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Sample records for bulimia nervosa

  1. Bulimia nervosa

    OpenAIRE

    Hay, Phillipa J; Claudino, Angélica Medeiros

    2008-01-01

    Up to 1% of young women may have bulimia nervosa, characterised by an intense preoccupation with body weight, uncontrolled binge-eating episodes, and use of extreme measures to counteract the feared effects of overeating. People with bulimia nervosa may be of normal weight, making it difficult to diagnose.Obesity has been associated with both an increased risk of bulimia nervosa and a worse prognosis, as have personality disorders and substance misuse.After 10 years, about half of people w...

  2. 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...

  3. Bulimia Nervosa – medical complications

    OpenAIRE

    Mehler, Philip S; Rylander, Melanie

    2015-01-01

    As with anorexia nervosa, there are many medical complications associated with bulimia nervosa. In bulimia nervosa, these complications are a direct result of both the mode and the frequency of purging behaviours. For the purposes of this article, we will review in detail the many complications of the two major modes of purging, namely, self-induced vomiting and laxative abuse; these two account for more than 90% of purging behaviours in bulimia nervosa. Some of these complications are potent...

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with or without bulimia, and presents a comprehensive picture of this eating disorder, focusing on terminology, historical references, prevalence, prognosis, classification, diagnostic criteria, physical and psychological characteristics, evolution of the disability, etiology, treatment, and…

  5. 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. PMID:26169883

  6. Bulimia Nervosa: A Primary Care Review

    OpenAIRE

    Rushing, Jona M.; Jones, Laura E.; Carney, Caroline P

    2003-01-01

    Bulimia nervosa is a psychiatric condition that affects many adolescent and young adult women. The disorder is characterized by bingeing and purging behavior and can lead to medical complications. Thus, patients with bulimia nervosa commonly present in the primary care setting. Physical and laboratory examinations reveal markers of bulimia nervosa that are useful in making the diagnosis. Treatment is beneficial, and outcomes of early intervention are good. This article discusses the history, ...

  7. Tratamento nutricional da bulimia nervosa Nutritional therapy for bulimia nervosa

    OpenAIRE

    Marle dos Santos Alvarenga; Fernanda Baeza Scagliusi

    2010-01-01

    A bulimia nervosa é um transtorno alimentar caracterizado por compulsões alimentares e métodos compen-satórios recorrentes. Os pacientes apresentam ingestão alimentar inadequada e comportamentos alimentares disfuncionais. O adequado tratamento do transtorno requer uma equipe multiprofissional e terapia nutricional especializada. Compreender as características desse transtorno, os padrões de consumo e o comportamento alimentar, bem como atentar para as atitudes alimentares dos pacientes, é fun...

  8. Bulimia nervosa in the Chinese.

    Science.gov (United States)

    Schmidt, U

    1993-12-01

    Typical DSM-III-R bulimia nervosa with self-induced vomiting was found in 2 women of Hong Kong Chinese origin and a Chinese man from Malaysia. All 3 cases had a family history of obesity. In 2 of the cases a period of weight gain and in the third case frank obesity preceded the onset of the eating disorder. Cultural transition seemed to play an important part in the onset and maintenance of the eating disorder. PMID:8293034

  9. 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…

  10. 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. PMID:25874112

  11. 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.

  12. Subtyping adolescents with bulimia nervosa

    OpenAIRE

    Chen, Eunice Yu; le Grange, Daniel

    2007-01-01

    Cluster analyses of eating disorder patients have yielded a “dietary-depressive” subtype, typified by greater negative affect, and a “dietary” subtype, typified by dietary restraint. This study aimed to replicate these findings in an adolescent sample with bulimia nervosa (BN) from a randomized controlled trial and to examine the validity and reliability of this methodology. In the sample of BN adolescents (N=80), cluster analysis revealed a “dietary-depressive” subtype (37.5%) and a “dietary...

  13. The course and outcome of bulimia nervosa.

    Science.gov (United States)

    Quadflieg, Norbert; Fichter, Manfred M

    2003-01-01

    We reviewed the literature on the course and outcome of bulimia nervosa. Longer-term outcome is associated with a considerable degree of relapse and chronification. Diagnostic crossover to anorexia nervosa and binge eating disorder is low. Mortality in bulimia nervosa is considerably lower than in anorexia nervosa. Social adjustment and sexuality apparently normalizes in quite a few bulimic women over the course of time. A large group of bulimic patients, however, chronifies and suffers from severe bulimic symptoms and social and sexual impairment. Assessments using more systematic categories and standardized reporting procedures are required in order to make the results of studies comparable and to allow generalized conclusions. PMID:12567221

  14. Tratamento nutricional da bulimia nervosa Nutritional therapy for bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Marle dos Santos Alvarenga

    2010-10-01

    Full Text Available A bulimia nervosa é um transtorno alimentar caracterizado por compulsões alimentares e métodos compen-satórios recorrentes. Os pacientes apresentam ingestão alimentar inadequada e comportamentos alimentares disfuncionais. O adequado tratamento do transtorno requer uma equipe multiprofissional e terapia nutricional especializada. Compreender as características desse transtorno, os padrões de consumo e o comportamento alimentar, bem como atentar para as atitudes alimentares dos pacientes, é fundamental para o planejamento e para a adequada condução da abordagem nutricional. A terapia nutricional para esse transtorno é diferenciada, exigindo do nutricionista maiores habilidades de aconselhamento nutricional. Educação nutricional e acon-selhamento nutricional, com ênfase na abordagem de atitudes alimentares e insatisfação corporal, são o foco da terapia nutricional. Para o atendimento eficaz desses pacientes e o sucesso no tratamento nutricional, é importante que o profissional se mantenha atualizado sobre nutrição e transtornos alimentares e procure especialização e experiência nessa área do conhecimento.Bulimia nervosa is an eating disorder characterized by binge eating and compensatory behaviors. The patients present inappropriate food intake and dysfunctional eating behaviors. Proper treatment of this disorder requires a multidisciplinary team and specialized nutrition therapy. It is fundamental to understand the characteristics of this disorder, the intake patterns and the eating behavior, and be attentive to the eating attitudes of these patients to plan and conduct a nutritional approach properly. The nutrition therapy for this disorder is specific and demands greater skillfulness in nutrition counseling from the dietician. Nutrition therapy focuses on nutrition education and nutrition counseling, mainly addressing eating attitudes and dissatisfaction with body image. The professional must keep abreast on nutrition and

  15. 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)

  16. Anorexia nervosa and bulimia nervosa: An appraisal.

    Science.gov (United States)

    Sharma, Ajay

    2001-04-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are eating disorders characterized by an aberrant pattern of eating behavior, relentless pursuit of thinness, an intense fear about weight gain and an altered perception of body shape. The pathobiology of eating disorders is complex. Several social, psychological and developmental phenomena are proposed to contribute to the etiology of eating disorders. The role of neuropeptide Y, corticotropin releasing hormone and leptin has also been investigated to understand the pathogenesis of eating disorders. However, most of the neuropeptide alterations noted in eating disorders are secondary to starvation. Several nonpharmacological approaches such as cognitive and behavior-based therapy and interpersonal therapy have been developed to assist weight gain and to modify the behavioral impairment associated with eating disorders. Pharmacotherapy serves as an adjunct in AN, whereas it plays a more significant role in the management of BN. Antidepressants are effective in a limited number of AN patients with comorbid depression. On the other hand, the efficacy of fluoxetine in BN patients in reducing the frequency of binge eating and in the severity of behavioral abnormalities is quite impressive. Several adjunct therapies such as prokinetics and anxiolytics have also been used in AN and BN to assist eating behavior. An insight into genetic and neurochemical abnormalities occurring in eating disorders will help to find better therapeutic agents for these disorders. (c) 2001 Prous Science. All rights reserved. PMID:12768223

  17. Bulimia Nervosa : A Review of Therapy Research

    OpenAIRE

    Garfinkel, Paul E.; Goldbloom, David S.

    1993-01-01

    Since the delineation of bulimia nervosa as a distinct syndrome in 1979, a variety of etiological models and related treatments have evolved. Methodological advances in evaluation have been reflected in recent outcome studies. There is now extensive evidence for the effectiveness of various short-term psychotherapies for bulimia nervosa. However, there is no convincing support for the specificity of any one form; all have a salubrious effect. Cognitive-behavioral therapy has...

  18. Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract

    OpenAIRE

    1997-01-01

    Bulimia nervosa is an eating disorder characterized by frequent bouts of binge eating accompanied by compensatory behaviour for preventing weight gain (purging). It is estimated that 3% to 5% of young women are affected by bulimia nervosa, and its prevalence is increasing. Bulimia nervosa afflicts both sexes and all races. It can lead to serious medical complications. The expression of the disease in the gastrointestinal tract may have a critical role in the diagnosis of bulimia nervosa. Phys...

  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. Subtyping adolescents with bulimia nervosa.

    Science.gov (United States)

    Chen, Eunice Y; Le Grange, Daniel

    2007-12-01

    Cluster analyses of eating disorder patients have yielded a "dietary-depressive" subtype, typified by greater negative affect, and a "dietary" subtype, typified by dietary restraint. This study aimed to replicate these findings in an adolescent sample with bulimia nervosa (BN) from a randomized controlled trial and to examine the validity and reliability of this methodology. In the sample of BN adolescents (N=80), cluster analysis revealed a "dietary-depressive" subtype (37.5%) and a "dietary" subtype (62.5%) using the Beck Depression Inventory, Rosenberg Self-Esteem Scale and Eating Disorder Examination Restraint subscale. The "dietary-depressive" subtype compared to the "dietary" subtype was significantly more likely to: (1) report co-occurring disorders, (2) greater eating and weight concerns, and (3) less vomiting abstinence at post-treatment (all p'svalidity, yielding more distinct groups than subtyping by vomiting frequency. In order to assess the reliability of the subtyping scheme, a larger sample of adolescents with mixed eating and weight disorders in an outpatient eating disorder clinic (N=149) was subtyped, yielding similar subtypes. These results support the validity and reliability of the subtyping strategy in two adolescent samples. PMID:17949682

  1. Efficiency Biliopancreatic bypass surgery in bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Yu I Yashkov

    2008-06-01

    Full Text Available A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the data of clinical observation of a small sample of patients. As a result, the treatment of these patients found that severe nervous BILIM can be seen as a latent form of morbid obesity. The choice of treatment should depend not only on the initial body weight of the patient, but also on the severity of the nervous BILIM. Unsuccessful attempts at organized-balanced, conservative treatment of patients with severe bulimia nervosa may be considered a variant of surgical treatment, while bilio-pancreatic bypass surgery is considered as the most preferred operation, compared with the installation of the gastric balloon and others. All candidates for surgical treatment of obesity must identify clinical signs of bulimia nervosa, as this may influence the choice of method of operation. Further study of the role of hyperinsulinemia, secretion of ghrelin, leptin, intestinal peptide may contribute to the elucidation of the true causes of bulimia nervosa, probably has a similar origin with morbid obesity.

  2. 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

  3. 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 ...

  4. Reboxetina no tratamento da bulimia nervosa Reboxetine in the treatment of bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Simone Mancini Castilho

    2003-06-01

    Full Text Available É vasta a literatura demonstrando a eficácia dos antidepressivos inibidores seletivos da recaptação de serotonina na Bulimia Nervosa, diminuindo a freqüência do comportamento alimentar compulsivo e dos vômitos. A boa resposta terapêutica aos agentes farmacológicos noradrenérgicos, como a desipramina e a reboxetina, embora menos encontrada na literatura, também já foi documentada. O presente relato de caso descreve o tratamento de uma paciente com Bulimia Nervosa utilizando-se reboxetina na dose de 4 a 8 mg ao dia. A resposta terapêutica vem confirmar os resultados favoráveis do uso desta droga no tratamento da Bulimia Nervosa.There is a substancial body of literature demonstrating the efficacy of selective serotonin reuptake inhibitors antidepressants (SSRI in reducing binge eating and vomiting frequency in Bulimia Nervosa. Good therapeutic response to noradrenergic agents, like desipramine and reboxetine, though not frequently reported in literature, has already been demonstrated. This case report describes the treatment of Bulimia Nervosa with reboxetine (4 to 8 mg/day and its favorable therapeutic results.

  5. The Effects of Exercise in Obese Women with Bulimia Nervosa

    OpenAIRE

    Habibzadeh, Nasim; Daneshmandi, Hassn

    2010-01-01

    Purpose Obesity has been identified as a risk factor for the development of bulimia nervosa (BN) in those who try to lose weight. The purpose of the present study was to examine the effect of walking exercise in order to provide a method for overcoming bulimia nervosa in obese young women suffering from bulimia nervosa. Methods Twenty obese women with bulimia nervosa (body mass index [BMI]>30) and a mean age of 22.00±1.50 years volunteered to participate in this study. They were randomly assi...

  6. Race, Social Class, and Bulimia Nervosa

    OpenAIRE

    Goeree, Michelle S.; Ham, John C; Iorio, Daniela

    2012-01-01

    In this paper we explore a serious eating disorder, bulimia nervosa (BN), which a­fflicts a surprising number of girls in the US. We challenge the long-held belief that BN primarily affects high income White teenagers, using a unique data set on adolescent females evaluated regarding their tendencies towards bulimic behaviors independent of any diagnoses or treatment they have received. Our results reveal that African Americans are more likely to exhibit bulimic behavior than Whites; as are g...

  7. Efficiency Biliopancreatic bypass surgery in bulimia nervosa

    OpenAIRE

    Yu I Yashkov; D K Bekuzarov; A V Nikol'skiy

    2008-01-01

    A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the dat...

  8. How bulimia nervosa relates to addictive behavior

    OpenAIRE

    Iorio, Daniela; Sovinsky, Michelle

    2012-01-01

    Using longitudinal data that tracks bulimic behavior among young girls (National Heart, Lung, and Blood Institute Growth and Health Study), we examine (1) whether bulimic behavior is consistent with addiction criteria as stated in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV (APA, 1994); and 2) whether the persistence in bulimia nervosa (BN) reflects tolerance formed from an addiction or if it can be attributed to slow learning about the deleterious health effects of BN. M...

  9. Bulimia

    Science.gov (United States)

    ... weight gain. Many people with bulimia also have anorexia nervosa . ... to go to the hospital, unless they: Have anorexia Have major ... treat bulimia. Treatment depends on how severe the bulimia is, ...

  10. Bulimia Nervosa: Changes in Its Prevalence on Campus.

    Science.gov (United States)

    Hill, Laura

    1989-01-01

    Administered Survey on Eating Habits to 382 male and female university students to elicit information relevant to bulimia nervosa. Prevalence of bulimia nervosa among subjects was 10 percent using old criteria and 1 percent using modified new criteria for the disorder. Whichever criteria were used, typical bulimic student was found to be White…

  11. 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.

  12. Cognitive behavioral therapy for bulimia nervosa.

    Science.gov (United States)

    Glasofer, Deborah R; Devlin, Michael J

    2013-12-01

    Cognitive-behavioral therapy (CBT) is a first-line psychotherapeutic treatment for bulimia nervosa (BN). This article outlines three specific interventions--introducing and using the CBT model of BN, self-monitoring of eating and related experiences, and psychoeducation regarding various aspects of BN--representative of CBT overall but unique in their application to individuals with BN. The theoretical basis and supporting research relevant to each technique are highlighted. Clinical vignettes are provided to illustrate how these interventions might be integrated into the psychotherapy. PMID:24295463

  13. Anorexia nervosa and bulimia in adolescent males.

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    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

  14. 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. PMID:24705938

  15. Anorexia nervosa, bulimia nervosa: causal theories and treatment.

    Science.gov (United States)

    Palmer, T A

    1990-04-01

    Anorexia nervosa and bulimia nervosa are eating disorders characterized by gross disturbances in eating behavior. Recently these disorders have reached near-epidemic proportions, affecting approximately 1.2 million adolescent and young adult females in the United States. The incidence in males is considerably less, and the prevalence rate has remained fixed at 5 percent during the last five years. The estimates of mortality range between 1 and 15 percent and are equally divided between medical complications (electrolyte disturbance, acute kidney failure, cardiac complications) and suicide. Successful treatment requires a combination of aggressive medical management, psychotherapy, behavioral management, food-intake management and nutritional counseling. This requires health care providers to understand 1) the psychological ramifications of these disorders, 2) the types of depression associated with them, 3) antidepressants used and therapeutic dosages, 4) correction of nutritional deficiencies, 5) outpatient management and 6) indications for hospitalization (inpatient management). PMID:2183095

  16. [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

  17. Diagnostik und Therapie der Anorexia und Bulimia nervosa

    OpenAIRE

    2003-01-01

    Obwohl es keine überzeugenden Hinweise darauf gibt, daß die Frequenz der Eßstörungen zunimmt, so ist doch die Anzahl der Patientinnen, die zur Behandlung kommen, in den letzten Jahren enorm angestiegen. Die Prävalenz der Anorexia nervosa liegt bei 1 %, die der Bulimia nervosa bei bis zu 3 % bei Mädchen in der Adoleszenz und bei jungen Frauen. AllgemeinmedizinerInnen entdecken nur etwa 12 % aller Patientinnen mit Bulimia nervosa und etwa 45 % aller Patientinnen mit Anorexia nervosa. Da ihne...

  18. 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…

  19. VR cue-exposure treatment for bulimia nervosa.

    Science.gov (United States)

    Gutiérrez-Maldonado, José; Ferrer-García, Marta; Riva, Giuseppe

    2013-01-01

    Several approaches to the treatment of bulimia nervosa have proved effective, including cognitive-behavioral therapy; however, not all patients improve. It is therefore necessary to explore the possibilities of increasing the efficacy of such treatments. One way to attempt this is to incorporate new technologies. This review explores the possibility of developing a new, empirically validated procedure for the treatment of bulimia nervosa patients that involves cue exposure via virtual reality. PMID:23792835

  20. Effect of eating rate on binge size in Bulimia Nervosa

    OpenAIRE

    Kissileff, Harry R.; Zimmerli, Ellen J.; Torres, Migdalia I; Devlin, Michael J.; Walsh, B. Timothy

    2007-01-01

    Effect of eating rate on binge size in bulimia nervosa. Bulimia Nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating. During binge eating episodes, patients often describe the rapid consumption of food, and laboratory studies have shown that during binges patients with BN eat faster than normal controls (NC), but the hypothesis that a rapid rate of eating contributes to the excessive intake of binge meals has not yet been experimentally tested. The aim of thi...

  1. Drugs in the treatment of bulimia nervosa.

    Science.gov (United States)

    Trygstad, O

    1990-01-01

    The neuro-transmitter serotonin seems to be important in the treatment of disturbed eating behaviour. In Anorexia Nervosa (AN) a serotonin antagonist has been proposed, whereas in Bulimia Nervosa (BN) serotonin agonists have been used with success, e.g. fenfluramine. A new generation of antidepressants has been introduced. that selectively have a serotonergic effect. The previous tricyclic and particularly the tetracyclic antidepressants had a noradrenergic effect as well. Fluoxetine belongs to the new generation. A total of 30 females with BN were treated with fluoxetine in an open study. Clinical effect was observed after 2 to 6 weeks. One patient discontinued after 3 weeks, the other were treated for 3 to 10 months. A moderate effect with 75% reduction of bingeing and purging was observed in 15 patients, 14 stopped bingeing and purging. There was no serious side effects. However, drug treatment alone had no significant effect. The fluoxetine treatment is not instead of, but in addition to the traditional behavioral treatment with strict limits regarding food and meals. PMID:2291423

  2. 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. PMID:24779385

  3. Oesophageal and gastric motor activity in patients with bulimia nervosa.

    OpenAIRE

    Kiss, A; Bergmann, H; Abatzi, T A; Schneider, C; Wiesnagrotzki, S; Höbart, J; Steiner-Mittelbach, G; Gaupmann, G; Kugi, A; Stacher-Janotta, G

    1990-01-01

    Previous studies showed that symptoms of oesophageal motor disorders can be misinterpreted as indicating anorexia nervosa and that in primary anorexia nervosa gastric motility is frequently impaired. We investigated in 32 women with bulimia nervosa whether symptoms of oesophageal motor disorders could be obscured by or be mistaken as forming part of bulimic behaviour, and whether impaired gastric motility was frequent as well. Oesophageal motility was normal in 18 of 26 patients studied, anot...

  4. Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970-1989

    DEFF Research Database (Denmark)

    Pagsberg, A K; Wang, A R

    1994-01-01

    In a retrospective study of anorexia nervosa and bulimia nervosa, potential cases were traced, studied, and diagnosed according to ICD-10. Forty-two cases were found in Bornholm County, comprising the island of Bornholm in Denmark, in a population of 47,000 from 1970 to 1989. Less than half of...... counting the number of cases in the population year by year, also increased during the late part of the study period. In 1989 the incidence rate of the high-risk group of females 10 to 24 years of age was 136 per 100,000 for anorexia nervosa and 45 per 100,000 for bulimia nervosa, and the prevalence rate...... was 222 per 100,000 for anorexia nervosa and 89 per 100,000 for bulimia nervosa....

  5. Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970-1989

    DEFF Research Database (Denmark)

    Pagsberg, A K; Wang, A R

    1994-01-01

    In a retrospective study of anorexia nervosa and bulimia nervosa, potential cases were traced, studied, and diagnosed according to ICD-10. Forty-two cases were found in Bornholm County, comprising the island of Bornholm in Denmark, in a population of 47,000 from 1970 to 1989. Less than half...... the number of cases in the population year by year, also increased during the late part of the study period. In 1989 the incidence rate of the high-risk group of females 10 to 24 years of age was 136 per 100,000 for anorexia nervosa and 45 per 100,000 for bulimia nervosa, and the prevalence rate was 222 per...... 100,000 for anorexia nervosa and 89 per 100,000 for bulimia nervosa....

  6. 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

  7. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Harrington, Brian C; Jimerson, Michelle; Haxton, Christina; Jimerson, David C

    2015-01-01

    Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). In addition to the role of environmental triggers and societal expectations of body size and shape, research has suggested that genes and discrete biochemical signals contribute to the development of eating disorders. Anorexia nervosa and bulimia nervosa occur most often in adolescent females and are often accompanied by depression and other comorbid psychiatric disorders. For low-weight patients with anorexia nervosa, virtually all physiologic systems are affected, ranging from hypotension and osteopenia to life-threatening arrhythmias, often requiring emergent assessment and hospitalization for metabolic stabilization. In patients with frequent purging or laxative abuse, the presence of electrolyte abnormalities requires prompt intervention. Family-based treatment is helpful for adolescents with anorexia nervosa, whereas short-term psychotherapy, such as cognitive behavior therapy, is effective for most patients with bulimia nervosa. The use of psychotropic medications is limited for anorexia nervosa, whereas treatment studies have shown a benefit of antidepressant medications for patients with bulimia nervosa. Treatment is most effective when it includes a multidisciplinary, teambased approach. PMID:25591200

  8. 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 ...

  9. Specificity of eating disorders diagnoses in families of probands with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Woodside, D B; Field, L L; Garfinkel, P E; Heinmaa, M

    1998-01-01

    This study examines the prevalence of anorexia nervosa and bulimia nervosa in relatives of probands, and examines the probandwise specificity of any familial clustering. Data were collected from probands using the family history method. Probands were recruited in a sequential cohort fashion. Information collected from probands was rated semiblindly by two of the authors, and a diagnostic hierarchy applied to arrive at a diagnosis for each of the relatives assessed. Data are reported on 2,125 family members, collected from 93 probands. Diagnostic agreement between raters was high, with serious disagreement present in three of 167 possible cases of an eating disorder. Rates of anorexia nervosa, bulimia nervosa, major depression, and substance abuse declined from first- to third-degree relatives, which is consistent with genetic clustering, and there was evidence of a cohort effect operating for anorexia nervosa and bulimia nervosa. The rates of anorexia nervosa and bulimia nervosa in all family members were 5.1%, and 4.3% respectively. An analysis of maternal and paternal descent showed no evidence for X-linked dominant transmission in these families. Preliminary analysis of the clustering of diagnoses in relatives showed a tendency (chi 2 = 14.47, P = .006) for family members to be affected by the same diagnosis as was the proband. This trend was strongest for anorexia nervosa, but there was overlap when the proband had a lifetime diagnosis of bulimia nervosa, with or without anorexia nervosa. These results are compatible with the existence of genetic factors influencing predisposition to eating disorders, but do not prove such. PMID:9777277

  10. Wait Not, Want Not: Factors Contributing to the Development of Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Murray, Trish

    2003-01-01

    The purpose of this literature review is to examine prevalence and incident rates of both anorexia nervosa and bulimia nervosa. In addition, this article will review the psychological and sociological factors that contribute to the development and maintenance of an eating disorder. Finally, different treatment approaches will be discussed in…

  11. Determinants of delayed gastric emptying in anorexia nervosa and bulimia nervosa.

    OpenAIRE

    Robinson, P H; M Clarke; Barrett, J.

    1988-01-01

    Gastric emptying was measured using a gamma camera in 22 patients with anorexia nervosa, in 10 patients of normal or high weight with bulimia nervosa and in 10 controls. Patients with anorexia nervosa were tested (1) while underweight and selecting their own diet (10 patients); (2) underweight, but receiving an adequate diet on an inpatient unit (refeeding diet) (12 patients); and (3) under refeeding diet conditions after weight gain (eight patients). Three meals, each labelled with technetiu...

  12. 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)

  13. Treatment of Bulimia Nervosa: Psychological and Psychopharmacologic Considerations.

    Science.gov (United States)

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

    2003-01-01

    Reviews the current literature on psychological and psychopharmacologic treatments for bulimia nervosa in the adolescent population. Describes the two most researched psychological treatments--cognitive behavior therapy and interpersonal therapy--in terms of treatment protocols and outcome research. Reviews psychopharmacologic treatment, including…

  14. 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)

  15. Exposure Plus Response-Prevention Treatment of Bulimia Nervosa.

    Science.gov (United States)

    Leitenberg, Harold; And Others

    1988-01-01

    Evaluated exposure plus response-prevention treatment of bulimia nervosa among 47 women. Subjects were assigned to either exposure plus response-prevention in one setting, exposure plus response-prevention in multiple settings, cognitive-behavioral therapy, or waiting-list control conditions. Found three treatment groups improved significantly on…

  16. 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…

  17. Weight Suppression Predicts Time to Remission from Bulimia Nervosa

    Science.gov (United States)

    Lowe, Michael R.; Berner, Laura A.; Swanson, Sonja A.; Clark, Vicki L.; Eddy, Kamryn T.; Franko, Debra L.; Shaw, Jena A.; Ross, Stephanie; Herzog, David B.

    2011-01-01

    Objective: To investigate whether, at study entry, (a) weight suppression (WS), the difference between highest past adult weight and current weight, prospectively predicts time to first full remission from bulimia nervosa (BN) over a follow-up period of 8 years, and (b) weight change over time mediates the relationship between WS and time to first…

  18. Incidence and outcomes of bulimia nervosa : a nationwide population-based study

    NARCIS (Netherlands)

    Keski-Rahkonen, A.; Hoek, H. W.; Linna, M. S.; Raevuori, A.; Sihvola, E.; Bulik, C. M.; Rissanen, A.; Kaprio, J.

    2009-01-01

    Background. Little is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide Study design. Method. To assess the incidence and natural course and outcomes of DSM-IV bulimia n

  19. Multi-Family Therapy for Bulimia Nervosa in Adolescence.

    Science.gov (United States)

    Stewart, Catherine; Voulgari, Stamatoula; Eisler, Ivan; Hunt, Katrina; Simic, Mima

    2015-01-01

    Existing randomized controlled trials of family therapy for treatment of bulimia nervosa in adolescence highlight the need for further development of treatments. This article describes the development of multi-family treatment for bulimia nervosa in adolescents aged 13-18. It outlines the theory guiding this development, the areas of need identified by previous studies, and the treatment that has been designed to meet these needs. Particular attention is given to the need to increase communication between family members, strategies to reduce high levels of criticism or hostility, and skills to manage emotion dysregulation and low tolerance for negative emotions. To these ends the program draws on the multi-family treatment for anorexia nervosa, cognitive behavioral therapy techniques, and dialectical behavior therapy. PMID:26010166

  20. Bulimia

    Science.gov (United States)

    ... Many people with bulimia also have anorexia nervosa . Causes Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or ...

  1. First step in managing bulimia nervosa: controlled trial of therapeutic manual.

    OpenAIRE

    Treasure, J.; U Schmidt; Troop, N; Tiller, J.; Todd, G.; Keilen, M.; Dodge, E.

    1994-01-01

    OBJECTIVE--To test the short term efficacy of a self directed treatment manual for bulimia nervosa. DESIGN--Randomised controlled trial of the manual against cognitive behavioural therapy and a waiting list. SETTING--Tertiary referral centre. SUBJECTS--81 consecutive referrals presenting with bulimia nervosa or atypical bulimia nervosa. MAIN OUTCOME MEASURES--Frequency of binge eating, vomiting, and other behaviours to control weight as well as abstinence from these behaviours. RESULTS--Cogni...

  2. Anorexia nervosa e bulimia nervosa: abordagem cognitivo-construtivista de psicoterapia Anorexia nervosa and bulimia nervosa: a psychotherapeutic cognitive-constructivist approach

    OpenAIRE

    Cristiano Nabuco de Abreu; Raphael Cangelli Filho

    2004-01-01

    Dos transtornos alimentares, a anorexia nervosa e a bulimia nervosa são os que mais têm levado pacientes adolescentes, geralmente do sexo feminino e cada vez mais jovens, a buscar ajuda. Essa ajuda se dá através de um tratamento multidisciplinar envolvendo médicos psiquiatras, psicólogos e nutricionistas. A psicoterapia tem se mostrado um componente eficaz para a melhora dessas pacientes. O presente artigo tem por objetivo expor uma proposta de tratamento psicoterápico a partir da abordagem c...

  3. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa. PMID:26467107

  4. Frontostriatal Circuits and the Development of Bulimia Nervosa

    OpenAIRE

    Berner, Laura A.; Rachel Marsh

    2014-01-01

    Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in part, defined by a sense of loss of control and compensatory behaviors to avoid weight gain. Impulsive behaviors are also common in individuals with BN, indicating more pervasive difficulties in behavioral self-regulation. Findings from functional and anatomical neuroimaging studies of individuals with BN suggest dysfunction in the dorsal frontostriatal circuits that support self-regulatory capacitie...

  5. Perspectives on the Prevention of Anorexia Nervosa and Bulimia

    OpenAIRE

    Steiger, Howard; Leichner, Pierre; Ghadirian, A. Missagh

    1987-01-01

    Ample evidence suggests a rising incidence of anorexia nervosa and bulimia over the past few decades. Correspondingly, medical knowledge about the etiology, symptomatology and treatment of these eating disorders has increased. Often the front line health-care workers who treat these disorders, family physicians are in a key position for early detection and prevention of these eating disorders. An adequate understanding of relevant risk factors, symptoms and signs may allow the physician to pr...

  6. A classical case of bulimia nervosa from India

    OpenAIRE

    Piyali Mandal; Arumuganathan, S.; Rajesh Sagar; Pakhi Srivastava

    2013-01-01

    A classic case of the bulimia nervosa in a young Indian female is reported. This is in the context of the impression that due to increasing western influence, and change in cultural concepts of beauty and thinness among women, illnesses previously considered rare in Indian subcontinent might be becoming more prevalent. Many of the established pre-disposing factors such as female gender, metropolitan domicile, family history of depressive disorder have conglomerated in this case. Rapid and sus...

  7. Gender, Phenotypical Differentation and Therapy Response for Bulimia Nervosa

    OpenAIRE

    Núñez Navarro, Araceli

    2012-01-01

    [eng] The present PhD thesis is a compilation of four empirical studies and one review that try to better understand the clinical presentation of Bulimia Nervosa (BN) by investigating three important aspects: (1) gender differences in eating disorder (ED) symptomatology, associated traits and therapy outcome (study 1 and study 2), (2) phenomenology and boundaries of BN-purging, BN-non-purging and BED diagnoses (study 3) and (3) new technological approaches for the treatment of EDs with bulimi...

  8. Evaluation of the DSM-5 Severity Indicator for Bulimia Nervosa

    OpenAIRE

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Sh...

  9. CCK response in bulimia nervosa and following remission

    OpenAIRE

    Hannon-Engel, Sandra L.; Filin, Evgeniy E.; Wolfe, Barbara E.

    2013-01-01

    The core defining features of bulimia nervosa (BN) are repeated binge eating episodes and inappropriate compensatory (e.g. purging) behavior. Previous studies suggest an abnormal postprandial response in the satiety-signaling peptide cholecystokinin (CCK) in persons with BN. It is unknown whether this altered response persists following remission or if it may be a potential target for the development of clinical treatment strategies. To examine the nature of this altered response, this study ...

  10. A psychological typology of females diagnosed with anorexia nervosa, bulimia nervosa or binge eating disorder

    OpenAIRE

    Bernadetta Izydorczyk

    2015-01-01

    Background The present paper reports the results of research aimed at identifying intra-group differences among females suffering from different eating disorders (anorexia nervosa, bulimia nervosa or binge eating disorder) in terms of the subjects’ psychological traits, adoption of socio-cultural norms (through media pressure, internationalization of norms, and exposure to information concerning body image standards), and the level of body dissatisfaction. The following research question...

  11. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    OpenAIRE

    Anna Tasegian; Francesco Curcio; Laura Dalla Ragione; Francesca Rossetti; Samuela Cataldi; Michela Codini; Francesco Saverio Ambesi-Impiombato; Tommaso Beccari; Elisabetta Albi

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical an...

  12. A comparison of neuropsychological test performance on the Ravello Profile between bulimia nervosa and anorexia nervosa

    OpenAIRE

    MacDonald, Kirsty

    2011-01-01

    Background The Ravello Profile is a battery of standardised neuropsychological measures of areas of functioning that evidence indicates are impaired in Anorexia Nervosa (AN), namely visuo-spatial functioning, central coherence and executive functioning. The neuropsychological profile of individuals with Bulimia Nervosa (BN) is less well established. The current study aimed to examine differences in cognitive performance between people with BN, AN and non-eating disordered controls on the Rave...

  13. A polysomnographic study in young psychiatric inpatients: major depression, anorexia nervosa, bulimia nervosa

    OpenAIRE

    Lauer, C J; Krieg, J. C.; Riemann, D; Zulley, Jürgen; Berger, M.

    1990-01-01

    The baseline EEG sleep patterns of 10 young depressed patients, 20 patients with anorexia nervosa, 10 patients with bulimia nervosa, and 10 healthy subjects were found to be indistinguishable, except for an increased REM density in the depressed patients. In eating disorder patients, a concomitant major depressive episode had no influence on EEG sleep. The results of the cholinergic REM sleep induction test revealed a significantly faster induction of REM sleep in the depressed patients when ...

  14. Psychopharmacotherapy of anorexia nervosa, bulimia nervosa and binge-eating disorder

    OpenAIRE

    S. Kruger; Kennedy, SH

    2000-01-01

    Pharmacotherapy for anorexia nervosa is considered to be of limited efficacy. However, many studies suffer methodological limitations, and the utility of newer drugs in the treatment of anorexia has not been examined yet. Although there have been more fruitful investigations on the efficacy of medication in the management of bulimia nervosa, there are still many unresolved issues regarding the optimal management of partial remission during the acute treatment phase and the intensity and durat...

  15. ТHE PRESENT STATE OF THE PROBLEM OF ANOREXIA NERVOSA AND BULIMIA NERVOSA

    OpenAIRE

    Shebanova, Vitaliya

    2014-01-01

    The article describes the analysis of scientific sources on the study of clinical forms of eating disorders (anorexia nervosa and bulimia nervosa). Close relationship of pathological patterns of eating behavior to bulimic and anorectic type is determined. There is a lack of accurate data on the therapeutic methods of treatment for people using pathological forms of eating behavior to correct their figures (anorexic and bulimic strategies).

  16. A Pilot Study of a Functional Contextual Treatment for Bulimia Nervosa

    Science.gov (United States)

    Anderson, Drew A.; Simmons, Angela M.

    2008-01-01

    This paper describes the initial development of a treatment for bulimia nervosa using a functional contextual treatment approach. Seven women (6 with a diagnosis of bulimia nervosa and 1 with a diagnosis of eating disorder not otherwise specified) completed 12 sessions of functional contextual treatment. Participants were assessed with the Eating…

  17. 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…

  18. Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

    OpenAIRE

    CarrieJMcadams; DanielCKrawczyk

    2013-01-01

    Self-evaluation closely dependent upon body shape and weight is one of the defining criteria for bulimia nervosa. We studied 53 adult women, 17 with bulimia nervosa, 18 with a recent history of anorexia nervosa, and 18 healthy comparison women, using three different fMRI tasks that required thinking about self-knowledge and social interactions: the Social Identity task, the Physical Identity task, and the Social Attribution task. Previously, we identified regions of interest (ROI) in the same...

  19. A classical case of bulimia nervosa from India

    Directory of Open Access Journals (Sweden)

    Piyali Mandal

    2013-01-01

    Full Text Available A classic case of the bulimia nervosa in a young Indian female is reported. This is in the context of the impression that due to increasing western influence, and change in cultural concepts of beauty and thinness among women, illnesses previously considered rare in Indian subcontinent might be becoming more prevalent. Many of the established pre-disposing factors such as female gender, metropolitan domicile, family history of depressive disorder have conglomerated in this case. Rapid and sustained improvement with the low-dose Fluoxetine and the Cognitive Behavioral Therapy is also worth paid attention.

  20. A classical case of bulimia nervosa from India.

    Science.gov (United States)

    Mandal, Piyali; Arumuganathan, S; Sagar, Rajesh; Srivastava, Pakhi

    2013-07-01

    A classic case of the bulimia nervosa in a young Indian female is reported. This is in the context of the impression that due to increasing western influence, and change in cultural concepts of beauty and thinness among women, illnesses previously considered rare in Indian subcontinent might be becoming more prevalent. Many of the established pre-disposing factors such as female gender, metropolitan domicile, family history of depressive disorder have conglomerated in this case. Rapid and sustained improvement with the low-dose Fluoxetine and the Cognitive Behavioral Therapy is also worth paid attention. PMID:24249937

  1. The Changing “Weightscape” of Bulimia Nervosa

    OpenAIRE

    Bulik, Cynthia M.; Marcus, Marsha D.; Zerwas, Stephanie; Levine, Michele D.; Via, Maria La

    2012-01-01

    Ms. Z, a 35-year-old African-American single woman with a body mass index (BMI) of 37.8 kg/m2 (height 5 feet, 5.5 inches, weight 238 lb.), presents for an evaluation for bulimia nervosa. She was referred to the eating disorders program by her primary care physician who knew about her eating disorder, but was primarily concerned about her weight and blood pressure. Ms. Z has an advanced degree and is employed full time. She has struggled with her eating, weight, and body image since childhood ...

