different areas and needs complete measurement and administration. Therefore the approach to this kind of pathology has necessarily to predict a multidisciplinary administration of patients. The aim of our work has been to point out the possible interactions between leptina and the development and progression of anorexia nervosa, on the basis of recent works and reviews in medical literature. PMID:14994520

  1. Leptin in Anorexia and Cachexia Syndrome

    OpenAIRE

    Engineer, Diana R; Garcia, Jose M.

    2012-01-01

    Leptin is a product of the obese (OB) gene secreted by adipocytes in proportion to fat mass. It decreases food intake and increases energy expenditure by affecting the balance between orexigenic and anorexigenic hypothalamic pathways. Low leptin levels are responsible for the compensatory increase in appetite and body weight and decreased energy expenditure (EE) following caloric deprivation. The anorexia-cachexia syndrome is a complication of many chronic conditions including cancer, chronic...

  2. Body perception and evaluation in anorexia nervosa

    OpenAIRE

    Lutz, Annika

    2015-01-01

    Body image disturbance is a prominent feature in anorexia nervosa (AN) and encompasses alterations across the different dimensions of body image, that is, perception, affect, cognition, and behaviour. There is a wealth of research regarding the subjective experience of body image disturbance and evidence for underlying neuronal alterations is beginning to emerge. The present project was designed to assess basic processes underlying body image disturbance with the help of psychophysiological m...

  3. Anorexia and Abjection:A Review Essay

    OpenAIRE

    Ferreday, Debra

    2012-01-01

    This article draws on a review of Megan Warin’s 2010 book, Abject Relations: Everyday Worlds of Anorexia, to discuss the ways in which a feminist ethnographic approach might disrupt dominant cultural narratives of eating disorders and embodiment. My argument draws on feminist work on figuration and ‘body image’ to discuss how the anorexic body becomes a figure of abjection, both in media images and in popular feminist discourse. I examine how cultural narratives and images are pathologically ...

  4. Anorexia: "uma neurose paralela à melancolia"

    Directory of Open Access Journals (Sweden)

    Flávia Coutinho Campos Cunha

    2013-06-01

    Full Text Available Investiga-se a assertiva freudiana de que "a neurose nutricional paralela à melancolia é a anorexia". Percorreremos a obra freudiana para construir o paralelo entre essas duas afecções. O conceito de narcisismo e o mecanismo de identificação fundamentarão essa aproximação desdobrada nos seguintes pontos: a anestesia sexual, a autodepreciação e o sadismo.

  5. Anorexia nervosa complicating inflammatory bowel disease.

    OpenAIRE

    Mallett, P; MURCH, S.

    1990-01-01

    Two cases of inflammatory bowel disease, occurring in adolescence and complicated by anorexia nervosa, are presented. The management of the bowel disease with corticosteroids appeared to precipitate the eating disorder in one case whereas covert withdrawal of steroid treatment led to life threatening complications of inflammatory bowel disease in the other. The difficulties of managing two serious conditions, each ideally treated in a specialist centre, are discussed and the dangers of treati...

  6. Anorexia nervosa and food avoidance emotional disorder.

    OpenAIRE

    Higgs, J F; Goodyer, I M; Birch, J.

    1989-01-01

    A retrospective and longitudinal study was carried out on all children and adolescents who presented to a child psychiatry service over a period of 26 years to identify the nature, course, and outcome of cases meeting criteria for anorexia nervosa (n = 27). Two groups of the same age were identified for comparison, firstly those with food avoidance and emotional disorders (n = 23), and secondly those with emotional disorders but no symptoms associated with eating (n = 22). The results confirm...

  7. Neurobiology of Inflammation-Associated Anorexia

    OpenAIRE

    Gautron, Laurent; Layé, Sophie

    2010-01-01

    Compelling data demonstrate that inflammation-associated anorexia directly results from the action of pro-inflammatory factors, primarily cytokines and prostaglandins E2, on the nervous system. For instance, the aforementioned pro-inflammatory factors can stimulate the activity of peripheral sensory neurons, and induce their own de novo synthesis and release into the brain parenchyma and cerebrospinal fluid. Ultimately, it results in the mobilization of a specific neural circuit that shuts do...

  8. Anorexia in the Adolescence - case study

    OpenAIRE

    Almeida de Paiva, Maria O.

    2010-01-01

    Eating disorders lead to special biological and psychological states. The result of the total lack of food is treated in a distinct way by anorexia. Nutritionists have thus had difficulty in coming to an agreement on the best therapy to prevent such disorders. First it is essential to understand which treatment aims are and then to attempt to know how the several treatment models used nowadays can reach those aims. Someone who suffers from eating disorders, together with an inner deformation,...

  9. Anorexia Nervosa : Emotion, Cognition, and Treatment

    OpenAIRE

    Parling, Thomas

    2011-01-01

    Anorexia nervosa (AN) is a serious disorder with long-term consequences for those afflicted. No evidence-based care is available for adults with full or subthreshold AN. The thesis research investigated aspects of emotion and cognition relevant to the maintenance of AN that might inform psychological treatment. In addition, the effectiveness of a recent psychotherapy model of AN was investigated. Study I investigated alexithymia and emotional awareness and their associations with depression, ...

  10. The Significance of Bradycardia in Anorexia Nervosa

    OpenAIRE

    Yahalom, Malka; Spitz, Marcelo; Sandler, Ludmila; Heno, Nawaf; Roguin, Nathan; Turgeman, Yoav

    2013-01-01

    Anorexia nervosa (AN) is a life-threatening condition, with a significant risk for death, due to cardiovascular complications. It is characterized by abnormal eating behavior and has the highest mortality rate of all psychiatric disorders. It has been associated with bradycardia (a heart rate [HR] of less than 60 beats per minute) (up to 95%), hypotension, mitral valve prolapse, and heart failure. The diagnosis of AN can be elusive, and more than half of all cases are undetected. The purpose ...

  11. Anorexia nervosa y terapia del comportamiento

    OpenAIRE

    Alfonso Martínez Taboas

    1981-01-01

    The clinical effectiveness of therapeutic techníques for the treatment of anorexia nervosa are reviewed. The most commonly used technique has been operant conditioning, of proved efficacy in the hospital but not always in the natural environment of the patient. Many cases su.ccessfuUy.treated show recovery of the problem. Recent atudies extend the treatment to the family and consider all the variables involved in the behavior. Severa! methodological shortcomings of the re...

  12. Neuroendocrine changes in patients with anorexia nevosa

    OpenAIRE

    Weiss, Deike

    2013-01-01

    Patients with anorexia nervosa show neuroendocrine changes compared to healthy controls. It remains unclear, whether those are preexisting alterations or caused by the disease and if they contribute to maintain the disease. The hormone leptin not only influences energy homeostasis but neuronal networks. We could show that patients with lower leptin lewels show higher drive for thinness and reported more sexual problems and hyperactivity, even when adjusted for the BMI. That confirms prior...

  13. Factors Associated With Recovery from Anorexia Nervosa

    OpenAIRE

    Zerwas, Stephanie; Lund, Brian C.; Holle, Ann Von; Thornton, Laura M.; Berrettini, Wade H.; Brandt, Harry; Crawford, Steven; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig; Kaplan, Allan S.; La Via, Maria; Mitchell, James; Rotondo, Alessandro; Strober, Michael

    2013-01-01

    Previous studies of prognostic factors of anorexia nervosa (AN) course and recovery have followed clinical populations after treatment discharge. This retrospective study examined the association between prognostic factors—eating disorder features, personality traits, and psychiatric comorbidity—and likelihood of recovery in a large sample of women with AN participating in a multi-site genetic study. The study included 680 women with AN. Recovery was defined as the offset of AN symptoms if th...

  14. Bone Metabolism in Adolescents with Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2011-01-01

    Adolescents with anorexia nervosa (AN) are at risk for low bone mass at multiple sites, associated with decreased bone turnover. Bone microarchitecture is also affected, with a decrease in bone trabecular volume and trabecular thickness, and an increase in trabecular separation. The adolescent years are typically the time when marked increases occur in bone mass accrual towards the attainment of peak bone mass, an important determinant of bone health and fracture risk in later life. AN often ...

  15. Extreme Achalasia Presenting as Anorexia Nervosa

    OpenAIRE

    Goldsmith, P. J.; Decadt, B.

    2012-01-01

    Background. Achalasia may lead to cachexia if not diagnosed in an early stage. Surgery in cachectic patients is hazardous and complications may result in a protracted recovery or even death. Different treatment options have been described. In this paper, we report a stepwise surgical laparoscopic approach which appears to be safe and effective. Methods. Over a one-year period, a patient with a body mass index (BMI) below 17 being treated for anorexia nervosa was referred with dysphagia. Becau...

  16. OLANZAPINE TREATMENT IN ANOREXIA NERVOSA: CASE REPORT

    OpenAIRE

    Dadić-Hero, Elizabeta; Ružić, Klementina; Pernar, Mirjana; Kabalin, Milena; Medved, Paola

    2009-01-01

    A 15 year old patient suffering from psychiatric disturbances looked for psychiatric help but refused hospital admission. Following an ambulatory treatment, the patient was diagnosed with Anorexia nervosa. The patient, a girl, was 175 centimeters tall, weighting only 39 kilos. Within the clinical picture, there were few dominant disorders present; anxiety, depression, low self-esteem, fear of feminization, with recurrent psychotic episodes. By the implementation of an intensive psychothera...

  17. Neurobiology of inflammation-associated anorexia

    OpenAIRE

    Laurent Gautron; Sophie Laye

    2010-01-01

    Compelling data demonstrate that inflammation-associated anorexia directly results from the action of pro-inflammatory factors, primarily cytokines and prostaglandins E2, on the nervous system. For instance, the aforementioned pro-inflammatory factors can stimulate the activity of peripheral sensory neurons, and induce their own de novo synthesis and release into the brain parenchyma and cerebrospinal fluid. Ultimately, it results in the mobilization of a specific neural circuit that shuts do...

  18. Anorexia nerviosa: una revisió

    OpenAIRE

    Félix López, Gustavo Alonso; Universidad Veracruzana; Nachón García, María Gabriela; Universidad Veracruzana; Hernández Parra, Tomás Gerardo; Universidad Veracruzana

    2014-01-01

    En este artículo se describen aspectos relacionados con la historia natural de la anorexia nerviosa, una enfermedad que se ha convertido en un serio problema de salud, así como su repercusión social y familiar, haciendo énfasis en la población de riesgo de padecer este síndrome y en los diferentes tratamientos aceptados internacionalmente.

  19. Porphyria and anorexia: cause and effect

    OpenAIRE

    Martins, Carlos R.; Bandeira, Barbara E.S.; Martinez, Alberto R. M.; Dalgalarrondo, Paulo; França, Marcondes C.

    2014-01-01

    Porphyrias are hereditary disorders related to impaired biosynthesis of heme and characterized by multisystemic manifestations. Acute intermittent porphyria (AIP) is the most common acute subtype of the disease, and often associated with psychiatric symptoms. We here report a patient who developed acute flaccid paralysis after remarkable weight loss, which was related to an eating disorder (anorexia nervosa). After an extensive neurologic workup, he was diagnosed with AIP. This case emphasize...

  20. Hematological abnormalities in severe anorexia nervosa.

    Science.gov (United States)

    Sabel, Allison L; Gaudiani, Jennifer L; Statland, Barbara; Mehler, Philip S

    2013-05-01

    Little is known about the prevalence of hematologic abnormalities in adults with severe anorexia nervosa. We report the first major analysis of hematologic dysfunction in such patients. We retrospectively analyzed the charts of 53 men and women with severe anorexia nervosa, admitted between October 2008 and December 2010 for medical stabilization to our center, which has a national referral base. Patients were predominantly female (89 %), with a median age of 28 years (range 17-65), and were hospitalized for a median duration of 15 days (I.Q.R. 9-29). Nadir body mass index during hospitalization was markedly low at 12.4 kg/m(2) (range 8.4-15.7), and the mean discharge BMI was 13.8 kg/m(2) (range 10.2-16.8). 83 % of patients were anemic (hematocrit  400 k/μL) during their hospitalization. Eighty-nine percent of patients had resolved their neutropenia by discharge. Marked hematologic deficiencies are often present in patients with severe anorexia nervosa, generally attributed to starvation-mediated gelatinous marrow transformation which resolves with proper nutritional rehabilitation. Improved provider awareness of this association may reduce unnecessary testing and costly treatment interventions.

  1. Anorexia nervosa: uma revisão

    Directory of Open Access Journals (Sweden)

    Eder Schmidt

    2008-12-01

    Full Text Available Os autores apresentam uma revisão de alguns pontos de vista com relação à anorexia nervosa. Alinham-se aspectos classificatórios, históricos, clínicos e terapêuticos. Reconhecida como a base para ocorrências místicas na Idade Média, foi entendida como uma apresentação histérica no século XVII, para tornar-se, logo em seguida, objeto das indagações freudianas. Discute-se a anorexia como uma apresentação da estrutura histérica, aqui abordada a partir dos conceitos freudianos sobre histeria, Édipo e feminino, e considerando-se o corpo físico como um mero suporte para articulações simbólicas. Para Freud, a anorexia nervosa seria um quadro pelo qual a histérica exprime sua aversão à sexualidade.

  2. Anorexia and eating patterns in the elderly.

    Directory of Open Access Journals (Sweden)

    Lorenzo Maria Donini

    Full Text Available OBJECTIVES: To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia. DESIGN: Cross-sectional, observational. SETTING: Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. PARTICIPANTS: A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards. MEASUREMENTS: All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables. RESULTS: In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables" whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety. CONCLUSION: Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

  3. Refeeding Hypophosphatemia in Adolescents With Anorexia Nervosa

    Science.gov (United States)

    Nicholls, Dasha

    2013-01-01

    The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices. Refeeding hypophosphatemia (RH) is the most common complication associated with refeeding the malnourished patient. This review sought to identify the range of refeeding rates adopted globally and the implication that total energy intake and malnutrition may have on RH while refeeding adolescents with anorexia nervosa. Studies were identified by a systematic electronic search of medical databases from 1980 to September 2012. Seventeen publications were identified, including 6 chart reviews, 1 observational study, and 10 case reports, with a total of 1039 subjects. The average refeeding energy intake was 1186 kcal/d, ranging from 125–1900 kcal/d, with a mean percentage median body mass index (% mBMI) of 78%. The average incidence rate of RH was 14%. A significant correlation between malnutrition (% mBMI) and post-refeeding phosphate was identified (R 2 = 0.6, P = .01). This review highlights the disparity in refeeding rates adopted internationally in treating malnourished adolescents with anorexia nervosa. Based on this review, the severity of malnutrition seems to be a marker for the development of RH more so than total energy intake. PMID:23459608

  4. The CT appearance of ''reversible'' cerebral pseudoatrophy in anorexia nervosa

    International Nuclear Information System (INIS)

    The CT appearance of ''reversible'' cerebral pseudoatrophy resulting from anorexia nervosa was demonstrated. The CT studies were performed in 3 young women with typical clinical course of anorexia nervosa. In all of them computed tomography revealed dilatation of the subarachnoid fluid space. After 5 months of therapy the follow-up scans have reverted to normal in all cases. (author)

  5. Physiological Regulation and Infantile Anorexia: A Pilot Study

    Science.gov (United States)

    Chatoor, Irene; Ganiban, Jody; Surles, Jaclyn; Doussard-Roosevelt, Jane

    2004-01-01

    Objective: To examine whether infantile anorexia is associated with physiological dysregulation. Method: This study included eight toddlers with infantile anorexia and eight healthy eaters matched for age, race, socioeconomic status, and gender. Physiological measures of heart period and respiratory sinus arrhythmia were assessed across three…

  6. Special Issue: Outcome of Anorexia Nervosa with Teenage Onset.

    Science.gov (United States)

    Casper, Regina C., Ed.

    1996-01-01

    The articles of this special issue report on studies of the outcomes of treatment of adolescent anorexia nervosa. These studies leave no doubt about the mortality risk and debilitating nature of chronic anorexia nervosa, but they do suggest that the prognosis, given expert treatment, is favorable for the most part. (SLD)

  7. Anorexia Nervosa: A Misdiagnosis of the Adolescent Male.

    Science.gov (United States)

    Svec, Henry

    1987-01-01

    Discusses rarity of anorexia nervosa among male population with primary reference to differences from female symptomatology. Presents case which implies that anorexia nervosa in the male may be a marker for other more severe pathology. Presents findings which suggest a diagnostic strategy based on familial, behavioral, environmental, educational,…

  8. An Adolescent with Anorexia Nervosa – A Case Report

    OpenAIRE

    Khairani, O; Majmin, SH; Saharuddin, A; Loh, SF; Azimah, NM; Tohid, H

    2011-01-01

    This case report illustrates an adolescent with clinical presentation of moderate anorexia nervosa with no significant co-morbidities. It highlights the management of anorexia nervosa in the outpatient setting by a multi-disciplinary health care team which includes a family physician, a dietician, a psychologist and a child psychiatrist.

  9. Adrenal Glucocorticoid and Androgen Precursor Dissociation in Anorexia Nervosa

    OpenAIRE

    Lawson, E. A.; Misra, M.; Meenaghan, E; Rosenblum, L.; Donoho, D. A.; Herzog, D.; Klibanski, A.; Miller, K K

    2009-01-01

    Context: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs.

  10. Anorexia nervosa: an increasing problem in children and adolescents

    OpenAIRE

    Halmi, Katherine A.

    2009-01-01

    Information from eating disorder clinics across five continents suggests that anorexia nervosa is becoming an increasing problem in children and young adolescents. There is some indication that anxiety disorders in childhood may be a major risk factor for the development of anorexia nervosa. Early recognition and family treatment for this disorder are essential to prevent chronic impairment.

  11. Anorexia nervosa associated with energy-wasting disorders.

    OpenAIRE

    Sreenivasan, U.

    1984-01-01

    Some patients with anorexia nervosa and energy-wasting disorders have been found to be able to use their illness to lose weight. This paper presents two patients with diabetes mellitus and one with ulcerative colitis in whom the illness was complicated by anorexia nervosa.

  12. The paradoxical nature of sexuality in anorexia nervosa

    NARCIS (Netherlands)

    Tuiten, A; Panhuysen, G; Everaerd, W; Koppeschaar, H; Krabbe, P; Zelissen, P

    1993-01-01

    Psychosexual dysfunctioning is often put forward as an etiological factor in anorexia nervosa. In contrast, we hypothesize that anorexia nervosa patients were in general psychosexually normal before their illness, and that the problems in their sexual life arise only after the emergence of hypogonad

  13. [Anorexia and refusal to eat in the elderly].

    Science.gov (United States)

    Hazif-Thomas, Cyril; Thomas, Philippe

    2016-01-01

    The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential.

  14. alpha-MSH enhances activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa (AN). In ABA, scheduled feeding in combination with voluntary access to running wheels, results in hyperactivity, hypophagia, body weight loss and activation of the HPA axis. Since stimulation of the melanocortin (MC) sy

  15. Neurobiology driving hyperactivity in activity-based anorexia

    NARCIS (Netherlands)

    Adan, R A H; Hillebrand, J J G; Danner, U N; Cardona Cano, S; Kas, M J H; Verhagen, L A W

    2011-01-01

    Hyperactivity in anorexia nervosa is difficult to control and negatively impacts outcome. Hyperactivity is a key driving force to starvation in an animal model named activity-based anorexia (ABA). Recent research has started unraveling what mechanisms underlie this hyperactivity. Besides a general i

  16. Adolescent Eating Disorders: Anorexia and Bulimia. Publication 352-004.

    Science.gov (United States)

    Bayer, Alan E.; Baker, Daniel H.

    This document presents an overview of anorexia nervosa and bulimia in adolescents. A brief review of the historical background of these eating disorders is included. Causes of anorexia and bulimia are discussed and physical, behavioral, emotional, and perceptual characteristics of the disorders are listed in a section on symptoms. The need for a…

  17. The Anorexia Relapse Prevention Guidelines in practice: a case report

    NARCIS (Netherlands)

    Berends, Tamara; Meijel, Berno van; Elburg, A.

    2012-01-01

    The purpose of this case report is to illustrate the application of the Anorexia Relapse Prevention Guidelines in nursing practice. In a single case report, the implementation of the intervention was described. A purposive use of the Anorexia Relapse Prevention Guidelines provides insight into the a

  18. Bullae, Bronchiectasis and Nutritional Emphysema in Severe Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Victoria J Cook

    2001-01-01

    Full Text Available STUDY OBJECTIVES: Pulmonary complications of anorexia nervosa are rarely documented. The case of a patient with anorexia nervosa and pulmonary disease is presented, a new quantitative computed tomography (CT method for the detection of emphysema is employed, the literature is reviewed and the concept of 'nutritional' emphysema is discussed.

  19. Death Related Themes in Anorexia Nervosa: A Practical Exploration.

    Science.gov (United States)

    Russell, Janice; And Others

    1990-01-01

    Explored death-related themes in psychodynamic etiology of anorexia nervosa by comparing anorexic adolescent patients (n=28) to age-matched controls (n=238). Results suggest that death-related themes are of significance in the understanding and management of anorexia nervosa. (Author/ABL)

  20. Symptoms, Causes and Possible Treatment of Anorexia Nervosa.

    Science.gov (United States)

    Odebunmi, Akin

    This document provides research findings, a discussion of etiology, case studies, and treatment approaches for anorexia nervosa. The research findings classify the anorexic patient by sex, age, presenting characteristics, socioeconomic status, premorbid personality, and cultural and familial characteristics. The etiology of anorexia nervosa is…

  1. Anorexia nervosa e gravidez: relato de caso Anorexia nervosa and pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Fabiano Gonçalves Nery

    2002-02-01

    Full Text Available Relata-se o caso de uma adolescente de 18 anos que desenvolveu quadro de hiperemese gravídica seguida de anorexia nervosa durante sua primeira gravidez, chegando a índice de massa corporal (IMC de 14,3 Kg/m². Os sintomas apresentados remitiram após o término prematuro da gestação. Apesar de a anorexia nervosa ser incomum na gravidez, seu diagnóstico é importante em virtude dos riscos para a saúde materna e fetal.The authors describe a case of an eighteen years-old adolescent who developed hyperemesis gravidarum followed by anorexia nervosa during her first pregnancy. Her body mass index (BMI achieved 14.3 Kg/m². The symptoms remitted after the premature delivery of the newborn. Although anorexia nervosa is uncommon in pregnancy, its diagnosis is important in view of the risks for the health of mother and fetus.

  2. Altered social reward and attention in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Karli K Watson

    2010-09-01

    Full Text Available Dysfunctional social reward and social orienting attend a variety of neuropsychiatric disorders including autism, schizophrenia, social anxiety, and psychopathy. Here we show that similar social reward and attention dysfunction attend anorexia nervosa, a disorder defined by avoidance of food and extreme weight loss. We measured the implicit reward value of social stimuli for female participants with (n=11 and without (n=11 anorexia nervosa using an econometric choice task and also tracked gaze patterns during free viewing of images of female faces and bodies. As predicted, the reward value of viewing bodies varied inversely with observed body weight for women with anorexia but not neurotypical women, in contrast with their explicit ratings of attractiveness. Surprisingly, women with anorexia nervosa, unlike neurotypical women, did not find female faces rewarding and avoided looking at both the face and eyes—independent of observed body weight. These findings demonstrate comorbid dysfunction in the neural circuits mediating gustatory and social reward in anorexia nervosa.

  3. Radiation-induced anorexia in Syrian hamsters

    International Nuclear Information System (INIS)

    The recovery of Syrian hamsters after split dose application (interval 11 days) was studied on the basis of the weight response and of food uptake. Two periods of weight loss and anorexia can be distinguished, an early one immediately after irradiation and a secondary one 6-10 days later. The secondary response is a function of the radiation dose and allows to distinguish survivors from non-survivors, since it is much more pronounced and longerlasting in the latter than in the former. The first response appears not to be influenced by a previous conditioning irradiation. (orig.)

  4. Anorexia Nervosa: A Unified Neurological Perspective

    OpenAIRE

    Hasan, Tasneem Fatema; Hasan, Hunaid

    2011-01-01

    The roles of corticotrophin-releasing factor (CRF), opioid peptides, leptin and ghrelin in anorexia nervosa (AN) were discussed in this paper. CRF is the key mediator of the hypothalamo-pituitary-adrenal (HPA) axis and also acts at various other parts of the brain, such as the limbic system and the peripheral nervous system. CRF action is mediated through the CRF1 and CRF2 receptors, with both HPA axis-dependent and HPA axis-independent actions, where the latter shows nil involvement of the a...

  5. Anorexia nervosa y terapia del comportamiento

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez Taboas

    1981-01-01

    Full Text Available The clinical effectiveness of therapeutic techníques for the treatment of anorexia nervosa are reviewed. The most commonly used technique has been operant conditioning, of proved efficacy in the hospital but not always in the natural environment of the patient. Many cases su.ccessfuUy.treated show recovery of the problem. Recent atudies extend the treatment to the family and consider all the variables involved in the behavior. Severa! methodological shortcomings of the research in the area are analyzed

  6. Neuromodulation for eating disorders: obesity and anorexia.

    Science.gov (United States)

    Gorgulho, Alessandra A; Pereira, Julio L B; Krahl, Scott; Lemaire, Jean-Jacques; De Salles, Antonio

    2014-01-01

    Extremes of eating disorders (ED) have become prevalent in both developed and developing countries. Available therapies, though largely effective, fail in a substantial number of patients and carry considerable side effects. Morbid obesity and anorexia nervosa (AN) represent important causes of morbidity and mortality among young adults. Morbid obesity affects disproportionate numbers of children. AN is also important for its high mortality in young adults. The challenges of effectively treating AN are well recognized. In this article, important aspects of ED are reviewed in detail and novel approaches to the treatment of ED are proposed. PMID:24262906

  7. Radiation-induced anorexia in Syrian hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Kindt, A.; Sattler, E.L.; Schraub, A.

    1980-10-01

    The recovery of Syrian hamsters after split dose application (interval 11 days) was studied on the basis of the weight response and of food uptake. Two periods of weight loss and anorexia can be distinguished, an early one immediately after irradiation and a secondary one 6-10 days later. The secondary response is a function of the radiation dose and allows to distinguish survivors from non-survivors, since it is much more pronounced and longerlasting in the latter than in the former. The first response appears not to be influenced by a previous conditioning irradiation.

  8. Medical management of acute severe anorexia nervosa.

    Science.gov (United States)

    Norrington, Amy; Stanley, Ruth; Tremlett, Michael; Birrell, Ginny

    2012-04-01

    Anorexia nervosa (AN) is a common condition affecting young people. The medical management of AN on a general paediatric ward is challenging. It is important to identify young people who are at risk of medical complications, so early intervention can be instigated. This article aims to review the clinical practice and evidence supporting the current medical management of young people with AN. It provides a system-based approach to potential complications of the disease, guidance on feeding and the management of re-feeding syndrome. Approaches to legal and ethical challenges are also considered. While the importance of psychiatric treatment is recognised, the same is not discussed within this article.

  9. Anorexia nervosa and bulimia in adolescent males.

    Science.gov (United States)

    Andersen, A E

    1984-12-01

    Anorexia nervosa or bulimia in adolescent males occurs ten times less frequently than in adolescent females. When they occur, however, they can be clearly identified and differentiated from disorders also associated with weight loss such as swallowing phobias. Early diagnosis and treatment leads to improved outcome. While the formal psychopathology of male anorectics is similar to that of females, there is often a different motivation for the initial weight loss in males. They are more often concerned with attaining an idealized male body and avoiding teasing or criticism about their appearance. When males become ill, they tend to develop the full anorectic syndrome or not to become ill at all. Recognition of the special needs of adolescent males for individualized treatment increases the change of optimal outcome. Anorexia nervosa and bulimia in the teenage male should be seen as an ineffective method of dealing with developmental crises by gaining a sense of effectiveness and control through weight reduction and food restriction. Treatment seeks to improve quickly the starvation-related aspects of the illness while attempting to find more appropriate methods of dealing with the life crises prompting the illness. The real goal of treatment is to make the anorectic or bulimic illness unnecessary by encouraging the patient to continue the work of individuation and separation so that challenges in development and problems in living are resolved in a direct rather than an indirect way through an eating disorder. PMID:6596548

  10. Autoimmune Polyglandular Syndrome Type 3 with Anorexia

    Directory of Open Access Journals (Sweden)

    Toshio Kahara

    2012-01-01

    Full Text Available A 71-year-old man with diabetes mellitus visited our hospital with complaints of anorexia and weight loss (12 kg/3 months. He had megaloblastic anemia, cobalamin level was low, and autoantibody to intrinsic factor was positive. He was treated with intramuscular cyanocobalamin, and he was able to consume meals. GAD autoantibody and ICA were positive, and he was diagnosed with slowly progressive type 1 diabetes mellitus (SPIDDM. Thyroid autoantibodies were positive. According to these findings, he was diagnosed with autoimmune polyglandular syndrome type 3 with SPIDDM, pernicious anemia, and Hashimoto's thyroiditis. Extended periods of cobalamin deficiency can cause serious complications such as ataxia and dementia, and these complications may not be reversible if replacement therapy with cobalamin is delayed. Although type 1 diabetes mellitus with coexisting pernicious anemia is very rare in Japan, physicians should consider the possibility of pernicious anemia when patients with diabetes mellitus have cryptogenic anorexia with the finding of significant macrocytosis (MCV > 100 fL.

  11. Anorexia in the Adolescence - case study

    Directory of Open Access Journals (Sweden)

    Almeida de Paiva, Maria O

    2010-07-01

    Full Text Available Eating disorders lead to special biological and psychological states. The result of the total lack of food is treated in a distinct way by anorexia. Nutritionists have thus had difficulty in coming to an agreement on the best therapy to prevent such disorders. First it is essential to understand which treatment aims are and then to attempt to know how the several treatment models used nowadays can reach those aims. Someone who suffers from eating disorders, together with an inner deformation, suffers from too much sensitiveness. In order to solve these problems, one needs a change in the relationship with oneself, with the others and with the world. This study presents a teenager’s case study – Anorexia. Is, in fact, a problem that society faces and can’t ignore. Many youngsters have already died and others are following their steps. But there are also those ones that succeeded in overcoming the problem and now are reporting their stories.

  12. Dysthymia in anorexia nervosa and bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Mercedes Borda-Más

    2008-01-01

    Full Text Available Este estudio ex post facto analiza la presencia de distimia en 155 mujeres. Noventa y tres pacientes cumplían los criterios diagnósticos para un trastorno de la conducta alimentaria (TCA: 31 con anorexia nerviosa restrictiva (ANr, 31 con anorexia nerviosa purgativa/bulímica (ANp y 31 con bulimia nerviosa purgativa (BNp; y 62 mujeres constituían los dos grupos comparativos: 31 con alto riesgo de padecer un TCA (grupo comparativo sintomático: GC-S y 31 sin patología conocida (grupo comparativo no sintomático: GC-NS. Todas ellas cumplimentaron la versión española del MCMI-II. En los resultados encontramos diferencias significativas en las medias obtenidas por los grupos con TCA respecto a los dos grupos comparativos, y que presentaban el posible síndrome distímico [puntuaciones Tasa Base (TB > 74] el 50% de las pacientes con ANr, el 60% con ANp y el 63,30% de las pacientes con BNp. Sólo el 16,70% de las mujeres de alto riesgo y el 5,70% de las mujeres sin patología lo presentaban. Estos hallazgos indican que el síndrome distímico es frecuente en las mujeres con TCA, y en aquellas que presentan conductas purgativas aumenta levemente la severidad del mismo.

  13. Perioperative management of severe anorexia nervosa.

    Science.gov (United States)

    Hirose, K; Hirose, M; Tanaka, K; Kawahito, S; Tamaki, T; Oshita, S

    2014-02-01

    As the prevalence of anorexia nervosa (AN) increased, surgery in severe AN patients also increased in the 2000s. We experienced a surgical case of a patient with severe AN, showing an extremely low BMI of 8.6 kg m(-2). We investigated the problems associated with this case and propose criteria to manage severe AN. We endeavour to report on the perioperative management of rare and severe symptoms and surgical indications of severely malnourished patients. All published reports were identified through comprehensive searches using PubMed, BioMedLib, and the Japan Medical Abstracts Society with the following terms and keywords: 'anorexia nervosa', 'eating disorder', 'hypoglycaemia', 'leucocytopaenia', 'gelatinous bone marrow', 'surgery', and 'operation'. In cases of AN with a BMI under 13 kg m(-2), marked hypoglycaemia, leucocytopaenia feeding syndrome until surgery. During the course of anaesthesia, careless loading of glucose or catecholamine may lead to disturbance of electrolytes or fatal arrhythmia. Intensive care and early feeding as soon as possible after surgery are important to prevent surgical site infection. Although not many perioperative cases of AN have been reported, clinicians must be aware of the danger and the causes of mortality in critical cases. Thus, the decision to undertake surgery must be taken carefully and close perioperative coordination among physicians, surgeons, psychiatrists, anaesthesiologists, and intensivists is essential.

