... and Bulimia What Causes Eating Disorders? Sports and Eating Disorders Effects of Eating Disorders Treatment for Eating Disorders Print ... when they are biologically destined to gain it. Effects of Eating Disorders Eating disorders are serious medical illnesses. They often ...
... weight loss. With anorexia, a person will deny hunger and refuse to eat, practice binge eating and ... to better insure healthy eating patterns, and increases awareness and support. Related Conditions People with eating disorders ...
Full Text Available Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient’s health condition, associated with behavior and eating habits, the experience of one’s own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.
Aranha, Ana Cecília Corrêa; Eduardo, Carlos de Paula; Cordás, Táki Athanassios
The aim of this article is to present a review of the literature on eating disorders and related oral implications in order to provide oral healthcare professionals and psychiatrists with information that will enable them to recognize and diagnose these disorders and render appropriate treatment. A comprehensive review of the literature was conducted with special emphasis on the oral implications of anorexia nervosa and bulimia nervosa. Currently, available knowledge that correlates eating disorders with dental implications is supported by data derived from well-conducted psychiatric and psychological literature. However, little is known about the aspects of oral medicine concerned with the subject. Dental erosion, xerostomia, enlargement of the parotid gland, and other dental implications might be present in individuals with eating disorders. Eating disorders are a serious concern with regard to the oral health of patients. They represent a clinical challenge to dental professionals because of their unique psychological, medical, nutritional, and dental patterns as well as their unique characteristics. However, there is a general lack of awareness of the fundamental importance of the dentist's role in the multidisciplinary treatment of affected patients. The failure of oral healthcare professionals to recognize dental characteristics of eating disorders may lead to serious systemic problems in addition to progressive and irreversible damage to the hard tissues. Considering the increasing incidence and prevalence rates of eating disorders the participation of oral healthcare professionals in a multidisciplinary team to provide care for affected patients rises to greater importance.
Eating disorders are serious behavior problems. They can include severe overeating or not consuming enough food to stay ... concern about your shape or weight. Types of eating disorders include Anorexia nervosa, in which you become too ...
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Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa
Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.
Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E
Abstract Health Issue Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. Key Issues Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and...
The aim of this bachelor thesis is to create an eating disorder prevention program. The thesis particularly focuses on the eating disorder problems during adolescence and early adulthood along with the explanation and specification of basic terms, history and cause of the disorder. A strong emphasis is placed on the possibilities of the prevention. A qualitative research was carried out within the scope of this thesis and it brought useful data about the students and their knowledge of the ea...
Yeh, Shin-Shyuan Sally; Brown, Rhonda Frances
We evaluated the relationship between poor sleep quality and high body mass index (BMI) in a community-derived sample. In addition, we explored the premise that disordered eating (i.e. eating late at night and/or binge eating, which can occur at night) may partly explain the relationship. An online survey asked 330 participants about their height and weight, recent sleep quality, and recent experiences of binge-eating and night-time eating. Using multiple regression analyses, high BMI was shown to be related to shorter sleep duration, increased sleep latency, use of sleeping medications and worse binge-eating, whereas worse sleep quality was related to worse night-eating, after controlling for depression and demographics. Using mediational analyses, binge-eating was shown to partly mediate the relationship between worse sleep quality to higher BMI, whereas night-eating mediated the reverse association of high BMI to worse sleep quality. The results suggest that night- and/or binge-eating may partly explain the observed relationship between worse sleep quality and overweight/obesity. Thus, the relationship may simply reflect that overweight people are more likely to binge-eat while they wait for sleep to come, and this may contribute to weight gain over time. In addition, the results may indicate that eating rather than weight gain or obesity may be responsible for causing the sleep deficits in overweight people. Copyright © 2014 Elsevier Ltd. All rights reserved.
Eating disorder - binge eating; Eating - binge; Overeating - compulsive; Compulsive overeating ... as having close relatives who also have an eating disorder Changes in brain chemicals Depression or other emotions, ...
Kontić Olga; Vasiljević Nadja; Trišović Marija; Jorga Jagoda; Lakić Aneta; Jašović-Gašić Miroslava
Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis...