  2. Psychoanalytic psychotherapy with a client with bulimia nervosa.

    Science.gov (United States)

    Lunn, Susanne; Daniel, Sarah I F; Poulsen, Stig

    2016-06-01

    This case study presents the progress of one patient with bulimia nervosa who was originally very compromised in psychological domains that are the focus of analytic treatment, and includes in-session therapeutic process and a range of outcomes, for example, eating disorder symptoms, attachment status, and reflective functioning. Nested in a study showing more rapid behavioral improvement in subjects receiving cognitive behavior therapy than in subjects receiving psychoanalytic psychotherapy, the case highlights the importance of supplementing RCTs with single case studies and the need of adapting the therapeutic approach as well as the current therapeutic dialogue to the individual client. (PsycINFO Database Record PMID:27267505

  3. Identifying Persuasive Public Health Messages to Change Community Knowledge and Attitudes About Bulimia Nervosa.

    Science.gov (United States)

    McLean, Siân A; Paxton, Susan J; Massey, Robin; Hay, Phillipa J; Mond, Jonathan M; Rodgers, Bryan

    2016-01-01

    Addressing stigma through social marketing campaigns has the potential to enhance currently low rates of treatment seeking and improve the well-being of individuals with the eating disorder bulimia nervosa. This study aimed to evaluate the persuasiveness of health messages designed to reduce stigma and improve mental health literacy about this disorder. A community sample of 1,936 adults (48.2% male, 51.8% female) from Victoria, Australia, provided (a) self-report information on knowledge and stigma about bulimia nervosa and (b) ratings of the persuasiveness of 9 brief health messages on dimensions of convincingness and likelihood of changing attitudes. Messages were rated moderately to very convincing and a little to moderately likely to change attitudes toward bulimia nervosa. The most persuasive messages were those that emphasized that bulimia nervosa is a serious mental illness and is not attributable to personal failings. Higher ratings of convincingness were associated with being female, with having more knowledge about bulimia nervosa, and with lower levels of stigma about bulimia nervosa. Higher ratings for likelihood of changing attitudes were associated with being female and with ratings of the convincingness of the corresponding message. This study provides direction for persuasive content to be included in social marketing campaigns to reduce stigma toward bulimia nervosa. PMID:26383053

  4. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Tasegian, Anna; Curcio, Francesco; Dalla Ragione, Laura; Rossetti, Francesca; Cataldi, Samuela; Codini, Michela; Ambesi-Impiombato, Francesco Saverio; Beccari, Tommaso; Albi, Elisabetta

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders. PMID:26903713

  5. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    Directory of Open Access Journals (Sweden)

    Anna Tasegian

    2016-01-01

    Full Text Available Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders.

  6. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    Science.gov (United States)

    Tasegian, Anna; Curcio, Francesco; Dalla Ragione, Laura; Rossetti, Francesca; Cataldi, Samuela; Codini, Michela; Ambesi-Impiombato, Francesco Saverio; Beccari, Tommaso; Albi, Elisabetta

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders. PMID:26903713

  7. Fractures in patients with anorexia nervosa, bulimia nervosa, and other eating disorders--a nationwide register study

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Emborg, Charlotte; Støving, René K;

    2002-01-01

    OBJECTIVE: To study fracture risk in patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not otherwise specified (EDNOS). METHOD: Cohort study including all Danes diagnosed with AN (n = 2,149), BN (n = 1,294), or EDNOS (n = 942) between 1977 and 1998. Each patient...

  8. Stepped care and cognitive–behavioural therapy for bulimia nervosa: randomised trial

    OpenAIRE

    Mitchell, James E; Agras, Stewart; Crow, Scott; Halmi, Katherine; Fairburn, Christopher G.; Bryson, Susan; Kraemer, Helena

    2011-01-01

    Background This study compared the best available treatment for bulimia nervosa, cognitive–behavioural therapy (CBT) augmented by fluoxetine if indicated, with a stepped-care treatment approach in order to enhance treatment effectiveness. Aims To establish the relative effectiveness of these two approaches. Method This was a randomised trial conducted at four clinical centres (Clinicaltrials.gov registration number: NCT00733525). A total of 293 participants with bulimia nervosa were randomise...

  9. Effect of Management of Patients with Anorexia and Bulimia nervosa on Symptoms and Impulsive Behavior

    OpenAIRE

    Sernec, Karin; Tomori, Martina; Zalar, Bojan

    2010-01-01

    The aim of the study was to provide further and up to date information on the evaluation of the management of Anorexia and Bulimia nervosa at the Eating Disorders Unit (EDU) of the Ljubljana Psychiatric Clinic, based upon detailed assessment of the eating disorders specific and non specific symptoms of impulsive behaviors, highly correlated with these entities. 34 female patients with anorexia (restrictive or purgative type) and 38 female patients with Bulimia nervosa (purgative or non-purgat...

  10. Olfaktorische Sensitivität und Geruchsperzeption bei Patientinnen mit Bulimia nervosa

    OpenAIRE

    Beez, Carolin

    2011-01-01

    Die Pathogenese der Bulimia nervosa ist multifaktoriell, das heißt, es handelt sich um ein Zusammenwirken biologischer, persönlichkeitsbedingter, soziokultureller und familiärer Faktoren (Herpertz-Dahlmann et al. 2003; Fichter 1998). Dabei ist die Rolle des Geruchssinns in der Pathobiologie der Bulimia nervosa wenig erforscht, obwohl die diagnostischen Kriterien - wie in dem „Diagnostischen und Statistischen Manual Psychischer Störungen“ und in der „Internationalen Klassifikation psychischer ...

  11. Bulimia nervosa symptomatology and body image disturbance associated with distance running and weight loss.

    OpenAIRE

    Gleaves, D H; Williamson, D. A.; Fuller, R D

    1992-01-01

    To investigate the hypothesis that problems characteristic of eating disorders may often be associated with distance running, 20 women who had lost weight through distance running were compared with a control group who did not exercise and had not lost weight and a comparison group of bulimia nervosa patients. Dependent variables were measures of depression, bulimia nervosa symptomatology, and body image disturbance. No differences were found between the runner group and the normal controls. ...

  12. Adjunctive Methylphenidate in the Treatment of Bulimia Nervosa Co-occurring with Bipolar Disorder and Substance Dependence

    OpenAIRE

    Guerdjikova, Anna I.; McElroy, Susan L

    2013-01-01

    Bulimia nervosa is associated with bipolar disorder, substance dependence, attention-deficit hyperactivity disorder, and anxiety disorders. Few reports, however, have addressed the treatment of patients with all of these conditions. We describe a young woman with bulimia nervosa, bipolar I disorder, cocaine and alcohol dependence, attention-deficit hyperactivity disorder, and panic disorder who achieved a sustained (>1 year) remission of her bulimia nervosa symptoms and significant improvemen...

  13. A abordagem familiar no tratamento da anorexia e bulimia nervosa Family assessment in the treatment of anorexia and bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Alicia Weisz Cobelo

    2004-01-01

    Full Text Available O final do século XX enfatiza a inclusão da família no tratamento de pacientes portadores de anorexia e bulimia nervosa. Pesquisas (Castro et al.,2000; Webster et al.,2000 colocam como relevante considerar a estrutura familiar, as práticas conversacionais e os legados transgeracionais como elementos que podem estar contribuindo, de modo significativo, no desenvolvimento ou na manutenção dos transtornos alimentares. No Ambulatório de Bulimia e Transtornos Alimentares e no Projeto de Atendimento a Crianças e Adolescentes do IPQ, o grande desafio dos terapeutas de família tem sido compartilhar com famílias e pacientes suas histórias repletas de inseguranças e angústias e construir uma ponte de união entre a família e a equipe multidisciplinar, para que a compreensão dos significados, refletida por todos, possa ser agilizada e transformada em novas contribuições de vida para as pacientes e seus familiares.The end of the 20th century emphasizes the inclusion of the family in the treatment of the patients with anorexia and bulimia nervosa. Researches (Castro et al.,2000; Webster et al.,2000 determine as relevant to consider the family structure, the interaction pattern, and the "transgeneration bequest" - the legacy that goes from one generation to the next - as elements that might contribute in a significant way to the development or maintenance of the eating disorders. At the Bulimia and Eating Disorders Ambulatory and in the IPQ's Project for Attendance of Children and Adolescents, the great challenge for the family therapists has been to share with the families and patients their histories full of insecurity and anguish. The therapists must also overcome the difficulties of building a bridge that brings together the family and the multidisciplinary team so that the comprehension of the meanings, reflected by all, might be quickly transformed into new life contributions to these patients and their families.

  14. Eßstörungen bei Männern - Charakteristika des Verlaufs von Anorexia nervosa und Bulimia nervosa bei Männern und Vergleich mit einer weiblichen Stichprobe

    OpenAIRE

    Heidelinde Krenn

    2004-01-01

    Der kurz-, mittel- und langfristige Verlauf der Anorexia nervosa und Bulimia nervosa in einer parallelisierten klinischen Stichprobe von N=62 Männern und Frauen mit Anorexia nervosa und N=55 Männern und Frauen mit Bulimia nervosa wird beschrieben. Ergebnisse zu komorbiden psychiatrischen Erkrankungen (Achse I und Achse II; DSM-IV) werden ebenso berichtet wie Ergebnisse zu Homosexualität. Trendanalysen erlauben Aussagen zum Verlauf...

  15. A systematic review on heart rate variability in Bulimia Nervosa.

    Science.gov (United States)

    Peschel, Stephanie K V; Feeling, Nicole R; Vögele, Claus; Kaess, Michael; Thayer, Julian F; Koenig, Julian

    2016-04-01

    Eating disorders are associated with alterations of the autonomic nervous system (ANS). Among other indices, heart rate variability (HRV) provides a readily available index of ANS function. While ANS dysfunction indexed by HRV in Anorexia Nervosa has been addressed in previous reviews, here we aimed to review the current evidence on HRV in Bulimia Nervosa (BN). A systematic literature search in Web of Science, PsycInfo, Scopus, and PubMed identified 17 studies reporting HRV in patients with BN. Studies described (i) differences in resting state HRV in patients compared to controls, (ii) alterations in the stress response in BN indexed by HRV, and (iii) treatment effects on HRV in patients with BN. Despite a number of conflicting results, we conclude that BN is characterized by increased resting state vagally-mediated HRV and an impaired stress-response. Intervention-studies suggest that altered ANS-activity in BN is at least partially reversible. Future studies on the complex relation between BN and HRV should investigate the effect of comorbid disorders, subtypes of BN, and mechanisms affecting treatment outcome. PMID:26828568

  16. Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa among Adolescents: A Case Series

    Science.gov (United States)

    Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.

    2008-01-01

    The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…

  17. Investigation of Oxytocin Secretion in Anorexia Nervosa and Bulimia Nervosa: Relationships to Temperament Personality Dimensions.

    Science.gov (United States)

    Monteleone, Alessio Maria; Scognamiglio, Pasquale; Volpe, Umberto; Di Maso, Virginia; Monteleone, Palmiero

    2016-01-01

    Published studies suggested an implication of oxytocin in some temperament characteristics of personality. Therefore, we measured oxytocin secretion in 23 women with anorexia nervosa (AN), 27 with bulimia nervosa (BN) and 19 healthy controls and explored the relationships between circulating oxytocin and patients' personality traits. Plasma oxytocin levels were significantly reduced in AN women but not in BN ones. In healthy women, the attachment subscale scores of the reward dependence temperament and the harm avoidance (HA) scores explained 82% of the variability in circulating oxytocin. In BN patients, plasma oxytocin resulted to be negatively correlated with HA, whereas no significant correlations emerged in AN patients. These findings confirm a dysregulation of oxytocin production in AN but not in BN and show, for the first time, a disruption of the associations between hormone levels and patients' temperament traits, which may have a role in certain deranged behaviours of eating disorder patients. PMID:26259495

  18. Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

    OpenAIRE

    Nagata Katsutaro; Ohkuma Kazuyoshi; Saito Satoshi; Yamaguchi Chikara; Koide Masanori; Okabe Kenjiro; Nishizono Aya; Okamoto Yuri; Nagata Toshihiko; Kawai Keisuke; Oka Takakazu; Nakahara Toshihiro; Ando Tetsuya; Komaki Gen; Nishimura Hiroki

    2008-01-01

    Abstract Background Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. Method All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80...

  19. Dying on the Inside: What Every Teacher Needs to Know About Anorexia Nervosa, Bulimia, and the Individual Child.

    Science.gov (United States)

    Zimmer, Marc

    This document provides teachers with information on the identifying features of anorexia nervosa and bulimia and suggests steps which teachers can take to encourage individual children in more positive behavior. The paper makes clear distinctions between anorexia nervosa, bulimia, and bulimarexia, describing the symptoms of each disorder. It is…

  20. Neural responses during social and self-knowledge tasks in bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Carrie J Mcadams

    2013-09-01

    Full Text Available Self-evaluation closely dependent upon body shape and weight is one of the defining criteria for bulimia nervosa. We studied 53 adult women, 17 with bulimia nervosa, 18 with a recent history of anorexia nervosa, and 18 healthy comparison women, using three different fMRI tasks that required thinking about self-knowledge and social interactions: the Social Identity task, the Physical Identity task, and the Social Attribution task. Previously, we identified regions of interest (ROI in the same tasks using whole brain voxel-wise comparisons of the healthy comparison women and women with a recent history of anorexia nervosa. Here, we report on the neural activations in those ROIs in subjects with bulimia nervosa. In the Social Attribution task, we examined activity in the right temporoparietal junction, an area frequently associated with mentalization. In the Social Identity task, we examined activity in the precuneus and dorsal anterior cingulate. In the Physical Identity task, we examined activity in a ventral region of the dorsal anterior cingulate. Interestingly, in all tested regions, the average activation in subjects with bulimia was more than the average activation levels seen in the subjects with a history of anorexia but less than that seen in healthy subjects. In three regions, the right temporoparietal junction, the precuneus, and the dorsal anterior cingulate, group responses in the subjects with bulimia were significantly different from healthy subjects but not subjects with anorexia. The neural activations of people with bulimia nervosa performing fMRI tasks engaging social processing are more similar to people with anorexia nervosa than healthy people. This suggests biological measures of social processes may be helpful in characterizing individuals with eating disorders.

  1. The efficacy of a brief group CBT program in treating patients diagnosed with bulimia nervosa: a brief report

    DEFF Research Database (Denmark)

    Jones, Allan; Clausen, Loa

    2013-01-01

    OBJECTIVE: The aim of the study was to evaluate the efficacy of a brief group cognitive behavior therapy (CBT) program in treating a large cohort of patients diagnosed with bulimia nervosa. METHOD: Treatment outcome defined as reductions in bulimia related behavioral symptoms and bulimia related ...

  2. Weight suppression in bulimia nervosa: Associations with biology and behavior.

    Science.gov (United States)

    Bodell, Lindsay P; Keel, Pamela K

    2015-11-01

    Bulimia nervosa (BN) is a serious eating disorder that can persist for years and contribute to medical complications and increased mortality, underscoring the need to better understand factors maintaining this disorder. Higher levels of weight suppression (WS) have been found to predict both the onset and maintenance of BN; however, no studies have examined mechanisms that may account for the effects of WS on BN. We hypothesized that high WS would lead to reduced leptin levels, which may increase risk of binge eating by modulating reward responses to food. The current study examined the relationship between WS, leptin levels, and the reinforcing value of food in women with BN (n = 32) and noneating disorder controls (n = 30). Participants provided information on WS, completed a fasting blood draw to obtain serum leptin, and completed a progressive ratio task to measure the reinforcing value of food. Individuals with BN had greater WS (p < .01) and reinforcing food value (p < .05) compared with controls. Additionally, higher WS was associated with both lower leptin (p < .05) and increased reinforcing value of food (p < .05). Contrary to hypotheses, BN and control participants did not differ on leptin levels, and leptin levels were not significantly associated with the reinforcing value of food. Findings support that efforts to conform to the thin ideal may alter drive to consume rewarding foods and leave women vulnerable to binge episodes. However, mechanisms through which WS contributes to food reward and binge eating remain unknown. PMID:26191637

  3. Frontostriatal circuits and the development of bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Laura A. Berner

    2014-11-01

    Full Text Available Bulimia nervosa (BN is characterized by both recurrent episodes of binge eating that are, in part, defined by a sense of loss of control and compensatory behaviors to avoid weight gain. Impulsive behaviors are also common in individuals with BN, indicating more pervasive difficulties in behavioral self-regulation. Findings from functional and anatomical neuroimaging studies of individuals with BN suggest dysfunction in the dorsal frontostriatal circuits that support self-regulatory capacities and habit learning and in overlapping ventral circuits that support reward processing and reward-based learning. In this review, we describe the normal development of frontostriatal circuits and then present behavioral and neuroimaging data from adolescents and adults with BN. These data suggest that the abnormal maturation of frontostriatal circuits may contribute to the habitual binge-eating and purging behaviors of BN. Future longitudinal imaging studies will improve understanding of how these circuits contribute to the developmental trajectory of BN and will inform novel interventions that could target or prevent the impulsive and habit-like features of this disorder.

  4. Normal interoceptive accuracy in women with bulimia nervosa.

    Science.gov (United States)

    Pollatos, Olga; Georgiou, Eleana

    2016-06-30

    Previous studies suggest that patients suffering from bulimia nervosa (BN) have difficulties in perceiving internal bodily signals, mostly assessed by self-report questionnaires. Whether interoception is, in this case, attenuated or not remains an open question. Therefore, interoceptive processes were examined in twenty-three patients with current BN and were compared to healthy participants. We investigated Interoceptive Accuracy (IAc) assessed by the heartbeat detection task and Interoceptive Awareness (IA) assessed by the Eating Disorder Inventory-2. Patients with BN and healthy participants did not differ in terms of IAc when controlling for BMI, depression and anxiety, whereas IA among BN patients was found to have decreased. Although IAc and IA were not related among controls, we observed an inverse correlation in BN, suggesting that an abnormal overlap between these two levels of interoceptive signal processing is present in BN. The current study introduces a new perspective concerning the role of interoceptive processes in BN and generates further questions regarding the therapeutic utility of methods targeting the interaction between different levels of interoception in the treatment of BN. PMID:27138826

  5. 神经性贪食症的心理干预%Psychotherapy for Bulimia Nervosa

    Institute of Scientific and Technical Information of China (English)

    刘勇; 陈健芷; 姜梦

    2013-01-01

    神经性贪食症(Bulimia Nervosa,BN)的治疗中,常采用心理干预的方法.本文对BN的心理干预研究进行系统的回顾,以确定不同干预方法的有效性、安全性及相关影响因素,并结合国内研究现状对其进行评价和展望.%In the treatment of bulimia nervosa,psychotherapy is a frequently-used method,which has certain effect.To evaluate the efficacy,security and influence factors of psychotherapy methods,we have reviewed the bulimia nervosa current research and put forward evaluations and prospects.

  6. Meal-induced compositional changes in blood and saliva in persons with bulimia nervosa

    DEFF Research Database (Denmark)

    Dynesen, Anja Weirsøe; Jensen, Allan Bardow; Astrup, Arne;

    2008-01-01

    be involved in the physiologic regulation of appetite and metabolism. Objective: The objective was to investigate whether circulating concentrations of the appetite-regulating peptides leptin and ghrelin and markers of metabolism (glucose and insulin) are different in persons with bulimia nervosa...... than in controls before and after intake of a meal and whether these changes may be reflected in saliva. Design: Twenty women with bulimia nervosa and 20 age- and sex-matched healthy controls participated. After an overnight fast, the subjects ate a standardized carbohydrate-rich breakfast. Whole...... saliva and blood were collected, and visual analogue scales for hunger and satiety were completed once before and continuously for 5 h after the breakfast. Results: A lower pre- and postprandial whole saliva flow rate was found in subjects with bulimia nervosa, which might have been attributable to a...

  7. Aetiopathogenesis and pathophysiology of bulimia nervosa: biological bases and implications for treatment.

    Science.gov (United States)

    Brambilla, F

    2001-01-01

    Bulimia nervosa is an eating disorder characterised by recurrent episodes of binge eating and associated efforts to purge the ingested calories through self-induced vomiting, laxative or diuretic abuse, fasting or intensive exercise. The aetiopathogenesis and pathophysiology of the disorder are currently unclear. Biological bases have been proposed repeatedly, based on several lines of evidence: hunger, satiety and food choice are regulated by neurotransmitters and neuropeptides, and impairment of eating habits may be related to alterations in the secretion of these chemicals; genetic studies suggest that these neurotransmitter systems are dysfunctional in individuals with bulimia nervosa; and the frequent comorbidity of bulimia nervosa with major depressive and obsessive-compulsive disorders, conditions in which multiple alterations of brain biochemical functions have been demonstrated. Data in the literature suggest that levels of noradrenaline (norepinephrine) and serotonin (5-hydroxytryptamine; 5-HT) are lower in individuals with bulimia nervosa than in healthy controls. Levels of dopamine are similar to, or lower than, those in controls. After remission of the disorder, noradrenergic function returns to that seen in controls, whereas dopaminergic and serotonergic function rebound to levels higher than in controls. Among the neuropeptides, alterations in the levels of neuropeptide Y, peptide YY, beta-endorphin, corticotrophin-releasing hormone, somatostatin, cholecystokinin and vasopressin have been found in the symptomatic phase of bulimia nervosa, with a return to levels seen in controls after remission. Pharmacological treatment of bulimia nervosa that is directed at correction of the neurochemical alterations observed is difficult because of the complexity of the impairments. However, such treatment is necessary and should be continued long after symptomatic remission to ensure reinstitution of cerebral biochemical homeostasis. PMID:11460890

  8. Client attachment security predicts alliance in a randomized controlled trial of two psychotherapies for bulimia nervosa

    DEFF Research Database (Denmark)

    Folke, Sofie; Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig Bernt;

    2015-01-01

    Objective: This study investigated the relation between clients’ attachment patterns and the therapeutic alliance in two psychotherapies for bulimia nervosa. Method: Data derive from a randomized clinical trial comparing cognitive-behavioral therapy and psychoanalytic psychotherapy for bulimia...... interaction whereby dismissing clients would develop weaker alliances in psychoanalytic psychotherapy and preoccupied clients would develop weaker alliances in cognitive-behavioral therapy. Conclusions: As the first study to examine client attachment and therapeutic alliance using observer-based instruments...

  9. Bulimia nervosa, binge eating, and psychogenic vomiting: a controlled treatment study and long term outcome.

    OpenAIRE

    J. H. Lacey

    1983-01-01

    An "epidemic" prevalence of binge eating and vomiting (bulimia nervosa) has been reported, and treatment has been claimed to be difficult. This paper describes a short term outpatient treatment programme of eclectic orientation capable of being conducted by non-specialist staff, under medical supervision, in local centres. The treatment programme was evaluated in a controlled trial and in long term follow up. In 30 women with severe bulimia the treatment programme significantly reduced their ...

  10. Neuropathy and myopathy in two patients with anorexia and bulimia nervosa.

    OpenAIRE

    Alloway, R; Reynolds, E H; Spargo, E; Russell, G F

    1985-01-01

    Two adolescent patients with eating disorders and severe weight loss presented with neuromyopathy. The first was female and had a twenty months' history of bulimia nervosa with weight loss and episodic gorging and vomiting. The second was male with a two-year history of anorexia nervosa characterised by vegetarianism and increasing food restriction. Both had severe wasting and asymmetrical weakness of proximal limb muscles. The first patient deteriorated on refeeding and became temporarily pa...

  11. Autoantibodies against α-MSH, ACTH, and LHRH in anorexia and bulimia nervosa patients

    OpenAIRE

    Fetissov, Sergueï O.; Hallman, Jarmila; Oreland, Lars; af Klinteberg, Britt; Grenbäck, Eva; Hulting, Anna-Lena; Hökfelt, Tomas

    2002-01-01

    The hypothalamic arcuate nucleus is involved in the control of energy intake and expenditure and may participate in the pathogenesis of eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN). Two systems are of particular interest in this respect, synthesizing α-melanocyte-stimulating hormone (α-MSH) and synthesizing neuropeptide Y, respectively. We report here that 42 of 57 (74%) AN and/or BN patients studied had in their plasma Abs that bind to melanotropes and/or corticotr...

  12. Management of anorexia and bulimia nervosa: An evidence-based review

    OpenAIRE

    Chakraborty, Kaustav; Basu, Debasish

    2010-01-01

    Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behavior. Eating disorders are most prevalent in the Western culture where food is in abundance and female attractiveness is equated with thinness. Eating disorders are rare in countries like India. Despite a plethora of management options available to the mental health professionals, no major breakthrough has been achieved in recent years. Nutritional rehabilitation along w...

  13. Average total energy expenditure in anorexia nervosa, bulimia nervosa, and healthy young women.

    Science.gov (United States)

    Pirke, K M; Trimborn, P; Platte, P; Fichter, M

    1991-10-01

    The double-labeled water method was used to measure average daily total energy expenditure (EE) in 11 healthy normal-weight women classified as unrestrained eaters, in 8 patients with anorexia nervosa, and in 8 patients with bulimia nervosa. The body mass index was 20.0 +/- 1.3 kg/m2 in the control group, 15.2 +/- 5.6 kg/m2 in the anorectic groups, and 19.7 +/- 1.9 kg/m2 in the bulimic group. EE was measured over a 2-week period during which weight remained constant in all groups and was 2357 +/- 504 kcal/day for the controls, 2510 +/- 920 kcal/day for the bulimics, and 2899 +/- 656 kcal/day for the anorectics. Differences were not significant among groups. Physical activity was recorded in diaries by all subjects. Anorectic patients showed significantly more activity than all other groups. The data suggest that EE is high in anorectic patients as a consequence of physical activity. PMID:1958768

  14. Comparison of Six- and Eight-Session Cognitive Guided Self-Help for Bulimia Nervosa

    Science.gov (United States)

    Furber, Gareth; Steele, Anna; Wade, Tracey D.

    2004-01-01

    A previous case-series evaluation of a six-session guided self-help (GSH) approach with 15 people with bulimia nervosa (BN) showed significant reductions across all measures, including binge eating, self-induced vomiting, weight concern, shape concern and dietary restraint. However, the reduction of binge eating and self-induced vomiting was…

  15. Mechanisms of Action in Cognitive-Behavioral and Pharmacological Interventions for Obesity and Bulimia Nervosa.

    Science.gov (United States)

    Craighead, Linda W.; Agras, W. Stewart

    1991-01-01

    Summarizes data pertaining to separate and combined effects of cognitive-behavioral and psychopharmacologic treatments for obesity and bulimia nervosa. Anorexiant medication appears to enhance restraint and facilitates weight loss with behavioral interventions in the treatment of obesity, but relapse occurs once medication is withdrawn.…

  16. Health services use in women with a history of bulimia nervosa or binge eating disorder

    NARCIS (Netherlands)

    Striegel-Moore, RH; Dohm, FA; Kraemer, HC; Schreiber, GB; Crawford, PB; Daniels, [No Value

    2005-01-01

    Objective: The current study examined health services use during the past 12 months in a sample of young women with a history of an adolescent eating disorder (bulimia nervosa [BN] or binge eating disorder [BED]). Method: A community sample of 1,582 young women (mean age = 21.5 years) was classified

  17. Familial Contributions to the Etiology and Course of Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Strober, Michael; Humphrey, Laura Lynn

    1987-01-01

    Discusses familial influences in anorexia nervosa and bulimia. Reviews descriptions of family interaction, familial correlates of course and phenomenology of symptoms, and studies of familial transmission. Concludes that certain personality factors, possibly genetically determined, predispose the individual to greater sensitivity and vulnerability…

  18. Depression and Drive for Thinness are Associated with Persistent Bulimia Nervosa in the Community

    NARCIS (Netherlands)

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

    2013-01-01

    Objective To examine psychiatric comorbidity and factors that influence the outcome of bulimia nervosa (BN) in the general population. Method Women from the nationwide birth cohorts of Finnish twins were screened for lifetime BN (N=59) by using questionnaires and the Structured Clinical Interview fo

  19. An Examination of the Mechanisms of Action in Cognitive Behavioral Therapy for Bulimia Nervosa

    Science.gov (United States)

    Spangler, Diane L.; Baldwin, Scott A.; Agras, W. Stewart

    2004-01-01

    Cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) has received considerable empirical support for its efficacy. However, few investigators have examined the mechanisms proposed to account for the reduction of BN symptoms during CBT. The current study examined the associations between therapist interventions, client mechanisms, and…

  20. How Schools Can Help Combat Student Eating Disorders. Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Levine, Michael P.

    This book presents a comprehensive review of anorexia nervosa and bulimia and the roles that schools can have in preventing, identifying, and treating these disorders. Chapter 1 provides an overview of student eating disorders and presents a case study of a high school student with an eating disorder. Chapter 2 discusses the nature of anorexia…

  1. Emotion Awareness and Identification Skills in Adolescent Girls with Bulimia Nervosa

    Science.gov (United States)

    Sim, Leslie; Zeman, Janice

    2004-01-01

    This study examined emotion-identification skills in 19 adolescent girls (M age = 16 years, 8 months) diagnosed with a Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnosis of bulimia nervosa or eating disorder not otherwise specified in the bulimic spectrum, 19 age-matched girls…

  2. Assessment and Treatment of Anorexia Nervosa and Bulimia in School Age Children.

    Science.gov (United States)

    Peters, Carole; And Others

    1984-01-01

    Anorexia nervosa and bulimia are major concerns for high school students, especially females. These syndromes interfere with normal functioning and social development and can be life-threatening. Definitions, characteristics, symptoms, and treatment approaches for these two eating disorders are discussed, and suggestions for involvement of the…

  3. Predictors and Moderators of Outcome in Family-Based Treatment for Adolescent Bulimia Nervosa

    Science.gov (United States)

    Le Grange, Daniel; Crosby, Ross D.; Lock, James

    2008-01-01

    The predictors and moderators of treatment outcome for adolescents with bulimia nervosa (BN) are explored among those who participated in family based treatment or individual supportive psychotherapy. It is concluded that family-based treatment of BN may be most effective in those cases with low levels of eating disorder psychopathology.

  4. The Clinical Features of Binge Eating Disorder and Bulimia Nervosa: What Are the Differences?

    Science.gov (United States)

    Sullivan, Keri A.

    2001-01-01

    Compares the clinical characteristics of binge eating disorder (BED) and the related syndrome bulimia nervosa (BN). Findings suggest individuals with BED are distinguishable from those with BN on a number of traits, including higher rates of obesity and lower levels of eating concern and dietary restraint. (Contains 29 references and 2 tables.)…

  5. Cognitive Behavior Therapy with Body Image Exposure for Bulimia Nervosa: A Case Example

    Science.gov (United States)

    Delinsky, Sherrie S.; Wilson, G. Terence

    2010-01-01

    Cognitive behavior therapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more…

  6. Coping Strategies in Bulimia Nervosa Treatment: Impact on Outcome in Group Cognitive-Behavioral Therapy

    Science.gov (United States)

    Binford, Roslyn B.; Mussell, Melissa Pederson; Crosby, Ross D.; Peterson, Carol B.; Crow, Scott J.; Mitchell, James E.

    2005-01-01

    This study's purpose was to examine the extent to which participants (N = 143) receiving cognitive-behavioral therapy for bulimia nervosa (BN) reported implementing therapeutic strategies to abstain from BN behaviors, and to assess whether use of specific strategies predicts outcome at treatment end and 1-and 6-month follow-up. Frequency of…

  7. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.

    Science.gov (United States)

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

    There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account. PMID:24311027

  8. A psychological typology of females diagnosed with anorexia nervosa, bulimia nervosa or binge eating disorder

    Directory of Open Access Journals (Sweden)

    Bernadetta Izydorczyk

    2015-11-01

    Full Text Available Background The present paper reports the results of research aimed at identifying intra-group differences among females suffering from different eating disorders (anorexia nervosa, bulimia nervosa or binge eating disorder in terms of the subjects’ psychological traits, adoption of socio-cultural norms (through media pressure, internationalization of norms, and exposure to information concerning body image standards, and the level of body dissatisfaction. The following research question was asked: is it possible to distinguish specific profiles of psychological characteristics, as well as levels of body dissatisfaction, social pressure, media exposure and internalization of common standards of body image? Participants and procedure The clinical population consisted of 121 females aged 20-26. The research was conducted in the years 2007-2012. The following research methods and procedures were applied: 1 a clinical interview, 2 the Contour Drawing Rating Scale, 3 the Eating Disorder Inventory (EDI, 4 a Polish translation of the Socio-cultural Attitudes Towards Appearance Questionnaire (SATAQ-3. Results Cluster analysis of the research data allowed four significantly different clusters to be distinguished in the group of 121 examined females suffering from eating disorders. In the next step, analysis of variance (the ANOVA test was used to compare the differences between the examined clusters in terms of the investigated variables and their indicators. Conclusions Due to significant differences between the examined females in terms of the strength levels and the configuration of psychological and socio-cultural variables investigated in the present study, the females were classified into four different psychological types referred to as neurotic, perfectionist, impulsive and adolescent-narcissistic.

  9. A Multidisciplinary Approach to the Functional and Esthetic Rehabilitation of a Patient with Bulimia Nervosa: A Clinical Report

    OpenAIRE

    Foteini P; Kamposiora P; Papavasiliou G

    2015-01-01

    Treatment of a patient with bulimia nervosa is a challenge for the dental clinician. The oral manifestations of bulimic behavior, which include sore and inflamed throat, swollen salivary glands, tooth wear and decay, require a multidisciplinary approach. This clinical report illustrates the treatment of a 22-year-old female patient with history of bulimia nervosa and dentition with extended signs of erosion. It included thorough diagnosis with the use of screening tool BITE (Buli...

  10. Cognitive behaviour therapy response and dropout rate across purging and nonpurging bulimia nervosa and binge eating disorder: DSM-5 implications

    OpenAIRE

    Agüera, Zaida; Riesco, Nadine; Jiménez Murcia, Susana; Islam, Mohammed Anisul; Granero, Roser; Vicente, Enrique; Peñas Lledó, Eva; Arcelus, Jon; Sánchez, Isabel; Menchón Magriñá, José Manuel; Fernández Aranda, Fernando

    2013-01-01

    Background: With the imminent publication of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there has been a growing interest in the study of the boundaries across the three bulimic spectrum syndromes [bulimia nervosa-purging type (BN-P), bulimia nervosa-non purging type (BN-NP) and binge eating disorder (BED)]. Therefore, the aims of this study were to determine differences in treatment response and dropout rates following Cognitive Behavioural Therapy ...

  11. Principles of Cognitive-Behavioral Therapy for Bulimia Nervosa.

    Science.gov (United States)

    Garner, David M.; Davis, Ron

    1986-01-01

    Outlines a cognitive-behavioral approach to treating bulimia, focusing on the client's eating behavior, physical condition, and dysfunctional attitudes responsible for deficiencies in self-concept. (Author/ABB)

  12. Prevalence of Disordered Eating Behaviors and Bulimia Nervosa in a Sample of Mexican American Female College Students.

    Science.gov (United States)

    Lester, Regan; Petrie, Trent A.

    1998-01-01

    Disordered eating behaviors and bulimia nervosa were examined in a sample of female Mexican Americans. Results showed that 1.45% to 4.3% could be classified with bulimia. Just over 11% indicated regular binge eating. Dieting and exercising were the primary techniques used for weight control. Implications for intervention are briefly discussed.…

  13. Neuropathy and myopathy in two patients with anorexia and bulimia nervosa.

    Science.gov (United States)

    Alloway, R; Reynolds, E H; Spargo, E; Russell, G F

    1985-10-01

    Two adolescent patients with eating disorders and severe weight loss presented with neuromyopathy. The first was female and had a twenty months' history of bulimia nervosa with weight loss and episodic gorging and vomiting. The second was male with a two-year history of anorexia nervosa characterised by vegetarianism and increasing food restriction. Both had severe wasting and asymmetrical weakness of proximal limb muscles. The first patient deteriorated on refeeding and became temporarily paralysed. Both had a purpuric rash and haematological abnormalities. They made a complete recovery on a mixed diet: vitamin supplements were given to the first but not to the second patient. PMID:3863893

  14. Bulimia nervosa symptomatology and body image disturbance associated with distance running and weight loss.

    Science.gov (United States)

    Gleaves, D H; Williamson, D A; Fuller, R D

    1992-09-01

    To investigate the hypothesis that problems characteristic of eating disorders may often be associated with distance running, 20 women who had lost weight through distance running were compared with a control group who did not exercise and had not lost weight and a comparison group of bulimia nervosa patients. Dependent variables were measures of depression, bulimia nervosa symptomatology, and body image disturbance. No differences were found between the runner group and the normal controls. Bulimics differed from runners and controls on most measures. Thus, the results did not support the proposition that weight loss through running leads to problems related to eating and body image. The failure to find disturbances in body image in runners suggests that body image disturbances are not a direct result of weight loss, as suggested by some theorists. PMID:1422651

  15. Negative Affect and Neural Response to Palatable Food Intake in Bulimia Nervosa

    OpenAIRE

    Bohon, Cara; Stice, Eric

    2012-01-01

    Binge eating is often preceded by reports of negative affect, but the mechanism by which affect may lead to binge eating is unclear. This study evaluated the effect of negative affect on neural response to anticipation and receipt of palatable food in women with bulimia nervosa (BN) versus healthy controls. We also evaluated connectivity between the amygdala and reward-related brain regions. Females with and without BN (N = 26) underwent functional magnetic resonance imaging (fMRI) during rec...

  16. Anorexia Nervosa and Bulimia: Problems of “The Pleasing Child”

    OpenAIRE

    McSherry, J. A.

    1984-01-01

    Widespread media publicity has resulted in increased case findings of eating disorders such as anorexia nervosa and bulimia. The etiology of these conditions is complex and multifactorial, and they may have devastating effects on physical and psychological health. Family physicians have an important role to play in recognizing, evaluating and managing eating disorders. Severe anorexics—those who have lost 25% or more of the average weight for their age and height—require specialist management...

  17. Significant Linkage on Chromosome 10p in Families with Bulimia Nervosa

    OpenAIRE

    Bulik, Cynthia M; Devlin, B.; Bacanu, Silviu-Alin; Thornton, Laura; Klump, Kelly L.; Fichter, Manfred M.; Halmi, Katherine A.; Kaplan, Allan S.; Strober, Michael; Woodside, D. Blake; Bergen, Andrew W.; Ganjei, J. Kelly; Crow, Scott; Mitchell, James; Rotondo, Alessandro

    2002-01-01

    Bulimia nervosa (BN) is strongly familial, and additive genetic effects appear to contribute substantially to the observed familiality. In turn, behavioral components of BN, such as self-induced vomiting, are reliably measured and heritable. To identify regions of the genome harboring genetic variants conferring susceptibility to BN, we conducted a linkage analysis of multiplex families with eating disorders that were identified through a proband with BN. Linkage analysis of the entire sample...