  14. Resting tachycardia, a warning sign in anorexia nervosa: case report

    Directory of Open Access Journals (Sweden)

    Krantz Mori J

    2004-07-01

    Full Text Available Abstract Background Among psychiatric disorders, anorexia nervosa has the highest mortality rate. During an exacerbation of this illness, patients frequently present with nonspecific symptoms. Upon hospitalization, anorexia nervosa patients are often markedly bradycardic, which may be an adaptive response to progressive weight loss and negative energy balance. When anorexia nervosa patients manifest tachycardia, even heart rates in the 80–90 bpm range, a supervening acute illness should be suspected. Case presentation A 52-year old woman with longstanding anorexia nervosa was hospitalized due to progressive leg pain, weakness, and fatigue accompanied by marked weight loss. On physical examination she was cachectic but in no apparent distress. She had fine lanugo-type hair over her face and arms with an erythematous rash noted on her palms and left lower extremity. Her blood pressure was 96/50 mm Hg and resting heart rate was 106 bpm though she appeared euvolemic. Laboratory tests revealed anemia, mild leukocytosis, and hypoalbuminemia. She was initially treated with enteral feedings for an exacerbation of anorexia nervosa, but increasing leukocytosis without fever and worsening left leg pain prompted the diagnosis of an indolent left lower extremity cellulitis. With antibiotic therapy her heart rate decreased to 45 bpm despite minimal restoration of body weight. Conclusions Bradycardia is a characteristic feature of anorexia nervosa particularly with significant weight loss. When anorexia nervosa patients present with nonspecific symptoms, resting tachycardia should prompt a search for potentially life-threatening conditions.

  15. Anorexia of aging: a modifiable risk factor for frailty.

    Science.gov (United States)

    Martone, Anna Maria; Onder, Graziano; Vetrano, Davide Liborio; Ortolani, Elena; Tosato, Matteo; Marzetti, Emanuele; Landi, Francesco

    2013-10-14

    Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social factors. Given the interconnection between weight loss, sarcopenia and frailty, anorexia is a powerful, independent predictor of poor quality of life, morbidity and mortality in older persons. One of the most important goals in the management of older, frail people is to optimize their nutritional status. To achieve this objective it is important to identify subjects at risk of anorexia and to provide multi-stimulus interventions that ensure an adequate amount of food to limit and/or reverse weight loss and functional decline. Here, we provide a brief overview on the relevance of anorexia in the context of sarcopenia and frailty. Major pathways supposedly involved in the pathogenesis of anorexia are also illustrated. Finally, the importance of treating anorexia to achieve health benefits in frail elders is highlighted.

  16. Adipocytokines, gut hormones and growth factors in anorexia nervosa.

    Science.gov (United States)

    Kowalska, Irina; Karczewska-Kupczewska, Monika; Strączkowski, Marek

    2011-09-18

    Anorexia nervosa is a complex eating disorder of unknown etiology which affects adolescent girls and young women and leads to chronic malnutrition. Clinical manifestations of prolonged semistarvation include a variety of physical features and psychiatric disorders. The study of different biological factors involved in the pathophysiology of anorexia nervosa is an area of active interest. In this review we have described the role of adipocytokines, neurotrophins, peptides of the gastrointestinal system and growth factors in appetite regulation, energy balance and insulin sensitivity in anorexia nervosa patients. PMID:21699889

  17. Anorexia nerviosa: del misticismo al culto del cuerpo

    OpenAIRE

    García Sánchez, María

    2016-01-01

    Revisión bibliográfica sobre la Anorexia Nerviosa y su evolución histórica en el mundo. Explicando las diferentes concepciones que se ha tenido de la enfermedad, hasta llegar a la actual. El trabajo irá desde el siglo XIV, donde se encuentran los primeros textos que pueden hacer mención a una posible anorexia, hasta la actualidad. Centrándose especialmente en el siglo XIX y siglo XX, donde la anorexia sufre su mayor desarrollo respecto a estudios y empieza a ser considerado un verdadero pr...

  18. An Adolescent Case of Citrin Deficiency With Severe Anorexia Mimicking Anorexia Nervosa.

    Science.gov (United States)

    Takeuchi, Satsuki; Yazaki, Masahide; Yamada, Shinji; Fukuyama, Tetsuhiro; Inui, Akio; Iwasaki, Yasushi; Ikeda, Shu-ichi

    2015-08-01

    We report a 12-year-old female citrin-deficient patient presenting with severe anorexia and body weight loss, mimicking the restricting type of anorexia nervosa (AN). She showed normal development until age 10 years when she started to play volleyball at school. She then became gradually anorexic, and her growth was stunted. At age 12, she was admitted to hospital because of severe anorexia and thinness. She was first thought to have AN, and drip infusion of glucose solution and high-calorie drinks were given, but her condition deteriorated further. She had a history of neonatal hepatitis and was therefore suspected to have citrin deficiency (CD). Genetic analysis of SLC25A13 revealed that she was compound heterozygous for 851del4 and IVS16ins3kb, and a diagnosis of CD was made. A low-carbohydrate diet with oral intake of arginine and ursodeoxycholic acid was started, and her condition gradually improved. The clinical features in our patient were similar to those of AN, and therefore AN may also be an important clinical sign in adolescent patients with CD.

  19. Understanding Eating Disorders, Anorexia, Bulimia, and Binge-Eating

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Understanding Eating Disorders Past Issues / Spring 2008 Table of Contents For ... this page please turn Javascript on. Photo: iStock Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge ...

  20. Indirect evidence for decreased hypothalamic somatostatinergic tone in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Andersen, M; Flyvbjerg, A;

    2002-01-01

    in the central feeding mechanism in anorexia nervosa (AN). Peripheral administration of pyridostigmine (PD) minimizes the release of hypothalamic SRIH. DESIGN: To study the influence of hypothalamic somatostatinergic inhibition on the exaggerated somatotroph responsiveness to GHRH in patients with severe AN, two...... indirectly to greater SRIH withdrawal and greater GHRH release in anorexia nervosa. Moreover, hypothalamic SRIH activity seems to be inversely related to cortisol levels, indirectly supporting the hypothesis that SRIH and CRH neuronal activity are inversely related in anorexia nervosa. Leptin, which...... is believed to act on hypothalamic feeding mechanisms, seems to be positively related to SRIH activity. Finally, the present data demonstrate that the potentiating effect of pyridostigmine in anorexia nervosa is related to body mass index and increases upon weight gain, suggesting that the low...

  1. Neuroendokrine forstyrrelser ved anorexia nervosa - primoere eller sekundoere?

    DEFF Research Database (Denmark)

    Støving, R K; Hansen-Nord, M; Hangaard, J;

    1996-01-01

    Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic neuropeptides and monoamines are involved in the regulation of human appetite, and they are changed in several ways in anorexia nervosa. But it remains to be clarified whether these alterations are secondary...... or etiologic. Feeding behaviour in anorexia nervosa is characterised by a strong ambivalence and not by loss of appetite. Hypothalamic amenorrhea is a diagnostic criterion, and is not only secondary as it often precedes the weight loss and persists for a long time after weight and motor activity have returned...... to normal. Hypersecretion of corticotropin releasing hormone seems to be secondary to starvation, but at the same time it may keep up and intensify the anorexia, physical hyperactivity and amenorrhea. Low production of insulinlike growth factor-I and high growth hormone secretion reflects the nutritional...

  2. Anorexia Nervosa: The More It Grows, the More It Starves.

    Science.gov (United States)

    Oldis, Katherine O.

    1986-01-01

    Presents a bibliography of books on anorexia nervosa that are appropriate for young adults. Includes fiction, autobiographies, informational books, and books on the related topics of bulimia, bulimarexia, and therapy. (EL)

  3. Disturbances of sex hormones in anorexia nervosa in the male.

    OpenAIRE

    McNab, D.; Hawton, K

    1981-01-01

    Sex hormone levels were measured in a male patient with anorexia nervosa throughout the course of his illness and recovery. Gonadotrophin levels returned to normal with weight gain but his testosterone remained low. Possible explanations for these findings are discussed.

  4. Emotion recognition and regulation in anorexia nervosa.

    Science.gov (United States)

    Harrison, Amy; Sullivan, Sarah; Tchanturia, Kate; Treasure, Janet

    2009-01-01

    It is recognized that emotional problems lie at the core of eating disorders (EDs) but scant attention has been paid to specific aspects such as emotional recognition, regulation and expression. This study aimed to investigate emotion recognition using the Reading the Mind in the Eyes (RME) task and emotion regulation using the Difficulties in Emotion Regulation Scale (DERS) in 20 women with anorexia nervosa (AN) and 20 female healthy controls (HCs). Women with AN had significantly lower scores on RME and reported significantly more difficulties with emotion regulation than HCs. There was a significant negative correlation between total DERS score and correct answers from the RME. These results suggest that women with AN have difficulties with emotional recognition and regulation. It is uncertain whether these deficits result from starvation and to what extent they might be reversed by weight gain alone. These deficits may need to be targeted in treatment.

  5. Extreme Achalasia Presenting as Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    P. J. Goldsmith

    2012-01-01

    Full Text Available Background. Achalasia may lead to cachexia if not diagnosed in an early stage. Surgery in cachectic patients is hazardous and complications may result in a protracted recovery or even death. Different treatment options have been described. In this paper, we report a stepwise surgical laparoscopic approach which appears to be safe and effective. Methods. Over a one-year period, a patient with a body mass index (BMI below 17 being treated for anorexia nervosa was referred with dysphagia. Because of the extreme cachexia, a laparoscopic feeding jejunostomy (LFJ was fashioned to enable long-term home enteral feeding. The patient underwent a laparoscopic Heller myotomy (LHM when the BMI was normal. Results. The patient recovered well following this stepwise approach. Conclusion. Patients with advanced achalasia usually present with extreme weight loss. In this small group of patients, a period of home enteral nutrition (HEN via a laparoscopically placed feeding jejunostomy allows weight gain prior to safe definitive surgery.

  6. Olanzapine treatment in anorexia nervosa: case report.

    Science.gov (United States)

    Dadić-Hero, Elizabeta; Ruzić, Klementina; Pernar, Mirjana; Kabalin, Milena; Medved, Paola

    2009-03-01

    A 15 year old patient suffering from psychiatric disturbances looked for psychiatric help but refused hospital admission. Following an ambulatory treatment, the patient was diagnosed with Anorexia nervosa. The patient, a girl, was 175 centimeters tall, weighting only 39 kilos. Within the clinical picture, there were few dominant disorders present; anxiety, depression, low self-esteem, fear of feminization, with recurrent psychotic episodes. By the implementation of an intensive psychotherapeutic treatment, without the use of psychopharmacs, the weight was kept stable. In accordance with the girl's mother, a psychopharmacotherapy was commenced, a combination of olanzapine and paroxetine (the choice of psychopharmacs was lead by the side effects known). At the end of a 24-month period of a psychological treatment which was combined with psychopharmacotherapy, the patient exhibited no symptomatology and a stable clinical remission of the illness was achieved. PMID:19270636

  7. [ANOREXIA AND BULIMIA: IMPACT ON NETWORK SOCIETY].

    Science.gov (United States)

    Alex Sánchez, María Dolores

    2015-01-01

    The Information and Communication Technologies (ICT) have an increasing influence on the way we relate and in shaping personal identity. The phenomenon of online social networking emerges strongly and contributes to the development of new spaces breaking with the official discourse that marks the scientific evidence on health. This paper analyzes the impact of ICT in relation to the identity of the digital natives and eating disorders (ED). Particular attention to how the network society determines the response of young people in situations of social tension is dedicated. To do this, provides a perspective on the concept of interaction from the analysis of the discourse on anorexia and bulimia in the network, and how to care nurses should consider these factors to improve efficiency and quality in clinical care and patient care.

  8. The body in anorexia and bulimia

    Directory of Open Access Journals (Sweden)

    Maria Helena Fernandes

    2012-09-01

    Full Text Available The psychoanalytic clinic for anorexia and bulimia puts us into immediate contact with the question of the body, as well as with aspects typical of adolescence. These aspects especially include difficulties in early relationships with the mother regarding the management of the drives, and relationships with primary identification. Consequently, we are dealing with ideals, differentiation, autonomy, time and death. Here hypotheses that were drawn up on the basis of metapsychology are discussed, with the objective of contributing to a broader understanding of the construction of the bodily image. This process includes the perception, representation and internal experience of the patients' own bodies. The impasses experienced in the analytic situation also indicate particularities in managing the transference in these cases.

  9. Intracranial germinoma presenting as anorexia and unexplained weight loss

    OpenAIRE

    Shashank Kraleti; David Nelsen

    2014-01-01

    Objective: To describe a patient with germinoma of pineal body who presented with anorexia and unexplained weight loss of 70 pounds. Case Summary: A 23-year-old man with no significant past medical history presented with nausea, vomiting, anorexia and weight loss of 70 pounds over a period of 6–8 months. Magnetic resonance imaging (MRI) scans demonstrated tumor lesions that were confirmed as germinoma histologically. A good treatment response to surgery, radiation, chemot...

  10. Adolescent male with anorexia nervosa: a case report from Iraq

    Directory of Open Access Journals (Sweden)

    Younis Maha S

    2012-01-01

    Full Text Available Abstract This is the first reported case of an adolescent male with anorexia nervosa in Iraq. This disorder is believed to be rare in males across cultures and uncommon for both genders in Arab countries. The patient met the DSM-IV diagnostic criteria for anorexia nervosa. He was hospitalized and received medical and psychiatric treatment at local facilities as discussed below and responded well to treatment.

  11. Severe anorexia nervosa in males: clinical presentations and medical treatment.

    Science.gov (United States)

    Sabel, Allison L; Rosen, Elissa; Mehler, Philip S

    2014-01-01

    The clinical presentation and medical complications of severe anorexia nervosa among males were examined to further the understanding of this increasingly prevalent condition. Fourteen males were admitted to a medical stabilization unit over the study period. Males with severe anorexia nervosa were found to have a multitude of significant medical and laboratory abnormalities, which are in need of treatment via judicious, nutritional rehabilitation and weight restoration to prevent additional morbidity and to facilitate transfer and admission to traditional eating disorder programs.

  12. Treatments of medical complications of anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori J; Sachs, Katherine V

    2015-01-01

    Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa.

  13. Emotional facial expression in women recovered from anorexia nervosa

    OpenAIRE

    Davies, Helen; Schmidt, Ulrike; Tchanturia, Kate

    2013-01-01

    Background Recent models of anorexia nervosa (AN) have emphasised the importance of social and emotional difficulties as maintenance factors of the disorder, however, empirical data are limited. The aim of this study was to examine whether altered emotional facial expression, previously observed in people currently ill with anorexia nervosa, is limited to the ill state or present in people recovered from the illness. Methods The sample consisted of 123 participants [49 AN, 21 recovered AN (Re...

  14. Causes of anorexia in untreated hyperthyroidism: a prospective study

    OpenAIRE

    Dai, W.; Meng, X

    2000-01-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after ...

  15. Anorexia nervosa: treatment expectations – a qualitative study

    OpenAIRE

    Paulson-Karlsson, Gunilla

    2012-01-01

    Gunilla Paulson-Karlsson,1 Lauri Nevonen21Academy of Health and Medical Sciences, Örebro University, Örebro and Anorexia-Bulimia Unit, Child and Adolescent Psychiatry Centre, Queen Silvia Children's Hospital, Göteborg, Sweden; 2Academy of Health and Medical Sciences, Örebro University, Örebro, SwedenBackground: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice ...

  16. Anorexia Nervosa and Body Fat Distribution: A Systematic Review

    OpenAIRE

    Marwan El Ghoch; Simona Calugi; Silvia Lamburghini; Riccardo Dalle Grave

    2014-01-01

    The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa ado...

  17. Defining recovery in Anorexia Nervosa - The importance of concept clarification

    OpenAIRE

    2007-01-01

    Objective: The purpose of this dissertation is to identify major problems that obscure understanding of recovery in Anorexia Nervosa, to differentiate recovery from other closely related concepts, and to highlight the importance of reaching a consensus on the use of terminology. Method: Literature review based on papers that address the concepts of recovery, remission and outcome in Anorexia Nervosa. Relevant literature included in this review was identified by searching the elect...

  18. Neurobiology of hyperactivity and reward: Agreeable restlessness in Anorexia Nervosa

    OpenAIRE

    Scheurink, Anton J. W.; Boersma, Gretha J.; Nergardh, Ricard; Sodersten, Per; Nergårdh, Ricard; Södersten, Per

    2010-01-01

    Restricted food intake is associated with increased physical activity, very likely an evolutionary advantage, initially both functional and rewarding. The hyperactivity of patients with Anorexia Nervosa, however, is a main problem for recovery. This seemingly paradoxical reward of hyperactivity in Anorexia Nervosa is one of the main aspects in our framework for the neurobiological changes that may underlie the development of the disorder. Here, we focus on the neurobiological basis of hyperac...

  19. Diminished creatinine clearance in anorexia nervosa: reversal with weight gain.

    OpenAIRE

    Boag, F.; Weerakoon, J; Ginsburg, J; Havard, C W; Dandona, P

    1985-01-01

    To assess whether patients with anorexia nervosa have abnormalities in creatinine clearance, we measured plasma creatinine concentration, urinary creatinine excretion, and creatinine clearance in 10 patients with anorexia nervosa before and during treatment. Urinary creatinine excretion and creatinine clearance were diminished in all patients. Nine patients had significant decreases in their plasma creatinine and creatinine clearance was increased even when corrected for body weight and body ...

  20. Neurological Soft Signs in Stadien der Anorexia nervosa

    OpenAIRE

    Oskamp, Andrea

    2013-01-01

    Loss of cerebral gray and white matter volume which cause brain function deficits are described in patients with anorexia nervosa (AN). Neurological soft signs (NSS) are minor neurological signs which indicate non-specific cerebral dysfunction. First investigations have shown their presence in Anorexia nervosa (AN) - including particularly poor motor coordination and difficulties in sequencing complex motor tasks. It is uncertain whether these deficiencies are endophenotype of AN, independent...

  1. Anorexia in cancer: role of feeding-regulatory peptides

    OpenAIRE

    Perboni, Simona; Inui, Akio

    2006-01-01

    Anorexia is one of the most common symptoms in advanced cancer and is a frequent cause of discomfort for cancer patients and their families. The pathogenesis of cancer anorexia is multi-factorial and involves most of the hypothalamic neuronal signalling pathways modulating energy homeostasis. It is considered to be the result of a failure of usual appetite and satiety signals. Loss of appetite can arise from decreased taste and smell of food, as well as from dysfunctional hypothalamic signall...

  2. Pathophysiology of anorexia in the cancer cachexia syndrome

    OpenAIRE

    Ezeoke, Chukwuemeka Charles; Morley, John E.

    2015-01-01

    Anorexia is commonly present in persons with cancer and a major component of cancer cachexia. There are multiple causes of anorexia in cancer. Peripherally, these can be due to (i) substances released from or by the tumour, e.g. pro-inflammatory cytokines, lactate, and parathormone-related peptide; (ii) tumours causing dysphagia or altering gut function; (iii) tumours altering nutrients, e.g. zinc deficiency; (iv) tumours causing hypoxia; (v) increased peripheral tryptophan leading to increas...

  3. Cancer cachexia-anorexia syndrome and skeletal muscle wasting

    OpenAIRE

    Jurdana, Mihaela

    2013-01-01

    Cachexia-anorexia syndrome is a common and important indicator of cancer. It occurs in 30% to 80% of cancer patients. Cachexia means "bad condition" and may be present in the early stages of tumor growth, before any signs of malignancy. Cancer cachexia is a syndrome of progressive body wasting, characterized by loss of adipose tissue and skeletal muscle mass. In most cancer patients, cachexia is characteriyed by anorexia, which implies a failure of food intake, regulated through a complex sys...

  4. Could Dopamine Agonists Aid in Drug Development for Anorexia Nervosa?

    Directory of Open Access Journals (Sweden)

    Guido eFrank

    2014-11-01

    Full Text Available Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological and social factors has complicated identifying neurobiological mechanisms that contribute to the illness. The dopamine D1 and D2 neurotransmitter receptors are involved in motivational aspects of food approach, fear extinction and cognitive flexibility. They could therefore be important targets to improve core and associated behaviors in anorexia nervosa. Treatment with dopamine antagonists has shown little benefit, and it is possible that antagonists over time increase an already hypersensitive dopamine pathway activity in anorexia nervosa. On the contrary, application of dopamine receptor agonists could reduce circuit responsiveness, facilitate fear extinction and improve cognitive flexibility in anorexia nervosa, as they may be particularly effective during underweight and low gonadal hormone states. This article provides evidence that the dopamine receptor system could be a key factor in the pathophysiology of anorexia nervosa and dopamine agonists could be helpful in reducing core symptoms of the disorder. This review is a theoretical approach that primarily focuses on dopamine receptor function as this system has been mechanistically better described than other neurotransmitters that are altered in anorexia nervosa. However, those proposed dopamine mechanisms in anorexia nervosa also warrant further study with respect to their interaction with other neurotransmitter systems, such as serotonin pathways.

  5. Anorexia nervosa among teenage girls: Emerging or prevalent?

    OpenAIRE

    Hisam, Aliya; Rahman, Mahmood Ur; Mashhadi, Syed Fawad

    2015-01-01

    Objectives: To find out frequency of anorexia nervosa (AN) among teenage girls (TG) and to find out the knowledge and practice regarding anorexia nervosa among teenage girls. Methods: A cross sectional study was conducted at higher secondary public school, Rawalpindi from June 2013 till December 2013. A sample of 100 female students of the age group 13-19 years were inducted by systematic sampling technique. Mixed pretested questionnaire was filled after informed verbal consent. Data was ente...

  6. Could Dopamine Agonists Aid in Drug Development for Anorexia Nervosa?

    OpenAIRE

    Guido eFrank

    2014-01-01

    Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological and social fa...

  7. Treatments of medical complications of anorexia nervosa and bulimia nervosa

    OpenAIRE

    Mehler, Philip S; Krantz, Mori J; Sachs, Katherine V.

    2015-01-01

    Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa.

  8. Could Dopamine Agonists Aid in Drug Development for Anorexia Nervosa?

    OpenAIRE

    Frank, Guido K.W.

    2014-01-01

    Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage-years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight, and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological, and social ...

  9. Anorexia nervosa: discourses of gender, subjectivity and the body

    OpenAIRE

    Malson, H. M.

    1995-01-01

    This thesis investigates how anorexia nervosa is constructed and deployed as a discursive social and psychological category, drawing critically on feminist psychoanalytic and Foucauldian theories of gender, subjectivity and discourse. The introduction provides a brief discussion of diagnostic criteria and the epidemiology of anorexia. It outlines the thesis as a whole, providing a brief explanation of the approach adopted in the thesis. Chapter 2 critically reviews rec...

  10. Could dopamine agonists aid in drug development for anorexia nervosa?

    Science.gov (United States)

    Frank, Guido K W

    2014-01-01

    Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage-years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight, and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological, and social factors has complicated identifying neurobiological mechanisms that contribute to the illness. The dopamine D1 and D2 neurotransmitter receptors are involved in motivational aspects of food approach, fear extinction, and cognitive flexibility. They could therefore be important targets to improve core and associated behaviors in anorexia nervosa. Treatment with dopamine antagonists has shown little benefit, and it is possible that antagonists over time increase an already hypersensitive dopamine pathway activity in anorexia nervosa. On the contrary, application of dopamine receptor agonists could reduce circuit responsiveness, facilitate fear extinction, and improve cognitive flexibility in anorexia nervosa, as they may be particularly effective during underweight and low gonadal hormone states. This article provides evidence that the dopamine receptor system could be a key factor in the pathophysiology of anorexia nervosa and dopamine agonists could be helpful in reducing core symptoms of the disorder. This review is a theoretical approach that primarily focuses on dopamine receptor function as this system has been mechanistically better described than other neurotransmitters that are altered in anorexia nervosa. However, those proposed dopamine mechanisms in anorexia nervosa also warrant further study with respect to their interaction with other neurotransmitter systems, such as serotonin pathways. PMID:25988121

  11. The syndrome of anorexia-cachexia.

    Science.gov (United States)

    Body, J J

    1999-07-01

    Cancer anorexia/cachexia is a major clinical problem, especially in advanced cancer patients. Its pathogenesis is quite complex. Anorexia plays a central role, but cancer cachexia is more complex than pure chronic starvation. One of the key differences is the preferential mobilization of fat and the sparing of skeletal muscle in simple starvation compared with an equal mobilization of fat and skeletal muscle in cancer patients. An increase in basal energy expenditures seems to play a contributory role in many patients. Cytokines, essentially but not exclusively tumor necrosis factor alpha, play an essential role, and the syndrome can be compared with a low-grade chronic inflammatory state. As it is in most fields in medicine, prevention is more efficacious than treatment, and, to avoid the final and dramatic stages of cancer cachexia, adequate nutritional advice and support must be provided sufficiently early. Parenteral nutrition could facilitate the administration of complete doses of chemotherapy or radiotherapy, but no significant survival benefit or decrease in treatment-induced toxicity have ever been demonstrated in prospective randomized trials. The gut should always be used if at all possible. Percutaneous endoscopic gastrostomy is used increasingly in patients who cannot eat but who have functionally intact gastrointestinal tracts, especially in patients with head and neck cancer. Eight randomized, double-blind, placebo-controlled studies have demonstrated that progestational drugs can somewhat stimulate appetite, food intake, and energy level; increase weight in many patients; and often decrease nausea and vomiting severity; however, pharmacologic treatment of cancer cachexia remains disappointing, and more trials with anticytokine drugs should be conducted.

  12. Mechanisms of the anorexia of aging-a review.

    Science.gov (United States)

    Wysokiński, Adam; Sobów, Tomasz; Kłoszewska, Iwona; Kostka, Tomasz

    2015-08-01

    Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly. PMID:26232135

  13. Social Cognition in Child and Adolescents with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    ipek Percinel

    2015-06-01

    Full Text Available Social cognition represents the mental processes of social interaction between oneself and others. In recent years, the interest in social cognition skills has increased in cases with eating disorders. Anorexia nervosa is an eating disorder that is associated with the multiple factors in etiology. Treatment of anorexia nervosa is still controversial. The youths diagnosed with anorexia nervosa are known to be as the most difficult group in eating disorders for building therapeutic relations. Studies, mostly suggests that there are difficulties in social cognitive functions in patients with anorexia nervosa. However, there are studies that reported different results. It seems that, the majority of studies which evaluate the social cognitive functions in patients with anorexia nervosa, are carried out with the adult age group. There are limited number of studies in child and adolescent age group. The purpose of this paper was to examinate the studies of social cognitive skills in children and adolescents diagnosed with anorexia nervosa and present the general characteristics. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 178-189

  14. Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus.

    Science.gov (United States)

    Reyes-Haro, Daniel; Labrada-Moncada, Francisco Emmanuel; Varman, Durairaj Ragu; Krüger, Janina; Morales, Teresa; Miledi, Ricardo; Martínez-Torres, Ataúlfo

    2016-01-01

    Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA) is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus) in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20%) in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (-23%) and dentate gyrus (-48%). The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression. PMID:27579183

  15. Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

    Directory of Open Access Journals (Sweden)

    Daniel Reyes-Haro

    2016-01-01

    Full Text Available Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20% in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (−23% and dentate gyrus (−48%. The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression.

  16. Female-biased anorexia and anxiety in the Syrian hamster.

    Science.gov (United States)

    Shannonhouse, John L; Fong, Li An; Clossen, Bryan L; Hairgrove, Ross E; York, Daniel C; Walker, Benjamin B; Hercules, Gregory W; Mertesdorf, Lauren M; Patel, Margi; Morgan, Caurnel

    2014-06-22

    Anorexia and anxiety cause significant mortality and disability with female biases and frequent comorbidity after puberty, but the scarcity of suitable animal models impedes understanding of their biological underpinnings. It is reported here that in adult or weanling Syrian hamsters, relative to social housing (SH), social separation (SS) induced anorexia characterized as hypophagia, weight loss, reduced adiposity, and hypermetabolism. Following anorexia, SS increased reluctance to feed, and thigmotaxis, in anxiogenic environments. Importantly, anorexia and anxiety were induced post-puberty with female biases. SS also reduced hypothalamic corticotrophin-releasing factor mRNA and serum corticosteroid levels assessed by RT-PCR and RIA, respectively. Consistent with the view that sex differences in adrenal suppression contributed to female biases in anorexia and anxiety by disinhibiting neuroimmune activity, SS elevated hypothalamic interleukin-6 and toll-like receptor 4 mRNA levels. Although corticosteroids were highest during SH, they were within the physiological range and associated with juvenile-like growth of white adipose, bone, and skeletal muscle. These results suggest that hamsters exhibit plasticity in bioenergetic and emotional phenotypes across puberty without an increase in stress responsiveness. Thus, social separation of hamsters provides a model of sex differences in anorexia and anxiety during adulthood and their pathogeneses during adolescence.

  17. Mechanisms of the anorexia of aging-a review.

    Science.gov (United States)

    Wysokiński, Adam; Sobów, Tomasz; Kłoszewska, Iwona; Kostka, Tomasz

    2015-08-01

    Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.

  18. Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

    Science.gov (United States)

    Labrada-Moncada, Francisco Emmanuel; Varman, Durairaj Ragu; Krüger, Janina; Morales, Teresa; Miledi, Ricardo; Martínez-Torres, Ataúlfo

    2016-01-01

    Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA) is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus) in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20%) in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (−23%) and dentate gyrus (−48%). The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression.

  19. Anorexia in human and experimental animal models: physiological aspects related to neuropeptides.

    Science.gov (United States)

    Yoshimura, Mitsuhiro; Uezono, Yasuhito; Ueta, Yoichi

    2015-09-01

    Anorexia, a loss of appetite for food, can be caused by various physiological and pathophysiological conditions. In this review, firstly, clinical aspects of anorexia nervosa are summarized in brief. Secondly, hypothalamic neuropeptides responsible for feeding regulation in each hypothalamic nucleus are discussed. Finally, three different types of anorexigenic animal models; dehydration-induced anorexia, cisplatin-induced anorexia and cancer anorexia-cachexia, are introduced. In conclusion, hypothalamic neuropeptides may give us novel insight to understand and find effective therapeutics strategy essential for various kinds of anorexia.

  20. Using the Activity-based Anorexia Rodent Model to Study the Neurobiological Basis of Anorexia Nervosa.

    Science.gov (United States)

    Chowdhury, Tara Gunkali; Chen, Yi-Wen; Aoki, Chiye

    2015-10-22

    Anorexia nervosa (AN) is a psychiatric illness characterized by excessively restricted caloric intake and abnormally high levels of physical activity. A challenging illness to treat, due to the lack of understanding of the underlying neurobiology, AN has the highest mortality rate among psychiatric illnesses. To address this need, neuroscientists are using an animal model to study how neural circuits may contribute toward vulnerability to AN and may be affected by AN. Activity-based anorexia (ABA) is a bio-behavioral phenomenon described in rodents that models the key symptoms of anorexia nervosa. When rodents with free access to voluntary exercise on a running wheel experience food restriction, they become hyperactive - running more than animals with free access to food. Here, we describe the procedures by which ABA is induced in adolescent female C57BL/6 mice. On postnatal day 36 (P36), the animal is housed with access to voluntary exercise on a running wheel. After 4 days of acclimation to the running wheel, on P40, all food is removed from the cage. For the next 3 days, food is returned to the cage (allowing animals free food access) for 2 hr daily. After the fourth day of food restriction, free access to food is returned and the running wheel is removed from the cage to allow the animals to recover. Continuous multi-day analysis of running wheel activity shows that mice become hyperactive within 24 hr following the onset of food restriction. The mice run even during the limited time during which they have access to food. Additionally, the circadian pattern of wheel running becomes disrupted by the experience of food restriction. We have been able to correlate neurobiological changes with various aspects of the animals' wheel running behavior to implicate particular brain regions and neurochemical changes with resilience and vulnerability to food-restriction induced hyperactivity.

  1. Rikkunshito, a ghrelin potentiator, ameliorates anorexia-cachexia syndrome

    Directory of Open Access Journals (Sweden)

    Naoki eFujitsuka

    2014-12-01

    Full Text Available Anorexia-cachexia syndrome develops during the advanced stages of various chronic diseases in which patients exhibit a decreased food intake, weight loss, and muscle tissue wasting. For these patients, this syndrome is a critical problem leading to an increased rate of morbidity and mortality. The present pharmacological therapies for treating anorexia-cachexia have limited effectiveness. The Japanese herbal medicine rikkunshito is often prescribed for the treatment of anorexia and upper gastrointestinal disorders. Thus, rikkunshito is expected to be beneficial for the treatment of patients with anorexia-cachexia syndrome. In this review, we summarize the effects of rikkunshito and its mechanisms of action on anorexia-cachexia.Persistent loss of appetite leads to a progressive depletion of body energy stores, which is frequently associated with cachexia. Consequently, regulating appetite and energy homeostasis is critically important for treating cachexia. Ghrelin is mainly secreted from the stomach, and it plays an important role in initiating feeding, controlling gastrointestinal motility, and regulating energy expenditure. Recent clinical and basic science studies have demonstrated that the critical mechanism of rikkunshito underlies endogenous ghrelin activity. Interestingly, several components of rikkunshito target multiple gastric and central sites, and regulate the secretion, receptor sensitization, and degradation of ghrelin. Rikkunshito is effective for the treatment of anorexia, body weight loss, muscle wasting, and anxiety-related behavior. Furthermore, treatment with rikkunshito was observed to prolong survival in an animal model of cachexia. The use of a potentiator of ghrelin signaling, such as rikkunshito, may represent a novel approach for the treatment of anorexia-cachexia syndrome.

  2. Osteopenia and bone fractures in a man with anorexia nervosa and hypogonadism

    International Nuclear Information System (INIS)

    Women with anorexia nervosa have reduced skeletal mass. Both anorexia and osteopenia are less common in men. We describe a 22-year-old man with anorexia nervosa and severe osteopenia involving both cortical and trabecular bone who developed a pelvic fracture and multiple vertebral compression fractures. He was found to have secondary hypogonadotropic hypogonadism that was reversible with weight gain. This case illustrates the need to consider osteopenia as a potential complication of anorexia nervosa in males as well as females

  3. Osteopenia and bone fractures in a man with anorexia nervosa and hypogonadism

    Energy Technology Data Exchange (ETDEWEB)

    Rigotti, N.A.; Neer, R.M.; Jameson, L.

    1986-07-18

    Women with anorexia nervosa have reduced skeletal mass. Both anorexia and osteopenia are less common in men. We describe a 22-year-old man with anorexia nervosa and severe osteopenia involving both cortical and trabecular bone who developed a pelvic fracture and multiple vertebral compression fractures. He was found to have secondary hypogonadotropic hypogonadism that was reversible with weight gain. This case illustrates the need to consider osteopenia as a potential complication of anorexia nervosa in males as well as females.

  4. Dysfunctional metacognition and drive for thinness in typical and atypical anorexia nervosa

    OpenAIRE

    Davenport, Emily; Rushford, Nola; Soon, Siew; McDermott, Cressida

    2015-01-01

    Background Anorexia nervosa is complex and difficult to treat. In cognitive therapies the focus has been on cognitive content rather than process. Process-oriented therapies may modify the higher level cognitive processes of metacognition, reported as dysfunctional in adult anorexia nervosa. Their association with clinical features of anorexia nervosa, however, is unclear. With reclassification of anorexia nervosa by DSM-5 into typical and atypical groups, comparability of metacognition and d...

  5. An examination of autism spectrum traits in adolescents with anorexia nervosa and their parents.

    OpenAIRE

    Rhind, C.; Bonfioli, E.; Hibbs, R.; Goddard, E; MacDonald, P; Gowers, S; Schmidt, U.; Tchanturia, K.; Micali, N; Treasure, J

    2014-01-01

    Background There may be a link between anorexia nervosa and autism spectrum disorders. The aims of this study were to examine whether adolescents with anorexia nervosa have autism spectrum and/or obsessive-compulsive traits, how many would meet diagnostic criteria for autism spectrum disorder, and whether these traits are shared by parents. Methods A total of 150 adolescents receiving outpatient treatment for anorexia nervosa or subthreshold anorexia nervosa and their parents completed the au...

  6. Resting state functional connectivity in anorexia nervosa.

    Science.gov (United States)

    Phillipou, Andrea; Abel, Larry Allen; Castle, David Jonathan; Hughes, Matthew Edward; Nibbs, Richard Grant; Gurvich, Caroline; Rossell, Susan Lee

    2016-05-30

    Anorexia Nervosa (AN) is a serious psychiatric illness characterised by a disturbance in body image, a fear of weight gain and significantly low body weight. The factors involved in the genesis and maintenance of AN are unclear, though the potential neurobiological underpinnings of the condition are of increasing interest. Through the investigation of functional connectivity of the brain at rest, information relating to neuronal communication and integration of information that may relate to behaviours and cognitive symptoms can be explored. The aim of this study was to investigate functional connectivity of the default mode network, and sensorimotor and visual networks in AN. 26 females with AN and 27 healthy control participants matched for age, gender and premorbid intelligence underwent a resting state functional magnetic resonance imaging scan. Default mode network functional connectivity did not differ between groups. AN participants displayed reduced functional connectivity between the sensorimotor and visual networks, in comparison to healthy controls. This finding is discussed in terms of differences in visuospatial processing in AN and the distortion of body image experienced by these individuals. Overall, the findings suggest that sensorimotor and visual network connectivity may be related to visuospatial processing in AN, though, further research is required. PMID:27111812

  7. Oral zinc supplementation in anorexia nervosa.

    Science.gov (United States)

    Safai-Kutti, S

    1990-01-01

    There is evidence to suggest that zinc (Zn) deficiency may be involved in the pathogenesis of anorexia nervosa (AN). In an open study of 20 females, aged 14-26 years, afflicted with AN the effect of oral zinc supplementation was investigated. In each case the diagnosis of AN was based on the criteria of DSM-III-R. After a careful history, complete physical examination and laboratory screening the subjects were started on 45-90 mg of Zn2+, as zinc sulfate, (SolvezinkR, Tika, Sweden) per day. During a follow-up period of 8-56 months 17 patients increased their body weight by more than 15%. The maximum gradual weight gain of 57% was encountered in one patient after 24 months of zinc therapy. The most rapid weight gain was recorded in a patient who increased her body weight by 24% over a period of 3 months. After the institution of zinc, weight loss was not registered in any of our patients. In 13 subjects the menstruation returned 1-17 months after the initiation of zinc therapy. None of our patients developed bulimia. The design of an ongoing multicenter placebo-controlled clinical trial of zinc supplementation to patients with AN is described. PMID:2291418

  8. Saccadic Eye Movements in Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Andrea Phillipou

    Full Text Available Anorexia Nervosa (AN has a mortality rate among the highest of any mental illness, though the factors involved in the condition remain unclear. Recently, the potential neurobiological underpinnings of the condition have become of increasing interest. Saccadic eye movement tasks have proven useful in our understanding of the neurobiology of some other psychiatric illnesses as they utilise known brain regions, but to date have not been examined in AN. The aim of this study was to investigate whether individuals with AN differ from healthy individuals in performance on a range of saccadic eye movements tasks.24 females with AN and 25 healthy individuals matched for age, gender and premorbid intelligence participated in the study. Participants were required to undergo memory-guided and self-paced saccade tasks, and an interleaved prosaccade/antisaccade/no-go saccade task while undergoing functional magnetic resonance imaging (fMRI.AN participants were found to make prosaccades of significantly shorter latency than healthy controls. AN participants also made an increased number of inhibitory errors on the memory-guided saccade task. Groups did not significantly differ in antisaccade, no-go saccade or self-paced saccade performance, or fMRI findings.The results suggest a potential role of GABA in the superior colliculus in the psychopathology of AN.

  9. Saccadic Eye Movements in Anorexia Nervosa

    Science.gov (United States)

    Phillipou, Andrea; Rossell, Susan Lee; Gurvich, Caroline; Hughes, Matthew Edward; Castle, David Jonathan; Nibbs, Richard Grant; Abel, Larry Allen

    2016-01-01

    Background Anorexia Nervosa (AN) has a mortality rate among the highest of any mental illness, though the factors involved in the condition remain unclear. Recently, the potential neurobiological underpinnings of the condition have become of increasing interest. Saccadic eye movement tasks have proven useful in our understanding of the neurobiology of some other psychiatric illnesses as they utilise known brain regions, but to date have not been examined in AN. The aim of this study was to investigate whether individuals with AN differ from healthy individuals in performance on a range of saccadic eye movements tasks. Methods 24 females with AN and 25 healthy individuals matched for age, gender and premorbid intelligence participated in the study. Participants were required to undergo memory-guided and self-paced saccade tasks, and an interleaved prosaccade/antisaccade/no-go saccade task while undergoing functional magnetic resonance imaging (fMRI). Results AN participants were found to make prosaccades of significantly shorter latency than healthy controls. AN participants also made an increased number of inhibitory errors on the memory-guided saccade task. Groups did not significantly differ in antisaccade, no-go saccade or self-paced saccade performance, or fMRI findings. Discussion The results suggest a potential role of GABA in the superior colliculus in the psychopathology of AN. PMID:27010196

  10. Genetic findings in anorexia and bulimia nervosa.

    Science.gov (United States)

    Hinney, Anke; Scherag, Susann; Hebebrand, Johannes

    2010-01-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are complex disorders associated with disordered eating behavior. Heritability estimates derived from twin and family studies are high, so that substantial genetic influences on the etiology can be assumed for both. As the monoaminergic neurotransmitter systems are involved in eating disorders (EDs), candidate gene studies have centered on related genes; additionally, genes relevant for body weight regulation have been considered as candidates. Unfortunately, this approach has yielded very few positive results; confirmed associations or findings substantiated in meta-analyses are scant. None of these associations can be considered unequivocally validated. Systematic genome-wide approaches have been performed to identify genes with no a priori evidence for their relevance in EDs. Family-based scans revealed linkage peaks in single chromosomal regions for AN and BN. Analyses of candidate genes in one of these regions led to the identification of genetic variants associated with AN. Currently, an international consortium is conducting a genome-wide association study for AN, which will hopefully lead to the identification of the first genome-wide significant markers.

  11. Compulsivity in Anorexia Nervosa: a transdiagnostic concept

    Directory of Open Access Journals (Sweden)

    Lauren Rose Godier

    2014-07-01

    Full Text Available The compulsive nature of weight loss behaviours central to Anorexia Nervosa (AN, such as relentless self-starvation and over-exercise, has led to the suggestion of parallels between AN and other compulsive disorders such as Obsessive-Compulsive Disorder (OCD and addictions. There is a huge unmet need for effective treatments in AN, which has high rates of morbidity and the highest mortality rate of any psychiatric disorder, yet a grave paucity of effective treatments. Viewing compulsivity as a transdiagnostic concept, seen in various manifestations across disorders, may help delineate the mechanisms responsible for the persistence of AN, and aid treatment development. We explore models of compulsivity that suggest dysfunction in cortico-striatal circuitry underpins compulsive behaviour, and consider evidence of aberrances in this circuitry across disorders. Excessive habit formation is considered as a mechanism by which initially rewarding weight loss behaviour in AN may become compulsive over time, and the complex balance between positive and negative reinforcement in this process is considered. The physiological effects of starvation in promoting compulsivity, positive reinforcement and habit formation are also discussed. Further research in AN may benefit from a focus on processes potentially underlying the development of compulsivity, such as aberrant reward processing and habit formation. We discuss the implications of a transdiagnostic perspective on compulsivity, and how it may contribute to the development of novel treatments for AN.

  12. Family cognitive remediation therapy for anorexia nervosa.

    Science.gov (United States)

    Lask, Bryan; Roberts, Alice

    2015-04-01

    Anorexia nervosa (AN) in childhood and adolescence has a poor prognosis. It is possible that this may in part be due to the fact that cognitive weaknesses that appear to be risk factors for its development and maintenance are not being targeted in treatment. Through its focus on these deficits, cognitive remediation therapy (CRT) has been shown to be a promising intervention for AN. Furthermore, family interventions are widely recommended for this patient population, but to date no studies have reported the use of CRT in a family setting. This paper presents a case series in which family-based CRT was a significant component of the management. It was well received by patients and their families and previously treatment resistant patients became more engaged with the entire treatment process. In addition, all patients receiving family-based CRT went on to make progress towards recovery. These initial clinical observations suggest family-based CRT is likely to be a useful addition to treatment for child and adolescent AN and justifies formal evaluation. PMID:24096368

  13. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  14. Anorexia: comer nada. Una perspectiva psicoanalítica.

    Directory of Open Access Journals (Sweden)

    Luis Salvador López Herrero

    1999-01-01

    Full Text Available La anorexia, palabra que procede del griego y que significa falta de apetito, mantuvo un significado en el mundo antiguo que, en realidad, no se corresponde con el sentido actual de este término (rechazo al alimento. Podemos decir que la anorexia, también denominada «Síndrome de las tres A» (amenorrea, adelgazamiento y anorexia como actitud de rechazo al alimento, a la que más tarde se añadirían otros elementos clínicos, tales como la distorsión de la imagen corporal y el miedo a engordar, es, como entidad nosológica, un tipo de trastorno alimentario que adquiere su carácter clínico a partir de finales del siglo XIX con las descripciones de Gull en Inglaterra y de Lasègue en Francia, quienes hablaban de anorexia nerviosa y de anorexia histérica respectivamente (no en vano la histeria, bajo la mirada de Charcot en París, eclipsaba a la ciencia médica con su camaleónica sintomatología.

  15. Neurofunctional areas related to food appetency in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Juán José Cervantes-Navarrete

    2012-07-01

    Full Text Available In Anorexia Nervosa the observable phenomenon is the suppression of appetite. Little is known about the biological and psychological (top-down bases that maintain this pathological state. However, Anorexia Nervosa is a biological, psychological and social model where the main behavioral characteristic is the inhibition of eating behavior; not by bottom-up but top-down regulation. Objective: To explore the areas of the brain associated with food appetency through functional magnetic resonance in women with anorexia nervosa. Methods: The subjects include 5 female with Restrictive type of Anorexia Nervosa and five controls female with similar in age and low weigh. The subjects were within the MRI scanner and while took fMRI they saw food images that would generate appetite. The subjects were in fasting state and mentally prepare by instruction “imagine you are eating the food presented in the following images”. Results: Compared differences in the activation between subjects four regions were found significant: the anterior cingulate, left front medial region and the left and right midbrain. Conclusions: The patients with Anorexia Nervosa present different activated cerebral areas to those of the controls during the visual exposition to food in hungry state and with evoke cognitions associated with eat food; those regions may be implicated in reward and self-control.

  16. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  17. The Treatment of Anorexia Nervosa and Bulimia: A Multidimensional Group Approach.

    Science.gov (United States)

    Richards, P. Scott

    This paper defines the eating disorders of anorexia nervosa, bulimia, and bulimia nervosa, a bulimic subtype of anorexia nervosa. The diagnosis of these disorders is discussed and similarities and differences among the three disorders are reviewed. Etiological factors are considered and current trends in treatment of anorexia nervosa, bulimia, and…

  18. Readiness to Recover in Adolescent Anorexia Nervosa: Prediction of Hospital Admission

    Science.gov (United States)

    Ametller, L.; Castro, J.; Serrano, E.; Martinez, E.; Toro, J.

    2005-01-01

    Objectives: To determine if motivation to change in anorexia nervosa during treatment is a predictor of hospitalisation in adolescent patients. Method: The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), the Eating Disorders Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI) were administered to a group of 70 anorexia nervosa…

  19. Remission of anorexia nervosa after thyroidectomy: A report of two cases with Graves' disease and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Noguchi Hitoshi

    2011-12-01

    Full Text Available Abstract We report two patients with anorexia nervosa and Graves' disease who received subtotal thyroidectomy for Graves' disease and concomitantly experienced remission from anorexia nervosa. Both were young women (aged 20 and 26 at the time of surgery. Both had well controlled thyroid function and eating behavior at the time of surgery. Both were followed for over five years without relapse of anorexia nervosa or hyperthyroidism. These cases suggest the existence of an endocrine factor originating from the thyroid gland that is involved in the pathogenesis of anorexia nervosa. Since patients of thyroidectomy can remain in good health with supplement of thyroxine alone, it can be hypothesized that this anorexigenic endocrine factor is an evolutionary relic not necessary for the normal function of humans and does not have physiological effects unless secreted beyond normal levels. Given that, it implies the existence of a creature in the animal kingdom for which such an anorexigenic hormone is essential for survival. Migrating birds eat beyond their caloric expenditure before migration and become anorexic for the duration of their flight. It is also known that their thyroid function is elevated during migration. The normal physiology of migration is a complex mechanism involving the hypothalamic, pituitary, thyroid, adrenal and reproductive hormones. The mechanism of disease, however, can be simpler. A review of the literature is presented that suggest a heretofore unreported thyroid hormone, which is involved in the regulation of migration behavior, may be the responsible factor behind anorexia nervosa.

  20. Vegetarianism in anorexia nervosa? A review of 116 consecutive cases.

    Science.gov (United States)

    O'Connor, M A; Touyz, S W; Dunn, S M; Beumont, P J

    A retrospective study was carried out of 116 consecutive patients with anorexia nervosa to ascertain the extent and nature of vegetarianism in this population. Sixty-three (54.3%) patients were found to be avoiding red meat. In only four (6.3%) of these did meat avoidance predate the onset of their anorexia nervosa. Of the remaining 59 patients (best termed pseudovegetarians), 25 (42.4%) patients continued to avoid red meat by the end of treatment. Pseudovegetarianism was associated with a longer duration of anorexia nervosa, a lower weight during the course of their illness, and living away from the parental home. The reintroduction of red meat into the diet was more likely if vegetarianism were of a short duration. PMID:3696039

  1. Increased reverse T3 concentration in patients with anorexia nerrosa

    International Nuclear Information System (INIS)

    In 20 female patients with anorexia nervosa, aging 16 - 26 years, the thyroid function was estimated by +- determining TSH secretion in response to TRH, and serum thyroxine (T4), 3,5,3'L-triiodothyronine (T3) and 3,3',5'L-triiodothyronine (reverse T3) concentrations. 14 healthy women of the same age were included into the control group. If compared with control group, a marked supression of TRH stimulated TSH secretion and a lowering of serum T3 concentration was found in patients with anorexia nervosa. On the other hand, serum reverse T3 concentration was markedly higher in patients with anorexia nervosa than in control ones. Gain of body weight leads to normalization of thyroid hormones level in the serum. Obtained results show for peripheral mechanism of described hormonal disorders. (author)

  2. The occupational roles of women with anorexia nervosa.

    Science.gov (United States)

    Quiles-Cestari, Leila Maria; Ribeiro, Rosane Pilot Pessa

    2012-01-01

    This study's objective was to understand how occupational roles of individuals with anorexia nervosa are configured. The sample was composed of a control group and 11 adult women with anorexia nervosa being cared for by the Eating Disorders Care Group in a hospital in Ribeirão Preto, SP, Brazil. Socio-demographic and anthropometric data were collected and the Role Checklist was applied. The results revealed a significant loss of roles for women with anorexia nervosa in relation to the performance of the roles worker, friend, and amateur/hobbyist, supporting the idea that psychosocial harm may arise from this eating disorder. The evaluation of occupational roles in the treatment of eating disorders is an important strategy for planning Occupational Therapy activities and supporting the creation of healthier spaces to enable individuals to resume occupational roles, and acquire independence and autonomy. PMID:22699719

  3. Anorexia and Attachment: Dysregulated Defense and Pathological Mourning

    Directory of Open Access Journals (Sweden)

    elisa edelvecchio

    2014-10-01

    Full Text Available The role of Defensive exclusion (Deactivation and Segregated Systems in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP. Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed.

  4. A Brief Review of the Biology of Anorexia Nervosa

    DEFF Research Database (Denmark)

    Sjögren, Magnus

    2015-01-01

    Background: The etiology of Anorexia Nervosa (AN) is unknown. A stress model for AN and other Eating Disorders, has been proposed by Connan and depicts risk factors and precipitating events, including biological, but several steps in this have yet to be evidenced. In order to elucidate the biology...... PUBMED and the following search terms: “Anorexia Nervosa” and “biomarker” revealed 180 articles (8th of May 2015). Additional searches included the search terms “gene”, “genetic”, “epigenetic”, “appetite”, “hormone”, and a specific search on “biology” and “review”. Furthermore, articles of interest were...

  5. A review of endocrine changes in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Hansen-Nord, M;

    1999-01-01

    Anorexia nervosa is a syndrome of unknown etiology. It is associated with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of human appetite, and in several ways...... secretion reflect the nutritional deprivation. The nutritional therapy of patients with anorexia nervosa might be improved by administering an anabolic agent such as growth hormone or insulin-like growth factor I. So far none of the endocrine abnormalities have proved to be primary, however...

  6. Early-onset anorexia nervosa in girls with Asperger syndrome

    Directory of Open Access Journals (Sweden)

    Dudova I

    2015-07-01

    Full Text Available Iva Dudova, Jana Kocourkova, Jiri Koutek Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic Abstract: Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome. Keywords: eating disorders, early-onset anorexia nervosa, autism spectrum disorders, Asperger syndrome, diagnostics, therapy

  7. The limits to pride: A test of the pro-anorexia hypothesis.

    Science.gov (United States)

    Cornelius, Talea; Blanton, Hart

    2016-01-01

    Many social psychological models propose that positive self-conceptions promote self-esteem. An extreme version of this hypothesis is advanced in "pro-anorexia" communities: identifying with anorexia, in conjunction with disordered eating, can lead to higher self-esteem. The current study empirically tested this hypothesis. Results challenge the pro-anorexia hypothesis. Although those with higher levels of pro-anorexia identification trended towards higher self-esteem with increased disordered eating, this did not overcome the strong negative main effect of pro-anorexia identification. These data suggest a more effective strategy for promoting self-esteem is to encourage rejection of disordered eating and an anorexic identity.

  8. Gut Dysbiosis in Patients with Anorexia Nervosa.

    Science.gov (United States)

    Morita, Chihiro; Tsuji, Hirokazu; Hata, Tomokazu; Gondo, Motoharu; Takakura, Shu; Kawai, Keisuke; Yoshihara, Kazufumi; Ogata, Kiyohito; Nomoto, Koji; Miyazaki, Kouji; Sudo, Nobuyuki

    2015-01-01

    Anorexia nervosa (AN) is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25), including restrictive (ANR, n = 14) and binge-eating (ANBP, n = 11) subtypes, with those of age-matched healthy female controls (n = 21) using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA-targeted RT-quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients. PMID:26682545

  9. Gut Dysbiosis in Patients with Anorexia Nervosa.

    Science.gov (United States)

    Morita, Chihiro; Tsuji, Hirokazu; Hata, Tomokazu; Gondo, Motoharu; Takakura, Shu; Kawai, Keisuke; Yoshihara, Kazufumi; Ogata, Kiyohito; Nomoto, Koji; Miyazaki, Kouji; Sudo, Nobuyuki

    2015-01-01

    Anorexia nervosa (AN) is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25), including restrictive (ANR, n = 14) and binge-eating (ANBP, n = 11) subtypes, with those of age-matched healthy female controls (n = 21) using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA-targeted RT-quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.

  10. Gut Dysbiosis in Patients with Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Chihiro Morita

    Full Text Available Anorexia nervosa (AN is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25, including restrictive (ANR, n = 14 and binge-eating (ANBP, n = 11 subtypes, with those of age-matched healthy female controls (n = 21 using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA-targeted RT-quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.

  11. Therapist adherence in the strong without anorexia nervosa (SWAN) study: A randomized controlled trial of three treatments for adults with anorexia nervosa

    OpenAIRE

    Andony, Louise Julia; Tay, Elaine; Allen, Karina L; Wade, Tracey D.; Hay, Phillipa; Touyz, Stephen; McIntosh, Virginia V W; Treasure, Janet; Schmidt, Ulrike H.; Fairburn, Christopher G.; Erceg-Hurn, David M; Fursland, Anthea; Crosby, Ross D; Byrne, Susan M.

    2015-01-01

    Objective To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). Method The SWAN Psychother...

  12. Nurse evaluation of hyperactivity in anorexia nervosa : A comparative study

    NARCIS (Netherlands)

    van Elburg, Annemarie A.; Hoek, Hans W.; Kas, Martien J.H.; van Engeland, Herman

    2007-01-01

    Up to 80% of patients with anorexia nervosa (AN) manifest elevated levels of physical activity or hyperactivity. A variety of methods have been used to evaluate activity levels, mostly questionnaires but also expensive and invasive methods such as actometry or other measurements of energy expenditur

  13. Drive for activity in patients with anorexia nervosa

    NARCIS (Netherlands)

    Sternheim, Lot; Danner, Unna; Adan, Roger; van Elburg, Annemarie

    2014-01-01

    OBJECTIVE: Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a drive for activity (DFA) may underlie these expressions, yet research into DFA in AN remains scant. This study investigated DFA levels in patient

  14. Drive for activity in patients with anorexia nervosa

    NARCIS (Netherlands)

    Sternheim, Lot; Danner, Unna; Adan, Roger; Van Elburg, Annemarie

    2015-01-01

    Method Two hundred and forty female patients with AN completed measures for DFA, eating disorder (ED) pathology, anxiety, and clinical parameters. Objective Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a

  15. [Neurofeedback in the Treatment of Anorexia Nervosa: a Case Report].

    Science.gov (United States)

    Lackner, N; Unterrainer, H F; Skliris, D; Wood, G; Dunitz-Scheer, M; Wallner-Liebmann, S J; Scheer, P J Z; Neuper, C

    2016-02-01

    Anorexia nervosa has been related to alterations in brain activity in terms of hyperactive EEG patterns. This case report illustrates the principles and results of a five-week neurofeedback treatment in a 29-year-old woman suffering from anorexia nervosa. A neurofeedback protocol to enhance alpha activity (8 - 12 Hz) was developed and conducted additionally to the standardized treatment for eating disorders in training sessions twice a week. Pre- and post-test measurements included resting state EEG measurements and a psychological test battery. The results show improvements from pre- to post-test in eating disorder psychopathology including psychological wellbeing, emotional competence, and eating behavior traits. In addition, a decrease in theta power (4 - 7 Hz), a well-known trait marker of anorexia nervosa, was measured. However, our data should be interpreted with caution because this is a single case study. Nevertheless, this report documents the practicability and method of neurofeedback as treatment adjunct in eating disorders from the clinical perspective. Although the use of neurofeedback in the treatment of anorexia nervosa is recommended in literature, empirical studies are still lacking. Randomized controlled trials to evaluate short- and long-term effects of neurofeedback are needed. PMID:26953548

  16. Bulimia and Anorexia Nervosa in Dental and Dental Hygiene Curricula.

    Science.gov (United States)

    Gross, Karen B. W.; And Others

    1990-01-01

    Dentists and dental hygienists are in a unique position to identify an eating disorder patient from observed oral manifestations and to refer the patient for psychological therapy. The inclusion of information on general and oral complications of bulimia and anorexia nervosa in dental and dental hygiene curriculum was examined. (MLW)

  17. A Primary Prevention Program to Reduce Bulimia and Anorexia Nervosa.

    Science.gov (United States)

    Cullari, Salvatore; Redmon, William K.

    This paper presents a theoretical model for a primary prevention program for bulimia and anorexia nervosa to be used with adolescents and young women considered most at risk of developing these eating disorders. Characteristics of potential anorexics and bulimics are identified to aid in the selection of target groups for the program. It is…

  18. [Anorexia nervosa and bulimia nervosa. Psychological considerations for its treatment].

    Science.gov (United States)

    Barriguete Meléndez, J Armando; Rojo, Luis; Emmelhainz, Marisa

    2004-11-01

    It is presented the current perspectives in the study and treatment of the eating disorders, in specific: anorexia nervosa and bulimia nervosa, epidemiology, and the interface among the different medical specialties, nutrition and sciences of the behavior, the diagnostic approaches, instruments and current therapeutic models.

  19. Biological Aspects of Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Kaplan, Allan S.; Woodside, D. Blake

    1987-01-01

    Reviews biological factors relevant to the understanding of anorexia nervosa and bulimia nervosa. Considers the physical presentation of these disorders; the medical complications of starvation, binging, and purging; and the cognitive and behavioral effects of starvation. Reviews neurophysiological and neurochemical aspects of these illnesses and…

  20. Reduced Automatic Motivational Orientation Towards Food in Restricting Anorexia Nervosa

    NARCIS (Netherlands)

    Veenstra, Esther M.; de Jong, Peter J.

    2011-01-01

    A striking and characteristic feature of the restricting subtype of anorexia nervosa (AN) is that they are extremely successful in regulating their food intake in a destructive manner. A possible explanation for the persistent character of their restricted food intake could be a loss of the motivati

  1. The Anorexia Relapse Prevention Guideline in Practice: A case report

    NARCIS (Netherlands)

    Meijel, Berno van; Berends, Tamara; Elburg, Annemarie van

    2014-01-01

    Dit artikel biedt inzicht in de wijze waarop hulpverleners in de geestelijke gezondheidszorg een bijdrage kunnen leveren aan het voorkomen van terugval bij patiënten met de psychiatrische ziekte anorexia nervosa. De auteurs ontwikkelden een praktische richtlijn bestemd voor hulpverleners, patenten e

  2. Dronabinol in severe, enduring anorexia nervosa: A randomized controlled trial

    DEFF Research Database (Denmark)

    Andries, Alin; Frystyk, Jan; Flyvbjerg, Allan;

    2013-01-01

    The evidence for pharmacological treatment of severe, longstanding anorexia nervosa (AN) is sparse and the few controlled pharmacologic studies have focused on a narrow range of drugs. The aim of the present study was to investigate the effects of treatment with a synthetic cannabinoid agonist...

  3. Perceived Personality Traits of Individuals with Anorexia Nervosa

    Science.gov (United States)

    Watters, Jessica E.; Malouff, John M.

    2012-01-01

    Background: Prior research has found evidence of a general negative personality stereotype for individuals who have anorexia nervosa (AN). Methods: This study examined the expected personality characteristics of individuals with AN using the Five-Factor Model of personality to allow identification of specific personality traits that are part of…

  4. Anorexia Nervosa in Adolescence and Maudsley Family-Based Treatment

    Science.gov (United States)

    Hurst, Kim; Read, Shelly; Wallis, Andrew

    2012-01-01

    Anorexia nervosa is a serious psychiatric disorder that usually occurs in adolescence. The course of the illness can be protracted. Current empirical evidence suggests that the Maudsley Family-Based Treatment (MFBT) is efficacious for adolescents. MFBT empowers parents as a crucial treatment resource to assist in their child's recovery. The…

  5. [Anorexia, treating and caring for the mistreated body].

    Science.gov (United States)

    Blanchet-Collet, Corinne; Moro, Marie Rose

    2015-01-01

    Anorexia is a complex, multifactorial disease, emerging during puberty and requiring cross-disciplinary care. The body, taken hostage, expresses psychological suffering and the patient's developmental impasse. Compassionate treatment and the care given to this mistreated and undernourished body facilitate the access to the psychological care and are an essential step towards recovery.

  6. Nutritional adequacy of dietary intake in women with anorexia nervosa

    Science.gov (United States)

    Background: Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the establishment of dietary treatment. Design: Women, aged 19 to 30 years, with both restricting and binge purge types of AN, participating in an ecological momentary assessment study, completed three nonc...

  7. Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

    Science.gov (United States)

    Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

    2008-01-01

    This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

  8. Neurobiology of hyperactivity and reward : Agreeable restlessness in Anorexia Nervosa

    NARCIS (Netherlands)

    Scheurink, Anton J. W.; Boersma, Gretha J.; Nergardh, Ricard; Sodersten, Per; Nergårdh, Ricard; Södersten, Per

    2010-01-01

    Restricted food intake is associated with increased physical activity, very likely an evolutionary advantage, initially both functional and rewarding. The hyperactivity of patients with Anorexia Nervosa, however, is a main problem for recovery. This seemingly paradoxical reward of hyperactivity in A

  9. Depression and Anorexia Nervosa of Persons with Down Syndrome.

    Science.gov (United States)

    Szymanski, Ludwik S.; Biederman, Joseph

    1984-01-01

    Manifestations of depression in three adults wth Down syndrome, one of whom also exhibited anorexia nervosa, are described. Overall findings indicate that major depression in Down syndrome may be more frequent than previously assumed and that it can be diagnosed with standard diagnostic criteria, modified according to the patient's developmental…

  10. Heightened sensitivity to punishment and reward in anorexia nervosa

    NARCIS (Netherlands)

    Glashouwer, Klaske A; Bloot, Lotte; Veenstra, Esther M; Franken, Ingmar H A; de Jong, Peter J

    2014-01-01

    OBJECTIVE: The aim of this study was to investigate reinforcement sensitivity in anorexia nervosa (AN). It was tested whether self-reported punishment (PS) and reward sensitivity (RS) differed between adolescents with AN and healthy controls, and/or between AN-subtypes. In addition, the predictive v

  11. [Somatic care and complications of anorexia nervosa in adolescent girls].

    Science.gov (United States)

    Helfer, Jennifer; Favaro, Alexandra; Ambresin, Anne-Emmanuelle

    2016-06-01

    Anorexia nervosa is a frequent condition that appears mainly during adolescence and may persist until adulthood. It can have serious consequences, which is why it must be quickly detected and treated. In this article, we describe the parameters to be followed in outpatient clinic, complications not to be missed and when a hospital treatment becomes necessary. PMID:27451511

  12. A Psychoeducational Group Approach for Individuals Recovering from Anorexia Nervosa.

    Science.gov (United States)

    Kapp, Lisa

    Although in-depth, long-term group psychotherapy is a beneficial therapeutic experience for adolescent females suffering from anorexia nervosa, these clients are notoriously resistant to treatment and to long-term, open-ended group settings. This dissidence may stem from a motivational deficiency toward changing their eating patterns and…

  13. Fast psychomotor functioning in underweight anorexia nervosa patients.

    NARCIS (Netherlands)

    Pieters, G.F.F.M.; Sabbe, B.G.C.C.; Hulstijn, W.; Probst, M.; Eycken, W. van der; Peuskens, J.

    2003-01-01

    To explore whether underweight anorexia nervosa patients show psychomotor differences relative to normal controls, 32 female hospitalised patients, aged between 14 and 25 years, were compared with 32 healthy, normal weight controls, matched for sex, age and educational level. Using computerised anal

  14. Outpatient Treatment of Primary Anorexia Nervosa in Adult Males.

    Science.gov (United States)

    Ziesat, Harold A., Jr.; Ferguson, James M.

    1984-01-01

    Describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. (JAC)

  15. ["Family groups" for relatives of patients with anorexia nervosa].