  18. Weight suppression predicts weight change over 5 years in bulimia nervosa

    OpenAIRE

    Herzog, David B.; Thomas, J. Graham; Kass, Andrea E.; Eddy, Kamryn T.; Franko, Debra L.; Lowe, Michael R.

    2010-01-01

    Recent studies suggest that weight suppression (WS), defined as the discrepancy between current and highest past weight, predicts short-term weight gain in bulimia nervosa (BN) during treatment. The current study was designed to build on this preliminary work by examining the relation between WS and long-term weight change in BN. Treatmentseeking women (N=97) with DSM-IV BN participated in a naturalistic longitudinal follow-up study of eating disorders. At intake, height and weight were measu...

  19. Conceptualizing the Role of Estrogens and Serotonin in the Development and Maintenance of Bulimia Nervosa

    OpenAIRE

    Hildebrandt, Tom; Alfano, Lauren; Tricamo, Michelle; Pfaff, Donald W.

    2010-01-01

    Serotonergic dysregulation is thought to underlie much of the pathology in bulimia nervosa (BN). The purpose of this review is to expand the serotonergic model by incorporating specific and nonspecific contributions of estrogens to the development and maintenance of bulimic pathology in order to guide research from molecular genetics to novel therapeutics for BN. Special emphasis is given to the organizing theory of general brain arousal which allows for integration of specific and nonspecifi...

  20. The Role of Impulsivity, Inattention and Comorbid ADHD in Patients with Bulimia Nervosa

    OpenAIRE

    Seitz, Jochen; Kahraman-Lanzerath, Berrak; Legenbauer, Tanja; Sarrar, Lea; Herpertz, Stephan; Salbach-Andrae, Harriet; Konrad, Kerstin; Herpertz-Dahlmann, Beate

    2013-01-01

    Introduction Little is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD) in the development and maintenance of bulimia nervosa (BN). In particular, their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear. Methods Fifty-seven female patients seeking treatment for BN and 40 healthy controls completed diagnostic questionnaires and i...

  1. De-Stabilization of the Positive Vago-Vagal Reflex in Bulimia Nervosa

    OpenAIRE

    Faris, Patricia L.; Hofbauer, Randall D.; Daughters, Randall; VandenLangenberg, Erin; Iversen, Laureen; Goodale, Robert L.; Maxwell, Robert; Eckert, Elke D.; Hartman, Boyd K.

    2007-01-01

    Bulimia nervosa is characterized by consuming large amounts of food over a defined period with a loss of control over the eating. This is followed by a compensatory behavior directed at eliminating the consumed calories, usually vomiting. Current treatments include antidepressants and/or behavioral therapies. Consensus exists that these treatments are not very effective and are associated with high relapse rates. We review evidence from literature and present original data to evaluate the hyp...

  2. Brain responses to body image stimuli but not food are altered in women with bulimia nervosa

    OpenAIRE

    Van den Eynde, Frederique; Giampietro, Vincent; Simmons, Andrew; Uher, Rudolf; Andrew, Chris M; Harvey, Philippe-Olivier; Campbell, Iain C.; Schmidt, Ulrike

    2013-01-01

    Background Research into the neural correlates of bulimia nervosa (BN) psychopathology remains limited. Methods In this functional magnetic resonance imaging study, 21 BN patients and 23 healthy controls (HCs) completed two paradigms: 1) processing of visual food stimuli and 2) comparing their own appearance with that of slim women. Participants also rated food craving and anxiety levels. Results Brain activation patterns in response to food cues did not differ between women with and without ...

  3. Effectiveness of general practitioner supported self-help for bulimia nervosa.

    OpenAIRE

    Durand, M. A. A.

    2005-01-01

    While bulimia nervosa may affect up to five percent of women attending general practice, little attention has been paid to the possibility of treating patients in primary care. Improvements have been reported in patients using cognitive behaviour, self-help manuals. General practitioners may be well placed to support such patients. The study was designed to compare in a pragmatic, randomised controlled trial, the effectiveness of a general practice based self-help approach to the treatment of...

  4. Specialist treatment versus self-help for bulimia nervosa: a randomised controlled trial in general practice.

    OpenAIRE

    Durand, Mary Alison; King, Michael

    2003-01-01

    BACKGROUND: Little is known about general practice management of patients with eating disorders. AIM: To compare the effectiveness of a general practice-based, self-help approach to the treatment of bulimia nervosa with that of specialist outpatient treatment. DESIGN OF STUDY: A prospective, parallel group, randomised controlled trial. SETTING: General practices and specialist eating disorder clinics in London. METHOD: Patients were recruited from general practitioner (GP) referrals to specia...

  5. A Risk and Maintenance Model for Bulimia Nervosa: From Impulsive Action to Compulsive Behavior

    OpenAIRE

    Pearson, Carolyn M.; Wonderlich, Stephen A.; Smith, Gregory T.

    2015-01-01

    This paper offers a new model for bulimia nervosa (BN) that explains both the initial impulsive nature of binge eating and purging as well as the compulsive quality of the fully developed disorder. The model is based on a review of advances in research on BN and advances in relevant basic psychological science. It integrates transdiagnostic personality risk, eating disorder specific risk, reinforcement theory, cognitive neuroscience, and theory drawn from the drug addiction literature. We ide...

  6. An empirical comparison of atypical bulimia nervosa and binge eating disorder

    OpenAIRE

    Fontenelle L.F.; Mendlowicz M.V.; Moreira R.O.; Appolinario J.C.

    2005-01-01

    The International Classification of Diseases, 10th edition (ICD-10) defines atypical bulimia nervosa (ABN) as an eating disorder that encompasses several different syndromes, including the DSM-IV binge eating disorder (BED). We investigated whether patients with BED can be differentiated clinically from patients with ABN who do not meet criteria for BED. Fifty-three obese patients were examined using the Structured Clinical Interview for DSM-IV and the ICD-10 criteria for eating disorders. Al...

  7. A Cost Effectiveness Analysis of Stepped Care Treatment for Bulimia Nervosa

    OpenAIRE

    Crow, Scott J.; Agras, W. Stewart; Halmi, Katherine A.; Fairburn, Christopher G.; Mitchell, James E; Nyman, John A.

    2013-01-01

    Background The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown. Aims To examine the cost effectiveness of stepped care treatment for BN. Method Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behav...

  8. Ecological Momentary Assessment of Bulimia Nervosa: Does Dietary Restriction Predict Binge Eating?

    OpenAIRE

    Zunker, Christie; Peterson, Carol B.; Crosby, Ross D.; Cao, Li; Engel, Scott G.; Mitchell, James E; Wonderlich, Stephen A.

    2011-01-01

    The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restrictio...

  9. Bulimia and anorexia nervosa in winter depression: lifetime rates in a clinical sample.

    OpenAIRE

    Gruber, N P; Dilsaver, S C

    1996-01-01

    Symptoms of an eating disorder (hyperphagia, carbohydrate craving, and weight gain) are characteristic of wintertime depression. Recent findings suggest that the severity of bulimia nervosa peaks during fall and winter months, and that persons with this disorder respond to treatment with bright artificial light. However, the rates of eating disorders among patients presenting for the treatment of winter depression are unknown. This study was undertaken to determine these rates among 47 patien...

  10. Can the reinforcing value of food be measured in bulimia nervosa?

    OpenAIRE

    Schebendach, Janet; Broft, Allegra; Foltin, Richard W.; Walsh, B. Timothy

    2012-01-01

    Binge eating is a core clinical feature of bulimia nervosa (BN). Enhanced reinforcing value of food may play a role in this behavioral disturbance, but a systematic behavioral assessment of objective measures of the rewarding value of binge eating is lacking. The purpose of this study was to quantify the reinforcing value of food in BN patients as compared with normal controls. A progressive ratio (PR) computerized work task was completed under binge and non-binge instruction. The task consis...

  11. The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge-Eating Disorder and Bulimia Nervosa

    OpenAIRE

    Kriz, Kerri-Lynn Murphy

    2002-01-01

    The purpose of this dissertation is to identify the variables associated with abstinence from binge-eating disorder and Bulimia Nervosa in the twelve-step recovery program of Overeaters Anonymous. The data were gathered through the completion of a survey by 231 active members of Overeaters Anonymous in the Washington metropolitan area. In addition to assessing the demographic composition of the aforementioned population, the variables that were assessed comprise the â toolsâ of Overeaters ...

  12. Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa

    OpenAIRE

    Ciao, Anna C.; Accurso, Erin C.; Fitzsimmons-Craft, Ellen E.; le Grange, Daniel

    2015-01-01

    This study examined predictors of psychological change among 80 adolescents with bulimia nervosa (BN) participating in a randomized-controlled trial comparing family-based treatment (FBT) to supportive psychotherapy (SPT). Psychological outcomes (cognitive eating disorder pathology, depression, and self-esteem) were explored at baseline, post-treatment, and 6-month follow-up. Multi-level growth models examined predictors of rate of change in psychological outcomes and moderators of treatment ...

  13. [Specific factors of sex behavior in patients with anorexia nervosa and bulimia].

    Science.gov (United States)

    Oleĭnikov, A N

    2000-01-01

    65 patients were examined. They were divided into three groups. Group 1 consisted of patients with anorexia nervosa (AN) without bulimia, complicated by cachexia and amenorrhea. Epileptoid personality masculinous body built and behaviour, essential disturbances of sexual self-identification prevailed in this group. 3 patients had homoerotic tendencies, while a syndrome of sex negation developed in 5 cases. In group 2 bulimia was a stage of AN development. The patients had frequently initial endocrinopathy (obesity, dysmenorrhea), experiences of phobia and anxiety, asynchronous disharmonious type of psychosexual ontogenesis. Group 3 of patients was characterized by predomination of bulimia symptoms as a variation of the disease course. Normostenic body built, normal somatoendocrine and psychosexual development were combined with hysteric personal characteristics, mood and sexual fluctuations. PMID:10849961

  14. Possible effects of the popular and medical recognition of bulimia nervosa.

    Science.gov (United States)

    Habermas, T

    1992-03-01

    Historical changes in psychological symptoms are analysed not only from a social causation approach but also from a labelling perspective. Modern eating disorders lend themselves to such an analysis because of their historical variability. Effects of the introduction and dispersion of the psychiatric concept of 'bulimia nervosa' at normal body weight and its propagation through the mass media are examined (relying on Devereux's model of 'ethnic disorders'). Data of an exploratory interview study with 39 bulimic patients evaluated along these lines (a) indicate that the recognition of bulimia has facilitated seeking of professional and non-professional help, (b) invite categorization of bulimic behaviour implying less self-blame, (c) render imitation of bulimia more probable, and (d) covary with less secretive illness behaviour indicating a broadening of underlying motivations. PMID:1571308

  15. Correlates of Bulimia Nervosa: Early Family Mealtime Experiences.

    Science.gov (United States)

    Miller, Debra A. F.; And Others

    1993-01-01

    Examined relationship of early mealtime experiences to later bulimia in 128 female college students. Found significant group differences among bulimics, nonbulimics, and repeat dieters on early meal experience questionnaire, with bulimic group reporting most negative and unusual experiences. Found significant differences among groups on depression…

  16. Orlistat abuse in a case of bulimia nervosa: the changing Indian society.

    Science.gov (United States)

    Deb, Koushik Sinha; Gupta, Rishab; Varshney, Mohit

    2014-01-01

    Eating disorders like bulimia nervosa, generally considered to be rare in Asian countries, are currently on the rise among the youth, probably secondary to rapid westernization and globalization of the orient. Clinical manifestations of these disorders, which were previously thought to be different in the oriental countries, are now also often seen to parallel their western counterparts. However, detailed clinical descriptions of such cases from Asian countries, documenting the societal change, are missing. In addition, the possibility of abuse of various anti-obesity drugs as a part of bulimic compensatory behavior is high in this population, given the easy and unsupervised access of these drugs over the counter. We report a case of bulimia nervosa in a female medical graduate from India, presenting with classic bulimic symptomatology and with a compensatory behavior consisting almost exclusively of Orlistat abuse. This case sensitizes health professionals to the abuse liability of new medications like Orlistat and also documents the changing symptomatology of bulimia nervosa in India. PMID:24953260

  17. Central and peripheral peptides regulating eating behaviour and energy homeostasis in anorexia nervosa and bulimia nervosa: a literature review.

    Science.gov (United States)

    Tortorella, Alfonso; Brambilla, Francesca; Fabrazzo, Michele; Volpe, Umberto; Monteleone, Alessio Maria; Mastromo, Daniele; Monteleone, Palmiero

    2014-09-01

    A large body of literature suggests the occurrence of a dysregulation in both central and peripheral modulators of appetite in patients with anorexia nervosa (AN) and bulimia nervosa (BN), but at the moment, the state or trait-dependent nature of those changes is far from being clear. It has been proposed, although not definitively proved, that peptide alterations, even when secondary to malnutrition and/or to aberrant eating behaviours, might contribute to the genesis and the maintenance of some symptomatic aspects of AN and BN, thus affecting the course and the prognosis of these disorders. This review focuses on the most significant literature studies that explored the physiology of those central and peripheral peptides, which have prominent effects on eating behaviour, body weight and energy homeostasis in patients with AN and BN. The relevance of peptide dysfunctions for the pathophysiology of eating disorders is critically discussed. PMID:24942507

  18. Women with bulimia nervosa exhibit attenuated secretion of glucagon-like peptide 1, pancreatic polypeptide, and insulin in response to a meal

    DEFF Research Database (Denmark)

    Naessén, Sabine; Carlström, Kjell; Holst, Jens Juul;

    2011-01-01

    The eating disorder bulimia nervosa (BN) is characterized by frequent episodes of binge eating, followed regularly by inappropriate compensatory behavior, such as self-induced vomiting.......The eating disorder bulimia nervosa (BN) is characterized by frequent episodes of binge eating, followed regularly by inappropriate compensatory behavior, such as self-induced vomiting....

  19. Long Term Health Risks Due to Impaired Nutrition in Women with a Past History of Bulimia Nervosa

    OpenAIRE

    Sagar, Ashwini

    2005-01-01

    Bulimia nervosa serves as a disease model for a variety of physiological problems associated with improper nutritional intake. Although there is extensive research on women who are actively bulimic, very little has been done to follow-up on women who have overcome bulimia. Amennorhea, anemia, constipation, severe dehydration, arrhythmias, osteoporosis, and diabetes can all be health risks due to impaired nutrition while a patient is bulimic. Fortunately, some of the health problems caused by ...

  20. Anorexia nervosa, Bulimia nervosa und andere Essstörungen im Kindes- und Jugendalter : Übersicht und Empfehlungen zu Diagnostik und Behandlung

    OpenAIRE

    Pauli, Dagmar

    2013-01-01

    The diagnosis and treatment of eating disorders in childhood and adolescence demands specific knowledge of the particular features of symptomatology and approaches in this age group. The diagnostic criteria in the handbooks are only conditionally valid in young patients and their application must be adapted to the patient’s age. Clinically relevant atypical eating disorders have a prevalence similar to the classic forms of anorexia nervosa or bulimia nervosa. High rates of comorbidity exist, ...

  1. Different Patterns of Emotional Eating and Visuospatial Deficits Whereas Shared Risk Factors Related with Social Support between Anorexia Nervosa and Bulimia Nervosa

    OpenAIRE

    Kim, Youl-Ri; Lim, Soo-Jin; Treasure, Janet

    2010-01-01

    Objective Although it is thought that eating disorders result from the interplay of personal and sociocultural factors, a comprehensive model of eating disorders remains to be established. The aim of this study was to determine the extent to which the childhood factors and deficit in visuoperceptual ability contribute to eating disorders. Methods A total of 76 participants - 22 women with anorexia nervosa (AN), 28 women with bulimia nervosa (BN), and 26 healthy women of comparable age, IQ, an...

  2. HERPUD - Homocystein-inducible endoplasmic reticulum-resident ubiquitin-like domain member protein mRNA-Expression und Promotormethylierung bei Patientinnen mit Anorexia nervosa und Bulimia nervosa

    OpenAIRE

    Kießlinger, Jens Harro

    2013-01-01

    Die Bedeutung der Epigentik in der Pathophysiologie von Erkrankungen verschiedener Art steigt. Dies betrifft auch psychiatrische Erkrankungen, wie die psychogenen Essstörungen Anorexia nervosa und Bulimia nervosa. Eine Rolle spielt hierbei das Homocystein-inducible endoplasmic reticulum-resident ubiquitin-like domain member protein (HERPUD), speziell seine mRNA-Expression und promotor-spezifische DNA-Methylierung. Ein möglicher Einfluss zuletzt genannter Mechanismen wurde bei Patientinnen mit...

  3. Comparison in decision-making between bulimia nervosa, anorexia nervosa, and healthy women: influence of mood status and pathological eating concerns

    OpenAIRE

    Matsumoto, Junko; Hirano, Yoshiyuki; Numata, Noriko; Matzuzawa, Daisuke; Murano, Shunichi; Yokote, Koutaro; Iyo, Masaomi; Shimizu, Eiji; Nakazato, Michiko

    2015-01-01

    Background Decision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear. The aims of this study were to investigate differential impairments in the decision-making process between AN, BN, and healthy controls (HC), and secondly, to explore the role of mood status, such as anxiety, depression, patholog...

  4. Stigmatizing attitudes and beliefs toward bulimia nervosa: the importance of knowledge and eating disorder symptoms.

    Science.gov (United States)

    Rodgers, Rachel Florence; Paxton, Susan J; McLean, Siân A; Massey, Robin; Mond, Jonathan M; Hay, Phillipa J; Rodgers, Bryan

    2015-04-01

    Widely held stigmatizing attitudes and beliefs toward bulimic eating disorders may lead to self-blame and reduced treatment seeking. Knowledge and familiarity with mental disorders may help decrease associated stigma. However, these relationships are not well understood in bulimia nervosa (BN). A community sample of 1828 adults aged 18 to 70 years completed a survey assessing stigmatizing attitudes and beliefs toward BN, knowledge and familiarity with the disorder, as well as levels of eating disorder symptoms. Knowledge of BN was negatively associated with three dimensions of stigmatization, personal responsibility (ρ = -0.28), unreliability (ρ = -0.19), and advantages of BN (ρ = -0.23). Familiarity revealed no association with stigmatization. Both men and women with high levels of eating disorder symptoms perceived BN as less serious than the participants with low levels of symptoms. Increasing community knowledge about bulimia may help mitigate stigmatization and perceived barriers to treatment. PMID:25751709

  5. The effects of childhood trauma on daily mood lability and comorbid psychopathology in bulimia nervosa.

    Science.gov (United States)

    Wonderlich, Stephen A; Rosenfeldt, Steven; Crosby, Ross D; Mitchell, James E; Engel, Scott G; Smyth, Joshua; Miltenberger, Raymond

    2007-02-01

    A study of bulimic women examined the relationship between histories of childhood trauma and psychiatric disorders, as well as daily measures of mood and behavior. One hundred twenty-three women with bulimia nervosa were assessed with interviews and completed an Ecological Momentary Assessment (EMA) protocol in which they carried a palmtop computer for 2 weeks. Sexual abuse was associated with a history of mood and anxiety disorders, and emotional abuse with eating disorder psychopathology. In the EMA assessment, sexual abuse was associated with daily purging frequency and self-destructive behavior. Emotional abuse was associated with average daily mood and mood lability. These findings support the idea that child maltreatment may be associated with various aspects of bulimia-related psychopathology. PMID:17345648

  6. Impulsive and compulsive self-injurious behavior in bulimia nervosa: prevalence and psychological correlates.

    Science.gov (United States)

    Favaro, A; Santonastaso, P

    1998-03-01

    A specific link between self-injurious behavior and bulimia nervosa has been observed. In affective spectrum disorders, some authors propose a distinction between impulsive and compulsive self-injurious behavior. One of the aims of the present study is to examine how different kinds of self-injurious behavior, including purging behavior, may be classified in bulimia nervosa. The clinical impact of the different types of self-injury will be studied. The subjects of the study were 125 consecutive patients with bulimia nervosa, diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistructured interview and self-report questionnaires (Eating Disorders Inventory and Hopkins Symptom Checklist). In our sample, the distinction between compulsive and impulsive self-injurious behavior appeared to be confirmed by a principal component analysis. Self-induced vomiting loaded on the compulsive dimension and laxative abuse on the impulsive dimension. To study the clinical impact of the two kinds of behavior, bulimic subjects were divided according to their position in the two dimensions. The presence of impulsive self-injurious behavior is associated with a history of sexual abuse and with higher scores on the Symptom Checklist. The presence of both impulsive and compulsive behavior is associated with greater depression, whereas the presence of impulsive features in the absence of compulsive ones seems to be linked to a longer duration of illness and to a higher dropout rate. Both compulsive and impulsive self-injurious behaviors are associated with a greater lack of interoceptive awareness. PMID:9521351

  7. Distinguishing Between Risk Factors for Bulimia Nervosa, Binge Eating Disorder, and Purging Disorder.

    Science.gov (United States)

    Allen, Karina L; Byrne, Susan M; Crosby, Ross D

    2015-08-01

    Binge eating disorder and purging disorder have gained recognition as distinct eating disorder diagnoses, but risk factors for these conditions have not yet been established. This study aimed to evaluate a prospective, mediational model of risk for the full range of binge eating and purging eating disorders, with attention to possible diagnostic differences. Specific aims were to determine, first, whether eating, weight and shape concerns at age 14 would mediate the relationship between parent-perceived childhood overweight at age 10 and a binge eating or purging eating disorder between age 15 and 20, and, second, whether this mediational model would differ across bulimia nervosa, binge eating disorder, and purging disorder. Participants (N = 1,160; 51 % female) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to age 20. Eating disorders were assessed via self-report questionnaires when participants were aged 14, 17 and 20. There were 146 participants (82 % female) with a binge eating or purging eating disorder with onset between age 15 and 20 [bulimia nervosa = 81 (86 % female), binge eating disorder = 43 (74 % female), purging disorder = 22 (77 % female)]. Simple mediation analysis with bootstrapping was used to test the hypothesized model of risk, with early adolescent eating, weight and shape concerns positioned as a mediator between parent-perceived childhood overweight and later onset of a binge eating or purging eating disorder. Subsequently, a conditional process model (a moderated mediation model) was specified to determine if model pathways differed significantly by eating disorder diagnosis. In the simple mediation model, there was a significant indirect effect of parent-perceived childhood overweight on risk for a binge eating or purging eating disorder in late adolescence, mediated by eating, weight and shape concerns in early adolescence. In the conditional process model

  8. Neurobiological and clinical variables associated with alcohol abuse in bulimia nervosa.

    Science.gov (United States)

    Vaz-Leal, Francisco J; Ramos-Fuentes, María I; Rodríguez-Santos, Laura; Flores-Mateos, Isabel S; Franco-Zambrano, Andrés; Rojo-Moreno, Luis; Beato-Fernández, Luis

    2015-05-01

    The study was aimed at analysing the reciprocal relationships of several clinical and neurobiological items in order to predict alcohol misuse in patients with bulimia nervosa (BN). Seventy BN patients and 70 healthy controls were assessed for depression, impulsivity, borderline personality traits and self-defeating behaviours using specific scales; serum cortisol and 24-hour urinary excretion of serotonin and 5-hydroxiindolacetic acid were also assessed. The study confirmed the implications of these clinical factors for alcohol misuse in BN patients, but the results suggested that depressive symptoms and hypercortisolism could lie behind these relationships. PMID:25766414

  9. Sexual dysfunction in married female patients with anorexia and bulimia nervosa.

    Science.gov (United States)

    Simpson, W S; Ramberg, J A

    1992-01-01

    The immediacy of anorexia and bulimia nervosa tends to obscure the adjunct problems of eating-disordered patients. The literature records no data pertaining to the treatment of concomitant psychosexual dysfunctions. The authors report the cases of five young married women referred for psychosexual therapy from eating disorders programs. The therapists found that each of the women was suffering from at least one additional disorder. Basic issues of control, grounded in these patients' early lives, generated intense resistance to treatment. The authors emphasize the need for accelerated research to gather the data from which to develop an effective treatment program for eating-disordered patients with associated sexual dysfunctioning. PMID:1556757

  10. Expressed emotion among white and ethnic minority families of adolescents with bulimia nervosa.

    Science.gov (United States)

    Hoste, Renee Rienecke; le Grange, Daniel

    2008-09-01

    Expressed emotion (EE), a measure of a relative's attitudes and behaviours towards an ill family member, has been found to be related to treatment outcome for both anorexia nervosa (AN) and bulimia nervosa (BN). Although cultural and ethnic background can influence the way in which family members interact, very little is known about cultural differences in EE among families of an eating disordered adolescent. As part of a treatment study for adolescent BN, 55 patients and 84 parents participated in a structured interview, from which EE ratings were made. White and ethnic minority families were compared on five subscales of EE as well as overall level of EE (high vs. low). No significant differences were found between white and minority families. These findings are consistent with previous studies suggesting that white and minority families of eating disorder patients may share several similarities. PMID:18240126

  11. Psychiatric comorbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships.

    Science.gov (United States)

    O'Brien, Karina M; Vincent, Norah K

    2003-02-01

    Eating disorders are complex, multifactorially determined phenomena. When individuals with eating disorders present for treatment with comorbid conditions, case conceptualization is further complicated and, as a result, it may be difficult to determine optimal psychological or pharmacological treatment. This article reviews the evidence of the association between eating disorders (anorexia nervosa [AN] and bulimia nervosa [BN]) and Axis I depression, obsessive-compulsive disorder (OCD), substance abuse, and Axis II personality disorders, for the purposes of increasing awareness about the different options for case conceptualization. Although other diagnoses comorbid with eating disorders are of interest to clinicians (e.g., posttraumatic stress disorder [PTSD] and social phobia), their comprehensive review is currently premature due to a lack of empirical scrutiny. Finally, future directions for research, including suggestions for the use of particular assessment tools and more sophisticated research designs, are discussed. PMID:12559994

  12. Bulimia nervosa with and without obsessive-compulsive syndromes.

    Science.gov (United States)

    Albert, U; Venturello, S; Maina, G; Ravizza, L; Bogetto, F

    2001-01-01

    The present study was performed in a group of bulimic (BN) females (1) to assess prevalence rates of comorbid obsessive-compulsive phenomena; (2) to investigate whether BN patients display a characteristic cluster of obsessive-compulsive symptoms; and (3) to determine whether obsessive-compulsive symptoms influence the clinical picture of BN. Thirty-eight DSM-IV BN females were interviewed by means of the Structured Clinical Interview for DSM-III-R (SCID) to assess the prevalence rate of obsessive compulsive disorder (OCD); the Yale-Brown Obsessive-Compulsive Symptom Scale (Y-BOCS) Symptom Check-List was also used to evaluate the presence of obsessive-compulsive symptoms. The phenomenology of BN females with obsessive-compulsive syndromes (OCS) as detected by the Y-BOCS was compared to that shown by a "control" group of nonbulimic OCD females. Finally, the eating-related psychopathology of BN women with and without OCS was compared. The current prevalence rates of OCD and of subthreshold obsessive-compulsive syndrome (sOCS) in our sample were 10.5% and 15.8%, respectively. Thus, a total of 26.3% of BN females had a current OCS that comprised both clinical disorders and subthreshold syndromes. No differences were detected between obsessive-compulsive symptoms of these females and those of the control group of nonbulimic OCD females. BN females with OCS had higher ratings on the Eating Disorder Inventory (EDI) total score and on the "drive for thinness" and the "bulimia" items of the scale, as compared to BN females without OCS. In conclusion, it appears that a considerable proportion of BN females display OCS, which sometimes are not severe enough to fulfill diagnostic criteria for OCD. Moreover, in these patients, obsessive-compulsive symptoms are undistinguishable from those of OCD females, and exert a negative influence on the clinical picture of the bulimic disorder. PMID:11704935

  13. A comparison of two psychological treatments for bulimia nervosa: implications for models of maintenance.

    Science.gov (United States)

    Cooper, P J; Steere, J

    1995-11-01

    In an effort to elucidate the role of cognitive factors in the maintenance of bulimia nervosa, the efficacy of two psychological treatments was examined in a randomised control trial: cognitive behaviour therapy in the absence of explicit exposure instructions was compared with exposure and response prevention treatment in the absence of cognitive restructuring procedures. In the short term both treatments were successful at effecting substantial improvement in both the specific and the non-specific psychopathology of the disorder. However, at a one year follow up, whilst improvements were well maintained for those who had received the cognitive-behavioural treatment, virtually all of those who had responded to the purely behavioural treatment had relapsed. This provides some support for the cognitive model of the maintenance of bulimia nervosa. Nevertheless, the two treatment groups could not be distinguished on post-treatment measures of cognitive disturbance and neither was it the case that residual levels of cognitive disturbance, as assessed, predicted relapse. This may suggest that the level at which the necessary cognitive change takes place may not be accessible by conventional assessment procedures. PMID:7487847

  14. The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity

    NARCIS (Netherlands)

    De Jonge, PV; Van Furth, EF; Lacey, JH; Waller, G

    2003-01-01

    Background. There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality patholog

  15. Psychiatric Disorders Associated with the Onset and Persistence of Bulimia Nervosa and Binge Eating Disorder during Adolescence.

    Science.gov (United States)

    Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.

    2002-01-01

    Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the…

  16. Subtyping Women with Bulimia Nervosa along Dietary and Negative Affect Dimensions: Further Evidence of Reliability and Validity

    Science.gov (United States)

    Stice, Eric; Bohon, Cara; Marti, C. Nathan; Fischer, Kathryn

    2008-01-01

    Studies have found that individuals with bulimia nervosa can be classified into dietary and dietary-negative affect subtypes and that the latter exhibit greater eating pathology, psychiatric comorbidity, and functional impairment; a more protracted clinical course; and a worse treatment response. In this report, the authors describe 2 prospective…

  17. Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

    Science.gov (United States)

    Loeb, Katharine L.; Wilson, G. Terence; Labouvie, Erich; Pratt, Elizabeth M.; Hayaki, Jumi; Walsh, B. Timothy; Agras, W. Stewart; Fairburn, Christopher G.

    2005-01-01

    The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome…

  18. Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Nagata Katsutaro

    2008-02-01

    Full Text Available Abstract Background Patients with anorexia nervosa-restricting type (AN-R sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN. If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. Method All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores. Results In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p Conclusion The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.

  19. Drop-out and treatment outcome of outpatient cognitive-behavioral therapy for anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Schnicker, Katja; Hiller, Wolfgang; Legenbauer, Tanja

    2013-10-01

    In the present study, drop-out-analyses were carried out for a manual-based cognitive-behavioral therapy for 104 females with anorexia nervosa (AN) and bulimia nervosa (BN), in the service setting of a university outpatient clinic (naturalistic setting). A total of 22.9% of patients with AN terminated therapy prematurely (drop-outs), compared to 40.6% of patients with BN. Group differences between drop-outs and completers show that the group of drop-outs with BN had higher values in the depression score at the start of therapy and was almost two times more likely to have a comorbid disorder (odds ratio 1.69), whereas drop-outs with AN had higher values in the outcome-scale drive for thinness and the odds ratio for being employed or living in a partnership was slightly lower. Completers and drop-outs did not differ significantly within groups in regard to age, body mass index at the start and end of therapy, or the number of comorbid disorders. On the whole, the therapy effect in the group of drop-outs was relatively moderate. For patients with AN, even higher therapy effects were observed among the drop-outs than among the completers. These data suggest that moderate therapy effects and responses can be achieved even among the drop-outs. PMID:23587528

  20. Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature.

    Science.gov (United States)

    Lavender, Jason M; Wonderlich, Stephen A; Engel, Scott G; Gordon, Kathryn H; Kaye, Walter H; Mitchell, James E

    2015-08-01

    Several existing conceptual models and psychological interventions address or emphasize the role of emotion dysregulation in eating disorders. The current article uses Gratz and Roemer's (2004) multidimensional model of emotion regulation and dysregulation as a clinically relevant framework to review the extant literature on emotion dysregulation in anorexia nervosa (AN) and bulimia nervosa (BN). Specifically, the dimensions reviewed include: (1) the flexible use of adaptive and situationally appropriate strategies to modulate the duration and/or intensity of emotional responses, (2) the ability to successfully inhibit impulsive behavior and maintain goal-directed behavior in the context of emotional distress, (3) awareness, clarity, and acceptance of emotional states, and (4) the willingness to experience emotional distress in the pursuit of meaningful activities. The current review suggests that both AN and BN are characterized by broad emotion regulation deficits, with difficulties in emotion regulation across the four dimensions found to characterize both AN and BN, although a small number of more specific difficulties may distinguish the two disorders. The review concludes with a discussion of the clinical implications of the findings, as well as a summary of limitations of the existing empirical literature and suggestions for future research. PMID:26112760

  1. Altered 5-HT2A Receptor Binding after Recovery from Bulimia-Type Anorexia Nervosa: Relationships to Harm Avoidance and Drive for Thinness

    OpenAIRE

    Bailer, Ursula F.; Price, Julie C.; Meltzer, Carolyn C.; Mathis, Chester A.; Frank, Guido K.; Weissfeld, Lisa; McConaha, Claire W; Henry, Shannan E; Brooks-Achenbach, Sarah; Barbarich, Nicole C; Kaye, Walter H.

    2004-01-01

    Several lines of evidence suggest that a disturbance of serotonin neuronal pathways may contribute to the pathogenesis of anorexia nervosa (AN) and bulimia nervosa (BN). This study applied positron emission tomography (PET) to investigate the brain serotonin 2A (5-HT2A) receptor, which could contribute to disturbances of appetite and behavior in AN and BN. To avoid the confounding effects of malnutrition, we studied 10 women recovered from bulimia-type AN (REC AN–BN, >1 year normal weight, re...

  2. Client attachment and therapist feelings in the treatment of bulimia nervosa.

    Science.gov (United States)

    Daniel, Sarah Ingrid Franksdatter; Lunn, Susanne; Poulsen, Stig

    2015-06-01

    The relationship between client attachment and therapist postsession feelings was investigated in a randomized clinical trial of psychoanalytic psychotherapy (PPT) and cognitive behavior therapy (CBT) for bulimia nervosa. Therapists completed feeling word checklists after each session, and client attachment was assessed with the Adult Attachment Interview. A factor analysis identified 3 feeling factors, Happy/Enthusiastic, Overwhelmed/Moved, and Indifferent/Bored. Positive feelings were predominant, but PPT therapists reported more negative and fewer positive feelings than CBT therapists did. Client improvement in terms of frequency of bulimic episodes and general psychiatric distress was related to an increase in Happy/Enthusiastic feelings. Multilevel analyses indicated significant interactions between therapy type and client dismissing versus preoccupied attachment in predicting therapist negative emotional reactions. PPT therapist felt more Indifferent/Bored the more dismissing clients were, whereas CBT therapists felt more Overwhelmed/Moved the more preoccupied clients were. PMID:25985045

  3. Recovery of low plasma BDNF over the course of treatment among patients with bulimia nervosa.

    Science.gov (United States)

    Yamada, Hisashi; Yoshimura, Chiho; Nakajima, Takenori; Nagata, Toshihiko

    2012-08-15

    Recent studies have suggested that brain-derived neurotrophic factor (BDNF) is associated with energy balance, eating behaviors, and psychological states such as depression. Although decreased BDNF levels in patients with bulimia nervosa (BN) have been reported, the mechanism is still unclear. Few studies have investigated longitudinal changes of BDNF in BN patients. We investigated changes in the levels of plasma BDNF before and after inpatient treatment. Subjects were 16 female patients with BN and 10 control females. The levels of plasma BDNF were measured. In seven patients who completed a 4-week inpatient treatment program based on cognitive behavior therapy, levels of plasma BDNF were measured twice, before and after inpatient treatment. Plasma BDNF levels were significantly lower in BN subjects than in controls. BDNF levels were significantly higher following inpatient treatment. Increased plasma BDNF after inpatient treatment suggests that lower plasma BDNF levels in BN patients are associated with abnormal eating behaviors, especially binge eating. PMID:22425474

  4. Major affective disorder in anorexia nervosa and bulimia. A descriptive diagnostic study.

    Science.gov (United States)

    Laessle, R G; Kittl, S; Fichter, M M; Wittchen, H U; Pirke, K M

    1987-12-01

    DSM-III lifetime diagnoses were assessed in 52 patients with a lifetime history of anorexia nervosa or bulimia by means of a standardised diagnostic interview. It was found that 44.2% had a lifetime diagnosis of DSM-III major affective disorder, with abstaining anorectics having a lower rate of depression than those with bulimic symptoms. In the great majority of cases, the onset of affective disorder post-dated the onset of the eating disorder by at least one year. In patients whose eating disorder was in remission, the rate of depressive symptoms was lower than in those in the acute stage of their illness. These findings, combined with recent studies on biological changes in eating disorders, and psychological theories of depression, suggest that in most cases in which the two conditions are associated, the depression is secondary to the eating disorder. PMID:3502805

  5. [Diuretic-Abuse in Chronic Bulimia Nervosa--Case Report and Clinical Management].

    Science.gov (United States)

    Greetfeld, Martin; Bröckel-Ristevski, Nicole; Fumi, Markus; Cuntz, Ulrich; Voderholzer, Ulrich

    2015-09-01

    We give account of a patient, who works in health care, with bulimia nervosa (BN) and a long term abuse of Furosemide. Due to patients' tendency to conceal addictive behavior and symptoms of BN, the prevalence of purging behavior caused by the intake of diuretics is difficult to quantify 10% of BN patients exhibit a long-term harmful abuse. Discontinuation of diuretics causes the development of edema, attributable to pathophysiological changes with hyperaldosteronism. These can lead to renewed escalation of purging behaviour, provoked either by phobia of weight gain or by unbearable feelings of tension in the facial area or in the legs. For an adequate clinical management, it is vital to have thorough knowledge of the pathophysiological context which consists of psychoeducation, provision of information, treatment of water-electrolyte imbalance and, in individual cases, the administration of aldosterone antagonists. PMID:26039368

  6. The role of the evaluation of gastric emptying in anorexia nervosa and bulimia

    International Nuclear Information System (INIS)

    Anorexia nervosa and bulimia are common eating disorders that are frequently associated with symptoms of bloating, belching, nausea, and vomiting. The authors currently studying this population with Tc-99m TETA to determine the gastric emptying time (ET) and response to metoclopramide. The authors' findings to date show that the majority (80%) of anorexics have a normal ET; the remainder are delayed. The bulimics demonstrate a normal ET in 34%, delayed in 45%, and rapid in 21%. The response to metoclopramide was good in the delayed anorexic patients and in 71% of bulimic patients treated. The extent of rapidity or delay in ET is being compared with the clinical data including age, weight/height, length and degree of disorder, diet, degree of symptoms, and response to drug and diet therapy. This correlation will help determine the incidence and severity of ET abnormality, the relation of disease and symptom severity to ET, and the effect of different treatments based on the ET

  7. Bulimia Nervosa

    Science.gov (United States)

    ... the patient: Receive nutritional advice and psychotherapy, especially cognitive behavioral therapy (CBT) Be prescribed medicine CBT is ... better chance of getting pregnant once their monthly cycle is normal. If you're having a hard ...