    Science.gov (United States)

    Brunswick, Astrid; Guy-Rubin, Aurore; Satori, Nadine

    2016-01-01

    Anorexia nervosa affects mainly young adults. During care, caregivers seek alliance with patients' friends and family to be able to relate to the patients' symptoms and also their environment. Collaborative work with families helps build confidence. The "family group" is an example of well-intended partnership. PMID:27157194

  16. Predictive factors of length of inpatient treatment in anorexia nervosa

    OpenAIRE

    Strik Lievers, Luisa; Curt, Florence; Wallier, Jenny; Perdereau, Fabienne; Rein, Zoé; Jeammet, Philippe; Godart, Nathalie

    2008-01-01

    Abstract Objective To identify clinical variables influencing the length of stay (LOS) of inpatient treatment for anorexia nervosa (AN). Method We analyzed structured clinical charts of 300 consecutive hospitalizations for AN in a specialized eating disorder unit. The sample included patients from 12 to 22 years ...

  17. Anorexia Nervosa and Bulimia: Questions and Answers for School Personnel.

    Science.gov (United States)

    Mallick, M. Joan

    1984-01-01

    School personnel can have a vital role in the early detection and treatment of anorexia nervosa and bulimia by understanding certain signs and symptoms. This article provides specific information about early detection, approaches to use when confronting the student, and methods to facilitate treatment. (Author/DF)

  18. Psychoneuroendocrinological aspects of anorexia nervosa: predictors of recovery

    NARCIS (Netherlands)

    Elburg, A.A. van

    2007-01-01

    Anorexia Nervosa (AN) is a psychosomatic eating disorder of unknown aetiology, which primarily affects adolescent girls and young women and is characterized by aberrant patterns of eating behaviour and weight regulation which result in weight loss and endocrine abnormalities such as amenorrhea, dist

  19. Epidemiology and course of anorexia nervosa in the community

    NARCIS (Netherlands)

    Keski-Rahkonen, Anna; Hoek, Hans W.; Susser, Ezra S.; Linna, Milla S.; Sihvola, Elina; Raevuori, Anu; Bulik, Cynthia M.; Kaprio, Jaakko; Rissanen, Aila

    2007-01-01

    Objective: Most previous studies of the prevalence, incidence, and outcome of anorexia nervosa have been limited to cases detected through the health care system, which may bias our understanding of the disorder's incidence and natural course. The authors sought to describe the onset and outcomes of

  20. Long-term outcome in anorexia nervosa in the community

    NARCIS (Netherlands)

    Mustelin, Linda; Raevuori, Anu; Bulik, Cynthia M.; Rissanen, Aila; Hoek, Hans W.; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2015-01-01

    ObjectiveFew studies have assessed outcomes of anorexia nervosa (AN) outside clinical settings. We aimed to assess mortality, recovery, and socio-demographic outcomes of AN in a community sample. MethodWomen in the nationwide FinnTwin16 cohort (born 1975-1979) were followed for 10 years after baseli

  1. A genome-wide association study of anorexia nervosa

    NARCIS (Netherlands)

    Boraska, V; Franklin, C S; Floyd, J A B; Thornton, L M; Huckins, L M; Southam, L; Rayner, N W; Tachmazidou, I; Klump, K L; Treasure, J; Lewis, C M; Schmidt, U; Tozzi, F; Kiezebrink, K; Hebebrand, J; Gorwood, P; Adan, R A H; Kas, M J H; Favaro, A; Santonastaso, P; Fernández-Aranda, F; Gratacos, M; Rybakowski, F; Dmitrzak-Weglarz, M; Kaprio, J; Keski-Rahkonen, A; Raevuori, A; Van Furth, E F; Slof-Op 't Landt, M C T; Hudson, J I; Reichborn-Kjennerud, T; Knudsen, G P S; Monteleone, P; Kaplan, A S; Karwautz, A; Hakonarson, H; Berrettini, W H; Guo, Y; Li, D; Schork, N J; Komaki, G; Ando, T; Inoko, H; Esko, T; Fischer, K; Männik, K; Metspalu, A; Baker, J H; Cone, R D; Dackor, J; DeSocio, J E; Hilliard, C E; O'Toole, J K; Pantel, J; Szatkiewicz, J P; Taico, C; Zerwas, S; Trace, S E; Davis, O S P; Helder, S; Bühren, K; Burghardt, R; de Zwaan, M; Egberts, K; Ehrlich, S; Herpertz-Dahlmann, B; Herzog, W; Imgart, H; Scherag, A; Scherag, S; Zipfel, S; Boni, C; Ramoz, N; Versini, A; Brandys, M K; Danner, U N; de Kovel, C; Hendriks, J; Koeleman, B P C; Ophoff, R A; Strengman, E; van Elburg, Annemarie; Bruson, A; Clementi, M; Degortes, D; Forzan, M; Tenconi, E; Docampo, E; Escaramís, G; Jiménez-Murcia, S; Lissowska, J; Rajewski, A; Szeszenia-Dabrowska, N; Slopien, A; Hauser, J; Karhunen, L; Meulenbelt, I; Slagboom, P E; Tortorella, A; Maj, M; Dedoussis, G; Dikeos, D; Gonidakis, F; Tziouvas, K; Tsitsika, A; Papezova, H; Slachtova, L; Martaskova, D; Kennedy, J L; Levitan, R D; Yilmaz, Z; Huemer, J; Koubek, D; Merl, E; Wagner, G; Lichtenstein, P; Breen, G; Cohen-Woods, S; Farmer, A; McGuffin, P; Cichon, S; Giegling, I; Herms, S; Rujescu, D; Schreiber, S; Wichmann, H-E; Dina, C; Sladek, R; Gambaro, G; Soranzo, N; Julia, A; Marsal, S; Rabionet, R; Gaborieau, V; Dick, D M; Palotie, A; Ripatti, S; Widén, E; Andreassen, O A; Espeseth, T; Lundervold, A; Reinvang, I; Steen, V M; Le Hellard, S; Mattingsdal, M; Ntalla, I; Bencko, V; Foretova, L; Janout, V; Navratilova, M; Gallinger, S; Pinto, D; Scherer, S W; Aschauer, H; Carlberg, L; Schosser, A; Alfredsson, L; Ding, B; Klareskog, L; Padyukov, L; Courtet, P; Guillaume, S; Jaussent, I; Finan, C; Kalsi, G; Roberts, M; Logan, D W; Peltonen, L; Ritchie, G R S; Barrett, J C; Estivill, X; Hinney, A; Sullivan, P F; Collier, D A; Zeggini, E; Bulik, C M

    2014-01-01

    Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countri

  2. The role of pharmacotherapy in anorexia nervosa and bulimia.

    Science.gov (United States)

    Tolstoi, L G

    1989-11-01

    The purpose of this article is to review the basic pharmacology and the role of drugs that are used to treat anorexia nervosa and bulimia. The pharmacological treatment of eating disorders is based upon theoretical principles. The theoretical models include: (a) an illness secondary to other psychiatric disorders, (b) a disorder in the hypothalamic control of food intake, (c) a disorder of hypothalamic endocrine regulation, (d) a syndrome secondary to depressive illness, and (e) a disorder in the hypothalamic regulation of food intake. Theoretical models a, b, and c govern the choice of drug therapy for anorexia nervosa, and models d and e govern the choice of drug therapy for bulimia. Drugs used to treat anorexia nervosa and bulimia include tricyclic antidepressants and lithium carbonate. Chlorpromazine, metoclopramide, cyproheptadine, and clomiphene citrate have also been prescribed for the treatment of anorexia nervosa. Monoamine oxidase inhibitors are commonly prescribed to treat bulimia. Fenfluramine has the potential to be of therapeutic value in patients with bulimia. Although drug therapy plays a limited role in the treatment of eating disorders, drugs are commonly prescribed. Therefore, the nutritionist should be familiar with the basic pharmacology and the side effects related to drug therapy. PMID:2572619

  3. The Impact of Childhood Sexual Abuse in Anorexia Nervosa

    Science.gov (United States)

    Carter, Jacqueline C.; Bewell, Carmen; Blackmore, Elizabeth; Woodside, D. Blake

    2006-01-01

    Objective: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). Method: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder…

  4. Anorexia Nervosa: An Overview for the School Counselor.

    Science.gov (United States)

    Nufrio, Ronald M.

    Anorexia nervosa is a serious eating disorder which affects thousands of people every year. Ninety-five percent of all anorexics are females with the peak age of onset between 14 and 18. While anorexics fit into no specific stereotype, high-risk candidates are often perfectionists and model children who exhibit self-doubt, high conformity,…

  5. Humanistic Approaches to the Understanding and Treatment of Anorexia Nervosa.

    Science.gov (United States)

    Dittmar, Helga; Bates, Brian

    1987-01-01

    Summarizes some attempts to understand the causes and consequent treatments of anorexia nervosa from the viewpoints of psychoanalytically informed, family, existential and feminist psychology. These perspectives, which focus on the individual experience of the anorexic, leave many questions unanswered, but provide fresh frameworks from which to…

  6. Anorexia mental como resistência à onipotência materna Mental anorexia as resistance to maternal omnipotence

    Directory of Open Access Journals (Sweden)

    Denise da Silva Barbosa

    2010-12-01

    Full Text Available Aborda-se a complexa relação do sujeito com o desejo da mãe no âmbito do fenômeno da anorexia mental. Destaca-se a relação que se estabelece entre a satisfação pulsional obtida pela atividade alimentar e o funcionamento mental na produção de sintomas concernentes ao transtorno alimentar. Evidencia-se o aspecto fundamental da singularidade própria da interferência do componente mãe/filha sobre o aparecimento dos sintomas anoréxicos, ou seja, a anorexia mental como resistência à onipotência materna.The text discusses the complex relationship of the subject with the mother's desire in the scope of the phenomenon of mental anorexia. It highlights the established relationship between the pulsional satisfaction from the feeding activity and the mental functioning in the production of symptoms related to the eating disorder. It focuses on the fundamental aspect of the singularity characteristic of the interference of the component mother/daughter on the appearance of the anorexic symptoms, that is, the mental anorexia as a resistant element to the maternal omnipotence.

  7. The occupational roles of women with anorexia nervosa Los papeles ocupacionales de mujeres con anorexia nervosa Os papéis ocupacionais de mulheres com anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Leila Maria Quiles-Cestari

    2012-04-01

    Full Text Available This study’s objective was to understand how occupational roles of individuals with anorexia nervosa are configured. The sample was composed of a control group and 11 adult women with anorexia nervosa being cared for by the Eating Disorders Care Group in a hospital in Ribeirão Preto, SP, Brazil. Socio-demographic and anthropometric data were collected and the Role Checklist was applied. The results revealed a significant loss of roles for women with anorexia nervosa in relation to the performance of the roles worker, friend, and amateur/hobbyist, supporting the idea that psychosocial harm may arise from this eating disorder. The evaluation of occupational roles in the treatment of eating disorders is an important strategy for planning Occupational Therapy activities and supporting the creation of healthier spaces to enable individuals to resume occupational roles, and acquire independence and autonomy.El objetivo es entender como figuran los papeles ocupacionales de las personas con anorexia nervosa. La casuística fue compuesta por 11 personas diagnosticadas en tratamiento en el Grupo de Asistencia en Trastornos Alimentares de un Hospital de Ribeirão Preto-Brasil y un grupo control. Se recogieron variables sociodemográficas, antropométricas y por la “Lista de Identificación de Papeles Ocupacionales”. Los resultados muestran hubo cambio, con pérdida de papeles debido a la anorexia nerviosa, con pérdida de los papeles de trabajador, voluntario, amigo y pasatiempo amador, corroborando los perjuicios psicosociales derivados de este trastorno. La evaluación de los papeles ocupacionales en el tratamiento de los trastornos alimentares es una estrategia importante para la planificación de la terapia ocupacional por la concesión de subvenciones para crear ambientes más saludables, donde las posibilidades de crear el rescate de los papeles ocupacionales, la independencia y autonomía.O objetivo desta pesquisa foi compreender como se

  8. Anorexia Nervosa: A Unified Neurological Perspective

    Directory of Open Access Journals (Sweden)

    Tasneem Fatema Hasan, Hunaid Hasan

    2011-01-01

    Full Text Available The roles of corticotrophin-releasing factor (CRF, opioid peptides, leptin and ghrelin in anorexia nervosa (AN were discussed in this paper. CRF is the key mediator of the hypothalamo-pituitary-adrenal (HPA axis and also acts at various other parts of the brain, such as the limbic system and the peripheral nervous system. CRF action is mediated through the CRF1 and CRF2 receptors, with both HPA axis-dependent and HPA axis-independent actions, where the latter shows nil involvement of the autonomic nervous system. CRF1 receptors mediate both the HPA axis-dependent and independent pathways through CRF, while the CRF2 receptors exclusively mediate the HPA axis-independent pathways through urocortin. Opioid peptides are involved in the adaptation and regulation of energy intake and utilization through reward-related behavior. Opioids play a role in the addictive component of AN, as described by the “auto-addiction opioids theory”. Their interactions have demonstrated the psychological aspect of AN and have shown to prevent the functioning of the physiological homeostasis. Important opioids involved are β-lipotropin, β-endorphin and dynorphin, which interact with both µ and κ opioids receptors to regulate reward-mediated behavior and describe the higher incidence of AN seen in females. Moreover, ghrelin is known as the “hunger” hormone and helps stimulate growth hormone (GH and hepatic insulin-like-growth-factor-1(IGF-1, maintaining anabolism and preserving a lean body mass. In AN, high levels of GH due to GH resistance along with low levels of IGF-1 are observed. Leptin plays a role in suppressing appetite through the inhibition of neuropeptide Y gene. Moreover, the CRF, opioid, leptin and ghrelin mechanisms operate collectively at the HPA axis and express the physiological and psychological components of AN. Fear conditioning is an intricate learning process occurring at the level of the hippocampus, amygdala, lateral septum and the

  9. Neurobiology of anorexia and bulimia nervosa.

    Science.gov (United States)

    Kaye, Walter

    2008-04-22

    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

  10. Anorexia nervosa versus hyperinsulinism: therapeutic effects of neuropharmacological manipulation

    Directory of Open Access Journals (Sweden)

    Fuad Lechin

    2011-02-01

    Full Text Available Fuad Lechin1,2, Bertha van der Dijs1,2, Betty Pardey-Maldonado1, Scarlet Baez1, Marcel E Lechin31Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Department of Pathophysiology, Institute of Experimental Medicine, Faculty of Medicine, Universidad Central de Venezuela, Caracas; 2Instituto de Vias Digestivas Caracas, Centro Clínico Profesional Caracas, Venezuela; 3Department of Internal Medicine, Texas A & M Health Science Center, College of Medicine, Texas, USABackground: We have demonstrated that anorexia nervosa is underpinned by overwhelming adrenal sympathetic activity which abolishes the neural sympathetic branch of the peripheral autonomic nervous system. This physiological disorder is responsible for gastrointestinal hypomotility, hyperglycemia, raised systolic blood pressure, raised heart rate, and other neuroendocrine disorders. Therefore, we prescribed neuropharmacological therapy to reverse this central and autonomic nervous system disorder, in order to normalize the clinical and neuroendocrine profile.Methods: The study included 22 female patients with anorexia nervosa (10 restricted type, 12 binge-eating type who received three months of treatment with amantadine 100 mg/day. We measured blood pressure, heart rate, and circulating neurotransmitters, (noradrenaline, adrenaline, dopamine, platelet serotonin, free plasma serotonin during supine resting, one minute of orthostasis, and a five-minute exercise test before and after one, two, and three months of treatment with amantadine, a drug which abrogates adrenal sympathetic activity by acting at the C1(Ad medullary nuclei responsible for this branch of the peripheral sympathetic activity.Results: We found the amantadine abolished symptoms of anorexia nervosa from the first oral dose onwards. Normalization of autonomic and cardiovascular parameters was demonstrated within the early days of therapy. Abrupt and sustained increases in the plasma noradrenaline

  11. Quando a anorexia é uma questão de sexuação

    OpenAIRE

    Joana Maia Simoni; Angélica Bastos

    2013-01-01

    From clinical observations of the high incidence of anorexia among young women, the present work is dedicated to the research of the relationship between the anorectic symptom and femininity. Our hypothesis is that the anorexic symptom configures a response of some young women in face of the consequences of sexuation and of the encounter with female jouissance. The continuity between children's anorexia, in which eating nothing pops up as a separator object, and anorexia as a response to fema...

  12. Acquired zinc deficiency in association with anorexia nervosa: case report and review of the literature.

    Science.gov (United States)

    Van Voorhees, A S; Riba, M

    1992-09-01

    Zinc deficiency, whether a result of an acquired or inherited abnormality of zinc metabolism, is associated with characteristic cutaneous findings. The inherited variety is known as acrodermatitis enteropathica. We present a case of zinc deficiency secondary to starvation induced by anorexia nervosa. Since the cutaneous stigmata of zinc deficiency and anorexia nervosa can initially be subtle and occasionally overlap, we believe that screening zinc levels in patients with anorexia nervosa with prominent cutaneous findings should be considered. PMID:1488378

  13. Help seeking in adults with anorexia nervosa: what is the role of significant others?

    OpenAIRE

    Cox, Samantha Jane

    2015-01-01

    Background: The aim of the study was to explore the role of significant others1 in problem disclosure and help seeking in adults with anorexia. Existing literature on help seeking is predominantly focused on anorexia in children and adolescents (Honey & Halse, 2005; Tierney, 2005; Thomson et al. 2014). Anorexia becomes more chronic the longer it is left untreated, and delays in seeking treatment are associated with poorer recovery outcomes (Ficher, Quadflieg & Hedlund, 2006). Therefore, early...

  14. Anorexia nervosa and dialysis: we have no time when the body is so damaged!

    OpenAIRE

    Osório, Eva; Milheiro, Isabel; Brandão, Isabel; Roma Torres, António

    2013-01-01

    Anorexia nervosa remains challenging to treat and difficult to prevent. Nearly 5% of affected individuals die of this disease and 20% develop a chronic eating disorder. Anorexia nervosa may be associated with several medical complications of varying severity, including dysfunction of the renal system. Though there are some reports of renal failure in patients with anorexia nervosa, few reports are available concerning patients who required maintenance dialysis. We report a case of a patient w...

  15. Translational neuroscience of anorexia nervosa: A genetic and environmental interplay underlying behavioural hyperactivity in mice

    OpenAIRE

    Pjetri, E.

    2012-01-01

    Anorexia Nervosa is a severe mental illness, affecting young females more than males. Anorexia nervosa runs a chronic, relapsing course and is associated with high disability and mortality rates. The hallmark of the disease is keeping a low body weight, less than 85% of what is expected. The etiology of anorexia nervosa is complex (unknown), with risks involving environmental, temperamental, developmental and genetic factors. Though not specified in the diagnosis criteria, excessive physical ...

  16. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa

    OpenAIRE

    Sheng, Min; Lu, Hanzhang; Liu, Peiying; Thomas, Binu P.; McAdams, Carrie J.

    2015-01-01

    Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to...

  17. Proteomic profiling of the hypothalamus in a mouse model of cancer-induced anorexia-cachexia

    OpenAIRE

    Ihnatko, Robert; Post, Claes; Blomqvist, Anders

    2013-01-01

    Background: Anorexia-cachexia is a common and severe cancer-related complication but the underlying mechanisms are largely unknown. Here, using a mouse model for tumour-induced anorexia-cachexia, we screened for proteins that are differentially expressed in the hypothalamus, the brain’s metabolic control centre. Methods: The hypothalamus of tumour-bearing mice with implanted methylcholanthrene-induced sarcoma (MCG 101) displaying anorexia and their sham-implanted pair-fed or free-fed litterma...

  18. Anoreksija nervoza s prikazom primera: Anorexia nervosa with a case study:

    OpenAIRE

    Arzenšek, Pia; Lahe, Milica; Turčin, Zlatan

    2005-01-01

    The article presents the summary of the diploma work Anorexia nervosa with a case study. Anorexia nervosa (AN) is presented together with its causes, specific symptoms and complications and the fact that their understanding is of crucial importance for the choice of relevant mode of treatment. The article stresses the importance of the role of the nurse in hospital treatment of patients with anorexia nervosa, and presents the measure called involuntary hospitalization which can prevent vital ...

  19. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    OpenAIRE

    Senay Akbay

    2014-01-01

    The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervos...

  20. Processo de Enfermagem para pacientes com Anorexia Nervosa Proceso de Enfermería para pacientes con Anorexia Nerviosa Nursing Process to patients with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Vanessa Pellegrino Toledo

    2011-02-01

    Full Text Available Relato de experiência da aplicação do Processo de Enfermagem a uma paciente portadora de Anorexia Nervosa, utilizando histórico, diagnósticos, intervenções e resultados de enfermagem. As intervenções foram fundamentadas nos diagnósticos de enfermagem: distúrbio da imagem corporal, nutrição desequilibrada menos que as necessidades corporais, ansiedade, baixa autoestima crônica, intolerância a atividade, controle ineficaz do regime terapêutico, risco de infecção, volume de líquidos deficiente e isolamento social. A partir da aplicação do Processo de Enfermagem, os resultados planejados foram alcançados, proporcionando melhor qualidade de vida, no período em que permaneceu internada. Os fatores psíquicos, neurológicos, endócrinos e imunológicos, peculiares na anorexia nervosa, propiciaram a elaboração de um Processo de Enfermagem, que contribuiu de maneira positiva para a complementação da reabilitação da saúde da mesmaRelato de experiencia de la aplicación del proceso de enfermería (PE a una paciente portadora de Anorexia Nerviosa, utilizando histórico, diagnósticos, intervenciones y resultados de enfermería. Las intervenciones fueron basadas en los diagnósticos de enfermería: trastorno de la imagen corporal, nutrición alterada ingesta inferior a las necesidades corporales, ansiedad, autoestima baja crónica, intolerancia a la actividad, manejo ineficaz del régimen terapéutico, riesgo de infección, déficits de volumen de líquidos y aislamiento social. A partir de la aplicación del Proceso de Enfermería, los resultados planeados fueron alcanzados, proporcionando mejor calidad de vida en el período en que permaneció hospitalizada. Los factores psíquicos, neurológicos, endócrinos y inmunológicos, peculiares en la anorexia nerviosa, propiciaron la elaboración de un Proceso de Enfermería, que contribuyó de manera positiva para la complementación de la rehabilitación de su salud

  1. Prolonged QT interval in a man with anorexia nervosa

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  2. Prolonged QT interval in a man with anorexia nervosa.

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  3. Att bemöta kvinnor med anorexia nervosa

    OpenAIRE

    Erlandsson, Christian; Heiler, Linnéa; Henningsson, Sofie

    2005-01-01

    Studiens syfte har varit att se vad kvinnor med anorexia har för behov av och hur de upplever närståendes/vårdares omtanke och omsorg, och hur dessa ser på kvinnornas behov. Studien är en litteraturstudie där tre skönlitterära böcker som följer tre kvinnor drabbade av anorexia granskats. I bakgrunden framkommer att enligt Världshälsoorganisationen har skolbarnens hälsovanor förandrats sedan 1980-talet, då framförallt hos flickor. Idealvikten har blivit lägre och skönhetsidealen står i fokus h...

  4. MRI demonstration of orbital lipolysis in anorexia nervosa

    International Nuclear Information System (INIS)

    The purpose of this article is to describe the orbital changes due to lipolysis in anorexia nervosa. We examined a cachectic patient with MR imaging using T1-weighted images before and after contrast enhancement. Orbital fat edema has been observed in extreme forms of cachexia and the CT and MR findings have recently been reported. The imaging appearances have been explained by the disappearance of the fat tissue and the appearance of edema due to a disturbance in the electrolyte fluid balance. In the recent literature particular attention has been paid to the increased lipid peroxidation and lipolysis in anorexia nervosa. These metabolic processes result in an increased permeability of the vessel wall endothelium, which can explain the extravasation of the contrast agent in the orbital fat on MR imaging. (orig.)

  5. Peculiar enlargement of the nasopharynx in patients with anorexia nervosa

    International Nuclear Information System (INIS)

    We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs

  6. MRI demonstration of orbital lipolysis in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe; Dekimpe, Piet; Wilms, Guy [Department of Radiology, University Hospitals, Herestraat 49, 3000 Leuven (Belgium); Muls, Erik [Department of Endocrinology, University Hospitals, Herestraat 49, 3000 Leuven (Belgium)

    2002-07-01

    The purpose of this article is to describe the orbital changes due to lipolysis in anorexia nervosa. We examined a cachectic patient with MR imaging using T1-weighted images before and after contrast enhancement. Orbital fat edema has been observed in extreme forms of cachexia and the CT and MR findings have recently been reported. The imaging appearances have been explained by the disappearance of the fat tissue and the appearance of edema due to a disturbance in the electrolyte fluid balance. In the recent literature particular attention has been paid to the increased lipid peroxidation and lipolysis in anorexia nervosa. These metabolic processes result in an increased permeability of the vessel wall endothelium, which can explain the extravasation of the contrast agent in the orbital fat on MR imaging. (orig.)

  7. EEG neurofeedback effects in the treatment of adolescent anorexia nervosa.

    Science.gov (United States)

    Lackner, Nina; Unterrainer, Human-Friedrich; Skliris, Dimitris; Shaheen, Sandra; Dunitz-Scheer, Marguerite; Wood, Guilherme; Scheer, Peter Jaron Zwi; Wallner-Liebmann, Sandra Johanna; Neuper, Christa

    2016-01-01

    A pre-post design including 22 females was used to evaluate the effectiveness of neurofeedback in the treatment of adolescent anorexia nervosa. Resting EEG measures and a psychological test-battery assessing eating behavior traits, clinical symptoms, emotionality, and mood were obtained. While both the experimental (n = 10) and control group (n = 12) received their usual maintenance treatment, the experimental group received 10 sessions of individual alpha frequency training over a period of 5 weeks as additional treatment. Significant training effects were shown in eating behavior traits, emotion regulation, and in relative theta power in the eyes closed condition. Although the results are limited due to the small sample size, these are the first empirical data demonstrating the benefits of neurofeedback as a treatment adjunct in individuals with anorexia nervosa. PMID:27027700

  8. Peculiar enlargement of the nasopharynx in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, K. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Ito, J. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Tokiguchi, S. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Kuwabara, G. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan); Nishihara, M. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan)

    1995-11-01

    We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs.

  9. [The cachexia-anorexia syndrome among oncological patients].

    Science.gov (United States)

    Sosa-Sánchez, Ricardo; Sánchez-Lara, Karla; Motola-Kuba, Daniel; Green-Renner, Dan

    2008-01-01

    Approximately two thirds of cancer patients at advanced stages of the disease suffer from anorexia, which leads to significant weight loss and progressive cachexia, an important factor that contributes to death. It has been observed that cancer cachexia differs from simple starvation, although the exact mechanisms associated with cancer cachexia are not well known. Several theories regarding its pathogenesis point to a complex mixture of tumor, host and treatment variables. Unfortunately, the wasting syndrome also constitutes for the patient, a progression of the cancer process, significantly affecting quality of life and social interactions. Treatable causes should be identified and treated. Knowledge of the mechanisms underlying the effects of caquexia on the patient may play a role in identifying treatment measures targetted to muscle wasting and to maintain body strength. In this article we review the main features and mechanisms of the anorexia-cachexia syndrome in patients with cancer. PMID:19043964

  10. Dermatologic signs in anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Gupta, M A; Gupta, A K; Haberman, H F

    1987-10-01

    The dermatologic changes in anorexia nervosa and bulimia nervosa may be the first signs to give the clinician a clue that an eating disorder is present, as many of these patients either deny their symptoms or secretly refuse to comply with treatment. The dermatologic signs are a result of (1) starvation or malnutrition, eg, lanugolike body hair, asteatotic skin, brittle hair and nails, and carotenodermia; (2) self-induced vomiting, eg, hand calluses, dental enamel erosion, gingivitis, and a Sjögrenlike syndrome; (3) use of laxatives, diuretics, or emetics and their dermatologic side effects; and (4) other concomitant psychiatric illness, eg, hand dermatitis from compulsive handwashing. Further, as most of the cutaneous signs are not specific to anorexia nervosa and bulimia nervosa, failure to include eating disorders in the differential diagnosis may lead to misdiagnosis of the cutaneous symptoms. PMID:3310913

  11. The Disjointed Historical Trajectory of Anorexia Nervosa Before 1970.

    Science.gov (United States)

    Court, John P M; Kaplan, Allan S

    2016-01-01

    Responses in pre-modern eras to anorexia nervosa (as now understood) varied widely, from religious piety and sanctity through fear and superstition. While noting briefly the limited conceptualizations from pre-modern history this article is primarily focused from the late 19th century, commencing with helpful but tentative formulations of anorexia nervosa for early-modern medicine that were laid out, consistently between themselves, by Lesègue, Gull and Osler. Yet that promising biomedical advent was superseded for more than a half-century by deep, internal divisions and bitter rifts that festered between three medical disciplines: neurology; Freudian psychotherapy; and Kraepelinian biological psychiatry. Mid-20th century developments preceded the 1960-1980s' improved understanding of suffering and movement toward effective remediation introduced by Dr. Hilde Bruch. PMID:26769199

  12. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects.

    Science.gov (United States)

    Brown, Carrie; Mehler, Philip S

    2015-12-01

    Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Many of the deaths are attributable to medical complications which arise as the malnutrition and weight loss worsens. Every body system may be adversely affected by anorexia nervosa. Yet, remarkably, most of the medical complications of anorexia nervosa are treatable and reversible with optimal medical care, as part of a multidisciplinary team who are often involved in the care of these patients. Herein, we will describe the medical complications of anorexia nervosa and their treatments.

  13. Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

    OpenAIRE

    Nicola Maria Vitola; Dante Lo Pardo; Romualdo Cirillo; Matteo De Roberto; Pier Giovanni Crocco; Dario Caputo

    2013-01-01

    BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has...

  14. Anorexia nervosa: from purgative behaviour to nephropathy. a case report

    OpenAIRE

    Manzato, Emilia; Mazzullo, Maria; Gualandi, Malvina; Zanetti, Tatiana; Scanelli, Giovanni

    2009-01-01

    Background Individuals who suffer from Anorexia Nervosa refuse to maintain a minimally normal body weight, are intensely afraid of gaining weight and exhibit a significant disturbance in the perception of the shape and size of their body. Postmenarchal females with this disorder are amenorrohic. In the Binge-Eating/Purging subtype individuals regularly engage in binge eating and purging behaviour (i.e self-induced vomiting or misuse of laxatives, diuretics, or enemas). Hypokalaemia is often s...

  15. Kwashiorkor-like zinc deficiency syndrome in anorexia nervosa.

    Science.gov (United States)

    Esca, S A; Brenner, W; Mach, K; Gschnait, F

    1979-01-01

    This report deals with a 26-year-old white woman exhibiting signs of both Kwashiorkor (marasmus, pallor, hypopigmentation of hair and hepatomegaly) and acrodermatitis enteropathica (eczematous dermatitis predominantly on acral areas). Clinical and laboratory examinations excluded malabsorption syndrome and glucagonoma syndrome and revealed hypoproteinemia and marked zinc deficiency. Psychiatric examination disclosed anorexia nervosa. Substitution therapy led to rapid clearing of the skin lesions. PMID:92154

  16. Anorexia nervosa: a multifactorial disease of nutritional origin?

    Science.gov (United States)

    Tannhauser, Pia P

    2002-01-01

    Nutrition in general, with infant and child nutrition in particular, have changed in the past century through altered farming practices and eating habits. Food intake in childhood can influence the expression of the genetic potential. In this paper it is attempted to show how childhood zinc deficiency, aggravated in puberty by high energy/low zinc ratio of the diet and stresses of various kinds, can influence both mental and physical development and ultimately lead to the development of anorexia nervosa. PMID:12467193

  17. Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

    OpenAIRE

    Méquinion, Mathieu; Langlet, Fanny; Zgheib, Sara; Dickson, Suzanne; Dehouck, Bénédicte; Chauveau, Christophe; Viltart, Odile

    2013-01-01

    Increasing clinical and therapeutic interest in the neurobiology of eating disorders reflects their dramatic impact on health. Chronic food restriction resulting in severe weight loss is a major symptom described in restrictive anorexia nervosa (AN) patients, and they also suffer from metabolic disturbances, infertility, osteopenia, and osteoporosis. Restrictive AN, mostly observed in young women, is the third largest cause of chronic illness in teenagers of industrialized countries. From a n...

  18. Prolonged QT interval in a man with anorexia nervosa

    OpenAIRE

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male wh...

  19. Early-onset anorexia nervosa in girls with Asperger syndrome

    OpenAIRE

    Dudova I; Kocourkova J; Koutek J

    2015-01-01

    Iva Dudova, Jana Kocourkova, Jiri Koutek Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic Abstract: Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases ...

  20. Exploring autistic traits in anorexia: a clinical study

    OpenAIRE

    Tchanturia, Kate; Smith, Emma; Weineck, Felicitas; Fidanboylu, Eliz; Kern, Nikola; Treasure, Janet; Baron Cohen, Simon

    2013-01-01

    Background The objectives of this study were to explore associations between autistic traits and self-reported clinical symptoms in a population with anorexia nervosa (AN). Experimental and self-report evidence reveals similarities between AN and autism spectrum condition (ASC) populations in socio-emotional and cognitive domains; this includes difficulties with empathy, set-shifting and global processing. Focusing on these similarities may lead to better tailored interventions for both condi...

  1. Cognitive processes in anorexia nervosa and bulimia nervosa

    OpenAIRE

    Cooper, Myra; Fairburn, Christopher G.; Clark, David M.; David Clark; Christopher Fairburn

    1991-01-01

    The series of studies reported in this thesis aimed to improve our knowledge of the cognitive disturbance in anorexia nervosa and bulimia nervosa. Techniques from experimental cognitive psychology were used to test predictions made by cognitive theories of eating disorders. In the first study, subjects performed three tasks related to eating, weight and shape and self-statements were measured using concurrent verbalisation and a selfreport questionnaire. Compared to dieters ...

  2. Abnormal white matter properties in adolescent girls with anorexia nervosa

    OpenAIRE

    Travis, Katherine E.; Neville H. Golden; FELDMAN, HEIDI M.; Murray Solomon; Jenny Nguyen; Aviv Mezer; Yeatman, Jason D.; Dougherty, Robert F.

    2015-01-01

    Anorexia nervosa (AN) is a serious eating disorder that typically emerges during adolescence and occurs most frequently in females. To date, very few studies have investigated the possible impact of AN on white matter tissue properties during adolescence, when white matter is still developing. The present study evaluated white matter tissue properties in adolescent girls with AN using diffusion MRI with tractography and T1 relaxometry to measure R1 (1/T1), an index of myelin content. Fifteen ...

  3. Neurocognitive and social cognition deficits in patients with anorexia nervosa

    OpenAIRE

    Kułakowska, Dorota; Biernacka, Katarzyna; Wilkos, Ewelina; Rybakowski, Filip; Kucharska-Pietura, Katarzyna

    2014-01-01

    In the first part of the article the authors present a set of the actual concepts explaining problems of cognitive functions and social cognition currently observed in patients with anorexia nervosa (AN). It is possible; through the neuroimaging research, to get better understanding of the brain specifics in these individuals. Even though, the AN remains a disease with very complex and multifactorial etiology which remains a huge medical challenge. Currently, popular is the view that takes in...

  4. Pharmacokinetics of Cannabis in Cancer Cachexia-Anorexia Syndrome.

    Science.gov (United States)

    Reuter, Stephanie E; Martin, Jennifer H

    2016-07-01

    Anorexia can affect up to 90 % of people with advanced cancer. It is a complex symptom associated with changes in taste, lack of hunger at mealtimes and lack of food enjoyment. Associated weight loss is part of the physical decline that occurs as cancer worsens. Weight loss can also occur from cachexia, the increased metabolism of energy due to raised inflammatory cytokines, liver metastases and other factors seen in several advanced cancers. Independent of anorexia, although frequently associated (where it is referred to as the cachexia-anorexia syndrome), it accounts for a significant amount of morbidity and deaths in people with cancer. In particular, quality of life for the patient and the family is significantly affected with this syndrome as it causes anxiety and distress. Therefore, it is important that research into therapies is undertaken, particularly focusing on an understanding of the pharmacokinetic properties of compounds in this cachexic population. Cannabinoids are one such group of therapies that have received a large amount of media focus recently. However, there appears to be a lack on rigorous pharmacokinetic data of these complex and varied compounds in the cachexic population. Similarly, there is a lack of pharmacokinetic data in any population group for the non- tetrahydrocannabinol (THC) and cannabidiol (CBD) cannabinoids (often due to the lack of analytical standards for quantification). This review will thus examine the pharmacokinetics of major cannabinoids i.e. THC and CBD in a cancer population. Overall, based on the current literature, evidence for the use of cannabinoids for the treatment of cancer-related cachexia-anorexia syndrome remains equivocal. A high-quality, rigorous, phase I/II study to elicit pharmacokinetic dose-concentration and concentration-response data, with a clinically acceptable mode of delivery to reduce intrapatient variability and enable more consistent bioavailability is needed in this population. PMID

  5. Minoxidil-associated anorexia in an infant with refractory hypertension.

    Science.gov (United States)

    Vesoulis, Zachary A; Attarian, Stephanie J; Zeller, Brandy; Cole, Francis Sessions

    2014-12-01

    Minoxidil is a potent antihypertensive used as an adjunctive agent in refractory hypertension. It exerts an antihypertensive effect through two mechanisms: selective arterial vasodilation by activation of potassium channels in the vascular smooth muscle and stimulation of carotid and aortic baroreceptors, leading to downstream release of renin and norepinephrine. Although frequently cited in reviews of antihypertensive agents, limited data about the use of minoxidil in neonates are available. We describe an infant girl, born at 35 weeks of gestation, who was diagnosed with idiopathic hypertension after extensive diagnostic evaluation. Adequate blood pressure control was not achieved with captopril, amlodipine, and clonidine. Oliguria secondary to captopril and rapid-onset congestive heart failure due to persistent hypertension led to the introduction of intravenous agents labetalol and nitroprusside. Although adequate blood pressure control was achieved, attempts to transition back to oral agents were unsuccessful, prompting the use of minoxidil as an alternative agent. Although good blood pressure control was achieved, the infant's oral intake plummeted from 210 to 63 ml/kg/day. The anorexia quickly resolved after stopping minoxidil, and she was discharged home at 5 months of age receiving propranolol, amlodipine, and doxazosin. Use of the Naranjo adverse drug reaction probability scale indicated a definite relationship (score of 10) between the patient's development of anorexia and minoxidil therapy. To our knowledge, there have been no previous reports of minoxidil-associated anorexia in preterm or term infants. Clinicians should be aware that anorexia is a possible adverse effect of minoxidil in this patient population when initiating the drug in similar patients. PMID:25280267

  6. Minoxidil-associated anorexia in an infant with refractory hypertension.

    Science.gov (United States)

    Vesoulis, Zachary A; Attarian, Stephanie J; Zeller, Brandy; Cole, Francis Sessions

    2014-12-01

    Minoxidil is a potent antihypertensive used as an adjunctive agent in refractory hypertension. It exerts an antihypertensive effect through two mechanisms: selective arterial vasodilation by activation of potassium channels in the vascular smooth muscle and stimulation of carotid and aortic baroreceptors, leading to downstream release of renin and norepinephrine. Although frequently cited in reviews of antihypertensive agents, limited data about the use of minoxidil in neonates are available. We describe an infant girl, born at 35 weeks of gestation, who was diagnosed with idiopathic hypertension after extensive diagnostic evaluation. Adequate blood pressure control was not achieved with captopril, amlodipine, and clonidine. Oliguria secondary to captopril and rapid-onset congestive heart failure due to persistent hypertension led to the introduction of intravenous agents labetalol and nitroprusside. Although adequate blood pressure control was achieved, attempts to transition back to oral agents were unsuccessful, prompting the use of minoxidil as an alternative agent. Although good blood pressure control was achieved, the infant's oral intake plummeted from 210 to 63 ml/kg/day. The anorexia quickly resolved after stopping minoxidil, and she was discharged home at 5 months of age receiving propranolol, amlodipine, and doxazosin. Use of the Naranjo adverse drug reaction probability scale indicated a definite relationship (score of 10) between the patient's development of anorexia and minoxidil therapy. To our knowledge, there have been no previous reports of minoxidil-associated anorexia in preterm or term infants. Clinicians should be aware that anorexia is a possible adverse effect of minoxidil in this patient population when initiating the drug in similar patients.

  7. Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings

    OpenAIRE

    Campbell Iain C; Davies Helen; Tchanturia Kate

    2007-01-01

    Abstract Background Anorexia nervosa (AN) is a severe mental illness. Drug treatments are not effective and there is no established first choice psychological treatment for adults with AN. Neuropsychological studies have shown that patients with AN have difficulties in cognitive flexibility: these laboratory based findings have been used to develop a clinical intervention based on Cognitive Remediation Therapy (CRT) which aims to use cognitive exercises to strengthen thinking skills. Aims 1) ...

  8. Current treatment for anorexia nervosa: efficacy, safety, and adherence

    OpenAIRE

    Lindsay P Bodell; Keel, Pamela K.

    2010-01-01

    Lindsay P Bodell, Pamela K KeelDepartment of Psychology, Florida State University, Tallahassee, FL, USAAbstract: Anorexia nervosa (AN) is a serious psychiatric illness associated with significant medical and psychiatric morbidity, psychosocial impairment, increased risk of death, and chronicity. Given the severity of the disorder, the establishment of safe and effective treatments is necessary. Several treatments have been tried in AN, but few favorable results have emerged. This paper review...

  9. Psychopathology and psychotherapy in adolescents with anorexia and bulimia nervosa

    OpenAIRE

    Salbach-Andrae, Harriet

    2010-01-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are multifactorial diseases, which are among the most prevalent disorders in child and adolescent psychiatry. Aesthetic sports are often considered as a risk factor for the development of an eating disorder. The present professorial dissertation for the first time demonstrates no higher risk for competitive athletes aged 12 to 18 years to develop an eating disorder. Research shows that psychiatric comorbidity is a very unfavorable prognostic ...

  10. Psychoneuroendocrinological aspects of anorexia nervosa: predictors of recovery

    OpenAIRE

    van Elburg, A A

    2007-01-01

    Anorexia Nervosa (AN) is a psychosomatic eating disorder of unknown aetiology, which primarily affects adolescent girls and young women and is characterized by aberrant patterns of eating behaviour and weight regulation which result in weight loss and endocrine abnormalities such as amenorrhea, disturbances in attitude and perception about weight and shape, and an intense fear of gaining weight. This thesis is based upon a follow up cohort study of 61 young girls and women consecutively refer...

  11. Time course of bone loss in patients with anorexia nervosa

    OpenAIRE

    Olmos Martínez, José Manuel; Valero Díaz de Lamadrid, Carmen; Gómez del Barrio, José Andrés; Amado Señarís, José Antonio; Hernández Hernández, José Luis; Menéndez Arango, José; González Macías, Jesús

    2010-01-01

    Objective: To evaluate the time course of bone mineral density (BMD) in women with anorexia nervosa (AN) during two years of follow-up. Methods: We prospectively studied 51 female with AN aged 18-38 years, and forty age-matched healthy women (19-34 years). BMD was measured in lumbar spine (LS), femoral neck (FN) and total hip (TH) by DXA. Results: At baseline, weight, body mass index, and lumbar and hip BMD were significantly (p

  12. Serum glutamine, set-shifting ability and anorexia nervosa

    OpenAIRE

    Collier David A; Campbell Iain C; Tchanturia Kate; Schmidt Ulrike; Hashimoto Kenji; Nakazato Michiko; Iyo Masaomi; Treasure Janet

    2010-01-01

    Abstract Background Set-shifting is impaired in people with anorexia nervosa (AN), but the underlying physiological and biochemical processes are unclear. Animal studies have established that glutamatergic pathways in the prefrontal cortex play an important role in set-shifting ability. However, it is not yet understood whether levels of serum glutamatergic amino acids are associated with set-shifting performance in humans. The aim of this study was to determine whether serum concentrations o...

  13. Mirroring voices of mother, daughter and therapist in Anorexia Nervosa

    OpenAIRE

    Weaver, Kathryn; Martin-McDonald, Kristine; Spiers, Judith

    2012-01-01

    "Die Erfahrungen von Frauen mit Essstörungen und die Deutungen, die Frauen aufgrund dieser Erfahrungen vollziehen, werden meist vor Professionellen im Gesundheitswesen zurückgehalten und sind deshalb in klinischen und akademischen Diskursen nur schlecht repräsentiert. In der hier vorgestellten Studie haben die Autorinnen sich - ausgehend von persönlichen Reflexionen, Tagebüchern und Briefen - mit der Beziehung zwischen einer Mutter, deren an Anorexia Nervosa leidender Tochter sowie einer Ther...

  14. Predictors of the resumption of menses in adolescent anorexia nervosa

    OpenAIRE

    Dempfle, Astrid; Herpertz-Dahlmann, Beate; Timmesfeld, Nina; Schwarte, Reinhild; Egberts, Karin M; Pfeiffer, Ernst; Fleischhaker, Christian; Wewetzer, Christoph; Bühren, Katharina

    2013-01-01

    Background: The resumption of menses is an important indicator of recovery in anorexia nervosa (AN). Patients with early-onset AN are at particularly great risk of suffering from the long-term physical and psychological consequences of persistent gonadal dysfunction. However, the clinical variables that predict the recovery of menstrual function during weight gain in AN remain poorly understood. The aim of this study was to investigate the impact of several clinical parameters on the resumpti...

  15. Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

    OpenAIRE

    Mathieu eMéquinion; Fanny eLanglet; Sara eZgheib; Suzanne eDickson; Bénédicte eDehouck; Christophe eChauveau; Odile eViltart

    2013-01-01

    Food intake and associated disorders are gaining large emphasis in our societies due to their dramatic physiological and psychological consequences on health. Chronic food restriction is a major symptom described in restrictive anorexia nervosa (AN) patients. This disease, mostly observed in young women is the third cause of chronic illness in teenagers. It leads to central and/or peripheral reprogramming that permits the organism to endure the reduced energy supplies. These drastic condition...

  16. Early-onset anorexia nervosa in girls with Asperger syndrome.

    Science.gov (United States)

    Dudova, Iva; Kocourkova, Jana; Koutek, Jiri

    2015-01-01

    Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome.

  17. Early-onset anorexia nervosa in girls with Asperger syndrome.

    Science.gov (United States)

    Dudova, Iva; Kocourkova, Jana; Koutek, Jiri

    2015-01-01

    Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome. PMID:26170676

  18. Body Image Disturbance and Emotional Regulation in Anorexia Nervosa

    OpenAIRE

    2011-01-01

    Anorexia nervosa (AN) is a severe mental illness with a number of physical, psychological and social conditions. In spite of the severity of the disorder, we still lack empirical evidence to choose one treatment over another. The failure to show scientific evidence of effective treatment and prevention might rely on the complex psychological mechanisms involved in the disorder. To further improve our ability to help patients with AN, a better understanding of the specific mechanisms involved ...

  19. Anorexia nervosa: treatment expectations – a qualitative study

    Directory of Open Access Journals (Sweden)

    Paulson-Karlsson G

    2012-07-01

    Full Text Available Gunilla Paulson-Karlsson,1 Lauri Nevonen21Academy of Health and Medical Sciences, Örebro University, Örebro and Anorexia-Bulimia Unit, Child and Adolescent Psychiatry Centre, Queen Silvia Children's Hospital, Göteborg, Sweden; 2Academy of Health and Medical Sciences, Örebro University, Örebro, SwedenBackground: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice for adults. Patients with anorexia nervosa strive for thinness in order to obtain self-control and are ambivalent toward change and toward treatment. In order to achieve a greater understanding of patients' own understanding of their situation, the aim of this study was to examine the expectations of potential anorexic patients seeking treatment at a specialized eating-disorder unit.Methods: A qualitative study design was used. It comprised 15 women between 18 and 25 years of age waiting to be assessed before treatment. The initial question was, "What do you expect, now that you are on the waiting list for a specialized eating-disorder unit?" A content analysis was used, and the text was coded, categorized according to its content, and further interpreted into a theme.Results: From the results emerged three main categories of what participants expected: "treatment content," "treatment professionals," and "treatment focus." The overall theme, "receiving adequate therapy in a collaborative therapeutic relationship and recovering," described how the participants perceived that their expectations could be fulfilled.Discussion: Patients' expectations concerning distorted thoughts, eating behaviors, a normal, healthy life, and meeting with a professional with knowledge and experience of eating disorders should be discussed before treatment starts. In the process of the therapeutic relationship, it is essential to continually address patients' motivations, in order to understand their personal motives behind

  20. Anorexia nervosa and body fat distribution: a systematic review.

    Science.gov (United States)

    El Ghoch, Marwan; Calugi, Simona; Lamburghini, Silvia; Dalle Grave, Riccardo

    2014-09-01

    The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa adolescent females lose more central body fat, while adult females more peripheral fat. Second, partial weight restoration leads to greater fat mass deposition in the trunk region than other body regions in adolescent females. Third, after short-term weight restoration, whether partial or complete, adults show a central adiposity phenotype with respect to healthy age-matched controls. Fourth, central fat distribution is associated with increased insulin resistance, but does not adversely affect eating disorder psychopathology or cause psychological distress in female adults. Fifth, the abnormal central fat distribution seems to normalize after long-term maintenance of complete weight restoration, indicating that preferential central distribution of body fat is a transitory phenomenon. However, a discrepancy in the findings has been noted, especially between adolescents and adults; besides age and gender, these appear to be related to differences in the methodology and time of body composition assessments. The PROSPERO Registry-Anorexia Nervosa and Body Fat Distribution: A Systematic Review (CRD42014008738). PMID:25251296

  1. Anorexia Nervosa and Body Fat Distribution: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Marwan El Ghoch

    2014-09-01

    Full Text Available The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa adolescent females lose more central body fat, while adult females more peripheral fat. Second, partial weight restoration leads to greater fat mass deposition in the trunk region than other body regions in adolescent females. Third, after short-term weight restoration, whether partial or complete, adults show a central adiposity phenotype with respect to healthy age-matched controls. Fourth, central fat distribution is associated with increased insulin resistance, but does not adversely affect eating disorder psychopathology or cause psychological distress in female adults. Fifth, the abnormal central fat distribution seems to normalize after long-term maintenance of complete weight restoration, indicating that preferential central distribution of body fat is a transitory phenomenon. However, a discrepancy in the findings has been noted, especially between adolescents and adults; besides age and gender, these appear to be related to differences in the methodology and time of body composition assessments. The PROSPERO Registry—Anorexia Nervosa and Body Fat Distribution: A Systematic Review (CRD42014008738.

  2. Pathophysiology of anorexia in the cancer cachexia syndrome.

    Science.gov (United States)

    Ezeoke, Chukwuemeka Charles; Morley, John E

    2015-12-01

    Anorexia is commonly present in persons with cancer and a major component of cancer cachexia. There are multiple causes of anorexia in cancer. Peripherally, these can be due to (i) substances released from or by the tumour, e.g. pro-inflammatory cytokines, lactate, and parathormone-related peptide; (ii) tumours causing dysphagia or altering gut function; (iii) tumours altering nutrients, e.g. zinc deficiency; (iv) tumours causing hypoxia; (v) increased peripheral tryptophan leading to increased central serotonin; or (vi) alterations of release of peripheral hormones that alter feeding, e.g. peptide tyrosine tyrosine and ghrelin. Central effects include depression and pain, decreasing the desire to eat. Within the central nervous system, tumours create multiple alterations in neurotransmitters, neuropeptides, and prostaglandins that modulate feeding. Many of these neurotransmitters appear to produce their anorectic effects through the adenosine monophosphate kinase/methylmalonyl coenzyme A/fatty acid system in the hypothalamus. Dynamin is a guanosine triphosphatase that is responsible for internalization of melanocortin 4 receptors and prostaglandin receptors. Dynamin is up-regulated in a mouse model of cancer anorexia. A number of drugs, e.g. megestrol acetate, cannabinoids, and ghrelin agonists, have been shown to have some ability to be orexigenic in cancer patients. PMID:26675762

  3. The role of the endogenous opiates in zinc deficiency anorexia.

    Science.gov (United States)

    Essatara, M B; Morley, J E; Levine, A S; Elson, M K; Shafer, R B; McClain, C J

    1984-03-01

    Anorexia is a major symptom of zinc deficiency, but the mechanism(s) for this anorexia are poorly defined. Recent studies have suggested an integral role for endogenous opiate peptides in appetite regulation. Dynorphin, a leucine-enkephalin containing opiate peptide, is a potent inducer of spontaneous feeding. In this study we showed that zinc deficient animals were relatively resistant to dynorphin-induced feeding. Measurement of dynorphin levels using a highly sensitive radioimmunoassay showed that zinc deficient animals had lower levels of dynorphin in the hypothalamus than did ad lib fed animals, with weight restricted animals having intermediate values. [3H]-naloxone binding was significantly increased to isolated brain membranes from zinc deficient animals using 1 nM unlabeled naloxone when compared to ad lib fed controls with the weight restricted animals again having intermediate values. These data suggest that abnormalities in endogenous opiate regulation of appetite may well play a role in the anorexia of zinc deficiency. The effects of zinc deficiency on endogenous opiate action appear to include alterations in receptor affinity, a post-receptor defect and alterations in the synthesis and/or release of dynorphin. PMID:6146993

  4. Manifestaciones muco cutáneas en anorexia nerviosa: Mucous and cutaneous manifestations of the anorexia nervosa

    Directory of Open Access Journals (Sweden)

    MB Leroux

    Full Text Available La anorexia nerviosa es una enfermedad psiquiátrica, cuya incidencia está creciendo en las últimas décadas. Afecta sobre todo a las adolescentes y mujeres jóvenes. Los signos clínicos son consecuencia de las carencias nutricionales y de los mecanismos de compensación, que el organismo implementa para conservar la vida. Las manifestaciones cutáneas y bucales son consecuencia de la desnutrición: vómitos autoprovocados, consumo de drogas o medicamentos no recetados y de la enfermedad psiquiátrica en sí misma. Se presentan diez pacientes, ocho mujeres y dos varones con signos cutáneos compatibles con anorexia nerviosa. El rango de edad es de 17 a 32 años. En orden de frecuencia se hallaron: acrocianosis, alopecia, acné, xerosis, palidez, hirsutismo, cambios en las membranas bucales y lesiones autoprovocadas. Creemos que el reconocimiento de estos signos cutáneos acompañado de un exhaustivo interrogatorio, puede colaborar en el diagnóstico de este trastorno alimentario.Anorexia nervosa is a psychiatric disease with an increasing incidence in the last decade, which affects principally adolescents and young women. Clinical signs are a consequence of malnutrition and the compensating mechanisms implemented to preserve life. Skin and oral lesions are caused by malnutrition, self-provoked vomiting, illegal drug consumption or therapeutic drugs utilization, and the psychiatric disease so far. Case reports: ten patients (eight females and two males with possible skin alterations due to anorexia nervosa, aged 17 to 32 yr. The most frequent signs, in order of priority were: acrocyanosis, alopecia, acne, xerodermia, pallor, hirsutism, oral injuries and self provoked injuries. We propose that the finding of these skin lesions plus an exhaustive questionnaire could aid to diagnose this eating disorder.

  5. Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa

    DEFF Research Database (Denmark)

    Weihe, Johan Petur; Birger Morillon, Melanie; Lambrechtsen, Jess;

    Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa......Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa...

  6. Autism and anorexia nervosa: Two facets of the same disease?

    Science.gov (United States)

    Odent, Michel

    2010-07-01

    We compiled data included in the Primal Health Research Database (www.primalhealthresearch.com) to test the hypothesis that when two pathological conditions or personality traits share the same critical period for gene-environment interaction, we should expect further similarities, particularly from clinical and pathophysiological perspectives. The keywords 'autism' and 'anorexia nervosa' (but not bulimia nervosa) lead to studies suggesting that for both conditions the perinatal period is critical. We take this example to look at other possible links between these pathological entities. From a clinical perspective, several teams have independently emphasized the importance of autistic traits in anorexia nervosa. Deficits in the processing of oxytocin have been demonstrated in both cases. Autistic groups have significantly lower blood oxytocin levels than normal groups, and oxytocin levels increase with age in the normal group only. In autistic groups there is a high ratio of intermediates of oxytocin synthesis (OX-T) to the nonapeptide oxytocin (OT). On the other hand, it has been reported that the level of oxytocin in the cerebrospinal fluid of anorexic women is significantly lower than the level of oxytocin in bulimic and control subjects. Scanning data reveal similar asymmetric functions with left hemisphere preponderance in autistic spectrum disorders and anorexia. A comparative study of the mirror neurons systems is another promising avenue for research. Such an accumulation of similarities from a great diversity of perspectives suggests that anorexia nervosa might be considered a female variant of the autistic spectrum. A plausible interpretation is that prenatal exposure to male hormones might protect against the expression of this disease: girls who have a twin brother are at low risk for anorexia nervosa, compared with girls who have a twin sister, and with controls; furthermore genetic linkage analyses do not detect change on the X chromosome. From an

  7. Cancer-induced anorexia in tumor-bearing mice is dependent on cyclooxygenase-1.

    Science.gov (United States)

    Ruud, Johan; Nilsson, Anna; Engström Ruud, Linda; Wang, Wenhua; Nilsberth, Camilla; Iresjö, Britt-Marie; Lundholm, Kent; Engblom, David; Blomqvist, Anders

    2013-03-01

    It is well-established that prostaglandins (PGs) affect tumorigenesis, and evidence indicates that PGs also are important for the reduced food intake and body weight loss, the anorexia-cachexia syndrome, in malignant cancer. However, the identity of the PGs and the PG producing cyclooxygenase (COX) species responsible for cancer anorexia-cachexia is unknown. Here, we addressed this issue by transplanting mice with a tumor that elicits anorexia. Meal pattern analysis revealed that the anorexia in the tumor-bearing mice was due to decreased meal frequency. Treatment with a non-selective COX inhibitor attenuated the anorexia, and also tumor growth. When given at manifest anorexia, non-selective COX-inhibitors restored appetite and prevented body weight loss without affecting tumor size. Despite COX-2 induction in the cerebral blood vessels of tumor-bearing mice, a selective COX-2 inhibitor had no effect on the anorexia, whereas selective COX-1 inhibition delayed its onset. Tumor growth was associated with robust increase of PGE(2) levels in plasma - a response blocked both by non-selective COX-inhibition and by selective COX-1 inhibition, but not by COX-2 inhibition. However, there was no increase in PGE(2)-levels in the cerebrospinal fluid. Neutralization of plasma PGE(2) with specific antibodies did not ameliorate the anorexia, and genetic deletion of microsomal PGE synthase-1 (mPGES-1) affected neither anorexia nor tumor growth. Furthermore, tumor-bearing mice lacking EP(4) receptors selectively in the nervous system developed anorexia. These observations suggest that COX-enzymes, most likely COX-1, are involved in cancer-elicited anorexia and weight loss, but that these phenomena occur independently of host mPGES-1, PGE(2) and neuronal EP(4) signaling.

  8. Unusual Presentation of Uncommon Disease: Anorexia Nervosa Presenting as Wernicke-Korsakoff Syndrome—A Case Report from Southeast Asia

    OpenAIRE

    Raheel Mushtaq; Sheikh Shoib; Tabindah Shah; Mudasir Bhat; Randhir Singh; Sahil Mushtaq

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa...

  9. Manualized Family-Based Treatment for Anorexia Nervosa: A Case Series.

    Science.gov (United States)

    Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.

    2005-01-01

    Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…

  10. Translational neuroscience of anorexia nervosa: A genetic and environmental interplay underlying behavioural hyperactivity in mice

    NARCIS (Netherlands)

    Pjetri, E.

    2012-01-01

    Anorexia Nervosa is a severe mental illness, affecting young females more than males. Anorexia nervosa runs a chronic, relapsing course and is associated with high disability and mortality rates. The hallmark of the disease is keeping a low body weight, less than 85% of what is expected. The etiolog

  11. Trastornos de personalidad en pacientes aquejados de anorexia y bulimia nerviosa : un estudio piloto

    OpenAIRE

    Echeburúa, Enrique; Marañón Guillan, Izaskun; Grijalvo López, Jorge

    2002-01-01

    En este artículo se comparó el perfil de trastornos de personalidad en 25 pacientes con un trastorno de la conducta alimentaria (5 con anorexia restrictiva, 7 con anorexia purgativa, 5 con bulimia purgativa y 8 con un trastorno de la conducta alimentari

  12. A Comparison of Short- And Long-Term Family Therapy for Adolescent Anorexia Nervosa.

    Science.gov (United States)

    Lock, James; Agras, W. Stewart; Bryson, Susan; Kraemer, Helena C.

    2005-01-01

    Objective: Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy. Method: Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or…

  13. Bulimics with and without Prior Anorexia Nervosa: A Comparison of Personality Characteristics.

    Science.gov (United States)

    Katzman, Melanie A.; Wolchik, Sharlene A.

    A controversial issue in the literature on eating disorders is whether or not bulimia is a disorder distinct from anorexia nervosa. To compare the personality and behavioral characteristics of bulimic women with and without prior anorexia nervosa, 14 female college students (mean age 19.6 years, 86 percent white) were divided into two groups…

  14. Fearing Fat: A Literature Review of Family Systems Understandings and Treatments of Anorexia and Bulimia.

    Science.gov (United States)

    Killian, Kyle D.

    1994-01-01

    Reviews literature examining family variables associated with anorexia nervosa and bulimia nervosa and family systems treatments for these eating disorders. Presents definitions of and diagnostic criteria for anorexia and bulimia, and discusses prevalence of these disorders. Reviews role played by psychopathological, sociological, and…

  15. Anorexia Nervosa/Bulimia. LC Science Tracer Bullet, TB 85-8.

    Science.gov (United States)

    Halasz, Hisako, Comp.

    This bibliography is intended to help readers locate material on anorexia nervosa and bulimia in the collections of the Library of Congress. A scope note briefly defines the terms "anorexia nervosa" and "bulimia" and discusses similarities and differences between the two eating disorders. Four references are included as introductions to the topic…

  16. Locus of Control, Psychopathology, and Weight Gain in Juvenile Anorexia Nervosa.

    Science.gov (United States)

    Strober, Michael

    1982-01-01

    Based on a hypothesized disturbance in personal control and efficacy in anorexia nervosa, locus of control score in female adolescents with anorexia nervosa was compared to scores obtained from depressed and conduct-disordered controls and to adolescent female standardization norms. (Author/CL)

  17. Einfluss von Mirtazapin auf die Cortisolsekretion und die klinischen Parameter bei Patientinnen mit Anorexia nervosa

    OpenAIRE

    Sighart, Christian

    2006-01-01

    Das Antidepressivum Mirtazapin senkt Cortisolsekretion im Speichel bei Patientinnen mit Anorexia nervosa statistisch signifikant über die Zeit. Es wurden bei 5 Patientinnen in einem Zeitraum von 21 Tagen Speichelproben genommen. Der Schluß lautet, dass eine Mirtazapintherapie sinnvoll sein könnte, Hypercortisolismus bei Anorexia nervosa zu behandeln und HPA-Achsendysfunktion wieder herzustellen.

  18. Voluntary access to a warm plate reduces hyperactivity in activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; de Rijke, Corine E; Brakkee, Jan H; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa. In ABA, scheduled feeding in combination with voluntary wheel running leads to hyperactivity, reduced food intake, severe body weight loss and hypothermia. In this study it was investigated whether hyperactivity in ABA

  19. Acquiring Research Access: Perspectives from Gatekeepers and Parents of Children with Anorexia Nervosa

    Science.gov (United States)

    Hunt, Tamara Jo-Lynne

    2010-01-01

    The purpose of this study was to understand the conditions necessary to gain research access to parents of children with anorexia. In this study, I also examined and explored avenues parents have for sharing their story and their experiences of parenting a child with anorexia as well as whether gatekeepers have a role in connecting parents and…

  20. Coming Together to Calm the Hunger: Group Therapy Program for Adults Diagnosed with Anorexia Nervosa

    Science.gov (United States)

    Ponech, Heather; McBride, Dawn Lorraine

    2012-01-01

    This project provides a comprehensive overview of the research literature on anorexia nervosa in female adults and concludes by offering 14 group therapy lesson plans for anorexia nervosa that therapists may use in their practice. There is a remarkable lack of research on the efficacy of treatment designed for individuals diagnosed with anorexia…

  1. Simultaneous introduction of a novel high fat diet and wheel running induces anorexia.

    Science.gov (United States)

    Scarpace, E T; Matheny, M; Strehler, K Y E; Shapiro, A; Cheng, K Y; Tümer, N; Scarpace, P J

    2012-02-28

    Voluntary wheel running (WR) is a form of physical activity in rodents that influences ingestive behavior. The present report describes an anorexic behavior triggered by the simultaneous introduction of a novel diet and WR. This study examined the sequential, compared with the simultaneous, introduction of a novel high-fat (HF) diet and voluntary WR in rats of three different ages and revealed a surprising finding; the simultaneous introduction of HF food and voluntary WR induced a behavior in which the animals chose not to eat although food was available at all times. This phenomenon was apparently not due to an aversion to the novel HF diet because introduction of the running wheels plus the HF diet, while continuing the availability of the normal chow diet did not prevent the anorexia. Moreover, the anorexia was prevented with prior exposure to the HF diet. In addition, the anorexia was not related to extent of WR but dependent on the act of WR. The introduction a HF diet and locked running wheels did not induce the anorexia. This voluntary anorexia was accompanied by substantial weight loss, and the anorexia was rapidly reversed by removal of the running wheels. Moreover, the HF/WR-induced anorexia is preserved across the age span despite the intrinsic decrease in WR activity and increased consumption of HF food with advancing age. The described phenomenon provides a new model to investigate anorexia behavior in rodents.

  2. AgRP(83-132) and SHU9119 differently affect activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; Kas, Martien J H; Scheurink, Anton J W; van Dijk, Gertjan; Adan, Roger A H

    2006-01-01

    Activity-based anorexia (ABA) mimics starvation and hyperactivity of anorexia nervosa patients in rats. Activation of the melanocortin (MC) system leads to hypophagia and increased energy expenditure in ad libitum fed rats. Therefore, activation of the MC system might underlie the development and pr

  3. AgRP(83—132) and SHU9119 differently affect activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J. G.; Kas, Martien J.H.; Scheurink, Anton J. W.; van Dijk, Gertjan; Adan, Roger A. H.