  8. Therapeutic alliance in Enhanced Cognitive Behavioural Therapy for bulimia nervosa: probably necessary but definitely insufficient.

    Science.gov (United States)

    Raykos, Bronwyn C; McEvoy, Peter M; Erceg-Hurn, David; Byrne, Susan M; Fursland, Anthea; Nathan, Paula

    2014-06-01

    The present paper assessed therapeutic alliance over the course of Enhanced Cognitive Behavioural Therapy (CBT-E) in a community-based sample of 112 patients with a diagnosis of bulimia nervosa (BN) or atypical BN. Temporal assessment of alliance was conducted at three time points (the start, middle and end of treatment) and the relationship between alliance and treatment retention and outcome was explored. Results indicated that the alliance between patient and therapist was strong at all stages of CBT-E, and even improved in the early stages of treatment when behaviour change was initiated (weekly in-session weighing, establishing regular eating, and ceasing binge-eating and compensatory behaviours). The present study found no evidence that alliance was related to treatment retention or outcomes, or that symptom severity or problematic interpersonal styles interacted with alliance to influence outcomes. Alliance was also unrelated to baseline emotional or interpersonal difficulties. The study provides no evidence that alliance has clinical utility for the prediction of treatment retention or outcome in CBT-E for BN, even for individuals with severe symptoms or problematic interpersonal styles. Early symptom change was the best predictor of outcome in CBT-E. Further research is needed to determine whether these results are generalizable to patients with anorexia nervosa. PMID:24841726

  9. Characteristics of suicide attempts in anorexia and bulimia nervosa: a case-control study.

    Directory of Open Access Journals (Sweden)

    Sébastien Guillaume

    Full Text Available OBJECTIVE: Compared to other eating disorders, anorexia nervosa (AN has the highest rates of completed suicide whereas suicide attempt rates are similar or lower than in bulimia nervosa (BN. Attempted suicide is a key predictor of suicide, thus this mismatch is intriguing. We sought to explore whether the clinical characteristics of suicidal acts differ between suicide attempters with AN, BN or without an eating disorders (ED. METHOD: Case-control study in a cohort of suicide attempters (n = 1563. Forty-four patients with AN and 71 with BN were compared with 235 non-ED attempters matched for sex, age and education, using interview measures of suicidal intent and severity. RESULTS: AN patients were more likely to have made a serious attempt (OR = 3.4, 95% CI 1.4-7.9, with a higher expectation of dying (OR = 3.7,95% CI 1.1-13.5, and an increased risk of severity (OR = 3.4,95% CI 1.2-9.6. BN patients did not differ from the control group. Clinical markers of the severity of ED were associated with the seriousness of the attempt. CONCLUSION: There are distinct features of suicide attempts in AN. This may explain the higher suicide rates in AN. Higher completed suicide rates in AN may be partially explained by AN patients' higher desire to die and their more severe and lethal attempts.

  10. Selective Visual Attention during Mirror Exposure in Anorexia and Bulimia Nervosa.

    Directory of Open Access Journals (Sweden)

    Brunna Tuschen-Caffier

    Full Text Available Cognitive theories suggest that body dissatisfaction results from the activation of maladaptive appearance schemata, which guide mental processes such as selective attention to shape and weight-related information. In line with this, the present study hypothesized that patients with anorexia nervosa (AN and bulimia nervosa (BN are characterized by increased visual attention for the most dissatisfying/ugly body part compared to their most satisfying/beautiful body part, while a more balanced viewing pattern was expected for controls without eating disorders (CG.Eye movements were recorded in a group of patients with AN (n = 16, BN (n = 16 and a CG (n = 16 in an ecologically valid setting, i.e., during a 3-min mirror exposure.Evidence was found that patients with AN and BN display longer and more frequent gazes towards the most dissatisfying relative to the most satisfying and towards their most ugly compared to their most beautiful body parts, whereas the CG showed a more balanced gaze pattern.The results converge with theoretical models that emphasize the role of information processing in the maintenance of body dissatisfaction. Given the etiological importance of body dissatisfaction in the development of eating disorders, future studies should focus on the modification of the reported patterns.

  11. Altered sensitization patterns to sweet food stimuli in patients recovered from anorexia and bulimia nervosa.

    Science.gov (United States)

    Wagner, Angela; Simmons, Alan N; Oberndorfer, Tyson A; Frank, Guido K W; McCurdy-McKinnon, Danyale; Fudge, Julie L; Yang, Tony T; Paulus, Martin P; Kaye, Walter H

    2015-12-30

    Recent studies show that higher-order appetitive neural circuitry may contribute to restricted eating in anorexia nervosa (AN) and overeating in bulimia nervosa (BN). The purpose of this study was to determine whether sensitization effects might underlie pathologic eating behavior when a taste stimulus is administered repeatedly. Recovered AN (RAN, n=14) and BN (RBN, n=15) subjects were studied in order to avoid the confounding effects of altered nutritional state. Functional magnetic resonance imaging (fMRI) measured higher-order brain response to repeated tastes of sucrose (caloric) and sucralose (non-caloric). To test sensitization, the neuronal response to the first and second administration was compared. RAN patients demonstrated a decreased sensitization to sucrose in contrast to RBN patients who displayed the opposite pattern, increased sensitization to sucrose. However, the latter was not as pronounced as in healthy control women (n=13). While both eating disorder subgroups showed increased sensitization to sucralose, the healthy controls revealed decreased sensitization. These findings could reflect on a neuronal level the high caloric intake of RBN during binges and the low energy intake for RAN. RAN seem to distinguish between high energy and low energy sweet stimuli while RBN do not. PMID:26596520

  12. Thought-shape fusion in anorexia and bulimia nervosa: a comparative experimental study.

    Science.gov (United States)

    Kostopoulou, Myrsini; Varsou, Eleftheria; Stalikas, Anastassios

    2013-09-01

    'Thought-shape fusion' (TSF) is a cognitive distortion specific in patients with eating disorders and occurs when the thought about eating a forbidden food increases a person's estimate of her weight/shape, elicits a perception of moral wrongdoing and makes her feel fat. This study aimed to experimentally induce, study and compare TSF between patients with bulimia nervosa (BN) and patients with anorexia nervosa (AN). 31 patients diagnosed with a current eating disorder, of which 20 met DSM-IV-TR criteria for BN and 11 for AN, participated in a mixed-model experimental design with the aim of eliciting TSF and investigating the effects of corrective behaviors (checking and mental neutralizing). Verbal analogue scales constituted the main outcome measures. TSF was experimentally induced and expressed in a similar way in both clinical groups, apart from 'feeling fat' which was higher in BN patients. TSF induction triggered heightened levels of anxiety, guilt and urges to engage in corrective behaviors in both groups. Body dissatisfaction only increased in the BN patients. Mental neutralizing and to a lesser extent checking reduced most effects of the experimental procedure, but this effect was larger for BN patients. The nature of TSF seems to have similarities between BN and AN patients; however, the precise connection between TSF and different types of eating disorders remains to be explored in future clinical trials. PMID:23881747

  13. Does a shared neurobiology for foods and drugs of abuse contribute to extremes of food ingestion in anorexia and bulimia nervosa?

    OpenAIRE

    Kaye, Walter H.; Wierenga, Christina E.; Bailer, Ursula F.; Simmons, Alan N.; Wagner, Angela; Bischoff-Grethe, Amanda

    2013-01-01

    Is starvation in anorexia nervosa (AN) or overeating in bulimia nervosa (BN) a form of addiction? Alternatively, why are individuals with BN more vulnerable and AN protected from substance abuse? Such questions have been generated by recent studies that suggest that there are overlapping neural circuits for foods and drugs of abuse.

  14. A Needs Assessment for Health Care Professionals in the Detection, Intervention and Interdisciplinary Treatment of Bulimia Nervosa Using Focus Group Methodology

    Science.gov (United States)

    Hague, Anne; Kovacich, Joann

    2007-01-01

    The incidence of bulimia nervosa has increased significantly in the second half of the twentieth century and its occurrence is more than twice that of anorexia nervosa. Due to its complex nature, successful treatment requires an interdisciplinary approach with nutritional, psychological, medical, pharmacological and dental therapies. Despite…

  15. The Emotional and Attentional Impact of Exposure to One's Own Body in Bulimia Nervosa: A Physiological View

    OpenAIRE

    Ortega-Roldán, Blanca; Rodríguez-Ruiz, Sonia; Perakakis, Pandelis; Fernández-Santaella, M. Carmen; Vila, Jaime

    2014-01-01

    Background: Body dissatisfaction is the most relevant body image disturbance in bulimia nervosa (BN). Research has shown that viewing one's own body evokes negative thoughts and emotions in individuals with BN. However, the psychophysiological mechanisms involved in this negative reaction have not yet been clearly established. Our aim was to examine the emotional and attentional processes that are activated when patients with BN view their own bodies. Method: We examined the effect...

  16. Reduced resting state functional connectivity of the somatosensory cortex predicts psychopathological symptoms in women with bulimia nervosa

    OpenAIRE

    Luca eLavagnino; Federico eAmianto; Federico eD'Agata; Zirui eHuang; Paolo eMortara; Giovanni eAbbate Daga; Enrica eMarzola; Angela eSpalatro; Secondo eFassino; Georg eNorthoff

    2014-01-01

    BackgroundAlterations in the resting state functional connectivity (rs-FC) of several brain networks have been demonstrated in eating disorders. However, very few studies are currently available on brain network dysfunctions in bulimia nervosa (BN). The somatosensory network is central in processing body-related stimuli and it may be altered in BN. The present study therefore aimed to investigate rs-FC in the somatosensory network in bulimic women. MethodsSixteen medication-free women with B...

  17. Reduced resting-state functional connectivity of the somatosensory cortex predicts psychopathological symptoms in women with bulimia nervosa.

    OpenAIRE

    Lavagnino, Luca; Amianto, Federico; D’Agata, Federico; Huang, Zirui; Mortara, Paolo; Abbate-Daga, Giovanni; Marzola, Enrica; Spalatro, Angela; Fassino, Secondo; Northoff, Georg

    2014-01-01

    Background: Alterations in the resting-state functional connectivity (rs-FC) of several brain networks have been demonstrated in eating disorders. However, very few studies are currently available on brain network dysfunctions in bulimia nervosa (BN). The somatosensory network is central in processing body-related stimuli and it may be altered in BN. The present study therefore aimed to investigate rs-FC in the somatosensory network in bulimic women. Methods: Sixteen medication-free women ...

  18. Femininity, Feminine Gender Role Stress, Body Dissatisfaction, and their Relationships to Bulimia Nervosa and Binge Eating Disorder

    OpenAIRE

    Romero, Nancy M.

    2008-01-01

    Femininity, Feminine Gender Role Stress, Body Dissatisfaction, and their Relationships to Bulimia Nervosa and Binge Eating Disorder Nancy Romero Abstract Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also...

  19. Micronuclei and nuclear abnormalities in buccal mucosa cells in patients with anorexia and bulimia nervosa.

    Science.gov (United States)

    Torres-Bugarín, Olivia; Pacheco-Gutiérrez, Angélica Guadalupe; Vázquez-Valls, Eduardo; Ramos-Ibarra, María Luisa; Torres-Mendoza, Blanca Miriam

    2014-11-01

    The aim of this study is to assess the frequency of micronucleated cell (MNC) and nuclear abnormalities (NA) in the buccal mucosa cells of females with anorexia nervosa (AN) or bulimia nervosa (BN), compared with healthy women. Individuals with AN and BN have inadequate feeding and compensatory behaviour to avoid weight gain. These behaviours can cause extreme body stress, thereby inducing DNA damage. In a cross-sectional study, we assessed the frequency of MNC and NA in the buccal mucosa cells of female participants with AN or BN. All of these patients had been admitted to a private clinic for the treatment of eating disorders after diagnosis with AN (n = 10) or BN (n = 7) according to the DSM-IV. Age-matched healthy female participants (n = 17) composed the control group. Oral mucosa samples were collected, fixed, stained by aceto-orcein/fast green and microscopically examined. Normal cells, MNC and NAs were counted within a 2000 cell sample. The results were analyzed with the Kruskal-Wallis and Mann-Whitney tests. Differences were observed in the frequency of MNC in healthy females (1.2±0.9) versus that of patients with AN (3.4±1.5) (P < 0.0001) and BN (4.1±2.2) (P < 0.001). No differences were found among these groups in terms of NA. AN and BN are related to the loss of genetic material through chromosomal fractures and/or damage to the mitotic spindle (i.e. possibly a result of a deficiency in DNA precursors). Self-imposed compensatory behaviours in AN and BN, such as severe food restriction, potential malnutrition, vomiting, use of diuretics and laxatives and acute exhaustive exercise, are possible inducers of MNC and genotoxic damage. Of these compensatory behaviours, only vomiting has not been linked to genotoxic damage. This is the first report in women with BN, which should be studied in the future. PMID:25232046

  20. Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults.

    Science.gov (United States)

    Nagl, Michaela; Jacobi, Corinna; Paul, Martin; Beesdo-Baum, Katja; Höfler, Michael; Lieb, Roselind; Wittchen, Hans-Ulrich

    2016-08-01

    We aimed to assess the prevalence, incidence, age-of-onset and diagnostic stability of threshold and subthreshold anorexia nervosa (AN) and bulimia nervosa (BN) in the community. Data come from a prospective-longitudinal community study of 3021 subjects aged 14-24 at baseline, who were followed up at three assessment waves over 10 years. Eating disorder (ED) symptomatology was assessed with the DSM-IV/M-CIDI at each wave. Diagnostic stability was defined as the proportion of individuals still affected with at least symptomatic eating disorders (EDs) at follow-ups. Baseline lifetime prevalence for any threshold ED were 2.9 % among females and 0.1 % among males. For any subthreshold ED lifetime prevalence were 2.2 % for females and 0.7 % for males. Symptomatic expressions of EDs (including core symptoms of the respective disorder) were most common with a lifetime prevalence of 11.5 % among females and 1.8 % among males. Symptomatic AN showed the earliest onset with a considerable proportion of cases emerging in childhood. 47 % of initial threshold AN cases and 42 % of initial threshold BN cases showed at least symptomatic expressions of any ED at any follow-up assessment. Stability for subthreshold EDs and symptomatic expressions was 14-36 %. While threshold EDs are rare, ED symptomatology is common particularly in female adolescents and young women. Especially threshold EDs are associated with a substantial risk for stability. A considerable degree of symptom fluctuation is characteristic especially for subthreshold EDs. PMID:26754944

  1. Serotonin neuronal function and selective serotonin reuptake inhibitor treatment in anorexia and bulimia nervosa.

    Science.gov (United States)

    Kaye, W; Gendall, K; Strober, M

    1998-11-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders characterized by aberrant patterns of feeding behavior and weight regulation, and disturbances in attitudes toward weight and shape and the perception of body shape. Emerging data support the possibility that substantial biologic and genetic vulnerabilities contribute to the pathogenesis of AN and BN. Multiple neuroendocrine and neurotransmitter abnormalities have been documented in AN and BN, but for the most part, these disturbances are state-related and tend to normalize after symptom remission and weight restoration; however, elevated concentrations of 5-hydroxyindoleacetic acid in the cerebrospinal fluid after recovery suggest that altered serotonin activity in AN and BN is a trait-related characteristic. Elevated serotonin activity is consistent with behaviors found after recovery from AN and BN, such as obsessionality with symmetry and exactness, harm avoidance, perfectionism, and behavioral over control. In BN, serotonergic modulating antidepressant medications suppress symptoms independently of their antidepressant effects. Selective serotonin reuptake inhibitors (SSRIs) are not useful when AN subjects are malnourished and under-weight; however, when given after weight restoration, fluoxetine may significantly reduce the extremely high rate of relapse normally seen in AN. Nonresponse to SSRI medication in ill AN subjects could be a consequence of an inadequate supply of nutrients, which are essential to normal serotonin synthesis and function. These data raise the possibility that a disturbance of serotonin activity may create a vulnerability for the expression of a cluster of symptoms that are common to both AN and BN and that nutritional factors may affect SSRI response in depression, obsessive-compulsive disorder, or other conditions characterized by disturbances in serotonergic pathways. PMID:9807638

  2. Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa.

    Science.gov (United States)

    Ciao, Anna C; Accurso, Erin C; Fitzsimmons-Craft, Ellen E; Le Grange, Daniel

    2015-06-01

    This study examined predictors of psychological change among 80 adolescents with bulimia nervosa (BN) participating in a randomized-controlled trial comparing family-based treatment (FBT) to supportive psychotherapy (SPT). Psychological outcomes (cognitive eating disorder pathology, depression, and self-esteem) were explored at baseline, post-treatment, and 6-month follow-up. Multi-level growth models examined predictors of rate of change in psychological outcomes and moderators of treatment effects. All psychological outcomes improved through 6-month follow-up (moderate to large effect sizes) across both treatments. Overall, few significant predictors were identified. Older adolescents had faster change in self-esteem relative to younger adolescents (p = 0.03). Adolescents taking psychotropic medication at baseline had faster change in eating concerns relative to adolescents not taking medication (p = 0.02). Age (p = 0.02) and baseline purging severity (p = 0.03) moderated the relationship between treatment condition and change in eating concerns, where younger adolescents and individuals with high baseline purging had greater change when treated with FBT relative to SPT. Age and purging did not significantly moderate change in other psychological outcomes. Bulimic symptom improvement did not predict change in psychological symptoms. Generally, FBT and SPT were equally efficacious with respect to psychological improvement, although FBT may be more efficacious in younger adolescents and those with more frequent purging. PMID:25874955

  3. Altered White Matter Microstructure in Adolescents and Adults with Bulimia Nervosa.

    Science.gov (United States)

    He, Xiaofu; Stefan, Mihaela; Terranova, Kate; Steinglass, Joanna; Marsh, Rachel

    2016-06-01

    Previous data suggest structural and functional deficits in frontal control circuits in adolescents and adults with bulimia nervosa (BN), but less is known about the microstructure of white matter in these circuits early in the course of the disorder. Diffusion tensor imaging (DTI) data were acquired from 28 female adolescents and adults with BN and 28 age- and BMI-matched healthy female participants. Tract-based spatial statistics (TBSS) was used to detect group differences in white matter microstructure and explore the differential effects of age on white matter microstructure across groups. Significant reductions in fractional anisotropy (FA) were detected in the BN compared with healthy control group in multiple tracts including forceps minor and major, superior longitudinal, inferior fronto-occipital, and uncinate fasciculi, anterior thalamic radiation, cingulum, and corticospinal tract. FA reductions in forceps and frontotemporal tracts correlated inversely with symptom severity and Stroop interference in the BN group. These findings suggest that white matter microstructure is abnormal in BN in tracts extending through frontal and temporoparietal cortices, especially in those with the most severe symptoms. Age-related differences in both FA and RD in these tracts in BN compared with healthy individuals may represent an abnormal trajectory of white matter development that contributes to the persistence of functional impairments in self-regulation in BN. PMID:26647975

  4. Multiple measures of rapid response as predictors of remission in cognitive behavior therapy for bulimia nervosa.

    Science.gov (United States)

    Thompson-Brenner, Heather; Shingleton, Rebecca M; Sauer-Zavala, Shannon; Richards, Lauren K; Pratt, Elizabeth M

    2015-01-01

    Bulimia nervosa (BN) treatment studies consistently observe that substantial reductions in purging frequency after four weeks of treatment predict outcome. Although baseline levels of other variables have been compared to change in purging, measures of early change in other domains have not been examined. This study aimed to compare percentage change in purging, depression, and cognitive eating disorder (ED) symptoms for associations with BN remission post-treatment and at six months follow-up. Data from N = 43 patients with BN in a clinical trial comparing the broad and focused versions of enhanced cognitive behavior therapy (CBT-E; Fairburn, 2008) were utilized. Measures included self-reported purging frequency, Beck Depression Inventory (BDI) score, and a mean of items from the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales. Results indicated that both percentage change in purging frequency and percentage change in BDI score at week four/session eight were significantly associated with remission at termination. The optimal cutoffs for purging change and BDI score change were 65% decrease and 25% decrease respectively. Only change in BDI score at week four significantly predicted remission at six-month follow-up. These data suggest that change in depressive symptoms may be as important as ED symptom change to predict outcome in some groups. PMID:25462877

  5. A risk and maintenance model for bulimia nervosa: From impulsive action to compulsive behavior.

    Science.gov (United States)

    Pearson, Carolyn M; Wonderlich, Stephen A; Smith, Gregory T

    2015-07-01

    This article offers a new model for bulimia nervosa (BN) that explains both the initial impulsive nature of binge eating and purging, as well as the compulsive quality of the fully developed disorder. The model is based on a review of advances in research on BN and advances in relevant basic psychological science. It integrates transdiagnostic personality risk, eating-disorder-specific risk, reinforcement theory, cognitive neuroscience, and theory drawn from the drug addiction literature. We identify both a state-based and a trait-based risk pathway, and we then propose possible state-by-trait interaction risk processes. The state-based pathway emphasizes depletion of self-control. The trait-based pathway emphasizes transactions between the trait of negative urgency (the tendency to act rashly when distressed) and high-risk psychosocial learning. We then describe a process by which initially impulsive BN behaviors become compulsive over time, and we consider the clinical implications of our model. (PsycINFO Database Record PMID:25961467

  6. Tratamento da bulimia nervosa: síntese das evidências

    Directory of Open Access Journals (Sweden)

    Bacaltchuk Josué

    1999-01-01

    Full Text Available As duas abordagens terapêuticas mais estudadas para o tratamento da bulimia nervosa (BN são os tratamentos psicológicos, principalmente a terapia cognitivo-comportamental (TCC e o uso de antidepressivos. Os resultados de duas revisões sistemáticas da literatura mostram que a TCC é melhor que fila de espera e que os antidepressivos são superiores ao placebo na remissão a curto prazo dos sintomas bulímicos. A comparação direta das duas abordagens mostra que, quando usados como abordagens exclusivas, a TCC é clinicamente mais eficaz e mais aceita do que os antidepressivos. A associação dos dois tipos de tratamento é clinicamente mais eficaz que cada um isoladamente, mas a aceitação das abordagens psicológicas exclusivas é maior. Como a BN é um transtorno grave e com baixa taxa de remissão espontânea, o tratamento associado, com abordagem multidimensional e multidisciplinar, pode ser indicado.

  7. An evaluation of the enhanced cognitive-behavioural model of bulimia nervosa.

    Science.gov (United States)

    Lampard, Amy M; Byrne, Susan M; McLean, Neil; Fursland, Anthea

    2011-09-01

    The original cognitive-behavioural model of bulimia nervosa (BN) has been enhanced to include four additional maintaining mechanisms: low self esteem, clinical perfectionism, interpersonal problems, and mood intolerance. These models have been used to guide cognitive-behavioural treatment for BN, but the enhanced model has yet to be directly evaluated as a whole in a clinical sample. This study aimed to compare and evaluate the original and the enhanced cognitive-behavioural models of BN using structural equation modelling. The Eating Disorder Examination and self-report questionnaires were completed by 162 patients seeking treatment for BN (N = 129) or atypical BN (N = 33). Fit indices suggested that both the original and enhanced models provided a good fit to the data, but the enhanced model accounted for more variance in dietary restraint and binge eating. In the enhanced model, low self esteem was associated with greater overevaluation of weight and shape, which, in turn, was associated with increased dietary restraint. Interpersonal problems were also directly associated with dietary restraint, and binge eating was associated with increased purging. While the current study provides support for some aspects of the enhanced cognitive-behavioural model of BN, some key relationships in the model were not supported, including the important conceptual relationship between dietary restraint and binge eating. PMID:21724176

  8. Integrative dynamic therapy for bulimia nervosa: An evidence-based case study.

    Science.gov (United States)

    Richards, Lauren K; Shingleton, Rebecca M; Goldman, Rachel; Siegel, Deborah; Thompson-Brenner, Heather

    2016-06-01

    Both cognitive-behavioral therapy (CBT) and psychodynamic psychotherapy are commonly used to treat eating disorders. To further investigate the effectiveness of integrative dynamic therapy (IDT) for bulimia nervosa (BN), our research group undertook a randomized, controlled pilot study comparing IDT with CBT for BN. The case described here was selected from a sample of N = 38 female patients with the symptoms of BN who enrolled in the study. IDT incorporated aspects of the first 4-week stage of CBT, including psychoeducation, self-monitoring, and regular eating. Subsequently, the treatment focused on emotional expression, emotion regulation (defenses), intrapsychic conflict, and interpersonal relationships. The objectives of the report are to demonstrate the effectiveness of an integrative approach to the treatment of eating disorders to address the symptoms of BN and personality issues using pre-, mid-, and posttreatment data, and to illustrate the patient and clinician reactions to each approach to treatment using excerpts from session transcripts and alliance data. (PsycINFO Database Record PMID:27267504

  9. Eating Disorders and Mentalization: High Reflective Functioning in Patients with Bulimia Nervosa.

    Science.gov (United States)

    Pedersen, Signe Holm; Poulsen, Stig; Lunn, Susanne

    2015-08-01

    The theory of mentalization has recently been applied in the area of eating disorders (Skårderud 2012). This article reports a qualitative study based on interviews with five women suffering from bulimia nervosa. All five scored high on the Reflective Functioning Scale, indicating a highly developed ability to mentalize. The present qualitative study, which focuses on the women's capacity to relate to and regulate affects, supports the finding that they are relatively skilled at reflecting on their own and others' thoughts and emotions. However, this highly developed capacity for mentalization is apparently not helping them regulate their emotions. This suggests that the capacity to mentalize may not be as closely related to the capacity to regulate affects as Fonagy et al. (2002) have proposed. Indeed, the concept of mentalization may be overinclusive and in need of stricter definition. Thus, it might be envisaged that while the ability to mentalize is closely related to the ability to put feelings into words (the opposite of alexithymia), an ability to mentalize may not necessarily entail a capacity to regulate affects. Finally, the study illustrates that far from all eating-disordered patients have problems mentalizing. PMID:26316406

  10. Acompanhamento da evolução dos distúrbios de imagem corporal em pacientes com bulimia nervosa, ao longo do tratamento multiprofissional Longitudinal assessment of body image disturbances in patients with bulimia nervosa submitted to multidisciplinary treatment

    Directory of Open Access Journals (Sweden)

    Fernanda Timerman

    2010-01-01

    Full Text Available OBJETIVO: Aumentar a compreensão sobre os distúrbios da imagem corporal em pacientes com bulimia nervosa e sua evolução após o tratamento multidisciplinar. MÉTODOS: Onze mulheres responderam dois questionários de imagem corporal (Body Attitudes Questionnaire e Escala de Figuras de Stunkard antes e após o tratamento e preencheram o diário alimentar, utilizado para a análise de sintomas de bulimia nervosa. RESULTADOS: Tanto no pré quanto no pós-tratamento o índice de massa corporal médio se encontrava na faixa de eutrofia. Cerca de 57,0% da amostra teve remissão total dos sintomas de bulimia nervosa. Em relação à imagem corporal, na escala de Stunkard, o tamanho da figura escolhida como ideal aumentou e houve redução da insatisfação corporal após o tratamento. Não houve redução significativa da superestimativa do tamanho corporal, porém no início do tratamento 57,1% das pacientes já não superestimavam seu tamanho. Em relação ao questionário de atitudes, notou-se diminuição das seguintes variáveis: depreciação corporal; sentir-se gorda; sensação de ter gordura nos membros inferiores e importância pessoal do corpo. CONCLUSÕES: O tratamento foi eficaz em alguns aspectos atitudinais, porém deve ser aprimorado em outros, como a distorção perceptual.OBJECTIVE: Increase the comprehension of body image disturbances in patients with bulimia nervosa and its evolution after treatment, multidisciplinary. METHODS: Eleven women answered two body image questionnaires (Body Attitudes Questionnaire and Stunkard's Figure Scale before and after treatment and filled a food diary used to analyze the frequency of bulimia nervosa symptoms. RESULTS: The mean body mass index was found at normal weight category before and after treatment. Approximately 57.0% of the sample had total remission of bulimia nervosa symptoms. In relation to body image based on Stunkard's scale, the size of the figure chosen as ideal increased and body

  11. A bulimia nervosa como fator de risco para distúrbios da voz: artigo de revisão Bulimia nervosa as a risk factor for voice disorders: literature review

    OpenAIRE

    Patricia Balata; Viviane Colares; Katia Petribu; Mariana de Carvalho Leal

    2008-01-01

    A bulimia nervosa é um tipo de transtorno alimentar que tem início na adolescência e que apresenta uma variedade de sintomas, dentre estes, os episódios recorrentes de vômitos que acometem a cavidade oral, podendo alcançar a laringe de forma semelhante ao refluxo gastroesofágico, ocasionando alterações laríngeas e distúrbios na voz. OBJETIVO: Este trabalho teve como objetivo investigar através da revista da literatura os estudos que relacionassem a BN como fator de risco para os distúrbios da...

  12. Atitudes em relação ao corpo e à alimentação de pacientes com anorexia e bulimia nervosa

    OpenAIRE

    Aline Cavalcante de Souza; Fernanda Pisciolaro; Viviane Ozores Polacow; Táki Athanássios Cordás; Marle dos Santos Alvarenga

    2014-01-01

    Objetivo: Avaliar como se relacionam as atitudes alimentares e corporais de pacientes com anorexia ou bulimia nervosa. Métodos: Pacientes adultas de um ambulatório especializado, com diagnóstico de anorexia (n = 48) ou bulimia nervosa (n = 58), responderam à Disordered Eating Attitude Scale (DEAS) para avaliação das atitudes alimentares e ao Body Attitude Questionnaire (BAQ) para atitudes corporais – ambos traduzidos e validados para mulheres jovens do Brasil. A correlação entre os escores ...

  13. The Effectiveness of Acceptance and Commitment Based Training on the Maladaptive Schemas of Female Students with Bulimia Nervosa

    Directory of Open Access Journals (Sweden)

    Moslem Abbasia

    2015-06-01

    Full Text Available Background & Aims of the Study: Recently, a lot of discussions have been done about the third wave of behavioral and cognitive approaches, particularly in areas with eating disorders. The aim of current research is the effectiveness of acceptance and commitment based training on the maladaptive schemas of female students with bulimia nervosa. Materials & Methods: The design of current study is as quasi-experiment research with pre-test and post-test with control group. Statistical population consist of all high school female students of Arak city in the 2013-14 academic years. Samples were selected at first by multi stage cluster sampling method and after completing young schema questionnaire short form and Diagnostic Interview, were placement using random sampling method in two experimental and control groups (N=20 per group. The experimental group participated in 8 sessions of acceptance and commitment based training and control group received no intervention. The gathered data were analyzed using Multivariate analysis of covariance (MANCOVA. Results: The results show that there exist significant differences between the pre-test and post-test scores of the experimental group. This difference is significant at the level of 0.01. Therefore it seems that acceptance and commitment based training decreased maladaptive schemas of students with bulimia nervosa. Conclusions: The results of current research explain the importance of acceptance and commitment therapy in decreasing maladaptive schema of female students with bulimia nervosa. Thus, interventions based on this approach in schools for students lead to decreasing the psychological problems

  14. CBT4BN versus CBTF2F: Comparison of Online versus Face-To-FaceTreatment for Bulimia Nervosa

    OpenAIRE

    Bulik, Cynthia M; Marcus, Marsha D.; Zerwas, Stephanie; Levine, Michele D.; Hofmeier, Sara; Trace, Sara E.; Hamer, Robert M.; Zimmer, Benjamin; Moessner, Markus; Kordy, Hans

    2012-01-01

    Cognitive-behavioral therapy (CBT) is currently the “gold standard” for treatment of bulimia nervosa (BN), and is effective for approximately 40–60% of individuals receiving treatment; however, the majority of individuals in need of care do not have access to CBT. New strategies for service delivery of CBT and for maximizing maintenance of treatment benefits are critical for improving our ability to treat BN. This clinical trial is comparing an Internet-based version of CBT (CBT4BN) in which ...

  15. ACERCA DE LA ETIMOLOGÍA DE "NERVOSA" EN LA BULIMIA Y ANOREXIA: UNA HISTORIA DE NERVIOS

    OpenAIRE

    Alfredo Hernández Alcántara

    2011-01-01

    Pese a que el término nervosa se atribuye a Richard Morton (1689), se revisan en este artículo sus verdaderos orígenes, los que pueden remontarse a Empédocles de Agrigento, y más atrás a Alcmeón de Crotona, discípulo de Pitágoras. La revisión etimológica del mencionado término arroja luz sobre los fascinantes inicios de esta palabra, indefectiblemente ligada a la bulimia y la anorexia.

  16. The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa.

    Directory of Open Access Journals (Sweden)

    Jochen Seitz

    Full Text Available INTRODUCTION: Little is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD in the development and maintenance of bulimia nervosa (BN. In particular, their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear. METHODS: Fifty-seven female patients seeking treatment for BN and 40 healthy controls completed diagnostic questionnaires and interviews that investigated: a ADHD, b impulsivity, c eating disorders and d general psychopathology. Attentional processes and impulsivity were assessed by a comprehensive computer-based neuropsychological battery. RESULTS: Twenty-one percent of patients with BN met the clinical cut-off for previous childhood ADHD compared to 2.5% of healthy controls. Adult ADHD according to DSM IV was also more prevalent in patients with BN, with an odds ratio of 4.2. Patients with BN and previous childhood ADHD were more impulsive and inattentive than patients with BN alone. These patients also displayed more severely disordered eating patterns and more general psychopathological symptoms compared with those without ADHD. Severity of eating disorder symptoms was better explained by inattentiveness than by either impulsivity or hyperactivity. DISCUSSION: Our data suggest an elevated rate of former childhood and current ADHD-symptoms in treatment-seeking patients with BN. Stronger impulsivity and inattention associated with more severe neuropsychological deficits and eating disorder symptoms indicate an additive risk that is clinically relevant for these patients. Thus, clinicians should identify comorbid patients who might profit from additional ADHD-specific treatments.

  17. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study.

    Directory of Open Access Journals (Sweden)

    Cristina eGiner-Bartolomé

    2015-07-01

    Full Text Available Background: Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa. Cognitive behavioral therapy (CBT is the treatment of choice for bulimia nervosa, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with bulimia nervosa, examining the effectiveness of using a videogame (Playmancer as an additional intervention designed to address impulsivity. Design: Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an A-B-A-C-A single case experimental design. Impulsivity levels were assessed with the Conners’ Continuous Performance Test II (CPT-II. After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. Results: After the videogame intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the videogame intervention. Discussion: This case report suggests that using the Playmancer videogame to reduce impulsivity prior to CBT may enhance the final results of the treatment for bulimia nervosa.

  18. Anorexia and Bulimia Nervosa in Same-Sex and Opposite-Sex Twins : Lack of Association With Twin Type in a Nationwide Study of Finnish Twins

    NARCIS (Netherlands)

    Raevuori, Anu; Kaprio, Jaakko; Hoek, Hans W.; Sihvola, Elina; Rissanen, Aila; Keski-Rahkonen, Anna

    2008-01-01

    Objective: The authors tested the hypothesis that either prenatal feminization or masculinization hormone influences in utero or later socialization affects the risk for anorexia and bulimia nervosa and disordered eating in members of opposite-sex twin pairs. Method: Finnish twins (N=2,426 women, N=

  19. Mental Health Literacy and Eating-Disordered Behavior: Beliefs of Adolescent Girls Concerning the Treatment of and Treatment-Seeking for Bulimia Nervosa

    Science.gov (United States)

    Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.

    2007-01-01

    This research examined the "mental health literacy" of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking for the…

  20. Daily and Momentary Mood and Stress Are Associated with Binge Eating and Vomiting in Bulimia Nervosa Patients in the Natural Environment

    Science.gov (United States)

    Smyth, Joshua M.; Wonderlich, Stephen A.; Heron, Kristin E.; Sliwinski, Martin J.; Crosby, Ross D.; Mitchell, James E.; Engel, Scott G.

    2007-01-01

    The relation of mood and stress to binge eating and vomiting in the natural environments of patients with bulimia nervosa (BN) was examined using real-time data collection. Women (n = 131; mean age = 25.3 years) with BN carried a palmtop computer for 2 weeks and completed ratings of positive affect (PA), negative affect (NA), anger/hostility (AH),…

  1. An empirical comparison of atypical bulimia nervosa and binge eating disorder

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    Fontenelle L.F.

    2005-01-01

    Full Text Available The International Classification of Diseases, 10th edition (ICD-10 defines atypical bulimia nervosa (ABN as an eating disorder that encompasses several different syndromes, including the DSM-IV binge eating disorder (BED. We investigated whether patients with BED can be differentiated clinically from patients with ABN who do not meet criteria for BED. Fifty-three obese patients were examined using the Structured Clinical Interview for DSM-IV and the ICD-10 criteria for eating disorders. All volunteers completed the Binge Eating Scale (BES, the Beck Depression Inventory, and the Symptom Checklist-90 (SCL-90. Individuals fulfilling criteria for both ABN and BED (N = 18, ABN without BED (N = 16, and obese controls (N = 19 were compared and contrasted. Patients with ABN and BED and patients with ABN without BED displayed similar levels of binge eating severity according to the BES (31.05 ± 7.7 and 30.05 ± 5.5, respectively, which were significantly higher than those found in the obese controls (18.32 ± 8.7; P < 0.001 and P < 0.001, respectively. When compared to patients with ABN and BED, patients with ABN without BED showed increased lifetime rates of agoraphobia (P = 0.02 and increased scores in the somatization (1.97 ± 0.85 vs 1.02 ± 0.68; P = 0.001, obsessive-compulsive (2.10 ± 1.03 vs 1.22 ± 0.88; P = 0.01, anxiety (1.70 ± 0.82 vs 1.02 ± 0.72; P = 0.02, anger (1.41 ± 1.03 vs 0.59 ± 0.54; P = 0.005 and psychoticism (1.49 ± 0.93 vs 0.75 ± 0.55; P = 0.01 dimensions of the SCL-90. The BED construct may represent a subgroup of ABN with less comorbities and associated symptoms.

  2. The Use of Videogames as Complementary Therapeutic Tool for Cognitive Behavioral Therapy in Bulimia Nervosa Patients.

    Science.gov (United States)

    Fernandez-Aranda, Fernando; Jimenez-Murcia, Susana; Santamaría, Juan J; Giner-Bartolomé, Cristina; Mestre-Bach, Gemma; Granero, Roser; Sánchez, Isabel; Agüera, Zaida; Moussa, Maher H; Magnenat-Thalmann, Nadia; Konstantas, Dimitri; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Lems, Peter; Tarrega, Salomé; Menchón, José Manuel

    2015-12-01

    Although cognitive behavioral therapy (CBT) has been demonstrated to be the most effective approach for the treatment of bulimia nervosa (BN), there is lack of studies showing whether a combination with a serious video game (SVG) might be useful to enhance patients' emotional regulation capacities and general outcome. The aims of this study were (a) to analyze whether outpatient CBT + SVG, when compared with outpatient CBT - SVG, shows better short-term outcome; (b) to examine whether the CBT + SVG group is more effective in reducing emotional expression and levels of anxiety than CBT - SVG. Thirty-eight patients diagnosed as having BN according to DSM-5 criteria were consecutively assigned to two outpatient group therapy conditions (that lasted for 16 weekly sessions): 20 CBT + SVG versus 18 CBT - SVG. Patients were assessed before and after treatment using not only a food and binging/purging diary and clinical questionnaires in the field of eating disorders but also additional indexes for measuring anger expression and anxiety. Regarding the post-treatment psychometric measures, most of the mean differences (Eating Disorder Inventory-2, Symptom Checklist-Revised, State-Trait Anxiety Index, and partially State-Trait Anger Expression Inventory) achieved moderate to high effect size (d > 0.5), in the sense that CBT + SVG obtained the best results compared with the CBT - SVG group. Regarding therapy outcome (dropout, partial remission, and total remission), CBT + SVG showed better results and a moderate effect size emerged for the comparison of the risk of dropout during the treatment, being higher for CBT - SVG compared with CBT + SVG (44.1 percent versus 20.0 percent, d = 0.54). Although the sample size in our study was low, and consequently results should be considered with caution, we have obtained promising findings suggesting that in the short-term CBT + SVG might be a good option not only for improving

  3. Teoria e eficácia da terapia comportamental dialética na bulimia nervosa e no transtorno da compulsão alimentar periódica Theory and efficacy of dialectical behavior therapy of bulimia nervosa and binge eating disorder

    OpenAIRE

    Rui Alexandre Nunes-Costa; Diogo Jorge Pereira do Vale Lamela; Laura Gil-Costa

    2009-01-01

    OBJETIVOS: Procura-se analisar as atuais evidências empíricas e teóricas sobre o modo de operar nas intervenções comportamentais dialéticas. Procedeu-se igualmente à análise da eficácia dessa terapia no tratamento da bulimia nervosa e no transtorno da compulsão alimentar periódica. MÉTODO: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave "dialectical behavior therapy", "bulimia nervosa" e "binge eating disorder" nas bases de dados PsycInfo e MedLine e em livros d...

  4. Conductas purgativas y estado nutricional en anorexia nerviosa y bulimia nerviosa Purging behaviours and nutritional status in anorexia nervosa and bulimia nervosa

    OpenAIRE

    F. J. Vaz; Mª A. García-Herráiz; B. López-Vinuesa; Monge, M; Mª A. Fernández-Gil; J. A. Guisado

    2003-01-01

    Objetivos: La intención del estudio fue comprobar si el empleo de métodos purgativos en pacientes con trastornos alimentarios (anorexia nerviosa [AN], y bulimia nerviosa [BN]) podía reflejarse en la existencia de un estado nutricional específico. Ámbito y pacientes: El grupo en estudio estuvo formado por 184 pacientes ambulatorios con diagnóstico confirmado de trastorno de la alimentación DSM-IV. Ciento dieciséis pacientes (63%) padecían BN: 90 del subtipo purgativo y 26 del subtipo no-purgat...

  5. Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial

    OpenAIRE

    Palavras, Marly Amorim; Hay, Phillipa; Touyz, Stephen; Sainsbury, Amanda; da Luz, Felipe; Swinbourne, Jessica; Estella, Nara Mendes; Claudino, Angélica

    2015-01-01

    Background Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed...

  6. Bulimia nervosa and major depression: a study of common genetic and environmental factors.

    Science.gov (United States)

    Walters, E E; Neale, M C; Eaves, L J; Heath, A C; Kessler, R C; Kendler, K S

    1992-08-01

    A genetic analysis of the co-occurrence of bulimia and major depression (MD) was performed on 1033 female twin pairs obtained from a population based register. Personal interviews were conducted and clinical diagnoses made according to DSM-III-R criteria. Additive genes, but not family environment, are found to play an important aetiological role in both bulimia and MD. The genetic liabilities of the two disorders are correlated 0.456. While unique environmental factors account for around half of the variation in liability to both bulimia and MD, these risk factors appear to be unrelated, i.e., each disorder has its own set of unique environmental risk factors. Thus, the genetic liability of bulimia and MD is neither highly specific nor entirely non-specific. There is some genetic correlation between the two disorders as well as some genetic and environmental risk factors unique to each disorder. Limitations and directions for future research are discussed. PMID:1410087

  7. Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa

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    Milisavljević Nemanja

    2013-01-01

    Full Text Available Introduction. The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. Case report. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac disease was confirmed with histopathology examination of duodenal biopsy specimen. Conclusion. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

  8. Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa

    OpenAIRE

    Milisavljević Nemanja; Cvetković Mirjana; Nikolić Goran; Filipović Branka; Milinić Nikola

    2013-01-01

    Introduction. The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. Case report. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac diseas...

  9. Esophageal cancer in a young woman with bulimia nervosa: a case report

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    Shinohara Eric T

    2007-11-01

    Full Text Available Abstract Adenocarcinoma of the esophagus has increased dramatically within the United States and continues to have a poor prognosis despite aggressive treatment. Identifying potential risk factors is critical for the early detection and treatment of this disease. The present case report describes a very young woman who developed adenocarcinoma of the esophagus after only a brief history of bulimia. These findings suggest that even in very young patients, bulimia may represent a risk factor for adenocarcinoma of the esophagus.

  10. [Psychophysiological mechanisms involved in the affective regulation and food restriction of women at risk of suffering from bulimia nervosa].

    Science.gov (United States)

    Rodríguez, Sonia; Mata, José Luis; Moreno, Silvia; Fernández, Maria Carmen; Vila, Jaime

    2007-02-01

    The aim of the study was to explore the effect of visualizing food images under different mood states and food restriction conditions on the emotional modulation of two defense reflexes (startle reflex and cardiac defense). 72 women at risk of suffering from bulimia nervosa were assigned to two groups: 1) a group under induced positive, neutral, or negative mood state and, 2) a 6-hour-food-deprived group or a non-deprived group. Second-by-second heart rate and electromyogram activity from the orbiculari oculi region were recorded after the auditory stimulus. The results showed that, while viewing food images, non-deprived women under negative mood state potentiated the cardiac defense response and the startle motor reflex. Results are discussed in the context of emotional eating theories and Peter Lang's motivational priming model. PMID:17295980

  11. Bulimia nervosa and its relation to voice changes in young adults: A simple review of epidemiology, complications, diagnostic criteria and management

    OpenAIRE

    Kingston Rajiah; Mathew, Elizabeth M.; Veettil, Sajesh K; Suresh Kumar

    2012-01-01

    Background: Bulimia nervosa (BN) is a type of feeding disorder that starts in adolescence and presents a variety of symptoms, recurrent vomiting in the oral cavity that may reach down to the larynx - similarly to gastro-esophageal reflux, causing laryngeal and voice disorder alterations. Objective: These studies aimed at surveying the literature and investigate the studies that considered BN a risk factor for voice disorders and its epidemiology, complications, diagnostic criteria, and manage...

  12. Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self-Esteem Among Treatment-Seeking Adolescents with Bulimia Nervosa

    OpenAIRE

    Fitzsimmons-Craft, Ellen E.; Ciao, Anna C.; Accurso, Erin C.; Pisetsky, Emily M.; Peterson, Carol B.; Byrne, Catherine E.; le Grange, Daniel

    2014-01-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa (BN). We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variabl...

  13. Physiological and Brain Activity After a Combined Cognitive Behavioral Treatment Plus Video Game Therapy for Emotional Regulation in Bulimia Nervosa: A Case Report

    OpenAIRE

    Fagundo, Ana Beatriz; Via, Esther; Sánchez, Isabel; Jiménez-Murcia, Susana; Forcano, Laura; Soriano-Mas, Carles; Giner-Bartolomé, Cristina; Santamaría, Juan J.; Ben-Moussa, Maher; Konstantas, Dimitri; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Lems, Peter; Cardoner, Narcís

    2014-01-01

    Background PlayMancer is a video game designed to increase emotional regulation and reduce general impulsive behaviors, by training to decrease arousal and improve decision-making and planning. We have previously demonstrated the usefulness of PlayMancer in reducing impulsivity and improving emotional regulation in bulimia nervosa (BN) patients. However, whether these improvements are actually translated into brain changes remains unclear. Objective The aim of this case study was to report on...

  14. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study

    OpenAIRE

    Giner-Bartolomé, Cristina; Fagundo, Ana B.; Sánchez, Isabel; Jiménez-Murcia, Susana; Santamaría, Juan J.; Ladouceur, Robert; Menchón, José M.; Fernández-Aranda, Fernando

    2015-01-01

    Background: Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional in...

  15. Bulimia nervosa and its relation to voice changes in young adults: A simple review of epidemiology, complications, diagnostic criteria and management

    Directory of Open Access Journals (Sweden)

    Kingston Rajiah

    2012-01-01

    Full Text Available Background: Bulimia nervosa (BN is a type of feeding disorder that starts in adolescence and presents a variety of symptoms, recurrent vomiting in the oral cavity that may reach down to the larynx - similarly to gastro-esophageal reflux, causing laryngeal and voice disorder alterations. Objective: These studies aimed at surveying the literature and investigate the studies that considered BN a risk factor for voice disorders and its epidemiology, complications, diagnostic criteria, and management. Materials and Methods: A review of the literature was done based on a survey of BIOMED CENTRAL and COCHRANE @ OVID databases, which are linked to the IMU ezproxy virtual library (http://ezp.imu.edu.my/menu. The keywords "bulimia nervosa", "teenage complications" and "voice changes" were used. Citations with summaries were chosen to limit the topic, for the period between 2000 and 2010, in English. Results: Of the ninety three papers we found, twenty three were used as a basis for this review. Among them, only three discuss BN as an etiology factor associated with voice changes in adult women, and we did not find any paper associating this with bulimic teenagers. Conclusion: It is necessary to observe laryngeal and vocal signs and symptoms associated with BN, especially in teenagers whose voices are going through a period of change. The contribution of this type of investigation, which should begin with a clinical history, is essential for minimizing the complications of bulimia nervosa. Thus, adolescents and adults with voice disorders should be investigated in greater detail.

  16. A bulimia nervosa como fator de risco para distúrbios da voz: artigo de revisão Bulimia nervosa as a risk factor for voice disorders: literature review

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    Patricia Balata

    2008-06-01

    Full Text Available A bulimia nervosa é um tipo de transtorno alimentar que tem início na adolescência e que apresenta uma variedade de sintomas, dentre estes, os episódios recorrentes de vômitos que acometem a cavidade oral, podendo alcançar a laringe de forma semelhante ao refluxo gastroesofágico, ocasionando alterações laríngeas e distúrbios na voz. OBJETIVO: Este trabalho teve como objetivo investigar através da revista da literatura os estudos que relacionassem a BN como fator de risco para os distúrbios da voz. RESULTADOS: Dos noventa e três artigos levantados, vinte e três foram usados como base para esta revisão, dentre os quais, apenas três referem-se à BN com fator etiológico de alterações na voz em mulheres adultas, não sendo encontrado nenhum trabalho referindo esta relação em adolescentes bulímicos. CONCLUSÃO: Faz-se necessária a observância de sinais e sintomas laríngeos e vocais que possam estar relacionados à BN, em especial nos adolescentes cuja voz passa por significativas mudanças quando do período da muda vocal.Bulimia nervosa (BN is a type of feeding disorder that starts in adolescence and presents a variety of symptoms, recurrent vomiting in the oral cavity that may reach down to the larynx - similarly to gastro-esophageal reflux, causing laryngeal and voice disorder alterations. AIM: These studies aimed at surveying the literature and investigate the studies that considered BN a risk factor for voice disorders. RESULTS: of the ninety three papers we found, twenty-three were used as a basis for this review, among them, only three discuss BN as an etiology factor associated with voice changes in adult women, and we did not find any paper associating this with bulimic teenagers. CONCLUSION: It is necessary to observe laryngeal and vocal signs and symptoms associated with BN, especially in teenagers whose voices are going through a period of change.

  17. Reduced resting state functional connectivity of the somatosensory cortex predicts psychopathological symptoms in women with bulimia nervosa

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    Luca eLavagnino

    2014-08-01

    Full Text Available BackgroundAlterations in the resting state functional connectivity (rs-FC of several brain networks have been demonstrated in eating disorders. However, very few studies are currently available on brain network dysfunctions in bulimia nervosa (BN. The somatosensory network is central in processing body-related stimuli and it may be altered in BN. The present study therefore aimed to investigate rs-FC in the somatosensory network in bulimic women. MethodsSixteen medication-free women with BN (age=23±5 years and 18 matched controls (age=23±3 years underwent a functional magnetic resonance resting state scan and assessment of eating disorder symptoms. Within-network and seed-based functional connectivity analyses were conducted to assess rs-FC within the somatosensory network and to other areas of the brain. ResultsBN patients showed a decreased resting state functional connectivity both within the somatosensory network (t=9.0, df=1, P=0.005 and with posterior cingulate cortex (PCC and two visual areas (the right middle occipital gyrus and the right cuneus(P=0.05 corrected for multiple comparison. The region in the right middle occipital gyrus is implicated in body processing and is known as extrastriate body area, or EBA. The rs-FC of the left paracentral lobule with the EBA correlated with psychopathology measures like bulimia (r=-0.4; P=0.02 and interoceptive awareness (r=-0.4; P=0.01. Analyses were conducted using age, BMI (body mass index and depressive symptoms as covariates. ConclusionsOur findings show a specific alteration of the rs-FC of the somatosensory cortex in BN patients, which correlates with eating disorder symptoms. The connectivity between the somatosensory cortex and the EBA might be related to dysfunctions in body image processing. The results should be considered preliminary due to the small sample size.

  18. Compulsão alimentar e bulimia nervosa em praticantes de exercício físico

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    Cláudia Raulino Tramontt

    2014-10-01

    Full Text Available INTRODUÇÃO: Estudos nacionais mostram variações na prevalência de compulsão alimentar entre 14,9 a 18,1%, enquanto a bulimia nervosa (BN apresenta-se em torno de 1 a 3,6%. Indivíduos que apresentam transtornos alimentares procuram espaços onde o exercício físico é estimulado e assim mascaram características da doença, exercitando-se compulsivamente após um episódio de compulsão alimentar. OBJETIVO: Identificar a prevalência de transtorno da compulsão alimentar periódica (TCAP e bulimia nervosa em praticantes de exercício físico associando ao estado nutricional, modalidade, frequência, duração e objetivo da prática do exercício físico. MÉTODOS: Estudo transversal composto por 103 indivíduos maiores de 18 anos com idade média de 37,7 (DP±15,6 anos, de ambos os sexos, praticantes de exercício físico há pelo menos três meses ininterruptos antes do início da pesquisa. Para análise da prevalência de TCAP e BN foi utilizado o Questionário sobre Alimentação e Peso (QEWP-R e um questionário específico sobre exercício físico. O estado nutricional foi classificado conforme o IMC. RESULTADOS: A prevalência de TCAP entre os indivíduos praticantes de exercício físico foi de 0,97%. Houve associação entre valores de IMC mais alto (p=0,026, idade menor (para TCAP p=0,036, BN p=0,01 e objetivo da prática de exercício físico declarado "estética" (para TCAP p=0,011 e BN p=0,043 com maiores pontuações nos escores de TCAP e BN. CONCLUSÃO: A prevalência de TCAP e BN encontrada neste estudo está de acordo com o referido na literatura internacional. Não foram encontradas associações entre compulsão alimentar e maior frequência de exercício físico.

  19. Reciprocal associations between negative affect, binge eating, and purging in the natural environment in women with bulimia nervosa.

    Science.gov (United States)

    Lavender, Jason M; Utzinger, Linsey M; Cao, Li; Wonderlich, Stephen A; Engel, Scott G; Mitchell, James E; Crosby, Ross D

    2016-04-01

    Although negative affect (NA) has been identified as a common trigger for bulimic behaviors, findings regarding NA following such behaviors have been mixed. This study examined reciprocal associations between NA and bulimic behaviors using real-time, naturalistic data. Participants were 133 women with bulimia nervosa (BN) according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders who completed a 2-week ecological momentary assessment protocol in which they recorded bulimic behaviors and provided multiple daily ratings of NA. A multilevel autoregressive cross-lagged analysis was conducted to examine concurrent, first-order autoregressive, and prospective associations between NA, binge eating, and purging across the day. Results revealed positive concurrent associations between all variables across all time points, as well as numerous autoregressive associations. For prospective associations, higher NA predicted subsequent bulimic symptoms at multiple time points; conversely, binge eating predicted lower NA at multiple time points, and purging predicted higher NA at 1 time point. Several autoregressive and prospective associations were also found between binge eating and purging. This study used a novel approach to examine NA in relation to bulimic symptoms, contributing to the existing literature by directly examining the magnitude of the associations, examining differences in the associations across the day, and controlling for other associations in testing each effect in the model. These findings may have relevance for understanding the etiology and/or maintenance of bulimic symptoms, as well as potentially informing psychological interventions for BN. PMID:26692122

  20. The emotional and attentional impact of exposure to one's own body in bulimia nervosa: a physiological view.

    Directory of Open Access Journals (Sweden)

    Blanca Ortega-Roldán

    Full Text Available Body dissatisfaction is the most relevant body image disturbance in bulimia nervosa (BN. Research has shown that viewing one's own body evokes negative thoughts and emotions in individuals with BN. However, the psychophysiological mechanisms involved in this negative reaction have not yet been clearly established. Our aim was to examine the emotional and attentional processes that are activated when patients with BN view their own bodies.We examined the effects of viewing a video of one's own body on the physiological (eye-blink startle, cardiac defense, and skin conductance and subjective (pleasure, arousal, and control ratings responses elicited by a burst of 110 dB white noise of 500 ms duration. The participants were 30 women with BN and 30 healthy control women. The experimental task consisted of two consecutive and counterbalanced presentations of the auditory stimulus preceded, alternatively, by a video of the participant's own body versus no such video.The results showed that, when viewing their own bodies, women with BN experienced (a greater inhibition of the startle reflex, (b greater cardiac acceleration in the first component of the defense reaction, (c greater skin conductance response, and (d less subjective pleasure and control combined with greater arousal, compared with the control participants.Our findings suggest that, for women with BN, peripheral-physiological responses to self-images are dominated by attentional processes, which provoke an immobility reaction caused by a dysfunctional negative response to their own body.

  1. A review of the father-child relationship in the development and maintenance of adolescent anorexia and bulimia nervosa.

    Science.gov (United States)

    Gale, Christopher J; Cluett, Elizabeth R; Laver-Bradbury, Cathy

    2013-01-01

    There are disproportionately fewer studies examining the role of the father in the development of child and adolescent psychopathology. This is pertinent in the field of eating disorders, where there is a wealth of research related to family influences and the value of family-based interventions. This article reviews the key themes within the literature around the potential impact of the father-child relationship on the development and maintenance of Anorexia and Bulimia Nervosa in young people. The critical review searched relevant health and social care databases, as well as manually searching key journals in the eating disorder field. In these results, 13 studies met the inclusion/exclusion criteria and were critiqued, with 8 being taken forward for discussion. The 8 studies identified key themes within the relationship of the father and child (particularly daughters) around conflict and communication, parental protection and psychological control, emotional regulation and self-esteem, and self-perfectionism. All of these factors appear to influence the child's level of self-determining autonomy, which in turn can impact maladaptive eating attitudes and psychopathology. Tentative recommendations are made around working with fathers to encourage free expression of ideas and foster a sense of autonomy through compromise and collaboration with their adolescent child. Further research around these themes in relation to other family members is also suggested. PMID:23597275

  2. CBT4BN versus CBTF2F: comparison of online versus face-to-face treatment for bulimia nervosa.

    Science.gov (United States)

    Bulik, Cynthia M; Marcus, Marsha D; Zerwas, Stephanie; Levine, Michele D; Hofmeier, Sara; Trace, Sara E; Hamer, Robert M; Zimmer, Benjamin; Moessner, Markus; Kordy, Hans

    2012-09-01

    Cognitive-behavioral therapy (CBT) is currently the "gold standard" for treatment of bulimia nervosa (BN), and is effective for approximately 40-60% of individuals receiving treatment; however, the majority of individuals in need of care do not have access to CBT. New strategies for service delivery of CBT and for maximizing maintenance of treatment benefits are critical for improving our ability to treat BN. This clinical trial is comparing an Internet-based version of CBT (CBT4BN) in which group intervention is conducted via therapeutic chat group with traditional group CBT (CBTF2F) for BN conducted via face-to-face therapy group. The purpose of the trial is to determine whether manualized CBT delivered via the Internet is not inferior to the gold standard of manualized group CBT. In this two-site randomized controlled trial, powered for non-inferiority analyses, 180 individuals with BN are being randomized to either CBT4BN or CBTF2F. We hypothesize that CBT4BN will not be inferior to CBTF2F and that participants will value the convenience of an online intervention. If not inferior, CBT4BN may be a cost-effective approach to service delivery for individuals requiring treatment for BN. PMID:22659072

  3. Specificity of psychological treatments for bulimia nervosa and binge eating disorder? A meta-analysis of direct comparisons.

    Science.gov (United States)

    Spielmans, Glen I; Benish, Steven G; Marin, Catherine; Bowman, Wesley M; Menster, Maria; Wheeler, Anthony J

    2013-04-01

    Treatment guidelines state that cognitive-behavioral therapy (CBT) and interpersonal therapy are the best-supported psychotherapies for bulimia nervosa (BN) and that CBT is the preferred psychological treatment for binge eating disorder (BED). However, no meta-analysis which both examined direct comparisons between psychological treatments for BN and BED and considered the role of moderating variables, such as the degree to which psychotherapy was bona fide, has previously been conducted Thus, such an analysis was undertaken. We included 77 comparisons reported in 53 studies. The results indicated that: (a) bona fide therapies outperformed non-bona fide treatments, (b) bona fide CBT outperformed bona fide non-CBT interventions by a statistically significant margin (only approaching statistical significance for BN and BED when examined individually), but many of these trials had confounds which limited their internal validity, (c) full CBT treatments offered no benefit over their components, and (d) the distribution of effect size differences between bona fide CBT treatments was homogeneously distributed around zero. These findings provide little support for treatment specificity in psychotherapy for BN and BED. PMID:23454220

  4. An examination of affect prior to and following episodes of getting drunk in women with bulimia nervosa.

    Science.gov (United States)

    Pisetsky, Emily M; Crosby, Ross D; Cao, Li; Fitzsimmons-Craft, Ellen E; Mitchell, James E; Engel, Scott G; Wonderlich, Stephen A; Peterson, Carol B

    2016-06-30

    The current study examined the association between affect and self-reported alcohol intoxication in women with bulimia nervosa (BN; N=133). Participants completed a two-week ecological momentary assessment protocol. Momentary global positive affect (PA) and negative affect (NA), as well as the facets of NA (fear, guilt, hostility and sadness), were measured. Forty-five participants endorsed that they "got drunk" during the study period. Daily mean and variability of global PA and NA were compared between days with self-reported alcohol intoxication and days without self-reported alcohol intoxication. Trajectories of affect were modeled prior to and following episodes of self-reported alcohol intoxication. There were no differences in the mean or variability of PA or NA on days characterized by self-reported alcohol intoxication compared to days with no self-reported alcohol intoxication (ps>0.05). PA decreased significantly prior to self-reported alcohol intoxication and remained stable afterwards. There were no changes in global NA before or after self-reported alcohol intoxication, but an examination of the facets of NA showed that sadness increased following episodes of self-reported alcohol intoxication. These findings showed only partial support for a negative reinforcement model of alcohol use in women with BN. PMID:27111214

  5. Identificação de distúrbios da imagem corporal e comportamentos favoráveis ao desenvolvimento da bulimia nervosa em adolescentes de uma Escola Pública do Ensino Médio de Maringá, Estado do Paraná = Identifying body image disorders and behaviors leading to the development of bulimia nervosa in adolescents from a Public High School in Maringá, Paraná State

    Directory of Open Access Journals (Sweden)

    Alice Maria de Souza-Kaneshima

    2008-07-01

    Full Text Available Ciente da importância de estudos de transtornos alimentares em adolescentes, este trabalho identificou a ocorrência de distúrbios da imagem corporal e de bulimia nervosa, em 187 adolescentes. Pelo Body Shape Questionnaire (BSQ, foi demonstrado que 48,13% dos adolescentes apresentaram distúrbios de imagem corporal. A aplicação do Teste de Investigação Bulímica de Edimburgo (BITE demonstrou que 3,74 e 39,04% dos adolescentes apresentaram alto e médio grau de desordem alimentar, respectivamente. Na subescala de gravidade do BITE, verificou-se que 2,67 e 7,49% dos adolescentes apresentaram gravidade alta e moderada de bulimia nervosa. Os resultados demonstram alguns adolescentes com atitudes e comportamentos que favorecem o desenvolvimento da bulimia nervosa, devido à percepção distorcida da própria imagem corporal. Portanto, são necessárias campanhas educacionais para esclarecer que o culto ao corpo está associado a graves transtornos alimentares.Conscious of the importance of studying eating disorders inadolescents, this work identified the onset of body image disorders and bulimia nervosa in 187 adolescents. Using the Body Shape Questionnaire (BSQ, it was shown that 48.13% of adolescents displayed body image disorders. The application of the Bulimic Investigatory Test, Edinbugh (BITE demonstrated that 3.74 and 39.04% of adolescents presented a high or medium level of eating disorder, respectively. In the subscale of BITE severity, it was detected that 2.67 and 7.49% of adolescents showed high and moderated gravity of bulimia nervosa. The results revealed some adolescents with attitudes and behaviors that favor the development of bulimia nervosa, due to a distorted perception of their body image. Therefore, educational campaigns are necessary to clarify that the cult of the body is associated with serious eating disorders.

  6. Atitudes em relação ao corpo e à alimentação de pacientes com anorexia e bulimia nervosa

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    Aline Cavalcante de Souza

    2014-03-01

    Full Text Available Objetivo: Avaliar como se relacionam as atitudes alimentares e corporais de pacientes com anorexia ou bulimia nervosa. Métodos: Pacientes adultas de um ambulatório especializado, com diagnóstico de anorexia (n = 48 ou bulimia nervosa (n = 58, responderam à Disordered Eating Attitude Scale (DEAS para avaliação das atitudes alimentares e ao Body Attitude Questionnaire (BAQ para atitudes corporais – ambos traduzidos e validados para mulheres jovens do Brasil. A correlação entre os escores da DEAS e do BAQ foi avaliada utilizando o coeficiente de Pearson. Modelos de regressão linear testaram preditores para atitudes alimentares e corporais. Resultados: Pacientes com bulimia apresentam relação com o alimento mais disfuncional – subescala 1 da DEAS (p 0,6 para ambas apenas quando se analisou a relação com o alimento e o sentir-se gorda e entre atitudes corporais como um todo e a relação com o alimento. O escore total da DEAS foi preditor da BAQ total: cada um ponto na DEAS aumenta 0,788 na BAQ (R2 = 0,628. Conclusão: Pacientes com bulimia apresentam pior relação com o alimento e piores atitudes corporais. As atitudes corporais se correlacionaram com as atitudes alimentares, de maneira mais forte para pacientes com anorexia; atitudes alimentares mais disfuncionais predizem pior relação com o corpo para ambos os diagnósticos.

  7. Stigma towards Eating Disorders in Italian Students (STEaDIS): Studio osservazionale delle opinioni sull’Anoressia e la Bulimia Nervosa in un campione di studenti universitari italiani

    OpenAIRE

    Caslini,

    2015-01-01

    Razionale: La richiesta di cure per l’anoressia (AN) e la bulimia nervosa (BN) rimane bassa rispetto alla diffusione dei disturbi nonostante la disponibilità di trattamenti e l’associazione tra una buona prognosi e la precocità delle cure: una delle motivazioni alla base del problema è insita nelle paure generate dalle credenze e dagli atteggiamenti stigmatizzanti verso i disturbi del comportamento alimentare (DCA). Lo stigma per i disturbi psichiatrici è un fenomeno radicato nella società, d...

  8. [Review of certain conceptions on eating disorders. Suggestions on psychotherapy for women with anorexia and bulimia nervosa (the authors' own experience)].

    Science.gov (United States)

    Izydorczyk, Bernadetta; Czekaj, Barbara

    2006-01-01

    The article is a review of the selected theoretical concepts of eating disorder etiological factors and the authors' experience in the field of psychotheraphy of women with anorexia and bulimia nervosa. The authors describe various psychological and psychoanalytical concepts, for instance the theory of object relations by R. Spitz, D. Winnicott and H. Bruch's the theory of development. They indicate the importance of primary mother-child relations in the genesis of eating disorders as well as the process of the child's separation, his becoming independent and the basis of forming the child's attitude towards eating. They also show the difficulties during the course of psychotherapy for women with eating disorders. PMID:16756029

  9. Plasma intact fibroblast growth factor 23 levels in women with bulimia nervosa: A cross-sectional pilot study

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    Yoshiuchi Kazuhiro

    2011-06-01

    Full Text Available Abstract Fibroblast growth factor (FGF 23, a circulating 26-kDa peptide produced by osteogenic cells, is a novel phosphaturic factor. In our previous study, binge-eating/purging type anorexia nervosa (AN-BP patients had elevated plasma intact FGF23 (iFGF23 levels, while restricting type (AN-R patients had plasma iFGF23 levels similar to healthy controls. Although bulimia nervosa (BN patients as well as some patients with AN-BP regularly engage in binge eating, there have been no studies regarding plasma iFGF23 levels in BN patients. Therefore, this study was performed to determine plasma iFGF23 concentrations in BN patients and healthy controls. The study population consisted of 13 female BN patients and 11 healthy female controls. Blood samples were collected from all subjects after overnight fasting. Plasma iFGF23 was measured using an ELISA kit in a cross-sectional manner. The two-tailed Mann-Whitney U-test was used to assess differences between BN patients and healthy controls. In addition, BN patients were divided into two groups based on questionnaire-reported binge eating frequency immediately prior to participation in this study: high frequency of binge eating (once a week or more; HF group; n = 8 and low frequency of binge eating (less than once a week; LF group; n = 5. Two-tailed Mann-Whitney U-test with Bonferroni's correction was performed after the Kruskal-Wallis test to assess differences between HF group, LF group, and healthy controls. Median (quartiles plasma iFGF23 levels were greater in BN patients (35.5 [14.8-65.0] pg/ml than in controls (3.8 [not detected-5.3] pg/ml; p = 0.002. In addition, median (quartiles plasma iFGF23 levels were greater in the HF group (62.3 [44.4-73.4] pg/ml than in controls (p

  10. Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

    OpenAIRE

    Huurne, E.D. ter; Postel, M.G.; Haan, H.A. de; Jong, C.A.J. de

    2013-01-01

    Background Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet ...

  11. Participation and outcome in manualized self-help for bulimia nervosa and binge eating disorder - a systematic review and metaregression analysis.

    Science.gov (United States)

    Beintner, Ina; Jacobi, Corinna; Schmidt, Ulrike H

    2014-03-01

    There is a growing body of research on manualized self-help interventions for bulimia nervosa (BN) and binge eating disorder (BED). Study and treatment dropout and adherence represent particular challenges in these studies. However, systematic investigations of the relationship between study, intervention and patient characteristics, participation, and intervention outcomes are lacking. We conducted a systematic literature review using electronic databases and hand searches of relevant journals. In metaregression analyses, we analyzed study dropout as well as more specific measures of treatment participation in manualized self-help interventions, their association with intervention characteristics (e.g. duration, guidance, intervention type [bibliotherapy, CD-ROM or Internet based intervention]) and their association with treatment outcomes. Seventy-three publications reporting on 50 different trials of manualized self-help interventions for binge eating and bulimia nervosa published through July 9th 2012 were identified. Across studies, dropout rates ranged from 1% to 88%. Study dropout rates were highest in CD-ROM interventions and lowest in Internet-based interventions. They were higher in samples of BN patients, samples of patients with higher degrees of dietary restraint at baseline, lower age, and lower body mass index. Between 6% and 88% of patients completed the intervention to which they had been assigned. None of the patient, study and intervention characteristics predicted intervention completion rates. Intervention outcomes were moderated by the provision of personal guidance by a health professional, the number of guidance sessions as well as participants' age, BMI, and eating disorder related attitudes (Restraint, Eating, Weight and Shape Concerns) at baseline (after adjusting for study dropout and intervention completion rates). Guidance particularly improved adherence and outcomes in samples of patients with bulimia nervosa; specialist guidance led

  12. Teoria e eficácia da terapia comportamental dialética na bulimia nervosa e no transtorno da compulsão alimentar periódica Theory and efficacy of dialectical behavior therapy of bulimia nervosa and binge eating disorder

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    Rui Alexandre Nunes-Costa

    2009-01-01

    Full Text Available OBJETIVOS: Procura-se analisar as atuais evidências empíricas e teóricas sobre o modo de operar nas intervenções comportamentais dialéticas. Procedeu-se igualmente à análise da eficácia dessa terapia no tratamento da bulimia nervosa e no transtorno da compulsão alimentar periódica. MÉTODO: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave "dialectical behavior therapy", "bulimia nervosa" e "binge eating disorder" nas bases de dados PsycInfo e MedLine e em livros da especialidade, sob o critério da atualidade e premência das publicações levantadas. RESULTADOS: A terapia comportamental dialética, inicialmente desenhada para o transtorno de personalidade borderline, tem-se estendido a outros transtornos do eixo I. Sua aplicação às perturbações alimentares sustentase num paradigma dialético com o recurso das estratégias comportamentais e cognitivas. Esse modelo permite aos pacientes uma regulação mais efetiva dos estados afetivos negativos, reduzindo a probabilidade da ocorrência de comportamentos bulímicos e de compulsão alimentar periódica. CONCLUSÃO: Embora escasseiem estudos sobre a sua eficácia, os resultados existentes parecem comprovar a eficácia da terapia comportamental dialética nas populações descritas.OBJECTIVES: Current theoretical and empirical evidences on how to operate in dialectical behavioral interventions were examined. The effectiveness of these interventions in the treatment of bulimia nervosa and binge eating disorder were analyzed too. METHOD: An aggregative literature review was made, using the keywords "dialectical behavior therapy", "bulimia nervosa" and "binge eating disorder", from the database PsycInfo and MedLine and from reference books, selecting the most representative and recent scientific texts about this psychotherapy model. RESULTS: Dialectical behavior therapy, initially designed for borderline personality disorder, has been extended to other

  13. Subjective and objective binge eating in relation to eating disorder symptomatology, depressive symptoms, and self-esteem among treatment-seeking adolescents with bulimia nervosa.

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E; Ciao, Anna C; Accurso, Erin C; Pisetsky, Emily M; Peterson, Carol B; Byrne, Catherine E; Le Grange, Daniel

    2014-07-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. PMID:24852114

  14. Group Work for Bulimia: A Review of Outcomes.

    Science.gov (United States)

    Zimpfer, David G.

    1990-01-01

    Reviews descriptive and experimental research relating to the eating disorder known as bulimia nervosa. Reviews outcome studies of group treatment of bulimia to examine the effectiveness of group intervention. Provides recommendations for practice and future research. (Author/PVV)

  15. The results of research aimed at identifying psychological predictors of impulsive and restrictive behaviours in a population of females suffering from anorexia or bulimia nervosa – the author’s own research report

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    Izydorczyk, Bernadetta

    2014-06-01

    Full Text Available Aim of the study. The results of research aimed at identifying psychological predictors of impulsive and restrictive behaviours in a population of females suffering from anorexia or bulimia. Subject or material and methods . Eating Disorder Inventory (EDI devised by D. Garner. Clinical group:90 Polish females with bulimia and anorexia, A control group: 121 women, who exhibited no eating disorders. Results . Analysis of the data gathered as a result of this research demonstrated that the females comprising the clinical sample, who exhibited symptoms of bulimia or anorexia displayed inappropriate levels of all emotional and cognitive characteristics. Statistically significant differences were observed between the clinical and control subjects in terms of the variables investigated in the study. Discussion. The data analysis revealed that low interoceptive awareness proved to be a significant predictor of impulsive and restrictive behaviors in anorexia and bulimia. Perfectionism and body dissatisfaction were found to be significant determinants of restrictive behaviors. Whereas, such variables as a tendency towards bulimia and body dissatisfaction emerged as predictive factors for the symptoms of bulimia and bulimia type anorexia. Conclusions . Possibility that a psychological diagnosis of the emotional and cognitive characteristics displayed by females diagnosed with anorexia or bulimia nervosa is likely to facilitate the process of detecting the symptoms which are typical of the particular types of eating disorders, and thus it is a tool that can be useful at the initial stage of treatment, which involves establishing appropriate psychological interventions aimed at eliminating impulsive and restrictive behaviors developed in patients diagnosed with the aforementioned eating disorders.