    2006-01-01

    Activity-based anorexia (ABA) mimics starvation and hyperactivity of anorexia nervosa patients in rats. Activation of the melanocortin (MC) system leads to hypophagia and increased energy expenditure in ad libitum fed rats. Therefore, activation of the MC system might underlie the development and pr

  4. The impact of hyperactivity and leptin on recovery from anorexia nervosa

    NARCIS (Netherlands)

    Elburg, A.A. van; Kas, M.J.H.; Hillebrand, J.J.G.; Eijkemans, R.J.C.; Engeland, H. van

    2007-01-01

    In anorexia nervosa (AN), hyperactivity is observed in about 80% of patients and has been associated with low leptin levels in the acute stage of AN and in anorexia animal models. To further understand the importance of this correlation in AN, we investigated the relationship between hypoleptinaemia

  5. Recovery of Normal Body Weight in Adolescents with Anorexia Nervosa: The Nurses’ Perspective on Effective Interventions

    NARCIS (Netherlands)

    Bakker, René; Meijel, Berno van; Beukers, Laura; Ommen, Joyce van; Meerwijk, Esther; Elburg, Annemarie van

    2011-01-01

    Little is known about effective nursing interventions for adolescents with anorexia nervosa. The purpose of this study was to discover which aspects of nursing care are most effective, according to nurses, in recovery of normal body weight in adolescents with anorexia nervosa. METHODS: A qualitative

  6. Factors Associated with Recovery from Anorexia Nervosa : A Population-Based Study

    NARCIS (Netherlands)

    Keski-Rahkonen, Anna; Raevuori, Anu; Bulik, Cynthia M.; Hoek, Hans W.; Rissanen, Aila; Kaprio, Jaakko

    2014-01-01

    Background: To examine factors associated with the outcome of anorexia nervosa among women from the general population. Method: Women (N = 2,881) from the 1975-1979 birth cohorts of Finnish twins were screened for lifetime DSM-IV anorexia nervosa (N = 55 cases) using questionnaires and the SCID inte

  7. Drive for muscularity and drive for thinness: the impact of pro-anorexia websites.

    Science.gov (United States)

    Juarez, Lilia; Soto, Ernesto; Pritchard, Mary E

    2012-01-01

    In recent years, websites that stress the message of thinness as the ideal and only choice have surfaced on the internet. The possibility that pro-anorexia websites may reinforce restrictive eating and exercise behaviors is an area of concern. In addition, friends may be influencing one another to view these websites, further contributing to drive for thinness in women and drive for muscularity in men. Three hundred male and female undergraduate psychology students responded to questionnaires assessing: internalization of pro-anorexia website content, internalization of general media content, influence of friends to view pro-anorexia websites, peer influence, drive for muscularity, and drive for thinness. Results showed internalization of pro-anorexia website content was positively correlated with drive for thinness in women, and negatively correlated with drive for muscularity in men. Internalization of pro-anorexia website content was found to be related to both drive for thinness in women and drive for muscularity in men.

  8. Psychiatrists' attitudes towards autonomy, best interests and compulsory treatment in anorexia nervosa: a questionnaire survey

    Directory of Open Access Journals (Sweden)

    Stewart Anne

    2008-12-01

    Full Text Available Abstract Background The compulsory treatment of anorexia nervosa is a contentious issue. Research suggests that psychiatrists have a range of attitudes towards patients suffering from anorexia nervosa, and towards the use of compulsory treatment for the disorder. Methods A postal self-completed attitudinal questionnaire was sent to senior psychiatrists in the United Kingdom who were mostly general adult psychiatrists, child and adolescent psychiatrists, or psychiatrists with an interest in eating disorders. Results Respondents generally supported a role for compulsory measures under mental health legislation in the treatment of patients with anorexia nervosa. Compared to 'mild' anorexia nervosa, respondents generally were less likely to feel that patients with 'severe' anorexia nervosa were intentionally engaging in weight loss behaviours, were able to control their behaviours, wanted to get better, or were able to reason properly. However, eating disorder specialists were less likely than other psychiatrists to think that patients with 'mild' anorexia nervosa were choosing to engage in their behaviours or able to control their behaviours. Child and adolescent psychiatrists were more likely to have a positive view of the use of parental consent and compulsory treatment for an adolescent with anorexia nervosa. Three factors emerged from factor analysis of the responses named: 'Support for the powers of the Mental Health Act to protect from harm'; 'Primacy of best interests'; and 'Autonomy viewed as being preserved in anorexia nervosa'. Different scores on these factor scales were given in terms of type of specialist and gender. Conclusion In general, senior psychiatrists tend to support the use of compulsory treatment to protect the health of patients at risk and also to protect the welfare of patients in their best interests. In particular, eating disorder specialists tend to support the compulsory treatment of patients with anorexia nervosa

  9. A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Franko, Debra L; Keshaviah, Aparna; Eddy, Kamryn T; Krishna, Meera; Davis, Martha C; Keel, Pamela K; Herzog, David B

    2013-08-01

    OBJECTIVE Although anorexia nervosa has a high mortality rate, our understanding of the timing and predictors of mortality in eating disorders is limited. The authors investigated mortality in a long-term study of patients with eating disorders. METHOD Beginning in 1987, 246 treatment-seeking female patients with anorexia nervosa or bulimia nervosa were interviewed every 6 months for a median of 9.5 years to obtain weekly ratings of eating disorder symptoms, comorbidity, treatment participation, and psychosocial functioning. From January 2007 to December 2010 (median follow-up of 20 years), vital status was ascertained with a National Death Index search. RESULTS Sixteen deaths (6.5%) were recorded (lifetime anorexia nervosa, N=14; bulimia nervosa with no history of anorexia nervosa, N=2). The standardized mortality ratio was 4.37 (95% CI=2.4-7.3) for lifetime anorexia nervosa and 2.33 (95% CI=0.3-8.4) for bulimia nervosa with no history of anorexia nervosa. Risk of premature death among patients with lifetime anorexia nervosa peaked within the first 10 years of follow-up, resulting in a standardized mortality ratio of 7.7 (95% CI=3.7-14.2). The standardized mortality ratio varied by duration of illness and was 3.2 (95% CI=0.9-8.3) for patients with lifetime anorexia nervosa for 0 to 15 years (4/119 died), and 6.6 (95% CI=3.2-12.1) for those with lifetime anorexia nervosa for >15 to 30 years (10/67 died). Multivariate predictors of mortality included alcohol abuse, low body mass index, and poor social adjustment. CONCLUSIONS These findings highlight the need for early identification and intervention and suggest that a long duration of illness, substance abuse, low weight, and poor psychosocial functioning raise the risk for mortality in anorexia nervosa.

  10. Tratamiento farmacológico de la anorexia-caquexia cancerosa Pharmacological therapy of cancer anorexia-cachexia

    Directory of Open Access Journals (Sweden)

    D. Cardona

    2006-05-01

    Full Text Available La anorexia es uno de los síntomas más comunes en los enfermos con cáncer avanzado y se manifiesta con pérdida de apetito por saciedad. Por otro lado, la caquexia se describe en aquellos enfermos con pérdida de peso involuntaria. El proceso canceroso produce un desequilibrio en el balance energético al disminuir la ingesta y aumentar el catabolismo, produciéndose un balance netamente negativo. Se observan diferentes factores que determinan a la caquexia, desde los desequilibrios metabólicos producidos tanto por los productos tumorales como las alteraciones endocrinas o la respuesta inflamatoria producida por las citoquinas, todo ello conlleva a un incremento de la lipólisis, pérdida de proteína muscular y anorexia. Además las causas de la anorexia son múltiples desde el tratamiento con citostáticos, radioterapia o inmunoterapia donde pueden producir diferentes grados de náuseas, vómitos, diarreas y al mismo tiempo contribuyen alterar las percepciones en el sabor y el olor, a la obstrucción del aparato digestivo, dolor, depresión, constipación... A partir de los conocimientos de los diferentes mecanismos que producen el síndrome anorexia-caquexia se han estudiado además de las dietas hipercalóricas de nutrición artificial con éxito relativo, una variedad de fármacos que fueran positivos a la ganancia de apetito como son los progestágenos, corticoesteroides y con menor evidencia clínica los cannabinoides, ciprohepatidina, mirtazapina (antidepresivo y la olanzapina (antipsicótico. Otros, se han estudiado por su efecto antiinflamatorio debido a su acción anticitoquinas como son la melatonina, ácidos polinsaturados omega-3, pentoxifilina y talidomida, excepto los segundos aún son escasos los datos clínicos para su utilización diaria. Otro tanto pasa con los fármacos anabolizantes derivados de la testosterona o los inhibidores metabólicos como el sulfato de hidracina. Sin duda alguna los progestágenos sobre todo el

  11. Anorexia y Bulimia: problemas de la sociedad desarrollada

    OpenAIRE

    Asensio Aller, Marta

    2014-01-01

    Según el Instituto Nacional de la Salud de Estados Unidos un trastorno de la alimentación es una enfermedad que causa graves perturbaciones en la dieta diaria, tales como comer cantidades muy pequeñas o comer en exceso. Los trastornos de la alimentación generalmente aparecen durante la adolescencia o adultez temprana, pero también se pueden dar durante la niñez o la adultez avanzada. Los trastornos de la alimentación más comunes son la anorexia nerviosa, bulimia nerviosa y e...

  12. Dying To Be Thin: Attachment to Death in Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Yael Latzer

    2005-01-01

    Full Text Available Anorexia Nervosa (AN usually follows a prolonged course accompanied by significant morbidity and high mortality. AN patients have been found to have elevated and attempted suicide rates, with suicide being the second most common cause of death in AN after the complications of the disorder itself. The suicide risk in AN is similar to that in major depression or conduct disorder and linked mainly to longer duration of illness, lower weight, bingeing and purging, impulsivity-related manifestations, comorbid substance abuse, and affective disorder. This paper reviews suicidal tendency and disturbed body image, death and eating disorders, and attachment and death with clinical implications related to AN.

  13. Radionuclide study of gastric emptying in anorexia nervosa patients

    International Nuclear Information System (INIS)

    To evaluate gastric emptying, 20 patients with anorexia nervosa were given 150 μCi of Tc-99m triethylene tetraamine polystyrene resin in cereal and were imaged in the supine position. Data were accumulated at 5-minute intervals to determine the gastric emptying time (GET). The GET results were divided into three categories: prolonged (10 patients); rapid (eight); and normal (two). Although all patients had symptoms of gastric dysfunction, only 50% had prolonged GET. This study allows the objective documentation of gastric emptying and the separation of patients with rapid or normal GET from those with prolonged GET, who might benefit from metoclopramide

  14. Trastorno de anorexia nerviosa, estilos de afrontamiento y situaciones estresantes

    OpenAIRE

    Ayala Sánchez, Carla Haydeé

    2006-01-01

    Los trastornos de la conducta alimentaria se han convertido en un importante tema relacionado a la salud debido a sus altos índices de prevalencia y mortandad así como las enfermedades que éstos conllevan. El objetivo principal de esta investigación fue analizar si las personas que presentan sintomatología del trastorno de Anorexia Nerviosa utilizan las dietas restrictivas y la perdida de peso corporal como una manera de reducir la tensión y por lo tanto, como un modo de af...

  15. [Anorexia nervosa is frequently associated with psychiatric co-morbidity].

    Science.gov (United States)

    Panchenko, Anna; Arnfred, Sidse Marie Hemmingsen

    2015-09-21

    Recent literature is explored focusing on the relationship between symptoms of anorexia nervosa (AN) and other psychiatric disorders and lines of treatment. In AN, restrictive subtype, anxiety and obsessive-compulsive disorders are the most frequent co-morbidities. In AN, bulimic subtype, depression, emotional instability/borderline and dependency disorders are most frequent. Psychopharmacological treatment could be tried in cases with AN and co-morbid depression, but otherwise the evidence base is lacking and pharmacological treatment relies on case stories and experience. PMID:26418641

  16. Late Onset Anorexia Nervosa Treated With Olanzapine: A Case Report

    Directory of Open Access Journals (Sweden)

    Paolo Santonastaso

    2008-12-01

    Full Text Available A case of late onset anorexia nervosa (AN treated with olanzapine is reported. The patient suffered AN onset at the age of 53 and was brought to our attention four years later in a very poor state of health due to extreme starvation and laxative abuse. She presented severe obsessions about food, a very disturbed body image, and “ascetic” rituals of self-punishment. There was no improvement of her symptoms with cognitive behavioural therapy, antidepressant drugs and inpatient nutritional therapy. After the prescription of olanzapine, the patient was more cooperative and able to maintain a stable acceptable weight, although her psychiatric and anorexic symptoms only improved partially.

  17. Tratamiento farmacológico de la anorexia-caquexia cancerosa Pharmacological therapy of cancer anorexia-cachexia

    OpenAIRE

    D. Cardona

    2006-01-01

    La anorexia es uno de los síntomas más comunes en los enfermos con cáncer avanzado y se manifiesta con pérdida de apetito por saciedad. Por otro lado, la caquexia se describe en aquellos enfermos con pérdida de peso involuntaria. El proceso canceroso produce un desequilibrio en el balance energético al disminuir la ingesta y aumentar el catabolismo, produciéndose un balance netamente negativo. Se observan diferentes factores que determinan a la caquexia, desde los desequilibrios metabólicos p...

  18. Infantile anorexia nervosa: a developmental disorder or separation and individuation.

    Science.gov (United States)

    Chatoor, I

    1989-01-01

    Infantile anorexia nervosa is an eating disorder that has its onset during the early developmental stage of separation and individuation between the ages of six months and three years. Infantile anorexia nervosa is characterized by food refusal and leads to failure to thrive. The infant refuses to eat in an attempt to achieve autonomy and control with regard to the mother, a maneuver that serves to involve the mother more deeply in the infant's eating behavior and to meet the infant's need for attention. Mother and infant become embroiled in a battle of wills over the infant's food intake. The infant's feeding is directed by his emotional needs instead of physiological sensations of hunger and satiety, and he fails to develop somatopsychological differentiation. The infant's temperament and maternal conflicts over control, autonomy, and dependency appear to contribute to this eating disorder. Treatment is aimed toward helping the parents understand and promote the developmental process of somatopsychological differentiation. Initially, a behavioral-cognitive approach is used; however, parents who struggle with unresolved issues around dependency and control require further psychotherapy. PMID:2470708

  19. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments

    Directory of Open Access Journals (Sweden)

    Francesco Landi

    2016-01-01

    Full Text Available Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.

  20. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments.

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-02-01

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an "ageist" approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons. PMID:26828516

  1. The socio-emotional processing stream in Anorexia Nervosa.

    Science.gov (United States)

    Oldershaw, A; Hambrook, D; Stahl, D; Tchanturia, K; Treasure, J; Schmidt, U

    2011-01-01

    The significance of socio-emotional factors in development and maintenance of Anorexia Nervosa (AN) has been noted, but the literature is poorly integrated without clear models guiding research or treatment. This systematic review retrieved experimental studies of social-cognitive or affective processing in AN and categorised them using Ochsner's "Social-Emotional Processing Stream." Ochsner's "Processing Stream", based on healthy data, comprises five constructs: (1) acquisition of and (2) recognition and response to social-affective stimuli, (3) low-level and (4) high-level mental state inference and (5) context-sensitive emotion regulation. Thirty-seven experimental studies in Anorexia Nervosa were identified, mapping on to four of the five constructs (not Construct 3). A meta-analysis of nine affect recognition studies was conducted. AN patients demonstrated impairments in each of the four domains with preliminary reports that some difficulties are trait-like, and others ameliorate following recovery. Socio-emotional data was integrated with previous reports of neural abnormalities to generate an AN specific model of socio-emotional processing. Additional research is required for further definition and to translate experimental findings into clinical practice.

  2. [Therapeutic itineraries of individuals with symptoms of anorexia and bulimia].

    Science.gov (United States)

    Carvalho, Maria Bernadete de; Val, Alexandre Costa; Ribeiro, Maria Mônica Freitas; Santos, Lúcia Grossi Dos

    2016-08-01

    The scope of this study is to identify and contextualize aspects of the therapeutic itineraries of patients treated at a university medical clinic specialized in nervous anorexia and bulimia. For this purpose, an attempt was made to reconstitute the succession of events triggered in 20 respondents and their families with the classification of anorexia and bulimia as "health problems." The narratives were analyzed in order to link the individual experiences and the social context of their occurrence (organization of health services, characteristics of treatment and medical knowledge and characteristics of contemporary subjectivity), in light of the theoretical studies of Public Health and Psychoanalysis. Data analysis revealed that these itineraries arise from connections and disconnections between two distinct approaches: one that organizes the management of patients and the other governing the conduct of health institutions and families. If the latter presuppose a quest for health, this is not what primarily concerns the individuals in question. Their refusal to moderate their own eating disorders is notable on their itineraries, and indicates the functionality of those practices. Such practices play a part in the reconstruction of their self-images.

  3. [Therapeutic itineraries of individuals with symptoms of anorexia and bulimia].

    Science.gov (United States)

    Carvalho, Maria Bernadete de; Val, Alexandre Costa; Ribeiro, Maria Mônica Freitas; Santos, Lúcia Grossi Dos

    2016-08-01

    The scope of this study is to identify and contextualize aspects of the therapeutic itineraries of patients treated at a university medical clinic specialized in nervous anorexia and bulimia. For this purpose, an attempt was made to reconstitute the succession of events triggered in 20 respondents and their families with the classification of anorexia and bulimia as "health problems." The narratives were analyzed in order to link the individual experiences and the social context of their occurrence (organization of health services, characteristics of treatment and medical knowledge and characteristics of contemporary subjectivity), in light of the theoretical studies of Public Health and Psychoanalysis. Data analysis revealed that these itineraries arise from connections and disconnections between two distinct approaches: one that organizes the management of patients and the other governing the conduct of health institutions and families. If the latter presuppose a quest for health, this is not what primarily concerns the individuals in question. Their refusal to moderate their own eating disorders is notable on their itineraries, and indicates the functionality of those practices. Such practices play a part in the reconstruction of their self-images. PMID:27557019

  4. BODY AND ANOREXIA, CONTRIBUTIONS OF PSYCHOANALYSIS AND CULTURE

    Directory of Open Access Journals (Sweden)

    Luis Vinicius do Nascimento

    2009-07-01

    Full Text Available Through this study, we intend to ask ourselves about anorexia, and their relationship with the body and culture. What this symptom can tell us about the way that the subject establishes his relationship with the Other? The body of the anorexic show a paradox for psychoanalysis, the “Meagers/Phallicisation” in this symptom show us the radical side of the psychoanalytical statutes of the body, drive and “jouissance”. The anorexic, to assert his desire, uses a bad strategy of separation, which meagers his body arresting him in a more voracious alienation into the Other desire. His symptom is a desperate attempt to insert a lack in this devastating Other. From this, we can contemplate if there is a relationship of the current configuration of culture with the increasing cases of anorexia. The contemporaneous, in an attempt to expel the lack of the speech, fall in the same mistake of the modernism, which didn’t considered the subject in his relationship with the “jouissance”.

  5. Body weight, anorexia, and undernutrition in older people.

    Science.gov (United States)

    Soenen, Stijn; Chapman, Ian M

    2013-09-01

    Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people.

  6. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments.

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-01-27

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an "ageist" approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.

  7. Review article: anorexia and cachexia in gastrointestinal cancer.

    Science.gov (United States)

    Ockenga, J; Valentini, L

    2005-10-01

    In patients with gastrointestinal malignancies, i.e. cancers of the stomach, colon, liver, biliary tract or pancreas, progressive undernutrition can be regularly observed during the course of illness. Undernutrition significantly affects the patients' quality of life, morbidity and survival. Pathogenetically, two different causes are relevant in the development of undernutrition in patients with gastrointestinal cancer. One cause is reduced nutritional intake. This condition is referred to as anorexia and can be worsened by the side effects of cancer therapy. The other cause is the release of endogenous transmitters and/or other products of the tumour leading to the cachexia syndrome, which is characterized by loss of body weight, negative nitrogen balance and fatigue. Cancer anorexia and cancer cachexia may have synergistic negative effects in affecting the patients' status. In this review, current nutritional support strategies with respect to different clinically relevant situations are described. An algorithm of the treatment strategies, including dietetic counselling, oral supplements, enteral and parenteral nutritional support is given. One focus is the approach of nutrition-focused patient care, which shows promising results. In addition, the possibilities of pharmacological intervention are discussed. PMID:16181298

  8. The socio-emotional processing stream in Anorexia Nervosa.

    Science.gov (United States)

    Oldershaw, A; Hambrook, D; Stahl, D; Tchanturia, K; Treasure, J; Schmidt, U

    2011-01-01

    The significance of socio-emotional factors in development and maintenance of Anorexia Nervosa (AN) has been noted, but the literature is poorly integrated without clear models guiding research or treatment. This systematic review retrieved experimental studies of social-cognitive or affective processing in AN and categorised them using Ochsner's "Social-Emotional Processing Stream." Ochsner's "Processing Stream", based on healthy data, comprises five constructs: (1) acquisition of and (2) recognition and response to social-affective stimuli, (3) low-level and (4) high-level mental state inference and (5) context-sensitive emotion regulation. Thirty-seven experimental studies in Anorexia Nervosa were identified, mapping on to four of the five constructs (not Construct 3). A meta-analysis of nine affect recognition studies was conducted. AN patients demonstrated impairments in each of the four domains with preliminary reports that some difficulties are trait-like, and others ameliorate following recovery. Socio-emotional data was integrated with previous reports of neural abnormalities to generate an AN specific model of socio-emotional processing. Additional research is required for further definition and to translate experimental findings into clinical practice. PMID:21070808

  9. Current treatment for anorexia nervosa: efficacy, safety, and adherence

    Directory of Open Access Journals (Sweden)

    Lindsay P Bodell

    2010-10-01

    Full Text Available Lindsay P Bodell, Pamela K KeelDepartment of Psychology, Florida State University, Tallahassee, FL, USAAbstract: Anorexia nervosa (AN is a serious psychiatric illness associated with significant medical and psychiatric morbidity, psychosocial impairment, increased risk of death, and chronicity. Given the severity of the disorder, the establishment of safe and effective treatments is necessary. Several treatments have been tried in AN, but few favorable results have emerged. This paper reviews randomized controlled trials in AN, and provides a synthesis of existing data regarding the efficacy, safety, and adherence associated with pharmacologic and psychological interventions. Randomized controlled trials for the treatment of AN published in peer-reviewed journals were identified by electronic and manual searches. Overall, pharmacotherapy has limited benefits in the treatment of AN, with some promising preliminary findings associated with olanzapine, an antipsychotic agent. No single psychological intervention has demonstrated clear superiority in treating adults with AN. In adolescents with AN, the evidence base is strongest for the use of family therapy over alternative individual psychotherapies. Results highlight challenges in both treating individuals with AN and in studying the effects of those treatments, and further emphasize the importance of continued efforts to develop novel interventions. Treatment trials currently underway and areas for future research are discussed.Keywords: anorexia nervosa, treatment, pharmacotherapy, psychotherapy, randomized controlled trials

  10. Symptoms of psychosis in anorexia and bulimia nervosa.

    Science.gov (United States)

    Miotto, Paola; Pollini, Barbara; Restaneo, Antonietta; Favaretto, Gerardo; Sisti, Davide; Rocchi, Marco B L; Preti, Antonio

    2010-02-28

    Despite evidence from case series, the comorbidity of eating disorders with psychosis is less investigated than their comorbidity with anxiety and mood disorders. We investigated the occurrence of symptoms of psychosis in 112 female patients diagnosed with DSM-IV eating disorders (anorexia nervosa=61, bulimia nervosa=51) and 631 high school girls in the same health district as the patients: the items of the SCL-90R symptom dimensions "paranoid ideation" and "psychoticism" were specifically examined. No case of co-morbid schizophrenia was observed among patients. Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia.

  11. Processo de Enfermagem para pacientes com Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Vanessa Pellegrino Toledo

    2011-02-01

    Full Text Available Relato de experiência da aplicação do Processo de Enfermagem a uma paciente portadora de Anorexia Nervosa, utilizando histórico, diagnósticos, intervenções e resultados de enfermagem. As intervenções foram fundamentadas nos diagnósticos de enfermagem: distúrbio da imagem corporal, nutrição desequilibrada menos que as necessidades corporais, ansiedade, baixa autoestima crônica, intolerância a atividade, controle ineficaz do regime terapêutico, risco de infecção, volume de líquidos deficiente e isolamento social. A partir da aplicação do Processo de Enfermagem, os resultados planejados foram alcançados, proporcionando melhor qualidade de vida, no período em que permaneceu internada. Os fatores psíquicos, neurológicos, endócrinos e imunológicos, peculiares na anorexia nervosa, propiciaram a elaboração de um Processo de Enfermagem, que contribuiu de maneira positiva para a complementação da reabilitação da saúde da mesma

  12. Reconciliarse consigo misma: cuando la enfermera sufre anorexia

    Directory of Open Access Journals (Sweden)

    Inmaculada Tejada Morón

    2013-09-01

    Full Text Available Relato biográfico de Sonia, una enfermera que sufrió anorexia y bulimia nerviosa, cuando estaba cursando la carrera de enfermería. El objetivo ha sido conocer de las palabras de la propia informante, cómo se vive la anorexia desde la perspectiva de una enfermera con conocimientos amplios sobre el tema, y cómo desde su posición de profesional puede ayudar a otros. Para construir el relato he realizado una entrevista semiestructurada, con preguntas abiertas centradas en los temas esenciales. La informante relata su historia describiendo aspectos como la percepción de lucha interna con la que describe el factor desencadenante y el desarrollo de la enfermedad, las estrategias de afrontamiento que utiliza para recuperar la salud y la principal motivación que la llevó a tomar conciencia del problema y querer tomar el control de su vida. Este tipo de relatos puede servir de ayuda y aprendizaje a la sociedad y en especial a otros jóvenes que pueden verse reflejados en el mismo.

  13. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-01-01

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons. PMID:26828516

  14. Spectral analysis of heart period variability in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Platiša Mirjana M.

    2005-01-01

    Full Text Available The aim of this study was to investigate the response of autonomic cardiac control to postural change using spectral analysis, in patients with anorexia nervosa. Spectral components of total variability as well as of low and high frequencies were analyzed for 17 anorexic patients with mean body mass index (14.9 ± 1.9 kg/m2 and for 9 healthy age-matched women with body mass index (20.3 ± 1.7 kg/m2, in supine and standing postures. During standing posture, increased heart rate in all subjects was accompanied by the decrease in total variability and high frequency spectral powers. In supine posture, anorexic patients demonstrated the reduced low frequency spectral power. Compared to control women, during standing posture anorexic patients showed higher heart rate, reduced total variability and high frequency spectral powers. Statistically significant correlation was noticed between body mass index and spectral power of low frequency in both supine and standing posture. Alterations in autonomic cardiac control induced by anorexia nervosa could be estimated by spectral analysis of heart period variability.

  15. How much should I eat? Estimation of meal portions in anorexia nervosa.

    Science.gov (United States)

    Milos, Gabriella; Kuenzli, Cornelia; Soelch, Chantal Martin; Schumacher, Sonja; Moergeli, Hanspeter; Mueller-Pfeiffer, Christoph

    2013-04-01

    Pathological concern regarding one's weight and weight gain is a crucial feature of anorexia nervosa. Consequently, anorexia nervosa patients often claim that they are uncertain regarding the amount of food they should eat. The present study investigated whether individuals with anorexia nervosa show an altered estimation of meal portion sizes and whether this estimation is modulated by an intent-to-eat instruction (where patients are asked to imagine having to eat the presented meal), meal type and meal portion size. Twenty-four women with anorexia nervosa and 27 healthy women estimated, using a visual analogue scale, the size of six different portions of three different meals, with and without intent-to-eat instructions. Subjects with anorexia nervosa estimated the size of small and medium meal portions (but not large meal servings) as being significantly larger, compared to estimates of healthy controls. The overestimation of small meal portions by anorexia nervosa subjects was significantly greater in the intent-to-eat, compared to general, condition. These findings suggest that disturbed perceptions associated with anorexia nervosa not only include interoceptive awareness (i.e., body weight and shape), but also extend to external disorder-related objects such as meal portion size. Specific therapeutic interventions, such as training regarding meal portion evaluation, could address these difficulties.

  16. Identifying predictors of activity based anorexia susceptibility in diverse genetic rodent populations.

    Directory of Open Access Journals (Sweden)

    Eneda Pjetri

    Full Text Available Animal studies are very useful in detection of early disease indicators and in unravelling the pathophysiological processes underlying core psychiatric disorder phenotypes. Early indicators are critical for preventive and efficient treatment of progressive psychiatric disorders like anorexia nervosa. Comparable to physical hyperactivity observed in anorexia nervosa patients, in the activity-based anorexia rodent model, mice and rats express paradoxical high voluntary wheel running activity levels when food restricted. Eleven inbred mouse strains and outbred Wistar WU rats were exposed to the activity-based anorexia model in search of identifying susceptibility predictors. Body weight, food intake and wheel running activity levels of each individual mouse and rat were measured. Mouse strains and rats with high wheel running activity levels during food restriction exhibited accelerated body weight loss. Linear mixed models for repeated measures analysis showed that baseline wheel running activity levels preceding the scheduled food restriction phase strongly predicted activity-based anorexia susceptibility (mice: Beta  =  -0.0158 (±0.003 SE, P<0.0001; rats: Beta  =  -0.0242 (±0.004 SE, P<0.0001 compared to other baseline parameters. These results suggest that physical activity levels play an important role in activity-based anorexia susceptibility in different rodent species with genetically diverse background. These findings support previous retrospective studies on physical activity levels in anorexia nervosa patients and indicate that pre-morbid physical activity levels could reflect an early indicator for disease severity.

  17. Potentiation of ghrelin signaling attenuates cancer anorexia-cachexia and prolongs survival.

    Science.gov (United States)

    Fujitsuka, N; Asakawa, A; Uezono, Y; Minami, K; Yamaguchi, T; Niijima, A; Yada, T; Maejima, Y; Sedbazar, U; Sakai, T; Hattori, T; Kase, Y; Inui, A

    2011-07-26

    Cancer anorexia-cachexia syndrome is characterized by decreased food intake, weight loss, muscle tissue wasting and psychological distress, and this syndrome is a major source of increased morbidity and mortality in cancer patients. This study aimed to clarify the gut-brain peptides involved in the pathogenesis of the syndrome and determine effective treatment for cancer anorexia-cachexia. We show that both ghrelin insufficiency and resistance were observed in tumor-bearing rats. Corticotropin-releasing factor (CRF) decreased the plasma level of acyl ghrelin, and its receptor antagonist, α-helical CRF, increased food intake of these rats. The serotonin 2c receptor (5-HT2cR) antagonist SB242084 decreased hypothalamic CRF level and improved anorexia, gastrointestinal (GI) dysmotility and body weight loss. The ghrelin receptor antagonist (D-Lys3)-GHRP-6 worsened anorexia and hastened death in tumor-bearing rats. Ghrelin attenuated anorexia-cachexia in the short term, but failed to prolong survival, as did SB242084 administration. In addition, the herbal medicine rikkunshito improved anorexia, GI dysmotility, muscle wasting, and anxiety-related behavior and prolonged survival in animals and patients with cancer. The appetite-stimulating effect of rikkunshito was blocked by (D-Lys3)-GHRP-6. Active components of rikkunshito, hesperidin and atractylodin, potentiated ghrelin secretion and receptor signaling, respectively, and atractylodin prolonged survival in tumor-bearing rats. Our study demonstrates that the integrated mechanism underlying cancer anorexia-cachexia involves lowered ghrelin signaling due to excessive hypothalamic interactions of 5-HT with CRF through the 5-HT2cR. Potentiation of ghrelin receptor signaling may be an attractive treatment for anorexia, muscle wasting and prolong survival in patients with cancer anorexia-cachexia.

  18. Dehydration-anorexia derives from a reduction in meal size, but not meal number.

    Science.gov (United States)

    Boyle, Christina N; Lorenzen, Sarah M; Compton, Douglas; Watts, Alan G

    2012-01-18

    The anorexia that results from extended periods of cellular dehydration is an important physiological adaptation that limits the intake of osmolytes from food and helps maintain the integrity of fluid compartments. The ability to experimentally control both the development and reversal of anorexia, together with the understanding of underlying hormonal and neuropeptidergic signals, makes dehydration (DE)-anorexia a powerful model for exploring the interactions of neural networks that stimulate and inhibit food intake. However, it is not known which meal parameters are affected by cellular dehydration to generate anorexia. Here we use continuous and high temporal resolution recording of food and fluid intake, together with a drinking-explicit method of meal pattern analysis to explore which meal parameters are modified during DE-anorexia. We find that the most important factor responsible for DE-anorexia is the failure to maintain feeding behavior once a meal has started, rather than the ability to initiate a meal, which remains virtually intact. This outcome is consistent with increased sensitivity to satiation signals and post-prandial satiety mechanisms. We also find that DE-anorexia significantly disrupts the temporal distribution of meals across the day so that the number of nocturnal meals gradually decreases while diurnal meal number increases. Surprisingly, once DE-anorexia is reversed this temporal redistribution is maintained for at least 4 days after normal food intake has resumed, which may allow increased daily food intake even after normal satiety mechanisms are reinstated. Therefore, DE-anorexia apparently develops from a selective targeting of those neural networks that control meal termination, whereas meal initiation mechanisms remain viable.