  16. Experience of cognitive-behavior Therapy in Anorexia Nervosa and Bulimia Nervosa%神经性厌食症及神经性贪食症的认知行为治疗分析

    Institute of Scientific and Technical Information of China (English)

    丁树明; 胡赤怡

    2001-01-01

    Objective To investigate suitable therapy for anorexia nervosa(AN)and bulimia nervosa(BN)and relation between the two kinds of disorders. Methods Using cognitive-behavior therapy(CBT)to treat the four cases. Clinical effects and relative factors were discussed. Results A patient with BN was cured. Another BN was significantly progressed. The symptoms of both patients with AN were improved. Conclusion CBT is surely effective to this two kinds of disorders. The effect of BN is better than AN with CBT.%目的探讨认知行为治疗对神经性厌食症及神经性贪食症的治疗效果及其有关影响因素。方法对符合CCMD-2-R诊断的2例神经性厌食症(AN)与2例神经性贪食症(BN)做认知行为治疗,对治疗效果及相关因素进行分析。结果1例神经性贪食症治愈.另1例显效;2例神经性厌食症好转。结论认知行为治疗对这两种疾患均有肯定的疗效,BN的疗效优于AN。

  17. Bulimia: A Medical Portrait.

    Science.gov (United States)

    Santomango, Gloria Jean

    There are three known diseases of eating disorders: compulsive overeating, anorexia nervosa, and bulimia. All three affect various body systems, are pathological in nature, and are addictive behaviors that mainly affect females. All can be fatal if not treated or under-treated. Compulsive overeating is the most known of the three disorders. The…

  18. Identificação de distúrbios da imagem corporal e comportamentos favoráveis ao desenvolvimento da bulimia nervosa em adolescentes de uma Escola Pública do Ensino Médio de Maringá, Estado do Paraná - DOI: 10.4025/actascihealthsci.v30i2.5986 Identifying body image disorders and behaviors leading to the development of bulimia nervosa in adolescents from a Public High School in Maringá, Paraná State - DOI: 10.4025/actascihealthsci.v30i2.5986

    Directory of Open Access Journals (Sweden)

    Daniele de Pinto Freitas Kneube

    2008-12-01

    Full Text Available Ciente da importância de estudos de transtornos alimentares em adolescentes, este trabalho identificou a ocorrência de distúrbios da imagem corporal e de bulimia nervosa, em 187 adolescentes. Pelo Body Shape Questionnaire (BSQ, foi demonstrado que 48,13% dos adolescentes apresentaram distúrbios de imagem corporal. A aplicação do Teste de Investigação Bulímica de Edimburgo (BITE demonstrou que 3,74 e 39,04% dos adolescentes apresentaram alto e médio grau de desordem alimentar, respectivamente. Na subescala de gravidade do BITE, verificou-se que 2,67 e 7,49% dos adolescentes apresentaram gravidade alta e moderada de bulimia nervosa. Os resultados demonstram alguns adolescentes com atitudes e comportamentos que favorecem o desenvolvimento da bulimia nervosa, devido à percepção distorcida da própria imagem corporal. Portanto, são necessárias campanhas educacionais para esclarecer que o culto ao corpo está associado a graves transtornos alimentares.Conscious of the importance of studying eating disorders in adolescents, this work identified the onset of body image disorders and bulimia nervosa in 187 adolescents. Using the Body Shape Questionnaire (BSQ, it was shown that 48.13% of adolescents displayed body image disorders. The application of the Bulimic Investigatory Test, Edinbugh (BITE demonstrated that 3.74 and 39.04% of adolescents presented a high or medium level of eating disorder, respectively. In the subscale of BITE severity, it was detected that 2.67 and 7.49% of adolescents showed high and moderated gravity of bulimia nervosa. The results revealed some adolescents with attitudes and behaviors that favor the development of bulimia nervosa, due to a distorted perception of their body image. Therefore, educational campaigns are necessary to clarify that the cult of the body is associated with serious eating disorders.

  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. Contribution of the serotoninergic system to anxious and depressive traits that may be partially responsible for the phenotypical variability of bulimia nervosa.

    Science.gov (United States)

    Ribasés, Marta; Fernández-Aranda, Fernando; Gratacòs, Mònica; Mercader, Josep M; Casasnovas, Carolina; Núñez, Araceli; Vallejo, Julio; Estivill, Xavier

    2008-01-01

    Eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN), are complex psychiatric phenotypes influenced by both genetic and environmental factors. We investigated the genetic contribution of four single nucleotide polymorphisms (SNPs) within the serotonin receptor 5HT2C and two sequence variants within the serotonin transporter SLC6A4 to different ED-related psychopathological symptoms in a total sample of 82 ED patients. All patients were diagnosed according to DSM-IV criteria and underwent diagnostic and psychopathological assessments by means of structured clinical interviews and rating scales. We detected significant evidence of association between the -995A/-759T/-697C/Cys23 haplotype of the 5HT2C gene and different anxious and depressive subscales of the SCL90-R instrument, that included Somatization (p = 0.029), Obsessive-Compulsiveness (p = 0.021), Depression (p = 0.032), Anxiety (p = 0.004), Hostility (p = 0.028), Phobic Anxiety (p = 0.029) and Paranoid Ideation (p = 0.008), in BN patients. We also observed a strong association between the 5HTTLPR polymorphism of the SLC6A4 gene and Anxiety in the same group of BN patients (p = 0.004). However, no epistatic effects between the 5HT2C and SLC6A4 genes on the different anxious and depressive subscales were observed. Our preliminary data suggest that the serotoninergic system contributes to the different psychopathological symptoms that may be partially responsible for the phenotypical variability within the bulimic phenotype. PMID:17055531

  1. Repetitive Transcranial Magnetic Stimulation Changes Cerebral Oxygenation on the Left Dorsolateral Prefrontal Cortex in Bulimia Nervosa: A Near-Infrared Spectroscopy Pilot Study.

    Science.gov (United States)

    Sutoh, Chihiro; Koga, Yasuko; Kimura, Hiroshi; Kanahara, Nobuhisa; Numata, Noriko; Hirano, Yoshiyuki; Matsuzawa, Daisuke; Iyo, Masaomi; Nakazato, Michiko; Shimizu, Eiji

    2016-01-01

    Previous studies showed that food craving in eating disorders can be weakened with high-frequency repetitive transcranial magnetic stimulation (rTMS) on the left dorsolateral prefrontal cortex (DLPFC). The aims of this study were to assess cerebral oxygenation change induced with rTMS and to assess the short-term impact of rTMS on food craving and other bulimic symptoms in patients with bulimia nervosa (BN). Eight women diagnosed with BN according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria participated in this study. We measured haemoglobin concentration changes in the DLPFC with near-infrared spectroscopy during cognitive tasks measuring self-regulatory control in response to food photo stimuli, both at baseline and after a single session of rTMS. Subjective ratings for food cravings demonstrated significant reduction. A significant decrease in cerebral oxygenation of the left DLPFC was also observed after a single session of rTMS. Measurement with NIRS after rTMS intervention may be applicable for discussing the mechanisms underlying rTMS modulation in patients with BN. PMID:26481583

  2. Interaction of the BcII glucocorticoid receptor polymorphism and childhood abuse in Bulimia Nervosa (BN): relationship to BN and to associated trait manifestations.

    Science.gov (United States)

    Steiger, Howard; Gauvin, Lise; Joober, Ridha; Israel, Mimi; Badawi, Guilaine; Groleau, Patricia; Bruce, Kenneth R; Yin Kin, N M K Ng; Sycz, Lindsay; Ouelette, Anne Sophie

    2012-02-01

    We recently documented a gene-environment interaction suggesting that individuals with Bulimia Nervosa (BN) differed from normal eaters as to the combined presence of the low-function allele of the glucocorticoid receptor polymorphism, BcII, and childhood abuse. The present study examined the extent to which any such interaction effect may have been attributable to behavioral impulsivity, sensation seeking, affective instability or depression. We had 174 bulimic and 130 nonbulimic women provide blood for genetic assays, and measured psychopathological traits and childhood abuse using structured interviews and self-report questionnaires. As expected, we observed a significant BcII × abuse interaction indicating genetic and environmental susceptibilities to co-occur significantly more often in bulimic than in nonbulimic individuals. The BcII × abuse interaction was attenuated when levels of depression were accounted for, but was surprisingly unaffected by controls for motoric impulsivity, sensation seeking or affective instability. Our findings suggest that stress-induced alterations in glucocorticoid sensitivity contribute to BN and depressive disturbances--without being associated with the behavioral/affective dysregulation seen in many BN sufferers. We discuss theoretical and clinical implications of these observations. PMID:22088926

  3. Client attachment in a randomized clinical trial of psychoanalytic and cognitive-behavioral psychotherapy for bulimia nervosa: Outcome moderation and change.

    Science.gov (United States)

    Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig; Lunn, Susanne

    2016-06-01

    In the context of a randomized clinical trial of psychoanalytic psychotherapy (PPT) versus cognitive behavior therapy (CBT) for bulimia nervosa (BN), this study performed secondary analyses of (a) the relation between attachment and pretreatment symptom levels, (b) whether client pretreatment attachment moderated treatment outcome, (c) whether change in client attachment was associated with symptomatic change, and (d) whether client attachment changed differently in the 2 treatments. Sixty-nine women and 1 man of a mean age of 25.8 years diagnosed with BN were randomly assigned to either 2 years of weekly PPT or 5 months of CBT. Assessments at intake, after 5 months, and after 2 years included the Eating Disorder Examination to assess eating disorder symptoms, the Adult Attachment Interview to assess client attachment, and the Symptom Checklist 90-R to assess general psychiatric distress. Repeated measures were analyzed using multilevel analysis. Higher scores on attachment insecurity and attachment preoccupation were associated with more frequent binging pretreatment. Pretreatment attachment did not predict treatment outcome. In PPT, but not in CBT, reduction of binging was associated with an increase in attachment security. The 2 treatment types were not associated with significantly different patterns of attachment-related change. Degree and type of attachment insecurity is related to the frequency of binging in BN. Increase in attachment security may be a treatment-specific mechanism of change in PPT for BN. (PsycINFO Database Record PMID:26950692

  4. Psychological and Social Mechanism and Intervention of Anorexia Nervosa and Bulimia Nervosa%神经性厌食症与贪食症心理社会机制及干预

    Institute of Scientific and Technical Information of China (English)

    潘光花

    2015-01-01

    神经性厌食症与贪食症是常见的进食障碍。为更好地了解其发病机制,从心理社会因素以及治疗预防等方面对这两类进食障碍进行了分析。研究内容包括心理社会因素以及预防干预分析。研究结果发现,病理性怕胖是两者发病的主要心理因素,追求苗条是其发病的主要社会文化因素,两者都可采用心理药物治疗相结合的方式进行干预,同时运用社会预防和健康教育。%Anorexia nervosa and bulimia nervosa are common eating disorders.To understand them better,this paper analyzed these two types of eating disorders from psychological and social factors and prevention and treat-ment.The research contents included the analysis of psychological and social factors and preventive intervention.We found that pathological fear of fat was the main psychological factors of the incidence of these two eating disorders, the pursuit of slim was a major social and cultural factor of the pathogenesis.The intervention measures of these both disorders were the combination of psychological therapy and drug therapy,meanwhile,social prevention and health education should be used.

  5. 神经性厌食症与贪食症心理社会机制及干预%Psychological and Social Mechanism and Intervention of Anorexia Nervosa and Bulimia Nervosa

    Institute of Scientific and Technical Information of China (English)

    潘光花

    2015-01-01

    神经性厌食症与贪食症是常见的进食障碍。为更好地了解其发病机制,从心理社会因素以及治疗预防等方面对这两类进食障碍进行了分析。研究内容包括心理社会因素以及预防干预分析。研究结果发现,病理性怕胖是两者发病的主要心理因素,追求苗条是其发病的主要社会文化因素,两者都可采用心理药物治疗相结合的方式进行干预,同时运用社会预防和健康教育。%Anorexia nervosa and bulimia nervosa are common eating disorders.To understand them better,this paper analyzed these two types of eating disorders from psychological and social factors and prevention and treat-ment.The research contents included the analysis of psychological and social factors and preventive intervention.We found that pathological fear of fat was the main psychological factors of the incidence of these two eating disorders, the pursuit of slim was a major social and cultural factor of the pathogenesis.The intervention measures of these both disorders were the combination of psychological therapy and drug therapy,meanwhile,social prevention and health education should be used.

  6. Choosing Assessment Instruments for Bulimia Practice and Outcome Research

    Science.gov (United States)

    Sandberg, Katie; Erford, Bradley T.

    2013-01-01

    Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using…

  7. Recurrent Acute Pancreatitis in Anorexia and Bulimia

    OpenAIRE

    Marti JL; Herring S; Stephenson KE; Morris LG

    2004-01-01

    CONTEXT: Mild pancreatitis has been reported as a consequence of anorexia nervosa, bulimia nervosa, or what has been termed the "dietary chaos syndrome". Either chronic malnutrition, or refeeding after periods of malnutrition, may precipitate acute pancreatitis through several pathogenetic mechanisms. CASE REPORT: A 26-year-old woman with a ten-year history of anorexia and bulimia presented with a third episode of acute pancreatitis in three months. The patient had been abstinent from alcohol...

  8. Bulimia Nervosa und Binge Eating Disorder unter extrem adipösen Jugendlichen, und Prädiktoren des Langzeiterfolgs einer konventionellen stationären Langzeittherapie von extremer Adipositas im Jugendalter

    OpenAIRE

    Mieg, Susanne

    2005-01-01

    Inhaltsverzeichnis 1 Einleitung 5 1.1 Beschreibung des Krankheitsbildes 7 1.1.1 Was ist eine Essstörung ? 7 1.1.2 Historische Gesichtspunkte 9 1.1.3 Klinisches Bild 10 1.1.3.1 Essattacken (Binge Eating) 10 1.1.3.2 Gegensteuernde Maßnahmen 13 1.1.3.3 Weitere medizinische Aspekte/Komplikationen 15 1.1.4 Klassifikation und Diagnose 18 1.1.4.1 Diagnosekriterien für Bulimia Nervosa und Binge Eating Disorder 18 1.1.4.2 Atypische Essstör...

  9. A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: results from the WHO World Mental Health Surveys.

    Science.gov (United States)

    Kessler, R C; Shahly, V; Hudson, J I; Supina, D; Berglund, P A; Chiu, W T; Gruber, M; Aguilar-Gaxiola, S; Alonso, J; Andrade, L H; Benjet, C; Bruffaerts, R; de Girolamo, G; de Graaf, R; Florescu, S E; Haro, J M; Murphy, S D; Posada-Villa, J; Scott, K; Xavier, M

    2014-03-01

    Background. Cross-national population data from the WHO World Mental Health surveys are used to compare role attainments and role impairments associated with binge-eating disorder (BED) and bulimia nervosa (BN). Methods. Community surveys assessed 23 000 adults across 12 countries for BED, BN and ten other DSM-IV mental disorders using the WHO Composite International Diagnostic Interview. Age-of-onset was assessed retrospectively. Ten physical disorders were assessed using standard conditions checklists. Analyses examined reciprocal time-lagged associations of eating disorders (EDs) with education, associations of early-onset (i.e., prior to completing education) EDs with subsequent adult role attainments and cross-sectional associations of current EDs with days of role impairment. Results. BED and BN predicted significantly increased education (females). Student status predicted increased risk of subsequent BED and BN (females). Early-onset BED predicted reduced odds of current (at time of interview) marriage (females) and reduced odds of current employment (males). Early-onset BN predicted increased odds of current work disability (females and males). Current BED and BN were both associated with significantly increased days of role impairment (females and males). Significant BED and BN effects on adult role attainments and impairments were explained by controls for comorbid disorders. Conclusions. Effects of BED on role attainments and impairments are comparable with those of BN. The most plausible interpretation of the fact that these associations are explained by comorbid disorders is that causal effects of EDs are mediated through secondary disorders. Controlled treatment effectiveness studies are needed to trace out long-term effects of BED-BN on secondary disorders. PMID:24054053

  10. Anorexia Nervosa and Bulima Nervosa Critical Analysis of It's Treatment: Implications and Interventions

    OpenAIRE

    Flourish Itulua-Abumere

    2013-01-01

    The diagnostic consideration of the eating disorders anorexia nervosa and bulimia nervosa has been given much focus over the last two decades than previously, as clinicians have become more aware of the frequency of these disorders and the difficulties associated with their treatment. Anorexia nervosa and bulimia nervosa as known in the DSM-IV as eating disorders are characterized by physically and/or psychologically harmful eating patterns. Although the psychological explanation of what we n...

  11. Bulimia e auto-mutilações

    OpenAIRE

    Miranda, Gilda Cristina Nunes de Paiva

    2012-01-01

    Diversos estudos sugerem uma associação entre Distúrbios Alimentares e Auto-Mutilações. A sua maioria foca principalmente a Anorexia Nervosa, deixando um vazio no que diz respeito à Bulimia Nervosa. Por outro lado, são várias as opiniões que defendem que as Auto-Mutilações ocorrem apenas em doentes com Distúrbio de Personalidade Borderline. Este trabalho de revisão visa preencher a lacuna no que diz respeito à ligação ente a Bulimia Nervosa e Comportamentos Auto-Lesivos, incluindo Comportamen...

  12. Use of the MMPI and MMPI-2 with Persons with Bulimia.

    Science.gov (United States)

    Geslak, Lisa

    The use of the MMPI and MMPI-2 to assist in the understanding of individuals with bulimia nervosa is examined. DSM-IV criteria for diagnosis of bulimia nervosa are reviewed. It is also important to understand the personality variables or psychological correlates associated with this disorder. The structure and history of the MMPI and MMPI-2 are…

  13. 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…

  14. SECCIÓN ABIERTA - 2. INFLUENCIA DE LA ESPIRITUALIDAD EN LOS ESTILOS DE AFRONTAMIENTO DE PACIENTES CON BULIMIA Y ANOREXIA NERVIOSA // INFLUENCE OF SPIRITUALITY IN COPING STYLES OF PATIENTS WITH BULIMIA AND ANOREXIA NERVOSA

    Directory of Open Access Journals (Sweden)

    Marisa Edith Oviedo Romero

    2012-06-01

    Full Text Available Basándose en el supuesto de que la espiritualidad es un factor que podría influir sobre los estilos de afrontamiento de las personas ante situaciones problemáticas, se analizó la influencia de la espiritualidad en el estilo de afrontamiento de pacientes diagnosticadas de anorexia y/o bulimia nerviosa.39 mujeres de Buenos Aires, Entre Ríos, San Luis y Mendoza (Argentina, fueron evaluadas mediante el Cuestionario de Modos de Afrontamiento (WCCL y el Inventario de Sistema de Creencias (SBI–15R.Los resultados mostraron una influencia moderada de la dimensión soporte social religioso (F(1;24= 2,094; p=0,054 en el uso y/o desarrollo del estilo de afrontamiento centrado en la evaluación, no así en los demás estilos, por parte de pacientes diagnosticadas de bulimia y/o anorexia nerviosa.

  15. 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...

  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. [Sweet bulimia, salty bulimia. 2 syndromes].

    Science.gov (United States)

    Vindreau, C; Ginestet, D

    1987-01-01

    We report the psychopathological study of 20 subjects with the Bulimia syndrome (DSM III criteria) specifying affective, emotional state and psychiatric symptoms associated with the eating disorder. Evaluation was made using self-rating questionnaires, anxiety and depression rating scales and specific rating scales for various clinical dimensions (impulsivity and mood). Two groups of subjects differing from one another on their elective appetite and taste for two types of food (sweet versus salty) are distinguished. Clinical characteristics of each group are different: Carbohydrate bulimics are more impulsive, dysphoric, make much greater use of medications, drugs, and alcohol than salted food bulimics do. Patients of the second group are more anxious and emotionally blunted. Anorexia nervosa was more often present in their past. The two groups differ also in their responses to serotoninergic and noradrenergic medications used here in open trial. These results are consistent with literature data on carbohydrate metabolism, impulsivity disorders, depression and cerebral serotonin. PMID:3109875

  18. SECCIÓN ABIERTA - 2. INFLUENCIA DE LA ESPIRITUALIDAD EN LOS ESTILOS DE AFRONTAMIENTO DE PACIENTES CON BULIMIA Y ANOREXIA NERVIOSA // INFLUENCE OF SPIRITUALITY IN COPING STYLES OF PATIENTS WITH BULIMIA AND ANOREXIA NERVOSA

    OpenAIRE

    Marisa Edith Oviedo Romero; Carlos Alexis Chimpén López

    2012-01-01

    Basándose en el supuesto de que la espiritualidad es un factor que podría influir sobre los estilos de afrontamiento de las personas ante situaciones problemáticas, se analizó la influencia de la espiritualidad en el estilo de afrontamiento de pacientes diagnosticadas de anorexia y/o bulimia nerviosa.39 mujeres de Buenos Aires, Entre Ríos, San Luis y Mendoza (Argentina), fueron evaluadas mediante el Cuestionario de Modos de Afrontamiento (WCCL) y el Inventario de Sistema de Creencias (SBI–15R...

  19. Interpersonal Group Therapy for Women Experiencing Bulimia

    Science.gov (United States)

    Choate, Laura

    2010-01-01

    Bulimia Nervosa (BN) is a chronic disorder that results in a high degree of psychological impairment for many women. This article presents a description of Interpersonal Therapy for Group (IPT-G), an evidence-based approach for the treatment of BN. The author presents a rationale for the use of IPT-G, an outline of the group model, and provides…

  20. Using latent growth curve modeling in clinical treatment research: An example comparing guided self-change and cognitive behavioral therapy treatments for bulimia nervosa

    OpenAIRE

    Hardy, Sam A.; Cornelia Thiels

    2009-01-01

    Este estudio experimental muestra la utilidad de los modelos multigrupo de curva de crecimiento latente por etapas en investigación clínica, concretamente en la evaluación y comparación de los efectos de tratamiento. Sesenta y dos pacientes femeninas (media de edad = 28,1; DT = 8) con bulimia nerviosa fueron asignadas al azar a: a) un auto-tratamiento guiado compuesto por un manual de autocuidados más ocho sesiones quincenales de terapia cognitivo conductual (TCC), o b) a 16 sesiones semanale...

  1. Using latent growth curve modeling in clinical treatment research: An example comparing guided self-change and cognitive behavioral therapy treatments for bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Sam A. Hardy

    2009-01-01

    Full Text Available Este estudio experimental muestra la utilidad de los modelos multigrupo de curva de crecimiento latente por etapas en investigación clínica, concretamente en la evaluación y comparación de los efectos de tratamiento. Sesenta y dos pacientes femeninas (media de edad = 28,1; DT = 8 con bulimia nerviosa fueron asignadas al azar a: a un auto-tratamiento guiado compuesto por un manual de autocuidados más ocho sesiones quincenales de terapia cognitivo conductual (TCC, o b a 16 sesiones semanales de terapia cognitivo conductual (TCC. Ambos grupos mostraron mejorías significativas durante el tratamiento, aunque la TCC mostró mayor mejoría. Sin embargo, el tratamiento auto-guiado evidenció una mejoría más continuada después del tratamiento. Ambos programas mostraron variabilidad en la eficacia durante el tratamiento al menos en un resultado, mientras que el auto-tratamiento mostró una mayor variabilidad que la TCC durante el seguimiento en dos resultados. Los niveles de la línea de base estaban relacionados con los niveles en el seguimiento, particularmente en el tratamiento auto-guiado. Los modelos de curva latente ofrecen un análisis rico de estos datos y resuelven importantes cuestiones sobre las diferencias en la efectividad de los dos programas de tratamiento.

  2. Anorexia Nervosa and Bulima Nervosa Critical Analysis of It's Treatment: Implications and Interventions

    Directory of Open Access Journals (Sweden)

    Flourish Itulua-Abumere

    2013-06-01

    Full Text Available The diagnostic consideration of the eating disorders anorexia nervosa and bulimia nervosa has been given much focus over the last two decades than previously, as clinicians have become more aware of the frequency of these disorders and the difficulties associated with their treatment. Anorexia nervosa and bulimia nervosa as known in the DSM-IV as eating disorders are characterized by physically and/or psychologically harmful eating patterns. Although the psychological explanation of what we now call anorexia nervosa have been known about for centuries, it has only recently attracted much interest, due to greater public knowledge and increased incidence (according to Gross and MclLveen 2006, the latter claim has been disputed. Most people suffering from anorexia nervosa and bulimia nervosa start by fasting. Anorexia nervosa is a deliberate self-starvation. A person whose body weight is less than expected for his or her body height and weight is considered to be anorexic. In contract, bulimia involves binge eating a large quantity of food followed by purging by self-induced vomiting, enemas, laxatives, or diuretics.

  3. The Role of “Mixed” Orexigenic and Anorexigenic Signals and Autoantibodies Reacting with Appetite-Regulating Neuropeptides and Peptides of the Adipose Tissue-Gut-Brain Axis: Relevance to Food Intake and Nutritional Status in Patients with Anorexia Nervosa and Bulimia Nervosa

    Directory of Open Access Journals (Sweden)

    Kvido Smitka

    2013-01-01

    Full Text Available Eating disorders such as anorexia (AN and bulimia nervosa (BN are characterized by abnormal eating behavior. The essential aspect of AN is that the individual refuses to maintain a minimal normal body weight. The main features of BN are binge eating and inappropriate compensatory methods to prevent weight gain. The gut-brain-adipose tissue (AT peptides and neutralizing autoantibodies play an important role in the regulation of eating behavior and growth hormone release. The mechanisms for controlling food intake involve an interplay between gut, brain, and AT. Parasympathetic, sympathetic, and serotoninergic systems are required for communication between brain satiety centre, gut, and AT. These neuronal circuits include neuropeptides ghrelin, neuropeptide Y (NPY, peptide YY (PYY, cholecystokinin (CCK, leptin, putative anorexigen obestatin, monoamines dopamine, norepinephrine (NE, serotonin, and neutralizing autoantibodies. This extensive and detailed report reviews data that demonstrate that hunger-satiety signals play an important role in the pathogenesis of eating disorders. Neuroendocrine dysregulations of the AT-gut-brain axis peptides and neutralizing autoantibodies may result in AN and BN. The circulating autoantibodies can be purified and used as pharmacological tools in AN and BN. Further research is required to investigate the orexigenic/anorexigenic synthetic analogs and monoclonal antibodies for potential treatment of eating disorders in clinical practice.

  4. 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)

  5. Functional magnetic resonance imaging research on bulimia nervosa with fluoxetine therapy%氟西汀治疗神经性贪食患者的功能磁共振成像初步研究

    Institute of Scientific and Technical Information of China (English)

    曹静; 吴宇洁; 王美娟; 石中永; 朱荣申; 申远

    2014-01-01

    目的 探讨抗抑郁剂氟西汀对神经性贪食(bulimia nervosa,BN)患者脑功能的影响.方法 符合中国精神障碍分类和诊断标准第三版(CCMD-3) BN诊断标准的患者7例,分别于治疗开始前和氟西汀(20 mg/d)治疗3个月后进行功能磁共振成像(functional magnetic resonance imaging,fMRI)检查.正常对照7例,于人组时接受一次fMRI检查.功能成像为组块设计,包括食物图片序列和非食物图片序列,均来自国际情绪图片系统(international aective picture system,IAPS),由计算机自动呈现.所有受试者完成汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、17项汉密尔顿抑郁量表(Hamilton depression scale,HAMD17)和对fMRI刺激图片的Likert Scale-likelihood态度评估.结果 BN患者治疗前脑激活强度和体积均较正常对照减小(P<0.05),在食物图片刺激下双侧前额叶及左侧杏仁核激活增强;经氟西汀治疗后脑激活强度和体积较治疗前显著增加(P<0.01),食物图片下激活最强的脑区为右侧颞叶、小脑坡、双侧前额叶,杏仁核未出现阈值以上激活.结论 氟西汀可改善BN患者贪食症状,同时使前额叶及边缘系统的异常激活减弱,其作用机制可能与前额叶及边缘系统的5-羟色胺能系统功能变化相关.%Objective To explore the effect of fluoxetine on the brain function of bulimia nervosa (BN) patients.Methods Seven female BN patients,who met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3),accepted functional magnetic resonance imaging (fMRI) examinations before and after the antidepressant treatment (fluoxetine (20 mg/day)) for three months.Seven normal controls accepted the same fMRI examination only at baseline.fMRI imaging was block-design.Blocks of food or non-food stimulus containing pictures selected from International Affective Picture System (IAPS) which were shown by computer automatically.All subjects were evaluated by Hamilton anxiety scale

  6. The results of research aimed at identifying psychological predictors of impulsive and restrictive behaviours in a population of females suffering from anorexia or bulimia nervosa – the author’s own research report

    OpenAIRE

    Izydorczyk, Bernadetta

    2014-01-01

    Aim of the study. The results of research aimed at identifying psychological predictors of impulsive and restrictive behaviours in a population of females suffering from anorexia or bulimia. Subject or material and methods . Eating Disorder Inventory (EDI) devised by D. Garner. Clinical group:90 Polish females with bulimia and anorexia, A control group: 121 women, who exhibited no eating disorders. Results . Analysis of the data gathered as a result of this research demonstrated that ...

  7. Similarities and differences between eating disorders and orthorexia nervosa

    OpenAIRE

    Larsen, Kristine Instefjord

    2013-01-01

    In today`s society there is an increased focus on having a healthy lifestyle and a good health. For some people, the attempt to achieve good health turns into an obsession which again may lead to an eating disorder. In recent years a new term is noticed, called orthorexia nervosa. Orthorexia is about being obsessed with healthy eating. Today there is a lot of research and literature about eating disorders such as anorexia nervosa and bulimia nervosa, while scientific literature...

  8. Functional magnetic resonance imaging research on bulimia nervosa during executing food pictures%神经性贪食患者食物图片刺激的功能磁共振对照研究

    Institute of Scientific and Technical Information of China (English)

    申远; 李清伟; 王培军; 戴工华; 李春波; 吴文源

    2009-01-01

    目的 观察神经性贪食(BN)患者加工食物图片时的脑功能特点,探讨BN的精神病理机制.方法 BN患者7例,均为女性,符合中国精神障碍分类和诊断标准第三版(CCMD-3)神经性贪食诊断标准;健康对照7例.2组性别、年龄匹配.所有受试者完成汉密尔顿焦虑量表(HAMA)、17项汉密尔顿抑郁量表(HAMD-17)、视觉模拟量表(VAS)评估和fMRI检查.功能成像为组块设计,包括食物图片序列和非食物图片序列,均来自国际情绪图片系统(1APS),计算机自动呈现.结果 BN患者食物图片VAS评分高于对照组(P<0.05);BN患者食物图片平均脑激活强度(7.86±0.78)、平均激活体积(557 voxels),主要激活双侧前额叶、右尾状核、左杏仁核和小脑;对照组食物图片平均脑激活强度(9.89±1.03),平均激活体积均(1340 voxels),主要激活双侧舌回、楔前叶、右梭状回.2组食物图片下激活差异有显著性(P<0.05),非食物图片下激活差异无显著性.结论 前额叶-纹状体-杏仁核-中脑通路功能异常可能是BN的主要神经病理机制.%Objective To observe the brain activation performance of bulimia nervosa (BN) patients and to investigate the possible mental mechanisms of BN. Method Seven female BN cases which met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3) and seven matched health girls were enrolled. All sub-jects were evaluated by Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD-17), and visual ana-logue scale (VAS). Then fulfill functional magnetic resonance imaging (fMRI) examination. It was block-design. Food or non-food pictures selected from International Affective Picture System (IAPS) independently composed the food and non-food task run of fMRI and were showed by computer automatically. Result VAS-food score was higher in BN group than in control (P<0.05). The average intensity activated of BN under food pictures was 7.86 ±0.78 ,average volume activated was

  9. Adolescent Eating Disorder: Bulimia.

    Science.gov (United States)

    Muuss, Rolf E.

    1986-01-01

    Defines bulimia and lists associated features of bulimia, physical side effects, and cognitive disturbances related to binging and purging. Asserts that bulimics resist treatment; but that such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising. (Author/ABB)

  10. 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…

  11. Terapia nutricional na anorexia e bulimia nervosas Nutritional therapy in anorexia and bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Marle Alvarenga

    2002-12-01

    Full Text Available A alimentação e a dieta têm um importante papel no desenvolvimento e manutenção dos transtornos alimentares. Portanto, devem ser levados em consideração nos programas de tratamento dessas condições clínicas. Pacientes com transtornos alimentares apresentam importantes restrições dietéticas, padrões alimentares inadequados e hábitos errôneos devido a uma série de falsos mitos e crenças e a uma sensação de incompetência para lidar com o alimento. Tais alterações podem levar a mudanças em seu estado nutricional, que necessita de cuidados dietéticos específicos, como reabilitação nutricional e orientação sobre dieta adequada. Além disto, o aconselhamento nutricional é necessário para esclarecer e desmistificar crenças inadequadas e para estabelecer uma adequada relação com o alimento.Food and diet have an important role in the development and maintenance of eating disorders. Thus, they should be properly addressed in the treatment program for such disorders. Patients with eating disorders present dietary restrictions, unhealthy eating patterns, modified nutritional patterns, and unhealthy eating behaviors due to false myths and beliefs, and to a feeling of incompetence in dealing with food. Dietary restrictions, as well as the unhealthy eating patterns carried out by these patients may lead to changes in the nutritional status that require specific dietetic care in order to be corrected. Nutrition rehabilitation is required to restore the dietetic pattern, teaching the meaning of a normal and balanced diet. Furthermore, this unhealthy eating behavior requires nutritional counseling, aiming at clarifying doubts and demystifying wrong beliefs, discussing and readjusting patients´ relationship with food.

  12. Características morfofuncionais do trânsito orofaríngeo na bulimia: revisão de literatura Morphofunctional characteristics of the oropharyngeal tract in bulimia: review of literature

    Directory of Open Access Journals (Sweden)

    Catarina Matos Brito Santos

    2010-04-01

    Full Text Available TEMA: deglutição e bulimia. OBJETIVO: apresentar e discutir os achados científicos descritos na literatura quanto às características orofaríngeas relacionadas à deglutição em portadores de bulimia nervosa do tipo purgativa. CONCLUSÃO: a bulimia nervosa acarreta uma série de alterações em estruturas e funções que compõem o trânsito orofaríngeo, como erosão dentária, hipersensibilidade, enfraquecimento e fratura dos dentes, problemas de oclusão, cáries, doenças periodontais, dessensibilização intra-oral, hipogeusia, úlceras, granulomas, queilite angular, hipertrofia das glândulas parótidas, tosse e odinofagia. Existe um predomínio na literatura científica de relatos sobre alterações morfológicas em detrimento das funcionais. Poucos relatos abordaram diretamente a relação entre a bulimia e deglutição, apenas mencionando superficialmente as possibilidades de desencadeamento da disfagia orofaríngea.BACKGROUND: deglutition and bulimia. PURPOSE: to submit and discuss the scientific research concerning oropharyngeal characteristics related to deglutition in patients with purging type bulimia nervosa. CONCLUSIONS: bulimia nervosa entails a series of changes in structures and functions that compose the oropharyngeal tract, such as dental erosion, hypersensitivity, weakness and fracture of the teeth, occlusion problems, caries, periodontal diseases, intraoral desensitization, hypogeusia, ulceration, granulomas, angular cheilitis, enlargement of the parotid glands, coughs and odynophagia. There is a prevalence in the scientific literature of reports about morphologic alterations on the detriment of the functional ones. Few reports discussed the relationship between bulimia and deglutition, superficially mentioning the possibilities for triggering oropharyngeal dysphagia.

  13. The Group Treatment of Bulimia.

    Science.gov (United States)

    Weinstein, Harvey M.; Richman, Ann

    1984-01-01

    Bulimia has become an increasing problem in the college population. This article describes a group psychotherapeutic treatment approach to the problem. A theoretical formulation of the psychodynamics that may underlie the development of bulimia is offered. (Author/DF)

  14. Symptom Management of Bulimia.

    Science.gov (United States)

    Johnson, Craig; And Others

    1987-01-01

    Describes a treatment approach for the symptom management of bulimia that is a synthesis of various techniques, including cognitive-behavioral therapy, response prevention, relapse training, and psychodynamic therapy. The model has been a useful teaching tool for staff and patients in both group and individual formats. Addresses the challenges of…

  15. Características morfofuncionais do trânsito orofaríngeo na bulimia: revisão de literatura Morphofunctional characteristics of the oropharyngeal tract in bulimia: review of literature

    OpenAIRE

    Catarina Matos Brito Santos; Vanessa de Oliveira Cansanção; Leandro de Araújo Pernambuco; Hilton Justino da Silva

    2010-01-01

    TEMA: deglutição e bulimia. OBJETIVO: apresentar e discutir os achados científicos descritos na literatura quanto às características orofaríngeas relacionadas à deglutição em portadores de bulimia nervosa do tipo purgativa. CONCLUSÃO: a bulimia nervosa acarreta uma série de alterações em estruturas e funções que compõem o trânsito orofaríngeo, como erosão dentária, hipersensibilidade, enfraquecimento e fratura dos dentes, problemas de oclusão, cáries, doenças periodontais, dessensibilização i...

  16. 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...

  17. 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...

  18. Exploring scientific legitimacy of orthorexia nervosa: a newly emerging eating disorder

    OpenAIRE

    Chaki, Biswajit; Pal, Sangita; Bandyopadhyay, Amit

    2013-01-01

    Eating disorders are a range maladaptive eating behaviours characterized by highly restrictive and unhealthy food intake patterns that lead to variety of psychiatric, physiological and health complications such as depression, anxiety, and personality disorders etc. Many of these psychological eating disorders such as anorexia nervosa or bulimia nervosa have been recognized as disease by the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) of American psychiatric association. How...

  19. Greater left cerebral hemispheric metabolism in bulimia assessed by positron emission tomography

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    Wu, J.C.; Hagman, J.; Buchsbaum, M.S.; Blinder, B.; Derrfler, M.; Tai, W.Y.; Hazlett, E.; Sicotte, N. (Univ. of California, Irvine (USA))

    1990-03-01

    Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using (18F)-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.

  20. Treating bulimia with hypnosis and low-level light therapy: a case report

    Science.gov (United States)

    Laser, Eleanor; Sassack, Michael

    2012-03-01

    This case report describes an effort to control bulimia nervosa by combining low-level laser therapy (LLLT)-the application of red and near-infrared light to specific body points-and hypnosis. A 29-year old female with a 14-year history of bulimia received one session of LLLT combined with hypnosis. Two weeks later, following a measurable decrease in bulimic episodes (purging), a session of psychotherapy and hypnosis was administered. Six months post-treatment, the patient has experienced a complete cessation of purging activities without recurrence. LLLT, when used in conjunction with hypnosis and psychotherapy, was effective in managing bulimia and may prove useful in treating other eating disorders.

  1. Taste and bulimia.

    Science.gov (United States)

    Drewnowski, A; Bellisle, F; Aimez, P; Remy, B

    1987-01-01

    Binge-eating episodes in bulimia often involve sweet or fat-containing foods. Sensory perceptions and preferences for sweetness and fat content were examined in 16 normal-weight women with a diagnosis of DSM IIIR bulimia and in 16 normal-weight volunteer controls. Taste stimuli were 15 semi-liquid mixtures of dessert-type soft white cheese ("fromage blanc") containing 0, 3 or 7 grams of fat per 100 g, and sweetened with 1, 5, 10, 20, or 40% sucrose (wt./wt.). The subjects used 9-point category scales to rate the perceived sweetness and fat content of the stimuli, and assigned a pleasantness (hedonic) rating to each sample. Taste preferences were modelled using the Response Surface Method (RSM). Mean estimates of sweetness intensity and fat content were generally similar for bulimic patients and controls. In contrast, profiles of taste preference differed significantly between groups. Optimal stimulus sweetness was 15% sucrose wt./wt. for bulimic patients and only 9% for controls, while optimal fat levels were lower for bulimic patients relative to controls. The present data are consistent with previous reports that patients with eating disorders crave sweetness but show reduced sensory preferences for fat-containing foods. PMID:3441532

  2. Relationship-focused therapy for bulimia and binge eating: Introduction to the special section.

    Science.gov (United States)

    Thompson-Brenner, Heather

    2016-06-01

    Individuals with bulimia nervosa and binge eating disorder commonly report co-occurring interpersonal problems, and treatment that focuses on relationships and relational functioning has shown benefit relative to other forms of treatment. Relational psychotherapy for eating disorders can vary on several important dimensions, such as how structured and symptom-focused versus exploratory and patient-directed it is, whether it focuses on past relationships and patterns in relationships over time versus focusing on current relationships, and whether it includes the relationship with the therapist as an explicit topic of conversation and mechanism for relational change. The cases in this special section provide the opportunity to closely compare 3 therapeutic approaches on each of these dimensions. Psychoanalytic Psychotherapy for Bulimia Nervosa, Integrative Dynamic Therapy for Bulimia Nervosa, and Interpersonal Psychotherapy for the Prevention of Weight Gain and Eating Disorders are each highly distinct approaches. The authors of each case explain the intended mechanisms of treatment response, the measures that assess changes in eating disorder symptoms as well as the mechanisms of change, and provide extensive excerpts from case material to demonstrate and illustrate the particular evidence-based treatment. Therapists and researchers may usefully consider the process and outcome variables described in these interpersonal approaches. (PsycINFO Database Record PMID:27267502

  3. 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…

  4. 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 ...

  5. The Clinical and Theoretical Impact of a Controlled Trial of Family Therapy in Anorexia Nervosa.

    Science.gov (United States)

    Dare, Christopher; And Others

    1990-01-01

    Compared family therapy with individual, supportive psychotherapy for management of severe eating disorder. Findings showed family therapy more effective for patients with early onset, short duration disorder but not in other subgroups (early onset, duration more than 3 years; late onset, after age of 18 years; and those with bulimia nervosa).…

  6. Der Schlaf bei Anorexia nervosa, Bulimia nervosa und depressiven Erkrankungen: Eine polysomnographische Vergleichsstudie (= Sleep in anorexia nervosa, bulimia nervosa and depressive diseases: a polysomnographic comparative study)

    OpenAIRE

    Lauer, C.; Krieg, J. C.; Zulley, Jürgen; Riemann, D; Berger, M.

    1989-01-01

    All-night EEG sleep in 20 anorexics, 10 bulimics, 10 endogenous depressives, and in 10 healthy subjects (all age matched) was compared. In addition, the REM sleep-induction-test was performed in 12 patients with an eating disorder, 7 depressives, and 12 controls by application of the cholinergic agent RS 86. During baseline night, EEG-sleep parameters, especially REM latency, did not differ between the patients and the controls, except for the phasic components of REM sleep (REM density) that...

  7. Complicações clínicas da anorexia nervosa e bulimia nervosa Medical complications of anorexia nervosa and bulimia nervosa

    OpenAIRE

    Carmen Leal de Assumpção; Mônica D Cabral

    2002-01-01

    Os transtornos alimentares estão associados a diversas complicações clínicas graves. Distúrbios hidroeletrolíticos e metabólicos assim como várias alterações endócrinas podem estar presentes, muitas dessas decorrentes da perda de peso e dos métodos compensatórios utilizados pelos pacientes. São importantes a identificação precoce e o manuseio adequado dessas complicações para a redução dos riscos relacionados. O objetivo desse artigo é discutir as complicações clínicas associadas com a anorex...

  8. The DST and TRH test in bulimia nervosa.

    Science.gov (United States)

    Kaplan, A S; Garfinkel, P E; Brown, G M

    1989-01-01

    Abnormal neuroendocrine responses have been found in depression and eating disorders. It remains unclear whether these reflect an underlying shared biology or epiphenomena. To evaluate this further, we conducted the 1 mg DST and the TSH response to 500 micrograms i.v. TRH in normal-weight bulimics and controls. Bulimics (n = 18) demonstrated significantly more DST non-suppression (45%) than controls (18%; n = 20). In the bulimic group, non-suppressors were significantly thinner than suppressors, but did not differ from them on any measure of depression. Bulimics (n = 19) and controls (n = 12) responded similarly without blunting on the TSH response to TRH. These data suggest that DST non-suppression may be related to non-specific variables such as weight. Bulimics do not demonstrate TSH blunting as found in some depressed patients. These tests do not support evidence for a biological link between these disorders. PMID:2505882

  9. Ortorexia nervosa: reflexões sobre um novo conceito Orthorexia nervosa: reflections about a new concept

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Teixeira Martins

    2011-04-01

    Full Text Available Ortorexia nervosa é o termo descrito para o comportamento obsessivo patológico caracterizado pela fixação por saúde alimentar. O quadro ainda não foi oficialmente reconhecido como um transtorno alimentar, mas discute-se o conceito, suas características, interações e sintomas. No presente trabalho foi realizada uma revisão dos vinte e um artigos publicados desde 1997, quando o comportamento da ortorexia nervosa foi inicialmente descrito. Foram apontadas semelhanças e diferenças entre o comportamento alimentar observado na ortorexia nervosa e nos transtornos alimentares mais frequentes (anorexia e bulimia nervosa. Um instrumento foi desen-volvido e validado para detecção do quadro ortoréxico. Os estudos apontam alguns grupos vulneráveis à orto-rexia nervosa: estudantes de medicina, médicos, nutricionistas, pessoas com sintomas de ansiedade, obsessivo-compulsivos e aqueles que supervalorizam o corpo perfeito. A ortorexia nervosa é situada a partir de uma análise dos conceitos de atitude alimentar e alimentação saudável, procurando um foco biopsicossocial para a alimentação adequada e não apenas um foco fisiológico. Não existem estudos investigativos sobre a ortorexia nervosa no Brasil, mas o tema deve ser discutido para alertar os profissionais da área da saúde sobre a existência desse comportamento inadequado e suas possíveis consequências não só para a saúde física e emocional, mas também para a visão de alimentação saudável.Orthorexia nervosa is a new term described as an obsessive pathological behavior characterized by fixation on healthy eating. It has not yet been officially recognized as an eating disorder, but its concept, characteristics, interactions and symptoms have been discussed. This work presents a review of the articles published on the theme since 1997, when orthorexic behavior was first described. Similarities and differences between orthorexic behavior and the more common eating

  10. 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. PMID:19503976

  11. Severity of eating disorder symptoms related to oxytocin receptor polymorphisms in anorexia nervosa.

    Science.gov (United States)

    Acevedo, Summer F; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J

    2015-08-30

    Oxytocin is a peptide hormone important for social behavior and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether single nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa. PMID:26106053

  12. [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

  13. Anorexia nervosa.

    Science.gov (United States)

    Treasure, Janet; Zipfel, Stephan; Micali, Nadia; Wade, Tracey; Stice, Eric; Claudino, Angélica; Schmidt, Ulrike; Frank, Guido K; Bulik, Cynthia M; Wentz, Elisabet

    2015-01-01

    Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. AN predominantly develops in adolescence in the peripubertal period. Without early effective treatment, the course is protracted with physical, psychological and social morbidity and high mortality. Despite these effects, patients are noted to value the beliefs and behaviours that contribute to their illness rather than regarding them as problematic, which interferes with screening, prevention and early intervention. Involving the family to support interventions early in the course of the illness can produce sustained changes; however, those with a severe and/or protracted illness might require inpatient nursing support and/or outpatient psychotherapy. Prevention programmes aim to moderate the overvaluation of 'thinness' and body dissatisfaction as one of the proximal risk factors. The low prevalence of AN limits the ability to identify risk factors and to study the timing and sex distribution of the condition. However, genetic profiles, premorbid features, and brain structures and functions of patients with AN show similarities with other psychiatric disorders and contrast with obesity and metabolic disorders. Such studies are informing approaches to address the neuroadaptation to starvation and the other various physical and psychosocial deficits associated with AN. This Primer describes the epidemiology, diagnosis, screening and prevention, aetiology, treatment and quality of life of patients with AN. PMID:27189821

  14. Complicações clínicas da anorexia nervosa e bulimia nervosa

    OpenAIRE

    Assumpção Carmen Leal de; Cabral Mônica D

    2002-01-01

    Os transtornos alimentares estão associados a diversas complicações clínicas graves. Distúrbios hidroeletrolíticos e metabólicos assim como várias alterações endócrinas podem estar presentes, muitas dessas decorrentes da perda de peso e dos métodos compensatórios utilizados pelos pacientes. São importantes a identificação precoce e o manuseio adequado dessas complicações para a redução dos riscos relacionados. O objetivo desse artigo é discutir as complicações clínicas associadas com a anorex...

  15. Untersuchung des autonomen Nervensystems bei Patientinnen mit Anorexia nervosa, Bulimie und bei gesunden Probandinnen

    OpenAIRE

    Walter, Corinna

    2010-01-01

    Hintergrund: Der Autor untersuchte die kardiale Funktion des autonomen Nervensystems bei Patientinnen mit Anorexia und Bulimia nervosa. Methode: 25 Anorexie- (AN), 11 Bulimiepatientinnen (BN) und 25 gesunde Kontrollpersonen (KO) nahmen an einer standardisierten Analyse teil, bei welcher Herzrate, Blutdruck sowie sympathische und parasympathische Funktionsinidizes während Ruhe und verschiedener Provokationsmanöver (metronomisches Atmen, Valsalva-, Orthostase-Manöver und mentale Stresstests...

  16. Non-bulimia: food regurgitation in a patient with self-diagnosed bulimia.

    Science.gov (United States)

    Copeland, P M; Herzog, D B

    1986-06-01

    The increased prevalence of bulimia has received great publicity by the news media. Such publicity predisposes individuals to self-diagnosis. A 57-year-old man with a 10-year history of food regurgitation presented to an eating disorder clinic complaining of bulimia, which he had heard discussed on a television talk show. He proved not to have bulimia but a large pharyngoesophageal (Zenker's) diverticulum. The diagnosis of bulimia may be misattributed to various symptoms by patients. The differential diagnosis of chronic regurgitation and vomiting must be considered in such patients. PMID:3086293

  17. Osteoporosis in anorexia nervosa.

    Science.gov (United States)

    Mehler, Philip S; Cleary, Barbara S; Gaudiani, Jennifer L

    2011-01-01

    Osteoporosis is common in anorexia nervosa. It places these patients at increased lifetime risk for fractures. Bone loss may never recover completely even once weight is restored. The strongest predictors of osteoporosis include low body weight and amenorrhea. Loss of bone density can occur rapidly and very early in the course of anorexia nervosa. The etiology of bone loss in the patient with anorexia nervosa is multifactorial. In addition to reduced estrogen and progesterone, excess cortisol levels and low levels of insulin growth factor (IGF-1), a correlate for bone formation, are observed. Dual energy x-ray absorptiometry screening is important to assess bone density. However, successful treatments to reverse bone loss, in those with anorexia nervosa, are lacking. Early diagnosis and treatment of anorexia nervosa are paramount to prevent initial weight loss and subsequent loss of bone. PMID:21360368

  18. Symptoms of achalasia in young women mistaken as indicating primary anorexia nervosa.

    Science.gov (United States)

    Stacher, G; Wiesnagrotzki, S; Kiss, A

    1990-01-01

    The case of a young women with dysphagia, regurgitation, and weight loss, who was diagnosed as having anorexia nervosa but in whom reevaluation showed that achalasia was causing the symptoms, is presented together with related observations. Misinterpretation of esophageal symptoms may occur not only as a consequence of inadequate history taking and of being biased by a patient's emaciation, age, and gender, which leads to view certain aspects of the patient's history and behavior as suggesting a pathologic attitude towards eating and body weight, but also as a consequence of a misinterpretation of the symptoms as indicative of an eating disorder by the patients themselves. In some cases a disordered attitude toward eating and body weight may develop together or coexist with achalasia. The clinical evaluation of patients with symptoms suggestive of anorexia nervosa but also of bulimia nervosa should include the taking of a thorough history regarding swallowing and vomiting in order to recognize a possible esophageal motor disorder. PMID:2272221

  19. Percepção de familiares sobre a anorexia e bulimia: revisão sistemática Percepción de familiares sobre la anorexia y bulimia: revisión sistemática Family perception of anorexia and bulimia: a systematic review

    OpenAIRE

    Cybele Ribeiro Espíndola; Sérgio Luís Blay

    2009-01-01

    Realizou-se revisão sistemática da literatura publicada entre 1990 e 2006 com metodologia qualitativa sobre a perspectiva de familiares de pessoas com anorexia e bulimia nervosa. Após revisão crítica dos artigos e metassíntese, utilizou-se a abordagem meta-etnográfica para analisar e sintetizar os dados. O processo de interpretação empregado foi a reciprocal translation. Dentre 3.415 estudos, nove atenderam aos critérios de inclusão e exclusão. Dois conceitos emergiram: reconhecimento da doen...

  20. Fad Bulimia: A Serious and Separate Counseling Issue.

    Science.gov (United States)

    Cesari, Joan P.

    1986-01-01

    Differences between fad bulimia and clinical bulimia are presented using Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, personality assessment measures, and responses to counseling. (Author)

  1. Treating Women with Bulimia from a Sociocultural Perspective.

    Science.gov (United States)

    Hotelling, Kathy

    1986-01-01

    Outlines a sociocultural perspective of bulimia. Notes that since bulimia occurs in a sociocultural context, which includes a socialized developmental path with concomittant norms and values, effective treatment must address those norms and values. Recommends group therapy. (ABB)

  2. [Personality disorders and psychiatric comorbidity in obsessive-compulsive disorder and anorexia nervosa].

    Science.gov (United States)

    Müller, B; Wewetzer, C; Jans, T; Holtkamp, K; Herpertz, S C; Warnke, A; Remschmidt, H; Herpertz-Dahlmann, B

    2001-08-01

    The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were "Cluster C"-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and "Cluster C"-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD. PMID:11584688

  3. Body and Bulimia Revisited: Reflections on "A Secret Life"

    Science.gov (United States)

    Tillmann, Lisa M.

    2009-01-01

    In 1996, the author published "A Secret Life in a Culture of Thinness: Reflections on Body, Food, and Bulimia" (Tillmann-Healy, 1996), an account of her struggle with binging and purging from ages 15 to 25. She came to understand bulimia as a communicative act, expressing fear, anxiety, and grief. From 25 to 35, her recovery from bulimia involved…

  4. Medical complications of anorexia nervosa.

    Science.gov (United States)

    Shuttleworth, E; Sharma, S; Lal, S; Allan, P J

    2016-05-01

    Anorexia nervosa is a psychiatric disorder with potential life-threatening medical sequelae. This article reviews the principal medical complications associated with anorexia nervosa, highlights associated diagnostic pitfalls and emphasizes the importance of a multidisciplinary approach to management. PMID:27166107

  5. [Body and subjectivity: about anorexia nervosa].

    Science.gov (United States)

    Pereña Garcia, Francisco

    2007-01-01

    To start with the clinical description of anorexia nervosa is indicative of the difficulty involved not only with regard to its etiology (whether it is an endocrine, neurological or psychological disorder) but also with regard to its diagnosis (whether or not it is a hysterical disorder, whether or not it is a disease as such) and with regard to its treatment (the stubbornness of the symptom). The early-onset differential criterion is rejection. The subject's eating-related problem must be placed within the framework of the radical dependency the human organism has with regard to the mother's body, thus breaking the close connection between need and demand, which throws the instinctive life out of balance. Drive is the name given to this imbalance. Drived life must be controlled by wish. The transmitting of life is the transmitting of the innermost wish to live, without which the body fails or life and the body separate from one another. Rejection, which is the subjectivity-related aspect, then turns into anorexia in rejection of the body and in submission to bewildering ideals with which anorexic subjects attempt to find their bearings. Bulimia marks the most addictive aspect of impulsive imbalance. There is no ready answer to the question as to why anorexia occurs more among females than males. Female sexuality (the relationship with sexual wish and reproduction), as well as how in a aboundance society, women symbolize the trimming on the cake, an inert virtual figure. Anorexia nervosa can be taken as a pronouncement against an automated, devitalized family life and of a society characterized by commodity fetishism and cannibalism. PMID:18274356

  6. Bulimia: clinical characteristics, development, and etiology.

    Science.gov (United States)

    Kirkley, B G

    1986-04-01

    Bulimia is characterized by recurrent episodes of binge eating and severe self-deprecation, often accompanied by self-induced vomiting and/or laxative abuse. It is most often found among young women in their late teens to mid-30s. Estimates of the disorder's prevalence vary widely, depending on the diagnostic criteria used, but usually range from 5% to 20% of college age women. Binge eating typically begins in late adolescence, frequently after a period of dieting to lose weight. Self-induced vomiting usually follows the onset of binge eating by about a year. To date, theories of the disorder's etiology have included several biological models, a psychosocial model, and a biopsychosocial model. The biological models proposed have viewed bulimia as a form of biological depression, neurological disturbance, or metabolic disturbance. The psychosocial model suggests that society's pressure on young women for extreme thinness leads to excessive dietary restraint, deprivation, and, paradoxically, binge eating. The presence of anxiety or depression exacerbates the process. The biopsychosocial model appears to be the most promising. It proposes that young women with biological predispositions toward overweight, depression, or metabolic disturbance are particularly vulnerable to social pressure for thinness, the binge eating that may result from excessive dieting, and, hence, bulimia. The complex nature of bulimia suggests that a multidisciplinary team approach treatment is appropriate. PMID:3514731

  7. Binging & Purging: Youth Who Suffer Bulimia.

    Science.gov (United States)

    Strodel, Donna

    1990-01-01

    Describes bulimia, its symptoms, characteristics and bulimic's family profile. Disorder may be more difficult to hide at camp. Camp staff could be first to recognize symptoms. Describes behavior indicators of bulimics. Suggests appropriate responses and counseling techniques for helping bulimic campers. (TES)

  8. 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

  9. Burden of illness of bulimia nervosa in the United States : an evaluation of the prevalence, incidence, and treatment costs of bulimia nervosa

    OpenAIRE

    Hunsche, Elke

    2007-01-01

    Ziel dieser Dissertation ist es - basierend auf dem Prävalenzansatz - die medizinischen Kosten der Bulimie in den USA zu schätzen und in einen globalen Kontext zu stellen. Zu diesem Zweck wurde eine eingehende Literaturrecherche bezüglich der globalen epidemiologischen Evidenz zur Bulimie vorgenommen sowie - anhand einer großen amerikanischen Krankenversicherungsdatenbank - eine gesundheitsökonomische Analyse der Behandlungskosten pro Patient. Die Ergebnisse dieser beiden Forschungsansätze wu...

  10. 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

  11. 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...

  12. Neurobiological and psychopharmacological basis in the therapy of bulimia and anorexia.

    Science.gov (United States)

    Mauri, M C; Rudelli, R; Somaschini, E; Roncoroni, L; Papa, R; Mantero, M; Longhini, M; Penati, G

    1996-02-01

    1. Eating disorders can be found in several psychiatric pathologies: schizophrenia, delusional disorder (somatic type), bipolar disorders, major depressive disorder, borderline personality disorder, generalized anxiety disorder, body dysmorphic disorder, somatization disorder and conversion disorder. 2. Although their clinical features have been defined, relatively little is known about the role of neurobiological patterns in the pathogenesis of these disorders. Several CNS neurotransmitters and neuromodulators are involved in the regulation of eating behavior in animals and have been implicated in symptoms such as depression and anxiety often observed in patients with eating disorders. The authors will review some studies on NA, DA, 5-HT, beta-endorphins, CRH, VP, OT, CCK, NPY and PYY involved in eating disorders. Furthermore, we will highlight some of the studies on drug therapy of eating disorders taking into account the effects of these agents on neurotransmitters and neuromodulators. 3. Antidepressant drugs have long been used for anorexia nervosa and bulimia, these disorders been claimed to be affective equivalent. Antidepressant agents seem to be effective in reducing the frequency of binge-eating episodes, purging behavior and depressive symptomatology. It is notable that antidepressant agents have been proved to be effective in patients with chronic bulimic symptoms, even in cases persisting for many years and in patients who had repeatedly failed courses of alternative therapeutic approaches. In all of the positive studies, antidepressant agents appeared effective even in bulimic subjects who did not display concomitant depression. 4. Few controlled studies on use of medications for anorexia nervosa have been published. Central serotonergic receptor-blocking compounds such as cyproheptadine cause marked increase in appetite and body weight. Zinc supplementation or cisapride could be a therapeutic option in addition to psychological and other approaches in

  13. Endocrinological changes in anorexia nervosa

    OpenAIRE

    Selma Bozkurt Zincir; Bilge Burcak Annagur

    2011-01-01

    Anorexia nervosa is an eating disorder that begins between the ages of 12 to18 and characterized by conscious trials of being excessively thin because of weight gain fears. Anorexia nervosa is mostly seen in girls and lifetime prevalence among young women is approximately 0.3%. It is suggested that endocrinological changes seen in anorexia nervosa are not due to primary endocrinological disorders and that they are usually common consequences of long duration fasting and excessive weight loss....

  14. Anorexia nervosa medical issues.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori

    2003-05-01

    Anorexia nervosa is an increasingly common chronic psychiatric disorder with a multitude of medical complications. Most of these complications are reversible if there is timely restoration of body weight. A few of them, particularly osteoporosis, refeeding complications, and cardiac arrhythmia, are potentially much more serious. In the end, a multidisciplinary team approach with input from a primary care provider who is familiar with these medical sequelae, together with psychiatric and dietary expertise, can effectuate a successful outcome. PMID:12804340

  15. 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...

  16. 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 ...

  17. Neurobiologie der Anorexia Nervosa

    OpenAIRE

    Ehrlich, Stefan

    2011-01-01

    According to the biopsychosocial model of Anorexia Nervosa (AN), neurobiological factors contribute to the vulnerability towards eating disorders and also seem to play a role after the onset of the disorder (Treasure and Campbell, 1994). In this work, I will focus on three important aspects in the neurobiology of AN: (1) In the state of undernutrition, many patients with AN show signs of cortical brain atrophy and an abnormal cerebral metabolism. These changes co-occur with a marked redu...

  18. 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...

  19. 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...

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. Bulimia: Issues a University Counseling Center Needs To Address.

    Science.gov (United States)

    Whitner, Phillip A.; Shetterly, Arminta

    The eating disorder known as bulimia is a relatively new and baffling phenomenon. This paper raises questions that college and university counseling center professionals need to address regarding this phenomenon. The first section focuses on defining the term "bulimia" and its evolution. The second section identifies numerous symptoms that need to…

  5. [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

  6. 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...

  7. 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...

  8. [Bulimia and depression. Their clinical relations].

    Science.gov (United States)

    Criquillion-Doublet, S; Samuel-Lajeunesse, B

    1989-01-01

    The multiplicity of actual studies about a possible correlation between eating disorders and affective disorders is found on clinical and family studies, biological, genetic and therapeutic studies. As depressive symptoms are associated to eating disorders in 30 to 88% of the cases according to the authors, family studies suggest the existence of a relationship between eating and affective disorders but no causal link between the two can be proved. Biological tests are difficult to interpret (the dexamethasone suppression test, the TRH stimulation test, a study of platelet MAO activity, of the metabolism of neurotransmitters). The imbrication of metabolic and neuroendocrine disorders being a characteristic of both affective and eating disorders. On the level of therapy, if the results of antidepressants--essentially tricyclics and IMAO--on bulimia are effective on a short-term basis, this is not enough to prove the dysthimic nature of eating disorders. Moreover, their efficiency on the long term (over 6 months) is very controversial. It is the research on genetic and biological index which will allow the precise characterization of the nature of the relationship between eating (bulimia) and affective disorders. PMID:2667951

  9. 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

  10. Change in psychotherapy: a dialogical analysis single-case study of a patient with bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Alessandro eSalvini

    2012-12-01

    Full Text Available Starting from the critical review of various motivational frameworks of change that have been applied to the study of eating disorders, the present paper provides an alternative conceptualization of the change in psychotherapy presenting a single case study. We analysed six psychotherapeutic conversations with a bulimic patient and found out narratives for and against change. We read them in terms of tension between dominance and exchange in I-positions, as described by Hermans. These results indicate that the dialogical analysis of clinical discourse may be a useful method to investigate change from the beginning to the end of therapy.

  11. Oral sensory and cephalic hormonal responses to fat and nonfat liquids in bulimia nervosa

    OpenAIRE

    Bello, Nicholas T.; Coughlin, Janelle W.; Redgrave, Graham W.; Moran, Timothy H.; Guarda, Angela S.

    2010-01-01

    Sensory evaluation of food involves endogenous opioid mechanisms. Bulimics typically limit their food choices to low fat “safe foods” and intermittently lose control and binge on high fat “risk foods”. The aim of this study was to determine whether the oral sensory effects of a fat versus a non-fat milk product (i.e., traditional versus non-fat half-and-half) resulted in different subjective and hormonal responses in bulimic women (n=10) compared with healthy women (n=11). Naltrexone (50 mg P...

  12. Virtual humans and formative assessment to train diagnostic skills in bulimia nervosa.

    Science.gov (United States)

    Gutiérrez-Maldonado, José; Ferrer-Garcia, Marta; Pla, Joana; Andrés-Pueyo, Antonio

    2014-01-01

    Carrying out a diagnostic interview requires skills that need to be taught in a controlled environment. Virtual Reality (VR) environments are increasingly used in the training of professionals, as they offer the most realistic alternative while not requiring students to face situations for which they are yet unprepared. The results of the training of diagnostic skills can also be generalized to any other situation in which effective communication skills play a major role. Our aim with this study has been to develop a procedure of formative assessment in order to increment the effectiveness of virtual learning simulation systems and then to assess their efficacy. PMID:24875685

  13. Change in Psychotherapy: A Dialogical Analysis Single-Case Study of a Patient with Bulimia Nervosa

    OpenAIRE

    GianlucaCastelnuovo; AlessandroSalvini; GiuseppeMininni; DiegoRomaioli; SabrinaCipolletta

    2012-01-01

    Starting from the critical review of various motivational frameworks of change that have been applied to the study of eating disorders, the present paper provides an alternative conceptualization of the change in psychotherapy presenting a single-case study. We analyzed six psychotherapeutic conversations with a bulimic patient and found out narratives “for” and “against” change. We read them in terms of tension between dominance and exchange in I-positions, as described by Hermans. These res...

  14. A Brief DBT Skills Group for Bulimia Nervosa: A Feasibility Study

    OpenAIRE

    Hall, A. R.

    2015-01-01

    The focus of this thesis is eating disorders, specifically treatment outcomes for individuals with eating disorders. This thesis consists of three parts. The first part of the thesis is a systematic literature review on the treatment outcomes and dropout rates for men with eating disorders. Men with eating disorders are often excluded from research because of the low prevalence rates of eating disorders in men. The consequence of this is that treatment guidelines are developed based on resear...

  15. Case Conceptualization and Treatment of Comorbid Body Dysmorphic Disorder and Bulimia Nervosa

    Science.gov (United States)

    Didie, Elizabeth R.; Reinecke, Mark A.; Phillips, Katharine A.

    2010-01-01

    Body dysmorphic disorder (BDD) and eating disorders often co-occur and share some clinical features. In addition, the co-occurrence of BDD and an eating disorder may be associated with greater impairment in functioning. Furthermore, clinical impressions suggest that this comorbidity may be more treatment resistant than either disorder alone. The…

  16. Anorexia nervosa and the kidney.

    Science.gov (United States)

    Bouquegneau, Antoine; Dubois, Bernard E; Krzesinski, Jean-Marie; Delanaye, Pierre

    2012-08-01

    Anorexia nervosa is a common psychiatric disorder that disproportionately affects adolescents and young adults and is associated with high rates of morbidity and mortality. Anorexia nervosa can affect the kidney in numerous ways, including increased rates of acute kidney injury and chronic kidney disease, electrolyte abnormalities, and nephrolithiasis. Additionally, the diagnosis and treatment of anorexia nervosa-associated kidney diseases are challenging, reflecting complications such as refeeding syndrome, as well as the limitations of serum creatinine level in this population to estimate kidney function and the psychosocial challenges inherent with treating systemic manifestations of psychiatric conditions. In this review, we discuss kidney diseases and kidney-associated conditions that occur in individuals with anorexia nervosa, summarizing many of the challenges in treating patients with this disease. PMID:22609034

  17. 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

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. Bone health in anorexia nervosa

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Purpose of review Anorexia nervosa is associated with low bone mineral density (BMD), concerning for an increased risk of fractures, and decreased bone accrual in adolescents, concerning for suboptimal peak bone mass. This review discusses causes of impaired bone health in anorexia nervosa and potential therapeutic strategies. Recent findings Low BMD in anorexia nervosa is consequent to decreased lean mass, hypogonadism, low insulin-like growth factor-1 (IGF-1), relative hypercortisolemia and alterations in hormones impacted by energy availability. Weight gain causes some improvement in bone accrual, but not to the extent observed in controls, and vitamin D supplementation does not increase BMD. Oral estrogen is not effective in increasing BMD, likely from IGF-1 suppressive effects. In contrast, transdermal estrogen replacement is effective in increasing bone accrual in adolescents with anorexia nervosa, although not to the extent seen in controls. Recombinant human IGF-1 increases bone formation in adolescents, and with oral estrogen increases BMD in adults with anorexia nervosa. Bisphosphonates increase BMD in adults, but not in adolescents, and should be used cautiously given their long half-life. Summary Further investigation is necessary to explore therapies for low BMD in anorexia nervosa. Weight gain is to be encouraged. Transdermal estrogen in adolescents, and bisphosphonates in adults, have a potential therapeutic role. PMID:21897220

  3. Seven years’ experience with etidronate in a woman with anorexia nervosa and vertebral fractures

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2011-07-01

    Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Tsuyoshi Takeda1, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, Japan; 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the case of a 30-year-old Japanese woman with anorexia nervosa and vertebral fractures who was treated with etidronate. She had a history of anorexia nervosa, chronic back pain, osteoporosis, and multiple vertebral fractures (morphometric fractures that responded poorly to treatment with alfacalcidol (1 µg daily for 1 year and was treated with cyclical etidronate (200 mg for 2 weeks every 3 months for 7 years. The lumbar spine bone mineral density (BMD increased, and the serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen levels and back pain decreased. During the 7-year period of treatment with etidronate, no osteoporotic fractures occurred. The patient experienced neither renal dysfunction nor hyperparathyroidism caused by osteomalacia. No gastrointestinal tract symptoms were observed. Thus, etidronate was effective for increasing the lumbar spine BMD and reducing back pain over a 7-year period without causing either osteoporotic fractures or adverse events.Keywords: anorexia nervosa, bulimia, etidronate, bone mineral density, osteoporosis, vertebral fracture

  4. Enhanced cognitive behaviour therapy for adults with anorexia nervosa: a UK-Italy study.

    Science.gov (United States)

    Fairburn, Christopher G; Cooper, Zafra; Doll, Helen A; O'Connor, Marianne E; Palmer, Robert L; Dalle Grave, Riccardo

    2013-01-01

    Anorexia nervosa is difficult to treat and no treatment is supported by robust evidence. As it is uncommon, it has been recommended that new treatments should undergo extensive preliminary testing before being evaluated in randomized controlled trials. The aim of the present study was to establish the immediate and longer-term outcome following "enhanced" cognitive behaviour therapy (CBT-E). Ninety-nine adult patients with marked anorexia nervosa (body mass index ≤ 17.5) were recruited from consecutive referrals to clinics in the UK and Italy. Each was offered 40 sessions of CBT-E over 40 weeks with no concurrent treatment. Sixty-four percent of the patients were able to complete this outpatient treatment and in these patients there was a substantial increase in weight (7.47 kg, SD 4.93) and BMI (2.77, SD 1.81). Eating disorder features also improved markedly. Over the 60-week follow-up period there was little deterioration despite minimal additional treatment. These findings provide strong preliminary support for this use of CBT-E and justify its further evaluation in randomized controlled trials. As CBT-E has already been established as a treatment for bulimia nervosa and eating disorder not otherwise specified, the findings also confirm that CBT-E is transdiagnostic in its scope. PMID:23084515

  5. Enhanced cognitive behaviour therapy for adults with anorexia nervosa: A UK–Italy study

    Science.gov (United States)

    Fairburn, Christopher G.; Cooper, Zafra; Doll, Helen A.; O'Connor, Marianne E.; Palmer, Robert L.; Dalle Grave, Riccardo

    2013-01-01

    Anorexia nervosa is difficult to treat and no treatment is supported by robust evidence. As it is uncommon, it has been recommended that new treatments should undergo extensive preliminary testing before being evaluated in randomized controlled trials. The aim of the present study was to establish the immediate and longer-term outcome following “enhanced” cognitive behaviour therapy (CBT-E). Ninety-nine adult patients with marked anorexia nervosa (body mass index ≤ 17.5) were recruited from consecutive referrals to clinics in the UK and Italy. Each was offered 40 sessions of CBT-E over 40 weeks with no concurrent treatment. Sixty-four percent of the patients were able to complete this outpatient treatment and in these patients there was a substantial increase in weight (7.47 kg, SD 4.93) and BMI (2.77, SD 1.81). Eating disorder features also improved markedly. Over the 60-week follow-up period there was little deterioration despite minimal additional treatment. These findings provide strong preliminary support for this use of CBT-E and justify its further evaluation in randomized controlled trials. As CBT-E has already been established as a treatment for bulimia nervosa and eating disorder not otherwise specified, the findings also confirm that CBT-E is transdiagnostic in its scope. PMID:23084515

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Disfonia e bulimia: avaliação dos sintomas e sinais vocais e laríngeos Dysphonia and bulimia: evaluation of vocal and laryngeal signs and symptoms

    Directory of Open Access Journals (Sweden)

    Cynthia Priscila Ferreira

    2009-01-01

    Full Text Available OBJETIVO: Descrever os sintomas e sinais vocais e laríngeos de pacientes com diagnóstico de bulimia. MÉTODOS: Estudo transversal, descritivo, randomizado, com experimento cego. Avaliou-se 11 indivíduos com diagnóstico de bulimia, com o subtipo purgativo, do sexo feminino e idade variando de 18 a 34 anos, que foram submetidas à avaliação fonoaudiológica e otorrinolaringológica. RESULTADOS: Os sintomas laríngeos e vocais mais relatados foram: o pigarro e a sensação de globus faríngeo relatados por dez sujeitos (90,9%. Na avaliação perceptivo-auditiva, os escores de maior ocorrência foram de grau leve em todos os parâmetros analisados. Os achados laríngeos de maior ocorrência foram os acúmulos de secreção espessa na laringe em cinco paciente (45,4%, seguido de fenda triangular médio-posterior e espessamento de mucosa na região interaritenoidea, ambos, ocorrendo em quatro sujeitos (36,3%. CONCLUSÃO: Os achados laringológicos e perceptivo-auditivos foram menos expressivos que os sintomas vocais e laríngeos relatados pelas pacientes.PURPOSE: To describe vocal and laryngeal signs and symptoms in patients with bulimia. METHODS: A blind, descriptive, randomized, transversal study was carried out. Eleven female subjects with the diagnosis of purgative bulimia nervosa and ages ranging from 18 to 34 years underwent otorhinolaryngological and vocal evaluations. RESULTS: The most common vocal and laryngeal symptoms were throat clearing and globus faringeus, related by 10 subjects (90.9%. In the auditory-perceptive evaluation, the most common scores were characterized as light in all analyzed parameters. The accumulation of thick mucus over the larynx occurred in five patients (45.4%, followed by median-posterior triangular glottic chink and mucosal thickening at the interaytenoid region, in four patients (36.3%. CONCLUSION: The laryngeal and perceptual findings were less expressive than vocal and laryngeal complaints.

  11. 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…

  12. 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

  13. Innovations in the Treatment of Bulimia: Transpersonal Psychology, Relaxation, Imagination, Hypnosis, Myth, and Ritual.

    Science.gov (United States)

    Brown, Michael H.

    1991-01-01

    Written for counselors who must help clients deal with bulimia, this article reviews bulimia's most obvious physical signs and symptoms, etiology, and behavioral characteristics. Considers innovative counseling approaches including Transpersonal Psychology, relaxation training, imagination, fantasy, hypnosis, myths, and rituals. (Author)

  14. 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.

  15. Anorexia nervosa and bone.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-06-01

    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 additional concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, and hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiological estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age, given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  16. Anorexia Nervosa and Bone

    Science.gov (United States)

    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 contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiologic estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  17. Orthorexia Nervosa in Turkish Dietitians.

    Science.gov (United States)

    Asil, Esma; Sürücüoğlu, Metin Saip

    2015-01-01

    The purpose of this study was to determine the prevalence of orthorexia nervosa in dietitians, as assessed by administering ORTO-15, Eating Attitudes Test-40 (EAT-40) and Maudsley Obsessive-Compulsive Inventory (MOCI). Our study included 117 dietitians (Ankara). Orto-15 test scores below 40 points was considered indicative of orthorexia, while higher scores indicated a normal eating behavior. It was found that participants with ORTO-15 scores less than 40 had higher scores for EAT-40 and MOCI (p orthorexia nervosa is recommended. PMID:25602930

  18. 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...

  19. [Menstrual dysfunction in anorexia nervosa].

    Science.gov (United States)

    Jagielska, Gabriela; Wolańczyk, Tomasz; Osuch, Beata

    2010-01-01

    One of the symptoms of anorexia nervosa (a.n.) is cessation of pubescence or secondary amenorrhea. Their origin in anorexia nervosa is multifactorial, partly resulting from starvation-induced hipogonadism. Amenorrhea in a.n. may persist despite weight recovery and is often related to osteoporosis. The authors' present causes of amenorrhea and its persisting in a.n., pointing to the factors influencing prognosis according to resumption of menses. They also review reports of hormonal replacement therapy in this group of patients. PMID:20677446

  20. 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 ...

  1. The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls.

    Science.gov (United States)

    Brand-Gothelf, Ayelet; Leor, Shani; Apter, Alan; Fennig, Silvana

    2014-10-01

    We examined the impact of comorbid depression and anxiety disorders on the severity of anorexia nervosa (AN) in adolescent girls. Adolescent girls with AN (N = 88) were divided into one group with and another group without comorbid disorders, and selected subjective and objective measures of illness severity were compared between the two groups. The comorbid group had significantly higher scores than the noncomorbid group for all four subscales and total scores of the Eating Disorders Examination as well as for all Eating Disorders Inventory-2 subscales, except for bulimia. The comorbid group also had significantly more suicide attempts and hospitalizations compared with the noncomorbid group. There were no significant group differences for the lowest ever body mass index, duration of AN symptoms, and age at AN onset. Our findings suggest that AN with comorbid depression and anxiety disorder is a more severe clinical variant of the disorder, especially with respect to severity of psychological symptoms and suicide risk. PMID:25265267

  2. 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…

  3. 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…

  4. 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.

  5. 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...

  6. 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...

  7. 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...

  8. Compliance and outcome in anorexia nervosa.

    OpenAIRE

    Steiner, H.; Mazer, C.; Litt, I. F.