  19. The nucleus accumbens 5-HTR₄-CART pathway ties anorexia to hyperactivity.

    Science.gov (United States)

    Jean, A; Laurent, L; Bockaert, J; Charnay, Y; Dusticier, N; Nieoullon, A; Barrot, M; Neve, R; Compan, V

    2012-12-11

    In mental diseases, the brain does not systematically adjust motor activity to feeding. Probably, the most outlined example is the association between hyperactivity and anorexia in Anorexia nervosa. The neural underpinnings of this 'paradox', however, are poorly elucidated. Although anorexia and hyperactivity prevail over self-preservation, both symptoms rarely exist independently, suggesting commonalities in neural pathways, most likely in the reward system. We previously discovered an addictive molecular facet of anorexia, involving production, in the nucleus accumbens (NAc), of the same transcripts stimulated in response to cocaine and amphetamine (CART) upon stimulation of the 5-HT(4) receptors (5-HTR(4)) or MDMA (ecstasy). Here, we tested whether this pathway predisposes not only to anorexia but also to hyperactivity. Following food restriction, mice are expected to overeat. However, selecting hyperactive and addiction-related animal models, we observed that mice lacking 5-HTR(1B) self-imposed food restriction after deprivation and still displayed anorexia and hyperactivity after ecstasy. Decryption of the mechanisms showed a gain-of-function of 5-HTR(4) in the absence of 5-HTR(1B), associated with CART surplus in the NAc and not in other brain areas. NAc-5-HTR(4) overexpression upregulated NAc-CART, provoked anorexia and hyperactivity. NAc-5-HTR(4) knockdown or blockade reduced ecstasy-induced hyperactivity. Finally, NAc-CART knockdown suppressed hyperactivity upon stimulation of the NAc-5-HTR(4). Additionally, inactivating NAc-5-HTR(4) suppressed ecstasy's preference, strengthening the rewarding facet of anorexia. In conclusion, the NAc-5-HTR(4)/CART pathway establishes a 'tight-junction' between anorexia and hyperactivity, suggesting the existence of a primary functional unit susceptible to limit overeating associated with resting following homeostasis rules.

  20. La anorexia. Una patolog??a cultural e irracional de la modernidad

    OpenAIRE

    J??uregui, Inmaculada

    2006-01-01

    Este art??culo pretende mostrar c??mo la anorexia -la elecci??n voluntaria de no alimentarse- representa m??s que una patolog??a individual y mental (o nerviosa), una patolog??a cultural propia de la modernidad. Se quiere as?? evidenciar las dimensiones culturales de la anorexia que la propia sociedad transmite a trav??s de la socializaci??n. La anorexia aparece aqu?? como la b??squeda, el reclamo justamente de la desaparecida dimensi??n cultural, en su sentido etimol??gico original, que la m...

  1. [Anorexia nervosa and obsessive-compulsive disorder in a young Russian immigrant].

    Science.gov (United States)

    Iancu, I; Kikenzon, L; Ratzoni, G; Apter, A

    1993-04-15

    Anorexia nervosa is a psychiatric disorder characterized by excessive dieting, severe weight loss, disturbed body image and inexplicable fear of gaining weight. It afflicts mainly upper class women of developed countries. We present a 16-year-old recent immigrant from Russia, where she had developed anorexia nervosa, obsessive-compulsive disorder and depression. The management of this patient is presented in the light of the sociocultural theory of the pathogenesis of anorexia nervosa and the clinical link between eating disorders and depression and obsessive-compulsive disorders. PMID:8335272

  2. Dietary zinc intake of vegetarian and nonvegetarian patients with anorexia nervosa.

    Science.gov (United States)

    Bakan, R; Birmingham, C L; Aeberhardt, L; Goldner, E M

    1993-03-01

    Anorexia nervosa (AN) and zinc deficiency, found most frequently in young females, have a number of symptoms in common. These include weight loss, alterations in taste and appetite, depression, and amenorrhea. Approximately half of anorexia nervosa patients (ANs) are vegetarian (VANs), a practice that may increase their risk for zinc deficiency. This study compared the dietary intake of zinc and related nutrients in 9 outpatient VANs with that of 11 outpatient nonvegetarian patients with anorexia nervosa (NVANs). VANs reported significantly lower (p zinc, fat, and protein, and a significantly higher (p zinc intake should be routinely assessed in VANs and that zinc supplementation of their diets may be indicated. PMID:8477292

  3. [Acupoint Selection Laws for Massage Therapy of Infantile Anorexia: an Analysis Based on Data Mining].

    Science.gov (United States)

    Liu, Kai; Wang Jie; Wang, Yan-guo

    2016-06-01

    Massage prescriptions for treating infantile anorexia in Chinese Academic Journal Full-Text Database (CNKI, 1979-2012), Chinese Scientific and Technological Journal Full-Text Database (VIP, 1989-2012) and Wanfang Database (1990-2012) were collected. By using Chinese Medicine Inheritance Auxiliary Platform (Version 2.0) Software, 286 massage prescriptions for treatment of infantile anorexia were screened involved 76 acupoints, 20 commonly used acupoints, and 57 core acupoint combinations. Infantile Tuina specific points were used as main acupoints in massage therapy for infantile anorexia, and core acupoints covered Jizhu, Pi meridian, abdomen, Nei-Bagua, Zusanli (ST36), and Ban-men.

  4. [Acupoint Selection Laws for Massage Therapy of Infantile Anorexia: an Analysis Based on Data Mining].

    Science.gov (United States)

    Liu, Kai; Wang Jie; Wang, Yan-guo

    2016-06-01

    Massage prescriptions for treating infantile anorexia in Chinese Academic Journal Full-Text Database (CNKI, 1979-2012), Chinese Scientific and Technological Journal Full-Text Database (VIP, 1989-2012) and Wanfang Database (1990-2012) were collected. By using Chinese Medicine Inheritance Auxiliary Platform (Version 2.0) Software, 286 massage prescriptions for treatment of infantile anorexia were screened involved 76 acupoints, 20 commonly used acupoints, and 57 core acupoint combinations. Infantile Tuina specific points were used as main acupoints in massage therapy for infantile anorexia, and core acupoints covered Jizhu, Pi meridian, abdomen, Nei-Bagua, Zusanli (ST36), and Ban-men. PMID:27491238

  5. Massa óssea em pacientes com anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Santos Evaldo dos

    2004-01-01

    Full Text Available OBJETIVO: avaliar a ingestão diária de cálcio e estabelecer sua correlação com a densidade óssea de pacientes com anorexia nervos. PACIENTES E MÉTODOS: quatorze mulheres com anorexia nervosa registraram, em diário alimentar padronizado, sua ingestão em 24 horas e foram submetidas ao exame de densitometria óssea. A análise estatística foi feita pelos testes do c² e correlação de Pearson, adotando-se como significância estatística p<0,05. RESULTADOS: a média da densidade óssea na coluna lombar foi de 0,95 ± 0,15 e no colo do fêmur foi de 0,88 ± 0,26. Houve correlação significativa entre o tempo de amenorréia e a perda de massa óssea, tanto na coluna lombar (r=-0,65; p=0,01 como no fêmur (r=-0,71; (p=0,0068. Com exceção de uma paciente, todas apresentavam ingestão de cálcio inferior ao recomendado pelo RDA, com média de 554,5 mg/dia (variando de 120 a 840 mg/dia. Observou-se que 64% das pacientes apresentavam algum grau de perda de massa óssea (osteopenia ou osteoporose na coluna e 57% no fêmur. Das seis pacientes com déficit na ingestão de cálcio inferior a 60%, nenhuma apresentou osteoporose, ao passo que das oito pacientes com déficit superior a 60% na ingestão de cálcio, três tinham osteoporose. CONCLUSÃO: Pacientes com anorexia nervosa têm baixa ingestão de cálcio e perda significativa de massa óssea, que estão diretamente relacionadas entre si. A baixa densidade óssea está, também, correlacionada com o tempo de amenorréia.

  6. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    Directory of Open Access Journals (Sweden)

    Senay Akbay

    2014-06-01

    Full Text Available The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervosa. But severe bone marrow supression has rarely been reported. To our knowledge, there is not any publication in the literature about bone marrow supression due to constipation.We reported here a 17 years old girl diagnosed as anorexia nervosa who was not wasted yet, presented with constipation and developed fever and pancytopenia.

  7. Phobic memory and somatic vulnerabilities in anorexia nervosa: a necessary unity?

    Directory of Open Access Journals (Sweden)

    Myslobodsky Michael

    2005-09-01

    Full Text Available Abstract Anorexia nervosa is a clinically significant illness that may be associated with permanent medical complications involving almost every organ system. The paper raises a question whether some of them are associated with premorbid vulnerability such as subcellular ion channel abnormalities ('channelopathy' that determines the clinical expression of the bodily response to self-imposed malnutrition. Aberrant channels emerge as a tempting, if rather speculative alternative to the notion of cognitively-driven neurotransmitter modulation deficit in anorexia nervosa. The concept of channelopathies is in keeping with some characteristics of anorexia nervosa, such as a genetically-based predisposition to hypophagia, early onset, cardiac abnormalities, an appetite-enhancing efficacy of some antiepileptic drugs, and others. The purpose of this article is to stimulate further basic research of ion channel biophysics in relation to restrictive anorexia.

  8. Anorexia nervosa complicated by diabetes mellitus: the case for permissive hyperglycemia.

    Science.gov (United States)

    Brown, Carrie; Mehler, Philip S

    2014-09-01

    The coexistence of Type 1 Diabetes Mellitus and anorexia nervosa results in an increased incidence of known diabetic complications such as retinopathy and nephropathy, presumably because blood glucose is difficult to control within the throes of comorbid anorexia nervosa. In addition, even when a diabetic patient with anorexia nervosa has committed to resolving his or her eating disorder, glucose control is again difficult and fraught with complexity and peril as will be highlighted in the following case report. Prudence dictates that strict glucose control is not indicated for the relatively short period of time that constitutes the early stage of refeeding in a patient with severe anorexia nervosa. Rather, "permissive hyperglycemia" may be the more optimal course to pursue, as a clinical strategy which is considerate of both the criticality of the refeeding treatment plan and of the long-term nature of the diabetic illness.

  9. Anorexia nervosa in pregnancy: a case report and review of the literature

    Science.gov (United States)

    Dinas, K; Daniilidis, A; Sikou, K; Tantanasis, T; Kasmas, S; Tzafettas, J

    2008-01-01

    Anorexia nervosa is a complex illness rarely encountered in pregnant women. It is a disorder characterized by markedly decreased food intake accompanied by a distorted body image, resulting in an inability to maintain the body weight within 85% of ideal body weight. We describe a case of a pregnant woman diagnosed with anorexia nervosa at 28 weeks of gestation. Her body mass index was 17 kg/m2. A live male infant weighing 2,08 kg was delivered prematurely via vaginal delivery at 35 weeks of gestation. Pregnant women with anorexia nervosa may have a higher risk of hypertension, miscarriage, difficult labour, premature delivery and intrauterine growth restriction. Management of pregnancy complicated with anorexia nervosa requires involvement of a multidisciplinary team and hospitalization in severe cases.

  10. Identifying predictors of activity based anorexia susceptibility in diverse genetic rodent populations

    NARCIS (Netherlands)

    Pjetri, Eneda; de Haas, Ria; de Jong, Simone; Gelegen, Cigdem; Oppelaar, Hugo; Verhagen, Linda A W; Eijkemans, Marinus J C; Adan, Roger A; Olivier, Berend; Kas, Martien J

    2012-01-01

    Animal studies are very useful in detection of early disease indicators and in unravelling the pathophysiological processes underlying core psychiatric disorder phenotypes. Early indicators are critical for preventive and efficient treatment of progressive psychiatric disorders like anorexia nervosa

  11. Immobilization stress-induced anorexia is mediated independent of MyD88.

    Science.gov (United States)

    Hosoi, Toru; Yamawaki, Yosuke; Kimura, Hitomi; Ozawa, Koichiro

    2016-09-01

    MyD88 is an adaptor protein for the toll-like receptor, which is involved in regulating innate immune function. Lipopolysaccharide-induced activation of toll-like receptor 4 signaling induces hypothalamic signal transducer and activator of transcription 3 (STAT3) phosphorylation and anorexia through MyD88. In the present study, we investigated the possible role of MyD88 in psychological stress-induced anorexia. We found that immobilization stress inhibited food intake in both wild-type mice and MyD88-deficient mice. Immobilization stress slightly increased STAT3 phosphorylation in the hypothalamus, but it was weaker than the lipopolysaccharide-induced increase in STAT3 phosphorylation. These observations suggest that the mechanisms involved in psychological stress-induced anorexia may be regulated differently from those involved in anorexia that is induced by infection. PMID:27391428

  12. Diurnal variation of the serum leptin concentration in patients with anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Vinten, J; Handberg, A;

    1998-01-01

    , however, this has been reported to be absent in normal weighted amenorrheic athletes. Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic amenorrhoea often precedes the weight loss and may persist after weight recovery. We hypothesized that leptin could be involved...... in the regulation of eating behaviour and gonadal function in anorexia nervosa. DESIGN: We measured the concentration of leptin in serum samples taken after an overnight fast in 18 female anorexia nervosa patients and 11 controls. To study diurnal variation, eight patients and 11 controls were hospitalized for 24 h...... and had a standardized diet at regular times. Seven blood samples were obtained at 4 h intervals from each subject. PATIENTS: The patients fulfilled the DSM-IV criteria for anorexia nervosa. The mean body mass index for the patients was 14.2 +/- 2.3 kg/m2 and for controls 20.3 +/- 1.7 kg/m2. RESULTS...

  13. Sexual function of women suffering from anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Gonidakis, Fragiskos; Kravvariti, Vasilliki; Varsou, Eleftheria

    2015-01-01

    The cross-sectional study aimed at examining the sexual function of young adult women suffering from eating disorders. The authors interviewed 53 women (26 with anorexia nervosa and 27 with bulimia nervosa) and 58 female students. Each participant was administered the Female Sexual Function Index, the Eating Attitudes Test, the Body Shape Questionnaire, and the Beck Depression Inventory. Comparisons among the 3 groups showed that patients with anorexia nervosa scored lower in each Female Sexual Function Index subscale than did healthy controls. There was no significant difference between bulimia nervosa and healthy controls. Sexual functionality of patients with anorexia nervosa was correlated only with body mass index (r = 0.5, p =.01). Sexual functionality of patients with bulimia nervosa was correlated only with the Beck Depression Inventory (r = -0.4, p =.03) Patients with anorexia nervosa had more disturbed sexual function than did controls. Sexual function can be related to the level of starvation and symptoms of depression.

  14. Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report

    OpenAIRE

    Doğramacı Yunus; Kalacı Aydıner; Sevinç Teoman; Yanat Ahmet

    2008-01-01

    Abstract We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.

  15. Quando a anorexia é uma questão de sexuação

    Directory of Open Access Journals (Sweden)

    Joana Maia Simoni

    2013-12-01

    Full Text Available From clinical observations of the high incidence of anorexia among young women, the present work is dedicated to the research of the relationship between the anorectic symptom and femininity. Our hypothesis is that the anorexic symptom configures a response of some young women in face of the consequences of sexuation and of the encounter with female jouissance. The continuity between children's anorexia, in which eating nothing pops up as a separator object, and anorexia as a response to female jouissance and the sexation dilemmas are questioned. We analyze Freud's contributions concerning the assumption of the sex and the resumption of this problematic undertaken by Lacan, who shifts the Freudian phallocentrism, proposing the logic of the not whole, peculiar to the female jouissance, correlative to the women's position. As a result, the article maintains that some types of anorexia in young women represent a rejection of this Other jouissance that erupts in the body.

  16. Cognitive Behavioral Therapy for Anorexia Nervosa: An Update.

    Science.gov (United States)

    Dalle Grave, Riccardo; El Ghoch, Marwan; Sartirana, Massimiliano; Calugi, Simona

    2016-01-01

    Cognitive behavioral therapy (CBT) for anorexia nervosa (AN), based on Beck's cognitive theory, was developed in a "generic" form in the early eighties. In recent years, however, improved knowledge of the mechanisms involved in maintaining eating disorder psychopathology has led to the development of a "specific" form of CBT, termed CBT-E (E = enhanced), designed to treat all forms of eating disorders, including AN, from outpatient to inpatient settings. Although more studies are required to assess the relative effectiveness of CBT-E with respect to other available treatments, the data indicate that in outpatient settings it is both viable and promising for adults and adolescents with AN. Encouraging results are also emerging from inpatient CBT-E, particularly in adolescents, and clinical services offering CBT-E at different levels of care are now offered in several countries around the world. However, CBT-E requires dissemination in order to become widely available to patients.

  17. Anorexia nervosa responding to zinc supplementation: a case report.

    Science.gov (United States)

    Yamaguchi, H; Arita, Y; Hara, Y; Kimura, T; Nawata, H

    1992-08-01

    An emaciated 16-year-old female with anorexia nervosa was hospitalized for treatment of vomiting, epigastralgia and diarrhea. The finding of a taste disorder, low serum alkaline phosphatase activity and relatively low serum zinc level strongly suggested a zinc deficiency. Zinc was initially administered intravenously (40 mumol/day) for 7 days, then orally (15 mg elemental zinc/day) for about 60 days. Her digestive symptoms disappeared after the second day of intravenous treatment and she began to gain weight. She rapidly regained her normal weight after one month of receiving the oral zinc supplementation. Both exocrine pancreatic function and intestinal absorption were improved by the prolonged oral administration of zinc. In such cases zinc supplementation may be a therapeutic option in addition to psychologic and other approaches to management. PMID:1526438

  18. [Pathogenesis of anorexia nervosa. Neurobiological risk factors and possible endophenotypes].

    Science.gov (United States)

    Pászthy, Bea; Törzsök-Sonnevend, Mária

    2014-01-26

    Anorexia nervosa is a serious, chronical state of illness which often starts in childhood or adolescence and has serious consequences on the quality of life. This review focuses on the heterogenity of the disease with emphasis on special diagnostic implications in case of childhood onset. Research findings of the last decade showed that genetic and neurobiological vulnerabilities are at least as potent risk factors as psychological, family constellations and sociocultural preferences. The heritability of eating disorders levels those of diseases predominantly influenced by biological factors. The authors give a summary of the most investigated neurobiologic and neurocognitive factors which could be the fundaments of a biological vulnerablilty. To date, no common risk factor could be identified, but some existing adversities can clearly be related to distinct subgroups with the disorder. The concept of endo- and subphenotypes leads to more specific and more efficient methods of therapy in other somatic and psychiatric diseases. PMID:24440724

  19. [Anorexia nervosa and bulimia nervosa. II. Somatic complications of undernourishment].

    Science.gov (United States)

    van Rijn, C A

    1998-08-15

    In anorexia nervosa and bulimia nervosa, cachexia and deficient nourishment cause various physical abnormalities, especially of the endocrine and digestive systems and the heart. Disorders in the serotoninergic and dopaminergic systems contribute to development of an eating disorder, whereas an acquired deficiency of tryptophan impairs the serotoninergic system. Any problems of nutritional deficiencies, low blood sugar levels and gastrointestinal disorders disappear after normal nourishment is resumed. Hypotension and sinus bradycardia are manifestations of a physiological adjustment to a lower basal metabolism and need no treatment. Osteoporosis occurs from two years after the onset of weight loss; oestrogen supplementation may protect against this. In patients with infections, symptoms such as fever, leukocytosis and high BSE may be lacking. Hypoglycaemia incidentally leads to coma and death, and a lengthened QT interval to acute cardiac death. During restoration of the nutritional status, the intake of fluid and calories should initially be limited. During the first two weeks, the risk of cardiovascular complications is increased. PMID:9856167

  20. Cognitive Profile of Children and Adolescents with Anorexia Nervosa

    DEFF Research Database (Denmark)

    Kjaersdam Telléus, Gry; Jepsen, Jens Richardt; Bentz, Mette;

    2014-01-01

    OBJECTIVE: Few studies of cognitive functioning in children and adolescents with anorexia nervosa (AN) have been conducted. The aim of this study was to examine the neurocognitive and intelligence profile of this clinical group. METHOD: The study was a matched case-control (N = 188), multi......-centre study including children and adolescents with AN (N = 94) and healthy control participants (N = 94). RESULTS: The results suggest that Full Scale Intelligence Quotient (Wechsler Intelligence Scale for Children-III/Wechsler Adult Intelligence Scale-III) in this patient group is close to the normal...... population mean of 100. Individuals with AN exhibited significantly worse performance in nonverbal intelligence functions (i.e. Wechsler Intelligence Scale for Children-III/Wechsler Adult Intelligence Scale-III, Perceptual Organization Index) and in verbal memory (Test of Memory and Learning-Second Edition...

  1. Enfermeiros e clientela com bulimia e anorexia: estudo de caso

    Directory of Open Access Journals (Sweden)

    Claudia Regina Carvalho Martins

    2012-06-01

    Full Text Available Investigação que objetivou identificar a interação de enfermeiros e clientes portadores de bulimia e anorexia. Utilizamos o estudo de caso como recurso, para o qual coletamos dados de prontuários e fizemos entrevistas com oito de quatorze enfermeiros, que foram nossos sujeitos-objeto. De acordo com os enfermeiros, os clientes se isolavam do mundo, vivendo num mundo sem fome e de espelhos que refletiam um corpo sempre acima do "peso ideal"; eram pessoas solitárias, que perderam o brilho pessoal, emitindo sinais de que podiam extinguir a vida deles a qualquer momento. Com o estudo, foi possível identificar a maneira pela qual os enfermeiros interagiam e percebiam os clientes e, em decorrência disso, explicitamos uma prática de cuidar peculiar na enfermagem.

  2. Anorexia nervosa and bulimia nervosa: brains, bones and breeding.

    Science.gov (United States)

    Starr, Taylor B; Kreipe, Richard E

    2014-05-01

    Recent research has modified both the conceptualization and treatment of eating disorders. New diagnostic criteria reducing the "not otherwise specified" category should facilitate the early recognition and treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Technology-based studies identify AN and BN as "brain circuit" disorders; epidemiologic studies reveal that the narrow racial, ethnic and income profile of individuals no longer holds true for AN. The major organs affected long term-the brain and skeletal system-both respond to improved nutrition, with maintenance of body weight the best predictor of recovery. Twin studies have revealed gene x environment interactions, including both the external (social) and internal (pubertal) environments of boys and of girls. Family-based treatment has the best evidence base for effectiveness for younger patients. Medication plays a limited role in AN, but a major role in BN. Across diagnoses, the most important medicine is food.

  3. Dynamic psychiatry and the treatment of anorexia psychosis.

    Science.gov (United States)

    Silver, Ann-Louise S; White, Janice

    2011-01-01

    Dynamic psychotherapy of psychosis works through gradually diminishing terror, replacing this with a clearer and shared understanding of the patient's life history, its traumas and its strengths. It is diametrically opposed to our current push for efficiency and an assumption of an underlying brain disorder that responds to our current medications. Over the course of a long treatment, this patient became a scholar of psychoanalytic contributions to understanding psychosis and is now a philosopher of this field, developing an understanding of anorexia psychosis. She draws on the writings of Freud, Bion, Lacan, and Julian Jaynes, placing the core of psychosis not in primary process but in a preceding, non-self phase of development. She relates this individual development to the history of human development.

  4. Clinical Observation of Tuina in Treating Anorexia in 78 Children

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-yu; XIAO Yuan-chun

    2004-01-01

    Seventy-eight children with anorexia were treated by circling Neibagua, rubbing abdomen and kneading navel, parting-pushing Fuyinyang, pressing Zusanli (ST 36) and pinching spine. Results showed cure in 48 cases, improvement in 27 cases and failure in 3 cases, with a total effective rate of 96.1%.%应用运内八卦,摩腹揉脐,分推腹阴阳,按揉足三里穴,捏脊等推拿手法治疗78例小儿厌食患者,结果治愈48例,好转27例,未愈3例.总有效率96.1%.

  5. Treatment of 46 Cases of Anorexia with Tuina plus Acupuncture

    Institute of Scientific and Technical Information of China (English)

    ZHOU Ying-ping; CHEN Tian-yun

    2004-01-01

    Forty-six anorexia kids were treated with pinching muscles along the spine, tonifying Pitu (spleen-earth), pressing and kneading Zusanli (ST 36) as well as needling Sifeng points (Ex-UE 10) and got recovery in 20 cases, better in 24 cases and failure in 2 cases with the total effective rate of 95.7% .%应用捏脊,补脾土和按揉足三里穴方法配合针刺四缝穴,治疗小儿厌食患者46例,结果痊愈20例,好转24例,无效2例,总有效率95.7%.

  6. Peptides and aging: Their role in anorexia and memory.

    Science.gov (United States)

    Morley, John E

    2015-10-01

    The rapid aging of the world's population has led to a need to increase our understanding of the pathophysiology of the factors leading to frailty and cognitive decline. Peptides have been shown to be involved in the pathophysiology of frailty and cognitive decline. Weight loss is a major component of frailty. In this review, we demonstrate a central role for both peripheral peptides (e.g., cholecystokinin and ghrelin) and neuropeptides (e.g., dynorphin and alpha-MSH) in the pathophysiology of the anorexia of aging. Similarly, peripheral peptides (e.g., ghrelin, glucagon-like peptide 1, and cholecystokinin) are modulators of memory. A number of centrally acting neuropeptides have also been shown to modulate cognitive processes. Amyloid-beta peptide in physiological levels is a memory enhancer, while in high (pathological) levels, it plays a key role in the development of Alzheimer's disease.

  7. Anorexia Nervosa and Refeeding Syndrome. A Case Report

    Directory of Open Access Journals (Sweden)

    Kohji Azumagawa

    2007-01-01

    Full Text Available This is a case story of a 14-year-old girl with severe anorexia nervosa (AN (158 cm, 28 kg, –44.1% ideal body mass index, admitted with purpura, edema, and general fatigue. We treated her carefully and paid particular attention to prevent development of refeeding syndrome (RS, and her body weight increased satisfactorily. However, RS (edema, hypoalbuminemia, and heart failure occurred despite careful treatment. We used albumin and diuretics for treatment of RS, but severe liver damage resulted. RS was aggravated by the medical treatment. More attention should have been paid to her weight gain and medical treatment should have been initiated more slowly to prevent dramatic changes in the patient's fluid and electrolyte status.

  8. Purtscher-Like Retinopathy Associated with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Bugra Karasu

    2016-01-01

    Full Text Available A 21-year-old girl presented with acute painless vision loss in her right eye. There was no remarkable ocular history and she had a history of anorexia nervosa. At presentation best-corrected visual acuities were counting fingers from 2 meters and 20/20, in the right and left eyes, respectively. Slit lamp examination result was normal. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages surrounding the optic disc and macula in the right eye. Fluorescein angiography showed capillary filling defect and leakage from optic disc in the late phase of the angiogram. One week later best-corrected visual acuities remained the same in both eyes with similar fundus appearance. One month after initial presentation visual acuity was 20/20 in both eyes with no abnormality in fundus appearance.

  9. Psychopharmacological options for adult patients with anorexia nervosa.

    Science.gov (United States)

    Miniati, Mario; Mauri, Mauro; Ciberti, Agnese; Mariani, Michela Giorgi; Marazziti, Donatella; Dell'Osso, Liliana

    2016-04-01

    The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-one papers were screened in detail, and salient characteristics of pharmacological options for AN were summarized for drug classes. The body of evidence for the efficacy of pharmacotherapy in AN was unsatisfactory, the quality of observations was questionable (eg, the majority were not blinded), and sample size was often small. More trials are needed, while considering that nonresponse and nonremission are typical of patients with AN. PMID:26145463

  10. Cognitive Behavioral Therapy for Anorexia Nervosa: An Update.

    Science.gov (United States)

    Dalle Grave, Riccardo; El Ghoch, Marwan; Sartirana, Massimiliano; Calugi, Simona

    2016-01-01

    Cognitive behavioral therapy (CBT) for anorexia nervosa (AN), based on Beck's cognitive theory, was developed in a "generic" form in the early eighties. In recent years, however, improved knowledge of the mechanisms involved in maintaining eating disorder psychopathology has led to the development of a "specific" form of CBT, termed CBT-E (E = enhanced), designed to treat all forms of eating disorders, including AN, from outpatient to inpatient settings. Although more studies are required to assess the relative effectiveness of CBT-E with respect to other available treatments, the data indicate that in outpatient settings it is both viable and promising for adults and adolescents with AN. Encouraging results are also emerging from inpatient CBT-E, particularly in adolescents, and clinical services offering CBT-E at different levels of care are now offered in several countries around the world. However, CBT-E requires dissemination in order to become widely available to patients. PMID:26689208

  11. [Affective disorders in patients with anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Briukhin, A E; Onegina, E Iu

    2011-01-01

    Authors studied 109 patients with eating disorders, including 49 with anorexia nervosa (AN) and 60 with bulimia nervosa (BN), using psychopathological and experimental/psychological methods, psychometric scales and follow-up. Four variants (2 AN and 2 BN) of clinical presentations and dynamics of affective disorders were singled out. It has been shown that many features of their symptoms and responses of patients to the complex therapy (diet-, psycho- and pharmacotherapy) depend on the belonging of AN or BN to a group of borderline mental disorders or to endogenous diseases. Taking into account the revealed features of affective disorders, the authors have formulated recommendations for treatment tactics and prevention measures for these groups of patients.

  12. [Nurses and clientele with anorexia and bulimia: a case study].

    Science.gov (United States)

    Martins, Claudia Regina Carvalho; Caccavo, Paulo Vaccari

    2012-01-01

    The research aimed to identify the interaction of nurses and clients suffering from bulimia and anorexia. We use the case study as a resource in which we collect clinical data and did interviews with eight of fourteen nurses, who have been our subject-object. According to the nurses, clients are isolated from the world living in a world without hunger and mirrors reflecting a body always above the "ideal weight", they were lonely people, personnel who have lost their shine, sending signals that could extinguish their lives at any time. In the study, was possible to identify the manner in which nurses interacted and perceived customers and, as a result, we elucidate a peculiar practice in nursing.

  13. Family perception of anorexia and bulimia: a systematic review.

    Science.gov (United States)

    Espíndola, Cybele Ribeiro; Blay, Sérgio Luís

    2009-08-01

    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.

  14. Purtscher-Like Retinopathy Associated with Anorexia Nervosa

    Science.gov (United States)

    Karasu, Bugra; Gunay, Betul Onal; Erdogan, Gurkan; Kardes, Esra; Gunay, Murat

    2016-01-01

    A 21-year-old girl presented with acute painless vision loss in her right eye. There was no remarkable ocular history and she had a history of anorexia nervosa. At presentation best-corrected visual acuities were counting fingers from 2 meters and 20/20, in the right and left eyes, respectively. Slit lamp examination result was normal. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages surrounding the optic disc and macula in the right eye. Fluorescein angiography showed capillary filling defect and leakage from optic disc in the late phase of the angiogram. One week later best-corrected visual acuities remained the same in both eyes with similar fundus appearance. One month after initial presentation visual acuity was 20/20 in both eyes with no abnormality in fundus appearance. PMID:27069703

  15. An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis

    Science.gov (United States)

    Pehlivantürk Kızılkan, Melis; Kanbur, Nuray; Akgül, Sinem; Alikaşifoğlu, Ayfer

    2016-01-01

    Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis. PMID:26757948

  16. Dehydration-Induced Anorexia Reduces Astrocyte Density in the Rat Corpus Callosum

    OpenAIRE

    Daniel Reyes-Haro; Francisco Emmanuel Labrada-Moncada; Ricardo Miledi; Ataúlfo Martínez-Torres

    2015-01-01

    Anorexia nervosa is an eating disorder associated with severe weight loss as a consequence of voluntary food intake avoidance. Animal models such as dehydration-induced anorexia (DIA) mimic core features of the disorder, including voluntary reduction in food intake, which compromises the supply of energy to the brain. Glial cells, the major population of nerve cells in the central nervous system, play a crucial role in supplying energy to the neurons. The corpus callosum (CC) is the largest w...

  17. [Role of the age factor in forming the clinical picture of anorexia nervosa].

    Science.gov (United States)

    Korkina, M V; Zeĭgarnik, B V; Kareva, M A; Marilov, V V

    1976-12-01

    The results of long-term clinical and experimental-psychological studies of patients with nervous anorexia were analyzed from the point of view of age psychology. Such approaches permitted to distinguish a peculiarity in the formation mechanism of this form of pathology. Dynamical studies of the moving forces in the personality development in morbid conditions allowed one to distinguish certain disorders in the process of periodization of the mental development. This in its turn exerts influence on the development of nervous anorexia.

  18. Acute gastric dilatation with infarction and perforation: Report of fatal outcome in patient with anorexia nervosa

    OpenAIRE

    Saul, S. H.; Dekker, A.; Watson, C G

    1981-01-01

    This is a report of a 22-year-old woman with treated anorexia nervosa who died of complications of acute gastric dilatation—that is, infarction and perforation with severe and irreversible shock. Binge eating and drinking, precipitated by emotional crises, contributed to her acute gastric dilatation. This complication of anorexia nervosa has been previously reported, but, unlike the others, this case ended fatally. The literature is reviewed.

  19. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions

    OpenAIRE

    Melissa Rizk; Christophe Lalanne; Sylvie Berthoz; Laurence Kern; Nathalie Godart

    2015-01-01

    "Hyperactivity" has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional ...