    1990-01-01

    Anorexia nervosa is notoriously difficult to treat, but little is known regarding the relationship of compliance to treatment outcome. We investigated in 41 adolescents who fulfilled DSM-III-R criteria for anorexia nervosa, the relationship between the completion of a standard psychosocial treatment program, subtypes of anorexia nervosa, and outcome as determined by standardized measurements. These adolescents were observed for an average of 32.4 months. Overall, 29 patients (70%) improved co...

  9. 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...

  10. [Hypopotassemia and prolongation of the Q-T interval in a patient with severe malnutrition caused by bulimia and post-prandial vomiting].

    Science.gov (United States)

    Contaldo, F; Di Paolo, M R; Mazzacano, C; Di Biase, G; Giumetti, D

    1990-04-01

    Patient L.A. (f., 20 yrs), affected by bulimia and self-induced vomiting, was hospitalized because of severe malnutrition (BMI 13.1), hypopotassemia (2.8 mEq/l) and prolonged QTc interval (0.469"). Intensive care treatment aimed to normalize mineral balance mainly serum potassium, consisted of administering e.v. potassium (mg 2346/day), magnesium (mg 72/day), calcium (mg 80/day), phosphorus (mg 769/day), chloride (mg 710/day), iron (mg 40/day). Dietary treatment was deliberately chosen to be slightly above minimum energy requirements in order to avoid possible side effects of forced hyperalimentation. The patient, immediately after hospitalization, interrupted vomiting and 2 wks later weight increased by 5 kg (from 34.9 kg to 40.0 kg). On the other hand normalization of serum potassium levels was slow and QTc interval reached normal range only after the 10th day of treatment (0.447"). This case supports the hypothesis that major ECG abnormalities may be present in severe malnutrition due to anorexia nervosa or bulimia with self-induced vomiting. The dangers of these complications were substantiated by the fact that intensive care treatment allowed prompt body weight recovery but normalization of electrolytic balance and cardiac function was very slow. For such patients, electrocardiographic monitoring should be routine. PMID:2377804

  11. Cognitive-Behavioral Therapy for Bulimia: An Initial Outcome Study.

    Science.gov (United States)

    Ordman, Arnold M.; Kirschenbaum, Daniel S.

    1985-01-01

    Examined the efficacy of a cognitive-behavioral therapy for bulimia. Assigned 20 bulimic women to full- or brief-intervention therapy programs. Results indicated that full-intervention clients, relative to brief-intervention clients, substantially reduced the frequency of their bingeing-vomiting; improved their psychological adjustment; and…

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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 ...

  18. 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.

  19. 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...

  20. 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...

  1. Endocrine consequences of anorexia nervosa.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-07-01

    Anorexia nervosa is prevalent in adolescents and young adults, and endocrine changes include hypothalamic amenorrhoea; a nutritionally acquired growth-hormone resistance leading to low concentrations of insulin-like growth factor-1 (IGF-1); relative hypercortisolaemia; decreases in leptin, insulin, amylin, and incretins; and increases in ghrelin, peptide YY, and adiponectin. These changes in turn have harmful effects on bone and might affect neurocognition, anxiety, depression, and the psychopathology of anorexia nervosa. Low bone-mineral density (BMD) is particularly concerning, because it is associated with changes in bone microarchitecture, strength, and clinical fractures. Recovery leads to improvements in many--but not all--hormonal changes, and deficits in bone accrual can persist. Oestrogen-replacement therapy, primarily via the transdermal route, increases BMD in adolescents, although catch-up is incomplete. In adults, oral oestrogen--combined with recombinant human IGF-1 in one study and bisphosphonates in another--increased BMD, but not to the normal range. More studies are necessary to investigate the optimum therapeutic approach in patients with, or recovering from, anorexia nervosa. PMID:24731664

  2. Anorexia nervosa with herpes simplex encephalitis

    OpenAIRE

    George, G. C. W.

    1981-01-01

    Studies of patients suffering from anorexia nervosa appear to show an increased immunity to certain infections, as well as immunological deficiencies. This is the report of a patient with anorexia nervosa who developed herpes simplex encephalitis, a condition associated with lowered immunological defence mechanisms.

  3. 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

  4. 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)

  5. 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…

  6. Uncontrollable behavior or mental illness? Exploring constructions of bulimia using Q methodology

    OpenAIRE

    Churruca, Kate; Perz, Janette; Ussher, Jane M

    2014-01-01

    Background In medical and psychological literature bulimia is commonly described as a mental illness. However, from a social constructionist perspective the meaning of bulimia will always be socially and historically situated and multiple. Thus, there is always the possibility for other understandings or constructions of bulimia to circulate in our culture, with each having distinct real-world implications for those engaging in bulimic behaviors; for instance, they might potentially influence...

  7. Percepção de familiares sobre a anorexia e bulimia: revisão sistemática Percepción de familiares sobre la anorexia y bulimia: revisión sistemática Family perception of anorexia and bulimia: a systematic review

    Directory of Open Access Journals (Sweden)

    Cybele Ribeiro Espíndola

    2009-08-01

    Full Text Available Realizou-se revisão sistemática da literatura publicada entre 1990 e 2006 com metodologia qualitativa sobre a perspectiva de familiares de pessoas com anorexia e bulimia nervosa. Após revisão crítica dos artigos e metassíntese, utilizou-se a abordagem meta-etnográfica para analisar e sintetizar os dados. O processo de interpretação empregado foi a reciprocal translation. Dentre 3.415 estudos, nove atenderam aos critérios de inclusão e exclusão. Dois conceitos emergiram: reconhecimento da doença e repercussões da doença. Na reorganização familiar, o sentimento de impotência foi predominante. Os resultados indicam a presença de distorções sobre os conceitos da doença associadas a um comprometimento familiar, que modifica a comunicação, atitudes e comportamentos dentro de um contexto de impotência.Se realizó revisión sistemática de la literatura publicada entre 1990 y 2006 con metodología cualitativa sobre la perspectiva de familiares de personas con anorexia y bulimia nerviosa. Posterior a la revisión crítica de los artículos y metasíntesis, se utilizó el abordaje meta-etnográfico para analizar y sintetizar los datos. El proceso de interpretación empleado fue el reciprocal translation. Entre 3.415 estudios, nueve atendieron a los criterios de inclusión y exclusión. Dos conceptos emergieron: reconocimiento de la enfermedad y repercusiones de la enfermedad. En la reorganización familiar, el sentimiento de impotencia fue predominante. Los resultados indican la presencia de distorsiones sobre los conceptos de la enfermedad asociados a un compromiso familiar, que modifica la comunicación, actitudes y comportamientos dentro de un contexto de impotencia.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

  8. 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.

  9. 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...

  10. 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...

  11. 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

  12. 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.

  13. 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

  14. Adolescence, Sexual Conflict, and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia F.

    1984-01-01

    Suggests that the high incidence of anorexia nervosa in adolescent girls may be related to developmental sexual pressure. Symptoms appear with the onset of puberty and are related to physiological and psychological changes. (JAC)

  15. Anorexia nervosa, obesity and bone metabolism.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-09-01

    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 increases in marrow adiposity and decreases in cold activated brown adipose tissue, both of which are related to low bone density. In obese individuals, greater visceral adiposity is associated with greater marrow fat, lower bone density and impaired bone structure. In this review, we discuss bone metabolism in anorexia nervosa and obesity in relation to adipose tissue distribution and hormones secreted or regulated by body fat content. PMID:24079076

  16. Anorexia Nervosa: Adolescent Starvation by Choice.

    Science.gov (United States)

    Gilbert, Evelyn H.; DeBlassie, Richard R.

    1984-01-01

    Discusses anorexia nervosa in terms of symptoms, characteristics of patients, family relationship, and modes of treatment. Suggests that a combination of psychological and medical treatment is more effective than behavior modification. (JAC)

  17. Jane: A Case Study in Anorexia Nervosa.

    Science.gov (United States)

    Willingham, Barbara

    1988-01-01

    The article reports the case history of a 15-year-old Australian girl with anorexia nervosa. Information is also given on prevalence, causes, definitions, and treatments including hospitalization, co-therapy, psychotherapy, behavior modification, family therapy, and counseling. (DB)

  18. 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)

  19. Anorexia Nervosa, Obesity and Bone Metabolism

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    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 increases in marrow adiposity and decreases in cold activated brown adipose tissue, both of which are related to low bone density. In obese individuals, greater visceral adiposity is associated with greater marrow fat, lower bone density and impaired bone structure. In this review, we discuss bone metabolism in anorexia nervosa and obesity in relation to adipose tissue distribution and hormones secreted or regulated by body fat content. PMID:24079076

  20. 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....

  1. Anorexia nervosa--diagnosis, aetiology, and treatment.

    OpenAIRE

    Hartman, D.

    1995-01-01

    The aetiology, assessment and treatment of anorexia nervosa are reviewed in the light of the classical accounts of Morton, Lasègue and Gull. The core symptoms are deliberate weight loss, disturbed body image and amenorrhoea, and complications may include cardiac failure, electrolyte disturbances, hypothermia and osteoporosis. Common clinical findings are described. Disturbed brain serotonin activity is implicated in the aetiology of anorexia nervosa, but there is little support for the use of...

  2. Effectiveness of psychopharmacology in Anorexia Nervosa treatment

    OpenAIRE

    Zadka Lukasz

    2015-01-01

    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 ...

  3. Anorexia nervosa, seasonality, and polyunsaturated fatty acids.

    Science.gov (United States)

    Scolnick, Barbara; Mostofsky, David I

    2015-09-01

    Anorexia nervosa is a serious neurobehavioral disorder marked by semistarvation, extreme fear of weight gain, frequently hyperactivity, and low body temperature. The etiology remains unknown. We present a speculation that a primary causative factor is that polyunsaturated fatty acids are skewed to prevent oxidative damage in phospholipid membranes. This causes a change in the trade off of oxidation protection vs homeoviscous adaptation to lower temperatures, which sets off a metabolic cascade that leads to the rogue state of anorexia nervosa. PMID:25981875

  4. 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.

  5. Dysregulation of Brain Reward Systems in Eating Disorders: Neurochemical Information from Animal Models of Binge Eating, Bulimia Nervosa, and Anorexia Nervosa

    OpenAIRE

    Avena, Nicole M.; Bocarsly, Miriam E.

    2011-01-01

    Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained t...

  6. [The Barbie-Matrix: effectiveness of a school-based German program for the primary prevention of anorexia nervosa developed for girls up to the age of 12].

    Science.gov (United States)

    Berger, Uwe; Joseph, Andrea; Sowa, Melanie; Strauss, Bernhard

    2007-06-01

    More than 25 % of the 12-year-old girls in Thuringia (Germany) show problematic eating behaviour as measured with the Eating-Attitudes-Test (EAT-26D), which corresponds to an increased risk for the development of anorexia nervosa or bulimia nervosa. This was the starting position of a controlled study using a pre-post-design to check the effectiveness of a newly developed German program for the prevention of anorexia nervosa in girls ("PriMa"). 42 Thuringian schools (20 as treatment group) with 1006 girls participated in the pilot study, which lasted from September 2004 to July 2005. Program effectiveness was analysed with mostly standardized questionnaires at three times of measurement (before, after the intervention and at 3 months follow-up) referring to body related self esteem (FBeK), satisfaction with body shape (KEDS), eating behaviour (EAT-26D) and body related attitudes. The program was established in 9 x 90-minute lessons including interactive exercises and discussing especially developed posters that show scenes of a Barbie-doll's life including the reports of a patient suffering from anorexia. Significant improvements on all variables could be reached for the higher risk group (EAT-26D >/= 10 points; = 26,7 %). Mean values in the EAT-26D decreased 5 points at the average which is equivalent with 6.6 % of the EAT-26D range, reflecting a practically significant change effect. PMID:17357902

  7. Peculiaridades do tratamento da anorexia e da bulimia nervosa na adolescência: a experiência do PROTAD Peculiarities in the treatment of anorexia and bulimia nervosa in adolescence: the PROTAD experience

    Directory of Open Access Journals (Sweden)

    Vanessa Pinzon

    2004-01-01

    Full Text Available Os transtornos alimentares são patologias severas, tendo aspectos especiais na adolescência. Este artigo objetiva apresentar a rotina de atendimento e as abordagens empregadas em um serviço de assistência brasileiro especializado no tratamento de transtornos alimentares nessa população.The particular aspects of eating disordes in adolescents are reviwed. This article presents the multidisciplinary approach used in this population.

  8. Peculiaridades do tratamento da anorexia e da bulimia nervosa na adolescência: a experiência do PROTAD Peculiarities in the treatment of anorexia and bulimia nervosa in adolescence: the PROTAD experience

    OpenAIRE

    Vanessa Pinzon; Ana Paula Gonzaga; Alícia Cobelo; Eunice Labaddia; Patrícia Belluzzo; Bacy Fleitlich-Bilyk

    2004-01-01

    Os transtornos alimentares são patologias severas, tendo aspectos especiais na adolescência. Este artigo objetiva apresentar a rotina de atendimento e as abordagens empregadas em um serviço de assistência brasileiro especializado no tratamento de transtornos alimentares nessa população.The particular aspects of eating disordes in adolescents are reviwed. This article presents the multidisciplinary approach used in this population.

  9. Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa).

    Science.gov (United States)

    Marikar, Dilshad; Reynolds, Sarah; Moghraby, Omer S

    2016-06-01

    We present a review of the Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa) guideline, which provides paediatricians with a framework for managing Anorexia Nervosa in the inpatient setting. PMID:26407730

  10. Bone metabolism in anorexia nervosa.

    Science.gov (United States)

    Fazeli, Pouneh K; Klibanski, Anne

    2014-03-01

    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 comorbidities 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 AN is associated with a significant risk of fractures and therefore treatments to prevent bone loss are critical. In this review, we discuss the hormonal determinants of low bone mass in AN and treatments that have been investigated in this population. PMID:24419863

  11. Bone disease in anorexia nervosa.

    Science.gov (United States)

    Dede, Anastasia D; Lyritis, George P; Tournis, Symeon

    2014-01-01

    Anorexia nervosa is a serious psychiatric disorder accompanied by high morbidity and mortality. It is characterized by emaciation due to self-starvation and displays a unique hormonal profile. Alterations in gonadal axis, growth hormone resistance with low insulin-like growth factor I levels, hypercortisolemia and low triiodothyronine levels are almost universally present and constitute an adaptive response to malnutrition. Bone metabolism is likewise affected resulting in low bone mineral density, reduced bone accrual and increased fracture risk. Skeletal deficits often persist even after recovery from the disease with serious implications for future skeletal health. The pathogenetic mechanisms underlying bone disease are quite complicated and treatment is a particularly challenging task. PMID:24722126

  12. Anorexia nervosa and bone metabolism.

    Science.gov (United States)

    Fazeli, Pouneh K; Klibanski, Anne

    2014-09-01

    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. Importantly, this low bone mass is also associated with a seven-fold increased risk of fracture. Therefore, strategies to effectively prevent bone loss and increase bone mass are critical. We will review hormonal adaptations that contribute to bone loss in this population as well as promising new therapies that may increase bone mass and reduce fracture risk in AN. PMID:24882734

  13. [Anorexia nervosa and the kidney].

    Science.gov (United States)

    Schneiter, Sabine; Berwert, Lorenzo; Bonny, Olivier; Teta, Daniel; Burnier, Michel; Vogt, Bruno

    2009-02-25

    Anorexia nervosa (AN) is a severe and potentially lethal disease of the young woman. It is defined as an anxious disorder not to gain weight, and an obsessive behavior regarding body weight and physical appearance. Different and variable patterns of behaviour are observed. This article focuses on the renal problems observed in anorexic patients. Anorexia is often associated with severe electrolyte disturbances, such as hypokalemia and hypophosphatemia, and alterations of water metabolism with hyponatremia and edema. Hypokalemia and chronic dehydration may contribute to the development of renal failure. Even end stage renal disease can be observed in these patients. A better understanding of the pathophysiology might improve treatment of patients suffering from AN. PMID:19317309

  14. 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

  15. 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

  16. Anorexia nervosa and bone metabolism

    Science.gov (United States)

    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. Importantly, this low bone mass is also associated with a seven-fold increased risk of fracture. Therefore, strategies to effectively prevent bone loss and increase low bone mass are critical. We will review hormonal adaptations that contribute to bone loss in this population as well as promising new therapies that may increase bone mass and reduce fracture risk in AN. PMID:24882734

  17. Bone Metabolism in Anorexia Nervosa

    Science.gov (United States)

    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 AN is associated with a significant risk of fractures and therefore treatments to prevent bone loss are critical. In this review, we discuss the hormonal determinants of low bone mass in AN and treatments that have been investigated in this population. PMID:24419863

  18. Anorexia nervosa and estrogen receptors.

    Science.gov (United States)

    Ramoz, Nicolas; Versini, Audrey; Gorwood, Philip

    2013-01-01

    Anorexia nervosa (AN) is a chronic psychiatric disorder with a high prevalence of 0.6% and the highest mortality rates among psychiatric diseases, around 10%, mostly due to undernutrition and suicide. AN is characterized by physiological features with a body mass index less than 17.5 kg/m(2), low bone mineral density and amenorrhea, psychological symptoms with a distortion of image body, and behavioral abnormalities. Estrogen molecules and estrogen biological pathway are clearly involved in food intake and body weight in animals and humans. Further, hypoestrogenism has been demonstrated in AN patients and convergent evidence involves the estrogen pathway in the development of AN. AN presents a high heritability and polymorphisms in genes coding the estrogen receptors alpha and beta have been found significantly associated with the disorder. This chapter shows the implication of estrogens in AN and suggests investigation to develop future pharmacological treatments for anorexia. PMID:23601424

  19. 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...

  20. 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...

  1. 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.

  2. 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.

  3. Modest familial aggregation of eating disorders in restrictive anorexia nervosa with adolescent onset in a Romanian sample.

    Science.gov (United States)

    Grigoroiu-Serbanescu, Maria; Magureanu, Sanda; Milea, Stefan; Dobrescu, Iuliana; Marinescu, Elvira

    2003-01-01

    The study of the familial psychopathology in relatives of restrictive anorexia nervosa (AN) probands whose diagnosis was verified during a long-term follow-up was aimed at determining behavioural phenotypes with which AN could share the genetic liability. A total of 185 first degree relatives of 68 restrictive AN patients with adolescent onset followed up for 5 to 18 years and 198 first degree relatives of 68 normal women were investigated. DSM-III-R criteria were used. The lifetime rate of clinical AN was 1% and the rate of any eating disorders was 2% in female proband relatives versus 0 in control relatives. No case of bulimia nervosa (BN) was found in proband relatives. The heritability of AN was low (0.18) when only the full-blown AN was considered in relatives and modest (0.36) when also a case of subthreshold AN was added. There were significantly higher rates of anxiety disorders (14.6%) and unipolar major depression (8.3%) in female proband relatives and "schizo"-spectrum disorders (8.3%) and alcoholism (13.1%) in male proband relatives compared to relatives of controls. Restrictive AN might share partial liability with phenotypes expressing emotional restraint and anxiety. A sex effect of the heterotypically affected relative on the vulnerability for AN was suggested. PMID:12567215

  4. Effects of weight gain and resumption of menses on reduced bone density in patients with anorexia nervosa.

    Science.gov (United States)

    Iketani, T; Kiriike, N; Nakanishi, S; Nakasuji, T

    1995-04-15

    The bone mineral density (BMD) of the lumbar vertebrae (L2-L4) and of the whole body were measured in cross-sectional and longitudinal studies in female patients with eating disorders, using dual photon absorptiometry before and after weight gain with or without resumption of menses. In the cross-sectional study, the low-body-weight anorectic patients, with or without bulimia nervosa, were found to have lower BMD of the lumbar vertebrae associated with severe weight loss, low physical activity, and earlier onset and longer duration of amenorrhea. In the longitudinal study, 11 patients attained subnormal body weight (70%SBW or = 85%SBW, 6 patients of them resumed regular menses) after treatment. The BMD of the lumbar vertebrae was found to increase with weight gain, but not to the control level. The BMD was further increased with the resumption of menses in patients with anorexia nervosa. These results suggest that resumption of menses, in addition to weight gain, is essential to normalize reduced bone mineral density. PMID:7619974

  5. Bulimia nerviosa, estilos de afrontamiento y situaciones estresantes

    OpenAIRE

    Echeverría Serrano, Elizabeth

    2006-01-01

    La presente investigación tuvo como objetivo estudiar la relación entre bulimia nerviosa, estilos de afrontamiento y situaciones estresantes. Se realizó una investigación no experimental, participaron 345 mujeres universitarias y la selección fue por disponibilidad. Los instrumentos utilizados fueron el Inventario de Trastornos de la Conducta Alimentaria (EDI-2), Test de Escalas de Afrontamiento para adolescentes (ACS) y la Escala de Apreciación General del Estrés (EAE). El ...

  6. 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...

  7. Enfermeiros e clientela com bulimia e anorexia: estudo de caso

    OpenAIRE

    Claudia Regina Carvalho Martins; Paulo Vaccari Caccavo

    2012-01-01

    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 pessoa...

  8. An MMPI Analysis of Similarities and Differences in Three Clasifications of Eating Disorders: Anorexia Nervosa, Bulimia, and Morbid Obesity.

    Science.gov (United States)

    Scott, Ronald L.; Baroffio, James R.

    1986-01-01

    Employed the Minnesota Multiphasic Personality Inventory to study similarities and differences of mean profiles of anorexic patients, bulimic patients, morbidly obese outpatients, and subjects in a matched control group. The results indicated that there was no significant difference in the overall profiles of the three experimental groups, but…

  9. The Association Between Patient Characteristics and the Therapeutic Alliance in Cognitive-Behavioral and Interpersonal Therapy for Bulimia Nervosa

    Science.gov (United States)

    Constantino, Michael J.; Arnow, Bruce A.; Blasey, Christine; Agras, W. Stewart

    2005-01-01

    The therapeutic alliance is an established predictor of psychotherapy outcome. However, alliance research in the treatment of eating disorders has been scant, with even less attention paid to correlates of alliance development. The goal of this study was to examine the relation between specific patient characteristics and the development of the…

  10. The brain serotonin transporter binding in young adults; methodological considerations and association with Bulimia Nervosa and acquired obesity

    OpenAIRE

    Koskela, Anu

    2008-01-01

    The neurotransmitter serotonin (5-HT) modulates many functions important for life, e.g., appetite and body temperature, and controls development of the neural system. Disturbed 5-HT function has been implicated in mood, anxiety and eating disorders. The serotonin transporter (SERT) controls the amount of effective 5-HT by removing it from the extracellular space. Radionuclide imaging methods single photon emission tomography (SPET) and positron emission tomography (PET) enable studies on the ...

  11. Emotional and Social Mind Training: A Randomised Controlled Trial of a New Group-Based Treatment for Bulimia Nervosa

    OpenAIRE

    Anna Lavender; Helen Startup; Ulrike Naumann; Nelum Samarawickrema; Hannah Dejong; Martha Kenyon; Frederique van den Eynde; Ulrike Schmidt

    2012-01-01

    OBJECTIVE: There is a need to improve treatment for individuals with bulimic disorders. It was hypothesised that a focus in treatment on broader emotional and social/interpersonal issues underlying eating disorders would increase treatment efficacy. This study tested a novel treatment based on the above hypothesis, an Emotional and Social Mind Training Group (ESM), against a Cognitive Behavioural Therapy Group (CBT) treatment. METHOD: 74 participants were randomised to either ESM or CBT Group...

  12. Emotional and social mind training: a randomised controlled trial of a new group-based treatment for bulimia nervosa.

    Directory of Open Access Journals (Sweden)

    Anna Lavender

    Full Text Available OBJECTIVE: There is a need to improve treatment for individuals with bulimic disorders. It was hypothesised that a focus in treatment on broader emotional and social/interpersonal issues underlying eating disorders would increase treatment efficacy. This study tested a novel treatment based on the above hypothesis, an Emotional and Social Mind Training Group (ESM, against a Cognitive Behavioural Therapy Group (CBT treatment. METHOD: 74 participants were randomised to either ESM or CBT Group treatment programmes. All participants were offered 13 group and 4 individual sessions. The primary outcome measure was the Eating Disorder Examination (EDE Global score. Assessments were carried out at baseline, end of treatment (four months and follow-up (six months. RESULTS: There were no differences in outcome between the two treatments. No moderators of treatment outcome were identified. Adherence rates were higher for participants in the ESM group. DISCUSSION: This suggests that ESM may be a viable alternative to CBT for some individuals. Further research will be required to identify and preferentially allocate suitable individuals accordingly. TRIAL REGISTRATION: ISRCTN61115988.

  13. Video Game Therapy for Emotional Regulation and Impulsivity Control in a Series of Treated Cases with Bulimia Nervosa

    OpenAIRE

    Konstantas, Dimitri; Ben Moussa, Maher; Fagundo, Ana Beatriz; Santamaría, Juan José; Forcano, Laura; Giner-Bartolomé, Cristina; Jiménez-Murcia, Susana; Sánchez, Isabel; Granero, Roser; Magnenat-Thalmann, Nadia; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Bults, Richard; Tarrega, Salomé

    2013-01-01

    Although standard psychological treatments have been successful in treating several core features in eating disorders (ED), other characteristics such as emotional regulation or impulsivity appear to be more resistant to change. There is a growing body of evidence to support the efficacy of cognitive remediation for cognitive and emotional difficulties in ED. Playmancer/ Islands is a video game (VG) designed to specifically treat mental disorders, characterized by problems in impulse control....

  14. "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.…

  15. Depression and bulimia: the link between depression and bulimic cognitions.

    Science.gov (United States)

    Schlesier-Carter, B; Hamilton, S A; O'Neil, P M; Lydiard, R B; Malcolm, R

    1989-08-01

    This study assessed the link between bulimic and depressive cognitions. Twenty-nine bulimics and 16 controls from the general population were first assessed on levels of depression using the Schedule for Affective Disorders and Schizophrenia-Change Version and the Beck Depression Inventory (BDI). Bulimics were significantly more depressed than controls. Bulimics differed significantly from controls on all cognitive measures associated with depression (Automatic Thoughts Questionnaire, Dysfunctional Attitude Scale, and Attributional Style Questionnaire), but differences on these measures were nonsignificant when depression, as measured by the BDI, was controlled. Bulimics differed from controls regardless of level of depression on the three scales of the Restraint Inventory, the Rationalization and All-or-None scales of the Thoughts About Eating Inventory, and most of the eight scales of the Eating Disorders Inventory. Bulimics showed more maladaptive thinking associated with depression, but these differences likely reflect the levels of depression for each group. The differences on the measures of cognitive and behavioral symptoms of bulimia remained when the level of depression was controlled statistically. This suggests that although depression can be frequently diagnosed in a bulimic sample, specific maladaptive cognitions and behaviors reflect a distinct disorder (bulimia) and are not simply the expression of an affective disorder. PMID:2768669

  16. [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

  17. Skin signs in anorexia nervosa.

    Science.gov (United States)

    Strumia, Renata

    2009-09-01

    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 diuretics, and of the psychiatric morbidity. They include xerosis, lanugo-like body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrhoeic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, acquired striae distensae, acral coldness.The most characteristic cutaneous sign of vomiting is Russell's sign (knuckle calluses). Symptoms due to laxative or diuretic abuse include adverse reactions by drugs. Symptoms due to psychiatric morbidity (artefacta) include the consequences of self-induced trauma. The role of the dermatologist in the management of eating disorders is to make an early diagnosis of the "hidden" signs of eating disorders in patients who tend to minimize or deny their disorder. PMID:20808514

  18. PHYTO-PHARMACOLOGICAL REVIEW OF ARGYREIA NERVOSA

    Directory of Open Access Journals (Sweden)

    A. Krishnaveni

    2011-02-01

    Full Text Available Herbal medicines are the significant and reliable sources for treating various diseases. Argyreia nervosa is traditionally used in wound healing, syphilius,diuretics,rheumatic affections, leucohorrhoea.,cerebral disorders, ulcers, as anti-tumour and to prevent contraception.Phytoconstituents such as flavanoids, steroids, ergoline alkaloids and triterpenoids were identified. Pharmacological studies proved its anticonvulsant, immunomodulatory, hypotensive, anti- inflammatory and nootropic effect.The present form of article highlights the phytochemical and pharmacological studies including traditional practice of Argyreia nervosa have been carried out so far.

  19. 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...

  20. [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

  1. Leptina e anorexia nervosa Leptin and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Roberta de Oliveira Corrêa

    2012-01-01

    Full Text Available Estudos recentes comprovam a importância da leptina no comportamento alimentar. A diminuição das concentrações séricas desse hormônio está diretamente relacionada com a variação da taxa de gordura corporal e provoca alterações em eixos neuroendócrinos, levando à amenorreia e à hiperatividade, entre outras consequências. Neste trabalho estamos apresentando uma revisão bibliográfica dos principais focos de estudo que relacionam a LEP com a ANN, bem como dos efeitos do excesso e da deficiência desse hormônio sobre o comportamento alimentar. Trata-se de um esforço para converter uma grande gama de conhecimentos obtidos da literatura em um texto, objetivando prover uma visão de como a LEP, funcionando como um sinal periférico de disponibilidade de energia, pode influenciar a atividade de circuitos neuronais que controlam mecanismos associados à regulação da homeostasia energética.Recent studies demonstrate the importance of leptin in feeding behavior. The decreasing of the serum concentration of this hormone is directly related to the body fatty amount and provokes alterations in neuroendocrine axis, causing amenorrhea and hyperactivity, among others consequences. In this paper, a review of the main aspects interconnecting leptin and anorexia nervosa is made, as well as of the effects of excess and deficiency of this hormone on feeding disease. It was an effort to convert a large amount of knowledge obtained from literature into a condensed text, aiming to provide an updated view, how leptin functioning as a peripheral signal of energy availability to central nervous system influences on the neural activity involved in regulation of body weight and energy homeostasis.

  2. Abdominal aortic occlusion and vascular compromise secondary to acute gastric dilatation in a patient with bulimia

    OpenAIRE

    Elsharif, M; Doulias, T; Aljundi, W; Balchandra, S

    2014-01-01

    Acute gastric dilation is a rare but recognised complication in patients with bulimia and anorexia following binge episodes owing to decreased bowel motility. We present a rare case of acute gastric dilation secondary to bulimia in an otherwise healthy 18-year-old female patient that resulted in compression and complete occlusion of the abdominal aorta, leading to acute mesenteric and bilateral lower limb ischaemia. This resolved immediately following a laparotomy and gastric decompression.

  3. 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.

  4. 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

  5. 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.

  6. [Masculine anorexia nervosa: realities and perspectives].

    Science.gov (United States)

    Chambry, Jean; Corcos, Maurice; Guilbaud, Olivier; Jeammet, Phillipe

    2002-05-01

    Since its description by Morton in 1694, masculine anorexia nervosa has been the subject of much debate. For many, two questions remain unanswered: does anorexia nervosa, as described in girls, exist in boys? - if so, is it the same disease? We analyzed the data in the literature which demonstrate a lower incidence than in the female population, although estimates are probable low due to underdiagnosis. The behavioral aspects suggest a similarity between masculine and feminine anorexia nervosa although the pure restrictive forms of anorexia are more rare in boys. There are however a few differences. Affected boys, according to Crips and Burns (1990), are heavier than girls at onset of the disorder but present a lower body weight during certain periods of the disease. Excessive physical activity is more frequent as is excessive intellectual involvement (Margo, 1987). The problem of amenorrhea, on/off periods, is not present in the male form. Testosterone and sexual function decline gradually, in parallel with the state of malnutrition (Anersen, 1990). The patient does not have particular difficulty discussing sexual relations but does exhibit a poor level of experience and mental representations. Contact with the opposite sex is rare and the fantastic life is generally very limited. The frequency of homosexual behavior would lie between 25% (Herzog, 1984) and 58% (Schneider and Agras, 1987), which is higher than in the female anorexia population (Herzog, 1984). This observation raises the question concerning the relationship between masculine mental anorexia nervosa and fragile sexual identity. PMID:12218886

  7. Self-injurious behavior in anorexia nervosa.

    Science.gov (United States)

    Favaro, A; Santonastaso, P

    2000-08-01

    Recent reports have postulated the existence of two different types of self-injurious behavior: impulsive and compulsive. The aim of the present study is to analyze the dimensionality of self-injurious behavior and to study the link between self-injurious behavior and clinical features in anorexia nervosa. The study involved 236 consecutive patients with anorexia nervosa, diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistructured interview and self-reported questionnaires, such as the Eating Disorders Inventory and Hopkins Symptom Checklist. A principal component analysis was used to study the dimensionality of different types of self-injurious behavior, including purging. Our findings confirm the distinction between impulsive and compulsive self-injurious behavior. The dimensions appear to be represented as a continuum in both the anorexia nervosa diagnostic subgroups. A third distinct dimension emerged that included self-induced vomiting and laxative/diuretics abuse. Childhood sexual abuse and anxiety significantly predict the presence of impulsive self-injury, whereas obsessionality and age predict compulsive self-injury. The coexistence of a positive score on both dimensions of self-injurious behavior was the strongest predictor of treatment dropout. The present study highlights the importance of self-injurious behavior; it should be given due consideration in future outcome studies on anorexia nervosa PMID:10972574

  8. PHYTO-PHARMACOLOGICAL REVIEW OF ARGYREIA NERVOSA

    OpenAIRE

    Krishnaveni, A; T. Sant Rani

    2011-01-01

    Herbal medicines are the significant and reliable sources for treating various diseases. Argyreia nervosa is traditionally used in wound healing, syphilius,diuretics,rheumatic affections, leucohorrhoea.,cerebral disorders, ulcers, as anti-tumour and to prevent contraception.Phytoconstituents such as flavanoids, steroids, ergoline alkaloids and triterpenoids were identified. Pharmacological studies proved its anticonvulsant, immunomodulatory, hypotensive, anti- inflammatory and no...

  9. 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…

  10. 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…

  11. 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)

  12. 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,…

  13. 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,…

  14. 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…

  15. 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

  16. Increased Bone Marrow Fat in Anorexia Nervosa

    OpenAIRE

    Bredella, Miriam A.; Fazeli, Pouneh K.; Miller, Karen K.; Misra, Madhusmita; Torriani, Martin; Thomas, Bijoy J.; Ghomi, Reza Hosseini; Rosen, Clifford J; Klibanski, Anne

    2009-01-01

    Context: Although women with anorexia nervosa (AN) have severe depletion of body fat, a paradoxical increase in bone marrow fat has been described. Recent data suggest that marrow fat measured by 1H-magnetic resonance spectroscopy (MRS) in combination with bone mineral density (BMD) may be more valuable than either parameter alone in detecting bone weakness.

  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. 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...

  19. 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...

  20. The clinical features of late onset anorexia nervosa.

    OpenAIRE

    Joughin, N. A.; Crisp, A H; Gowers, S. G.; Bhat, A V

    1991-01-01

    This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The population comprised 12 patients with a first onset of anorexia nervosa at or after the age of 30, 415 patients with an onset after 15 but before 20 and 9 patients with an onset ...

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

    OpenAIRE

    Krantz Mori J; Mehler Philip S

    2004-01-01

    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 su...

  2. Can A Rational Choice Framework Make Sense of Anorexia Nervosa?

    OpenAIRE

    Goldfarb, Robert S.; Thomas C. Leonard; Sara Markowitz; Steven Suranovic

    2009-01-01

    Can a rational choice modeling framework help broaden our understanding of anorexia nervosa? This question is interesting because anorexia nervosa is a serious health concern, and because of the following issue: could a rational choice approach shed useful light on a condition which appears to involve "choosing" to be ill? We present a model of weight choice and dieting applicable to anorexia nervosa, and the sometimes-associated purging behavior. We also present empirical evidence about fact...

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

    OpenAIRE

    Cook, Victoria J; Coxson, Harvey O.; Mason, Andrew G; Tony R Bai

    2001-01-01

    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.RESULTS: The case of a 34-year-old, nonsmoking woman with long-standing severe anorexia nervosa who was evaluated for cough and progressive shortness of b...

  4. 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...

  5. [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

  6. 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

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

    OpenAIRE

    Noguchi Hitoshi; Murakami Tsukasa; Uchino Shinya; Yamashita Hiroto; Noguchi Shiro

    2011-01-01

    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 ori...

  8. Study Ties Girls’ Bulimia To Arrival Of TV In Fiji

    Institute of Scientific and Technical Information of China (English)

    Leslie; Gevirtz; 张式昌

    1999-01-01

    斐济,南太平洋的一个美丽岛国,在1985年尚不通电。但是,随着通电而来的电视,给这个岛国带来了意料不到的变化!昔日,该国的少男少女均以强健和肌肉发达为美,为追求。而今,小小的电视荧屏让他们看到了外面的世界,知道了Western ideals of beauty。从此,少女们开始diet(节食减肥),孰料,少女减肥不当,减出了bulimia(易饿病)and anorexia(厌食)。电视的出现是祸是福?作者意味深长地“重温”了19世纪的历史:When the British came to Fiji andbrought the measles 【医】麻疹)with them.接着,作者写道:in the 20th century,television is another pathogen(病原体)exporting Western images and values.】

  9. 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.

  10. 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

  11. 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...

  12. 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...

  13. 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, ...

  14. 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 ...

  15. 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...

  16. 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...

  17. 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 ...

  18. 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...

  19. Behavioral neuroendocrinology and treatment of anorexia nervosa.

    Science.gov (United States)

    Södersten, P; Nergårdh, R; Bergh, C; Zandian, M; Scheurink, A

    2008-10-01

    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 amount of physical activity. In this condition, the human homeostatic phenotype, body fat content is also low and as a consequence, the synthesis and release of brain neurotransmitters are modified. As an example, the role of neuropeptide Y is analyzed in rat models of this state. It is suggested that the normal behavioral role of neuropeptide Y is to facilitate the search for food and switch attention from sexual stimuli to food. Descriptive neuroendocrine studies on patients with anorexia nervosa have not contributed to the management of the patients and the few studies in which hormones have been administered have, at best, reversed an endocrine consequence secondary to starvation. In a modified framework for understanding the etiology and treatment of anorexia nervosa it is suggested that the condition emerges because neural mechanisms of reward and attention are engaged. The neural neuropeptide Y receptor system may be involved in the maintenance of the behavior of eating disorder patients because the localization of these receptors overlaps with the neural systems engaged in cue-conditioned eating in limbic and cortical areas. The eating behavior of patients with anorexia nervosa, and other eating disorders as well, is viewed as a cause of the psychological changes of the patients. Patients are trained to re-learn normal eating habits using external support and as they do, their symptoms, including the psychological symptoms, dissolve. PMID:18602416

  20. Behavioral neuroendocrinology and treatment of anorexia nervosa

    OpenAIRE

    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 amount of physical activity. In this condition, the human homeostatic phenotype, body fat content is also low and as a consequence, the synthesis and release of brain neurotransmitters are modifie...