  20. A grounded theory exploration of the experiences of the early stages of anorexia in adolescence

    OpenAIRE

    Koruth, Nina

    2008-01-01

    Background: Anorexia Nervosa is mental health problem which crosses both psychological and physical realms. It is also known to be a difficulty that often arises in adolescence. Unfortunately its prognosis is not favourable with elevated rates of chronicity and a higher mortality rate than any other psychiatric disorder in adolescence. Objectives: This research set out to explore the experiences of young people about the early stages of Anorexia. It was anticipated that this wo...

  1. Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders.

    OpenAIRE

    2007-01-01

    Body and mind – new perspectives on eating disorders In this doctoral dissertation the author focuses on models of understanding of how body and mind might interact in eating disorders, with particular emphasis on anorexia nervosa. The thesis ”Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders” is based on six scientific articles which all have been published in referee-based psychiatric journals. Three of these scientific papers d...

  2. Central Nervous System and Innate Immune Mechanisms for Inflammation- and Cancer-induced Anorexia

    OpenAIRE

    Ruud, Johan

    2012-01-01

    Anyone who has experienced influenza or a bacterial infection knows what it means to be ill. Apart from feeling feverish, experiencing aching joints and muscles, you lose the desire to eat. Anorexia, defined as loss of appetite or persistent satiety leading to reduced energy intake, is a hallmark of acute inflammatory disease. The anorexia is part of the acute phase response, triggered as the result of activation of the innate immune system with concomitant release of inflammatory mediators, ...

  3. Anorexia nervosa: a validação divergente de uma narrativa protótipo

    Directory of Open Access Journals (Sweden)

    Margarida Rangel Henriques

    2002-01-01

    Full Text Available Este estudio es la continuación de otro en el que se elaboró una narrativa prototipo de la anorexia y se analizó su validez convergente (grado de verosimilitud. Se plantean tres objetivos: analizar la validez divergente (grado de discriminación de la narrativa prototipo de la anorexia, explorar aspectos de la historia de los sujetos que puedan estar asociados a una diferencia de intensidad en la identificación con la narrativa de la anorexia y, por último, realizar un estudio exploratorio del poder predictivo de algunas de las variables descriptivas de la muestra en relación a la identificación con la narrativa prototipo de la anorexia. La muestra está formada por 38 sujetos con diagnóstico de anorexia nerviosa según los criterios del DSM-IV. Los resultados no confirman la validación divergente de la narrativa prototipo de la anorexia, poniendo en duda la hipótesis de su veracidad. No obstante, en los tres subgrupos de la muestra relacionados a la duración del trastorno superior a 2,5 años, la puntuación total del EDI y la subescala de Miedo a la Madurez encima del punto de corte, los sujetos se identifican más con la narrativa prototipo de la anorexia que con la de la toxicodependencia y la de la agorafobia. La duración de la perturbación de más de 2,5 años se revela como variable predictiva de la identificación con la narrativa prototipo de la anorexia.

  4. Inpatient Cognitive Behavior Therapy for Adolescents with Anorexia Nervosa: Immediate and Longer-Term Effects

    OpenAIRE

    RiccardoDalle Grave; Christofer G.Fairburn

    2014-01-01

    Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based upon enhanced cognitive ...

  5. Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: An alternative to family therapy?

    OpenAIRE

    Dalle Grave, Riccardo; Calugi, Simona; Doll, Helen A.; Fairburn, Christopher G.

    2013-01-01

    A specific form of family therapy (family-based treatment) is the leading treatment for adolescents with anorexia nervosa. As this treatment has certain limitations, alternative approaches are needed. “Enhanced” cognitive behaviour therapy (CBT-E) is a potential candidate given its utility as a treatment for adults with eating disorder psychopathology. The aim of the present study was to establish, in a representative cohort of patients with marked anorexia nervosa, the immediate and longer t...

  6. The impact of hyperactivity and leptin on recovery from anorexia nervosa

    OpenAIRE

    van Elburg, A A; Kas, M. J. H.; Hillebrand, J.J.G.; Eijkemans, R.J.C.; van Engeland, H

    2007-01-01

    Summary In anorexia nervosa (AN), hyperactivity is observed in about 80% of patients and has been associated with low leptin levels in the acute stage of AN and in anorexia animal models. To further understand the importance of this correlation in AN, we investigated the relationship between hypoleptinaemia and hyperactivity in AN patients longitudinally and assessed their predictive value for recovery. Body weight, activity levels, and serum leptin levels were assessed in adolescents and adu...

  7. Recovery of Normal Body Weight in Adolescents with Anorexia Nervosa: The Nurses’ Perspective on Effective Interventions

    OpenAIRE

    Bakker, René; van Meijel, Berno; Beukers, Laura; Ommen, Joyce van; Meerwijk, Esther; van Elburg, Annemarie

    2011-01-01

    Little is known about effective nursing interventions for adolescents with anorexia nervosa. The purpose of this study was to discover which aspects of nursing care are most effective, according to nurses, in recovery of normal body weight in adolescents with anorexia nervosa. METHODS: A qualitative descriptive research design was applied with individual in-depth interviews and a focus group. Thematic analysis was used to analyze the data. FINDINGS: Nurses state that they are in a key positio...

  8. Focus on anorexia nervosa: modern psychological treatment and guidelines for the adolescent patient

    OpenAIRE

    Espie J; Eisler I

    2015-01-01

    Jonathan Espie,1 Ivan Eisler2 1Child and Adolescent Eating Disorders Service, Michael Rutter Centre, South London and Maudsley Hospital Foundation NHS Trust, 2Institute of Psychiatry, King's College London, London, UK Abstract: Anorexia nervosa is a serious condition associated with high mortality. Incidence is highest for female adolescents, and prevalence data highlight a pressing unmet need for treatment. While there is evidence that adolescent-onset anorexia has relatively high r...

  9. ‘Feelings stronger than reason’: conflicting experiences of exercise in women with anorexia nervosa

    OpenAIRE

    Kolnes, Liv-Jorunn

    2016-01-01

    Background Individuals with anorexia nervosa frequently feel ambivalent about treatment and weight restoration, and drop out and relapse rates in treatment are high. Increased insight into the function of the eating disorder is considered essential for achieving long-lasting, meaningful change. However, research investigating the functions of anorexia nervosa tends to focus on the role of the disease per se. Distinctions are rarely made across features. In particular, the subjective experienc...

  10. Tales from the edge : sufferers’ perspectives of the role of psychotherapy in recovery from anorexia nervosa

    OpenAIRE

    Ramage, Michelle

    2013-01-01

    As a psychotherapist working in the field of eating disorders, I have a long-standing interest in accessing the subjective expertise of a wider group of sufferers, including what it is like and what it means to suffer from anorexia, the factors that help to support recovery and the role psychotherapy plays in contributing towards the recovery process. This study provides a timely addition to the literature on the nature and role of psychotherapy as a treatment for anorexia. Stu...

  11. Experiences of specialist inpatient treatment for anorexia nervosa: a qualitative study from adult patients’ perspectives

    OpenAIRE

    Smith, Vivien

    2012-01-01

    Background: Response to treatment in anorexia nervosa entails various challenges, including an increased risk of relapse and re-admission in those treated as inpatients. A better understanding of patients’ experiences is paramount to improve treatment acceptability and outcome. This qualitative study aimed to explore the lived experiences of adult female inpatients undergoing a specialist inpatient treatment programme for anorexia nervosa. Methods: Semi-structured interviews...

  12. The significance of learned food aversions in the aetiology of anorexia associated with cancer.

    OpenAIRE

    Levine, J A; Emery, P W

    1987-01-01

    The results of 24 h food preference tests have suggested that learned food aversions may be involved in the development of anorexia in tumour bearing rats and in patients with cancer. We have performed similar tests over longer periods, up to 10 days, in male rats implanted with Leydig cell tumours, using semisynthetic diets containing differing proportions of fat, protein and carbohydrate. Tumour growth caused anorexia (16-30% decrease in food intake) and cachexia (78% decrease in body fat a...

  13. ANOREXIA NERVOSA AS AN ADVERSE EFFECT OF MEDICATION IN A CASE OF CHRONIC SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Mary C.

    2015-01-01

    Full Text Available INTRODUCTION: A 24 year old male patient presented to our department with anorexia nervosa in a long standing case of schizophrenia on treatment with resperidone and sodium valproate . The excessive weight gain due to side effect of medications resulted in development of anorexia nervosa in the patient. RESULT & CONCLUSION: We present this interesting case for its rarity and also to demonstrate how the use of the side effect of another medication can prove beneficial for therapeutic purpose.

  14. Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case study

    OpenAIRE

    Kracke, Elsa J; Tosh, Aneesh K.

    2014-01-01

    Introduction There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. Case description This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved an...

  15. Cancer-induced anorexia in tumor-bearing mice is dependent on cyclooxygenase-1

    OpenAIRE

    Ruud, Johan; Nilsson, Anna; Engström Ruud, Linda; Wang, Wenhua; Nilsberth, Camilla; Iresjo, Britt-Marie; Lundholm, Kent; Engblom, David; Blomqvist, Anders

    2013-01-01

    It is well-established that prostaglandins (PGs) affect tumorigenesis, and evidence indicates that PGs also are important for the reduced food intake and body weight loss, the anorexia–cachexia syndrome, in malignant cancer. However, the identity of the PGs and the PG producing cyclooxygenase (COX) species responsible for cancer anorexia–cachexia is unknown. Here, we addressed this issue by transplanting mice with a tumor that elicits anorexia. Meal pattern analysis revealed that the anorexia...

  16. The possibility or coercion treatment? Anorexia nervosa – legal regulations. A case report

    OpenAIRE

    Tylec, Aneta; Olajossy, Marcin; Dubas-Ślemp, Halina; Spychalska, Katarzyna

    2013-01-01

    Anorexia nervosa is diagnosed on the basis of well-defined diagnostic criteria and requires treatment, as it is associated with the highest mortality rate of all mental illnesses. In Poland, anorexia nervosa is not considered a mental illness, although the opinion of researchers and clinicians are divided. To reduce the death rate of AN correct and early diagnosis, appropriate treatment starting immediately and the appropriate regulations to allow people to take the AN treatment against their...

  17. What can we learn from the history of male anorexia nervosa?

    OpenAIRE

    Zhang, Chengyuan

    2014-01-01

    The eating disorders literature has focussed on females and little is known of the male experience. The overall image this has generated suggests a young woman in conflict with socio-cultural pressures which associate thinness with beauty. Historical studies have examined anorexia nervosa from an entirely female focus while ignoring how diagnostic categories have shaped approaches to the male body. This paper will track the case of the male with anorexia nervosa through changing theories of c...

  18. A discourse analysis of interactions from an online pro-anorexia forum

    OpenAIRE

    Ascari, Manuela

    2013-01-01

    My research takes a look at the phenomenon of pro-anorexia websites by focusing on conversations from a public pro-anorexia forum. There is pressure on health experts and Internet hosts to oppose this controversial phenomenon because of the concern, shared by experts and lay people alike, that these websites encourage eating disorders and provide a dysfunctional, anti-recovery type of social support to those who are struggling with this problem. However, to conceive of these online spaces as ...

  19. Intracerebroventricular Injection of Metformin Induces Anorexia in Rats

    Directory of Open Access Journals (Sweden)

    Chang Koo Lee

    2012-08-01

    Full Text Available BackgroundMetformin, an oral biguanide insulin-sensitizing agent, is well known to decrease appetite. Although there is evidence that metformin could affect the brain directly, the exact mechanism is not yet known.MethodsTo evaluate whether metformin induces anorexia via the hypothalamus, various concentrations of metformin were injected into the lateral ventricle of rats through a chronically implanted catheter and food intake was measured for 24 hours. The hypothalamic neuropeptides associated with regulation of food intake were also analyzed following 1 hour of intracerebroventricular (ICV injections of metformin.ResultsAn ICV injection of metformin decreased food intake in a dose-dependent manner in unrestrained conscious rats. Hypothalamic phosphorylated AMP-activated protein kinase (pAMPK increased by 3 µg with metformin treatment, but there was no further increase in pAMPK with increases in metformin dosage. The hypothalamic phosphorylated signal transducer and activator of transcription 3 (pSTAT3 increased by 3 µg with metformin treatment, but, there was no further increase in pSTAT3 level following increases of metformin dosage. Hypothalamic proopiomelanocortin was elevated with metformin treatment, while neuropeptide Y was not significantly changed.ConclusionOur results suggest that metformin induces anorexia via direct action in the hypothalamus and the increase in pSTAT3, at least in part, is involved in the process. However, hypothalamic pAMPK appears not to contribute to metformin-induced appetite reduction in normal rats. Further studies exploring new pathways connecting metformin and feeding regulation are needed.

  20. Selective cognitive empathy deficit in adolescents with restrictive anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Calderoni S

    2013-10-01

    Full Text Available Sara Calderoni,1 Pamela Fantozzi,1 Sandra Maestro,1 Elena Brunori,1 Antonio Narzisi,1 Giulia Balboni,2 Filippo Muratori1,31Department of Child Neurology and Psychiatry, IRCCS Stella Maris Foundation, 2Department of Surgery, Medical, Molecular and Critical Area Pathology, University of Pisa, 3Department of Developmental Medicine, University of Pisa, Pisa, ItalyBackground: A growing, but conflicting body of literature suggests altered empathic abilities in subjects with anorexia nervosa-restricting type (AN-R. This study aims to characterize the cognitive and affective empathic profiles of adolescents with purely AN-R.Methods: As part of a standardized clinical and research protocol, the Interpersonal Reactivity Index (IRI, a valid and reliable self-reported instrument to measure empathy, was administered to 32 female adolescents with AN-R and in 41 healthy controls (HC comparisons, matched for age and gender. Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures.Results: Patients scored significantly lower than HC on cognitive empathy (CE, while they did not differ from controls on affective empathy (AE. The deficit in CE was not related to either disease severity nor was it related to associated psychopathology.Conclusion: These results, albeit preliminary, suggest that a dysfunctional pattern of CE capacity may be a stable trait of AN-R that should be taken into account not only for the clinical management, but also in preventive and therapeutic intervention.Keywords: anorexia nervosa-restricting type, cognitive empathy, affective empathy, female adolescents, Interpersonal Reactivity Index

  1. A case series investigation of association between co-morbid psychiatric disorder and the improvement in body mass index among patients with anorexia nervosa and eating disorder not otherwise specified of the anorexia nervosa type

    OpenAIRE

    Goh, Robin

    2015-01-01

    Background Anorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore. Patients with eating disorders may also present with other psychiatric disorders such as depression and anxiety. The paper aims to investigate the association of co-morbid psychiatric disorders with the improvement of body mass index (BMI) in these patients. Methods A retrospective cohort analysis of 182 patients with anorexia and eating disor...

  2. Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Nicola Maria Vitola

    2013-05-01

    Full Text Available BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has been taken to the Emergency Department in very critical conditions. Despite the attempts of resuscitation, she died shortly afterwards. Therefore an autopsy has been requested in order to clarify the causes of death. RESULTS The clinical picture, laboratory parameters, histology and microbiological investigations were consistent with pneumococcal sepsis associated adrenal apoplexy. CONCLUSIONS The cause of death in anorexia nervosa cannot reliably be established from antemortem clinical features. All anorexia nervosa deaths should be reported together with description of necropsy. This may lead to advances in the knowledge and treatment practices.

  3. Interleukin-7 Plasma Levels in Human Differentiate Anorexia Nervosa, Constitutional Thinness and Healthy Obesity

    Science.gov (United States)

    Germain, Natacha; Viltart, Odile; Loyens, Anne; Bruchet, Céline; Nadin, Katia; Wolowczuk, Isabelle; Estour, Bruno; Galusca, Bogdan

    2016-01-01

    Introduction Interleukin-7 (IL-7) is a cytokine involved in energy homeostasis as demonstrated in rodents. Anorexia nervosa is characterized by restrained eating behavior despite adaptive orexigenic regulation profile including high ghrelin plasma levels. Constitutional thinness is a physiological condition of resistance to weight gain with physiological anorexigenic profile including high Peptide YY plasma level. Healthy obesity can be considered as a physiological state of resistance to weight loss with opposite appetite regulating profile to constitutional thinness including low Peptide YY plasma level. No studies in IL-7 are yet available in those populations. Therefore we evaluated circadian plasma levels of IL-7 in anorexia nervosa compared to constitutional thinness, healthy obese and control females. Materials and Methods 10 restrictive-type anorexia nervosa women, 5 bingeing/purging anorexia nervosa woman, 5 recovered restrictive anorexia nervosa women, 4 bulimic females, 10 constitutional thinness women, 7 healthy obese females, and 10 normal weight women controls were enrolled in this cross-sectional study, performed in endocrinology unit and academic laboratory. Twelve-point circadian profiles of plasma IL-7 levels were measured in each subject. Results 24h mean IL-7 plasma levels (pg/ml, mean±SEM) were decreased in restrictive-type anorexia nervosa (123.4±14.4, pobese patients (51±3.2, pobesity, with low IL-7, is once again in mirror image of constitutional thinness with normal high IL-7. PMID:27611669

  4. What can we learn from the history of male anorexia nervosa?

    Science.gov (United States)

    Zhang, Chengyuan

    2014-01-01

    The eating disorders literature has focussed on females and little is known of the male experience. The overall image this has generated suggests a young woman in conflict with socio-cultural pressures which associate thinness with beauty. Historical studies have examined anorexia nervosa from an entirely female focus while ignoring how diagnostic categories have shaped approaches to the male body. This paper will track the case of the male with anorexia nervosa through changing theories of causation and treatment approaches, from when the condition first emerged in 1873 to the present. In doing so, we gain a valuable new insight into how anorexia nervosa has been historically gendered and the far-reaching implications this has had for diagnosis and treatment of the male sufferer. Similarities between the sexes helped to establish male anorexia as a distinct category. However, this shifted focus away from important differences, which have yet unexplored implications in the assessment, diagnosis and management of disordered eating. Throughout history, there has been constant pressure to give a precise definition to anorexia nervosa, despite being fraught with medical uncertainties. This has resulted in inevitably harmful generalisations rooted in the dominant epidemiology. This paper reveals that anorexia nervosa is a truly global phenomenon which cannot be adequately constructed through exclusive studies of the female. There is consequently a pressing need to address the dearth of research examining eating disorders in males. PMID:25671131

  5. Autism spectrum disorder in individuals with anorexia nervosa and in their first- and second-degree relatives

    DEFF Research Database (Denmark)

    Koch, Susanne V; Tidselbak Larsen, Janne; Mouridsen, Svend E;

    2015-01-01

    BACKGROUND: Clinical and population-based studies report increased prevalence of autism spectrum disorders (ASD) in individuals with anorexia nervosa and in their relatives. No nationwide study has yet been published on co-occurrence of these disorders. AIMS: To investigate comorbidity of ASD...... in individuals with anorexia nervosa, and aggregation of ASD and anorexia nervosa in their relatives. METHOD: In Danish registers we identified all individuals born in 1981-2008, their parents, and full and half siblings, and linked them to data on hospital admissions for psychiatric disorders. RESULTS: Risk...... of comorbidity of ASD in probands with anorexia nervosa and aggregation of ASD in families of anorexia nervosa probands were increased. However, the risk of comorbid and familial ASD did not differ significantly from comorbid and familial major depression or any psychiatric disorder in anorexia nervosa probands...

  6. Anorexia nervosa: the diagnosis. A postmodern ethics contribution to the bioethics debate on involuntary treatment for anorexia nervosa.

    Science.gov (United States)

    Kendall, Sacha

    2014-03-01

    This paper argues that there is a relationship between understandings of anorexia nervosa (AN) and how the ethical issues associated with involuntary treatment for AN are identified, framed, and addressed. By positioning AN as a construct/discourse (hereinafter "AN: the diagnosis") several ethical issues are revealed. Firstly, "AN: the diagnosis" influences how the autonomy and competence of persons diagnosed with AN are understood by decision-makers in the treatment environment. Secondly, "AN: the diagnosis" impacts on how treatment and treatment efficacy are defined and the ethical justifiability of paternalism. Thirdly, "AN: the diagnosis" can limit the opportunity for persons with AN to construct an identity that casts them as a competent person. "AN: the diagnosis" can thus inherently affirm professional knowledge and values. Postmodern professional ethics can support professionals in managing these issues by highlighting the importance of taking responsibility for professional knowledge, values, and power and embracing moral uncertainty. PMID:24366443

  7. A auto-imagem corporal na anorexia nervosa: uma abordagem sociológica Body image in nervous anorexia: a sociological approach

    OpenAIRE

    Rubia Carla Formighieri Giordani

    2006-01-01

    A anorexia é um transtorno no comportamento alimentar com a distorção na auto-imagem corporal, sendo sua principal característica o medo mórbido de engordar e uma forma pervertida de realizar a restrição alimentar. O objetivo deste trabalho foi compreender os mecanismos de formação da imagem corporal na anorexia nervosa, bem como depreender os sentidos manifestos na construção da obesidade no corpo anoréxico. O caminho metodológico trilhado compreendeu a etnografia e o método biográfico, com ...

  8. Sipjeondaebo-tang in patients with cancer with anorexia: a protocol for a pilot, randomised, controlled trial

    OpenAIRE

    Cheon, ChunHoo; Park, Sunju; Park, Yu Lee; Huang, Ching-Wen; Ko, Youme; Jang, Bo-Hyoung; Shin, Yong-Cheol; Ko, Seong-Gyu

    2016-01-01

    Introduction Cancer-related anorexia is the loss of appetite or desire to eat in patients with cancer. Although treatments for cancer-related anorexia do exist, patients have sought complementary and alternative medicine including herbal remedies, due to safety concerns. Sipjeondaebo-tang is one among other popular herbal medicines that are beneficial to management of anorexia in Korea. The purpose of this study is to examine the feasibility for a full randomised clinical trial of Sipjeondaeb...

  9. Misleading Health-Related Information Promoted Through Video-Based Social Media: Anorexia on YouTube

    OpenAIRE

    Syed-Abdul, Shabbir; Fernandez-Luque, Luis; Jian, Wen-Shan; Li, Yu-Chuan (Jack); Crain, Steven; Hsu, Min-Huei; Wang, Yao-Chin; Khandregzen, Dorjsuren; Chuluunbaatar, Enkhzaya; Nguyen, Phung Anh; Liou, Der-Ming

    2013-01-01

    Introduction The amount of information being uploaded onto social video platforms, such as YouTube, Vimeo, and Veoh, continues to spiral, making it increasingly difficult to discern reliable health information from misleading content. There are thousands of YouTube videos promoting misleading information about anorexia (eg, anorexia as a healthy lifestyle). Objective The aim of this study was to investigate anorexia-related misinformation disseminated through YouTube videos. Methods We retrie...

  10. Unusual Presentation of Uncommon Disease: Anorexia Nervosa Presenting as Wernicke-Korsakoff Syndrome—A Case Report from Southeast Asia

    Directory of Open Access Journals (Sweden)

    Raheel Mushtaq

    2014-01-01

    Full Text Available Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome.

  11. Process evaluation of the MOSAIC trial: treatment experience of two psychological therapies for out-patient treatment of Anorexia Nervosa

    OpenAIRE

    Zainal, K. A.; Renwick, B.; Keyes, A.; Lose, A.; Kenyon, M.; DeJong, H; Broadbent, H.; Serpell, L; Richards, L.; Johnson-Sabine, E.; Boughton, N.; Whitehead, L.; Treasure, J; Schmidt, U.; MOSAIC trial group

    2016-01-01

    BACKGROUND: This study is part of a series of process evaluations within the MOSAIC Trial (Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions). This randomised controlled trial (RCT) compared two psychological treatments, the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM) for adult outpatients with Anorexia Nervosa. The present process study integrates quantitative (treatment acceptabi...

  12. Growth hormone releasing peptide 2 reverses anorexia associated with chemotherapy with 5-fluorouracil in colon cancer cell-bearing mice

    OpenAIRE

    Perboni, Simona; Bowers, Cyril; Kojima, Shinya; Asakawa, Akihiro; Inui, Akio

    2008-01-01

    The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemotherapy. Ghrelin is a orexigenic hormone that has been proposed to prevent anorexia. Aim of the study was to determine whether the addition of the ghrelin agonist growth hormone releasing peptide 2 (GHRP-2) to cytotoxic therapy with 5-fluorouracil (5-FU) prevents the anorexia associated with chemotherapy in cancer cachectic mice. Thirty-three BA...

  13. Partially restored resting-state functional connectivity in women recovered from anorexia nervosa

    Science.gov (United States)

    Boehm, Ilka; Geisler, Daniel; Tam, Friederike; King, Joseph A.; Ritschel, Franziska; Seidel, Maria; Bernardoni, Fabio; Murr, Julia; Goschke, Thomas; Calhoun, Vince D.; Roessner, Veit; Ehrlich, Stefan

    2016-01-01

    Background We have previously shown increased resting-state functional connectivity (rsFC) in the frontoparietal network (FPN) and the default mode network (DMN) in patients with acute anorexia nervosa. Based on these findings we investigated within-network rsFC in patients recovered from anorexia nervosa to examine whether these abnormalities are a state or trait marker of the disease. To extend the understanding of functional connectivity in patients with anorexia nervosa, we also estimated rsFC between large-scale networks. Methods Girls and women recovered from anorexia nervosa and pair-wise, age- and sex-matched healthy controls underwent a resting-state fMRI scan. Using independent component analyses (ICA), we isolated the FPN, DMN and salience network. We used standard comparisons as well as a hypothesis-based approach to test the findings of our previous rsFC study in this recovered cohort. Temporal correlations between network time-course pairs were computed to investigate functional network connectivity (FNC). Results Thirty-one patients recovered from anorexia nervosa and 31 controls participated in our study. Standard group comparisons revealed reduced rsFC between the dorsolateral prefrontal cortex (dlPFC) and the FPN in the recovered group. Using a hypothesis-based approach we extended the previous finding of increased rsFC between the angular gyrus and the FPN in patients recovered from anorexia nervosa. No group differences in FNC were revealed. Limitations The study design did not allow us to conclude that the difference found in rsFC constitutes a scar effect of the disease. Conclusion This study suggests that some abnormal rsFC patterns found in patients recovered from anorexia nervosa normalize after long-term weight restoration, while distorted rsFC in the FPN, a network that has been associated with cognitive control, may constitute a trait marker of the disorder. PMID:27045551

  14. In silico exploration of the mechanisms that underlie parasite-induced anorexia in sheep.

    Science.gov (United States)

    Laurenson, Yan C S M; Bishop, Stephen C; Kyriazakis, Ilias

    2011-10-01

    A model was used to investigate two mechanisms describing reductions in food intake (anorexia) observed during gastrointestinal parasitism in lambs, and to explore relationships between anorexia and food composition. The mechanisms were either a reduction in intrinsic growth rate, leading to a consequent reduction in food intake (mechanism 1; M1), or a direct reduction in food intake (mechanism 2; M2). For both mechanisms, lambs growing from 2 to 6 months of age were modelled, with one of three levels of trickle challenge with Teladorsagia circumcincta. Scenarios were simulated for feeds varying in either protein or energy content, or both. Major differences were found between the predictions resulting from M1 and M2 on low-energy foods that constrained the intake of uninfected lambs through bulk. With M1, food intake was governed by the first operating constraint, whereas with M2 an additivity of constraints was observed. On the other foods, the duration of anorexia increased with increasing energy content of feed for M1, whilst the duration of anorexia decreased with increasing protein content of feed for M2.For foods that did not have an impact upon lambs' gastrointestinal tract capacity, published data were consistent with predictions of M2. Due to an absence of experimental data, no conclusions could be drawn for relationships between anorexia and food composition in the presence of other limiting constraints, such as bulk for low-energy foods. In conclusion, available experimental data and model predictions were consistent with anorexia having an impact directly on food intake, and with impacts of anorexia increasing with decreasing protein content.

  15. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa.

    Science.gov (United States)

    Sheng, Min; Lu, Hanzhang; Liu, Peiying; Thomas, Binu P; McAdams, Carrie J

    2015-05-30

    Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder. PMID:25795596

  16. 厌食散配合刺四缝穴治疗小儿厌食症%Treatment of Children Anorexia with Anorexia San and Acupuncture Sifeng Point

    Institute of Scientific and Technical Information of China (English)

    谢彬; 沈红岩

    2011-01-01

    目的:探寻治疗小儿厌食症的有效方法.方法:将156例患儿随机分为治疗组和对照组各78例,对照组仅采用刺四缝穴治疗,治疗组采用口服厌食散(辽宁中医药大学附属医院院内制剂)配合剌四缝穴,疗程均为2周.结果:治疗组总有效率100%,优于对照组的92.3%(P<0.05).结论:厌食散配合刺四缝穴治疗小儿厌食症安全、有效、简单、经济,值得临床推广使用.%Objective: To explore an effective way to treat children anorexia.Methods: The 156 patients were randomly divided into treatment group and control group 78 patients, control group treated with points Sifeng, treatment group were anorexia san and acupuncture Sifeng point.Groups are 2 weeks as a course of treatment.Results: The total effective rate is 100% in treatment group and 92.3% in control group, the difference has statistical significance(P<0.05).Conclusion: Anorexia san and acupuncture sifeng point in treating children anorexia were safe, effective, simple, economical, should be widely applied.

  17. The assessment of anorexia in patients with cancer: cut-off values for the FAACT–A/CS and the VAS for appetite

    OpenAIRE

    Blauwhoff-Buskermolen, S.; Ruijgrok, C.; Ostelo, R. W.; de Vet, H. C. W.; Verheul, H.M.W.; de van der Schueren, M. A. E.; Langius, J. A. E.

    2015-01-01

    Purpose Anorexia is a frequently observed symptom in patients with cancer and is associated with limited food intake and decreased quality of life. Diagnostic instruments such as the Anorexia/Cachexia Subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire and the visual analog scale (VAS) for appetite have been recommended in the assessment of anorexia, but validated cut-off values are lacking. This study aimed to obtain cut-off values of these instrum...

  18. Therapeutic potential of ghrelin in restricting-type anorexia nervosa.

    Science.gov (United States)

    Hotta, Mari; Ohwada, Rina; Akamizu, Takashi; Shibasaki, Tamotsu; Kangawa, Kenji

    2012-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by a decrease in caloric intake and malnutrition. It is associated with a variety of medical morbidities as well as significant mortality. Nutritional support is of paramount importance to prevent impaired quality of life later in life in affected patients. Some patients with restricting-type AN who are fully motivated to gain body weight cannot increase their food intake because of malnutrition-induced gastrointestinal dysfunction. Chronicity of AN prevents participation in social activities and leads to increased medical expenses. Therefore, there is a pressing need for effective appetite-stimulating therapies for patients with AN. Ghrelin is the only orexigenic hormone that can be given intravenously. Intravenous infusion of ghrelin is reported to increase food intake and body weight in healthy subjects as well as in patients with poor nutritional status. Here, we introduce the results of a pilot study that investigated the effects of ghrelin on appetite, energy intake, and nutritional parameters in five patients with restricting-type AN, who are fully motivated to gain body weight but could not increase their food intake because of malnutrition-induced gastrointestinal dysfunction. PMID:22975066

  19. Role of the evolutionarily conserved starvation response in anorexia nervosa.

    Science.gov (United States)

    Dwyer, D S; Horton, R Y; Aamodt, E J

    2011-06-01

    This review will summarize recent findings concerning the biological regulation of starvation as it relates to anorexia nervosa (AN), a serious eating disorder that mainly affects female adolescents and young adults. AN is generally viewed as a psychosomatic disorder mediated by obsessive concerns about weight, perfectionism and an overwhelming desire to be thin. By contrast, the thesis that will be developed here is that, AN is primarily a metabolic disorder caused by defective regulation of the starvation response, which leads to ambivalence towards food, decreased food consumption and characteristic psychopathology. We will trace the starvation response from yeast to man and describe the central role of insulin (and insulin-like growth factor-1 (IGF-1))/Akt/ F-box transcription factor (FOXO) signaling in this response. Akt is a serine/threonine kinase downstream of the insulin and IGF-1 receptors, whereas FOXO refers to the subfamily of Forkhead box O transcription factors, which are regulated by Akt. We will also discuss how initial bouts of caloric restriction may alter the production of neurotransmitters that regulate appetite and food-seeking behavior and thus, set in motion a vicious cycle. Finally, an integrated approach to treatment will be outlined that addresses the biological aspects of AN. PMID:20838399

  20. A qualitative investigation into anorexia nervosa: The inner perspective

    Directory of Open Access Journals (Sweden)

    Enrica Marzola

    2015-12-01

    Full Text Available The ego-syntonic nature of anorexia nervosa (AN emphasizes how some aspects of this disorder can be highly valuable to patients. To understand the different perspectives that patients with AN hold about their condition, we explored the meanings they attribute to it. Thirty-four AN patients were asked to write a letter to their condition describing what it represents and means to them. Letters were then evaluated using a standardized coding scheme. Three pro-codes resulted to be mostly represented: difference (i.e. feeling different from others because of AN, company (i.e. being protected by the disorder, and identity (i.e. being totally represented by the illness. Some anti-codes were also particularly used: anger/hate, expressing anger toward AN, fear/distress, betrayal/pretend (i.e. feeling cheated by the disorder, and loss/waste (i.e. describing a feeling of life being wasted. In addition to pro- and anti-codes, the ambivalence theme was also well represented. Given the complex adaptive function of this disorder, this study may provide a framework of different perspectives that therapists could refer to and patients could identify with during the therapeutic process toward discovering individual meanings of the disorder.