Full Text Available Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES is an eating disorder characterised by the clinical features of morning anorexia, evening hyperphagia, and insomnia with awakenings followed by nocturnal food ingestion. Recently night eating syndrome, conceptualized as a delayed circadian intake of food. Sleep-related eating disorder, thought to represent a parasomnia and as such included within the revised International Classification of Sleep Disorders (ICSD-2, and characterized by nocturnal partial arousals associated with recurrent episodes of involuntary food consumption and altered levels of consciousness. Whether, however, sleep-related eating disorder and night eating syndrome represent different diseases or are part of a continuum is still debated. This review summarizes their characteristics, treatment outcomes and differences between them.
Neeta Misra; Anshul Mehra; Pradyuman Misra; Jaya Mehra
Eating disorders are potentially life-threatening disorders. In this article, we discuss the oral manifestations of eating disorders so as to enable dental practitioners to recognize the effects of eating disorders and to manage the patients with eating disorders.
Full Text Available Binge Eating Disorder, characterized by frequent and persistent overeating episodes that are accompanied by feeling of loss of control over eating without regular compensatory behaviors and was identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as a new eating disorder category. Binge Eating Disorder is the most common eating disorder among adults. Binge Eating Disorder is associated with significant morbidity, including medical complications related to obesity, eating disorder psychopathology, psychiatric comorbidity; reduced quality of life, and impaired social functioning. Current treatments of Binge Eating Disorder include pharmacotherapy, psychotherapy and bariatric surgery. In this review, the definition, epidemiology, etiology, clinical features, and also mainly treatment of Binge Eating Disorder are discussed.
Stewart, Tiffany M.; Williamson, Donald A.
This article describes the program content of a multidisciplinary, hospital-based program for severe eating disorders. Common goals for treatment of patients with eating disorders are discussed. Details about the specific therapeutic strategies used in individual and group therapy are provided. Also, information about dietary counseling and…
Kinzl, Johann F; Biebl, Wilfried
The various eating disorders, anorexia nervosa, bulimia nervosa, and binge-eating disorder, are characterized by severe disturbances in eating behavior and are seen as typical "psychosomatic disorders". The subdivision of anorexia nervosa into two subtypes, namely "anorexia nervosa restricting type" and "anorexia nervosa bulimic type" has proved to be very good. It is to be assumed that eating disorders are not a homogeneous group, and that the various subtypes of eating disorders are also heterogeneous at several levels. Co-morbid psychiatric disorders, especially affective disorders, anxiety disorders, substance-related disorders, and personality disorders, are often found in eating- disordered patients. Many anorectics of the restrictive type and orthorectics show co-morbid psychiatric disorders such as anxiety disorders, obsessive-compulsive disorders, and avoidant or obsessive-compulsive personality disorders, while a co-morbidity of affective disorders, addiction, personality disorders, especially multi-impulsivity and borderline personality disorder, is frequently found in anorectics of bulimic type, bulimics, and binge eaters. Addictive behavior manifests itself in permanent preoccupation with food and eating, withdrawal symptoms, continuation of disturbed eating behavior in spite of negative consequences, loss of control, and frequent relapse. There are some indications that there is a basic psychological disturbance common to eating disorders, especially bulimia nervosa, and to substance-related disorders, namely a personality disorder with an emotional instability and multi-impulsivity. The possible associations between eating disorders and mental disorders, particularly addictions, will be discussed.
Gonzalez, Aranzazu; Kohn, Michael R; Clarke, Simon D
The overall prevalence of eating disorders among children and adolescents is rising - the younger age group are more likely to present with anorexia nervosa (AN), while the older adolescent can present with either AN or bulimia nervosa (BN). However, eating disorders exist as part of a spectrum and general practitioners will encounter many adolescents that have an eating disorder that do not yet fulfil diagnostic criteria for either AN or BN. This article aims to provide an overview of assessment and principles of management of eating disorders in the adolescent patient. General practitioners are key in recognising and offering early intervention in cases of incipient eating disorders or problem dieting behaviour. The physical findings of AN are those of protein calorie malnutrition, while in BN, they reflect chronic purging. Failure of outpatient management requires hospitalisation for nutritional rehabilitation with close monitoring of fluid and electrolyte status to prevent the development of refeeding syndrome. Family involvement is vital, particularly in the younger patient, with ongoing family therapy offering the best outcomes.
Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M
Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.
Deniz Tuncel; Fatma Özlem Orhan
Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES) is an eating disorder characterised by the clinical features of morning anorexia, even...
Waller, Glenn; Evans, Jane; Stringer, Hannah
This study examined the strength of the therapeutic alliance in the early stages of cognitive-behavioral therapy (CBT) for the eating disorders, and whether the strength of that alliance is associated with early eating characteristics, comorbid Axis 1 and 2 features. Forty-four eating-disordered patients completed measures of eating and Axis 1 and 2 characteristics at the start of therapy, and measures of the therapeutic alliance and eating characteristics at the sixth session of CBT. The therapeutic alliance was strong, including in the domain of attachment. It was unrelated to initial eating pathology and early changes in eating cognitions and behaviors. However, there were links between initial emotional and interpersonal features and therapeutic alliance by the sixth session. The findings counter suggestions that CBT for eating disorders is characterized by a poor therapeutic relationship. The therapeutic alliance is likely to be enhanced by addressing high levels of emotional distress and difficulties in interpersonal function where appropriate. This research needs to be extended to other therapies, other domains of function and different time points in therapy, to build a fuller picture of the role of the therapeutic relationship in working with the eating disorders. Copyright © 2011 Wiley Periodicals, Inc.
Full Text Available This article reviews several most important evolutionary mechanisms that underlie eating disorders. The first part clarifies evolutionary foundations of mental disorders and various mechanisms leading to their development. In the second part selective pressures and evolved adaptations causing contemporary epidemic of obesity as well as differences in dietary regimes and life-style between modern humans and their ancestors are described. Concerning eating disorders, a number of current evolutionary explanations of anorexia nervosa are presented together with their main weaknesses. Evolutionary explanations of eating disorders based on the reproductive suppression hypothesis and its variants derived from kin selection theory and the model of parental manipulation were elaborated. The sexual competition hypothesis of eating disorder, adapted to flee famine hypothesis as well as explanation based on the concept of social attention holding power and the need to belonging were also explained. The importance of evolutionary theory in modern conceptualization and research of eating disorders is emphasized.
... Videos for Educators Search English Español Kids and Eating Disorders KidsHealth / For Kids / Kids and Eating Disorders What's ... and pee) withdrawing from social activities What Causes Eating Disorders? There really is no single cause for an ...
Srinivasan, T.N.; Suresh, T.R.; Jayaram, Vasantha; Fernandez, M. Peter
Data on the nature and extent of major eating disorders, anorexia nervosa and bulimia is lacking in non-white, native populations of the developing world, leaving a gap in understanding the determinants of these disorders. In a study on 210 medical students examined by a two-stage survey method, 31 subjects were found to have distress relating to their eating habits and body size not amounting to criterion-based diagnosis of eating disorders. The characteristics of this eating distress syndro...
... us in our mission. F.E.A.S.T.'s Eating Disorders Glossary Welcome to our comprehensive quick-reference eating ... Conversion Weight Manipulation Weight restoration, weight restored Zinc Eating disorders biology & pharmacology Antidepressants BDNF - brain-derived neurotophic factor ...
Full Text Available According to International Classification of Diseases by World Health Organization, eating disorders are behavioural syndromes associated with physiological disturbances . Eating disorders include anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances and vomiting associated with other psychological disturbances . Maladaptive eating pattern and inadequate physical activity are seen in adolescents with eating disorders and obesity . Those with comorbid eating disorder and obesity have a poorer prognosis and are at higher risk for future medical problems.
Polivy, Janet; Herman, C Peter
Anorexia nervosa and bulimia nervosa have emerged as the predominant eating disorders. We review the recent research evidence pertaining to the development of these disorders, including sociocultural factors (e.g., media and peer influences), family factors (e.g., enmeshment and criticism), negative affect, low self-esteem, and body dissatisfaction. Also reviewed are cognitive and biological aspects of eating disorders. Some contributory factors appear to be necessary for the appearance of eating disorders, but none is sufficient. Eating disorders may represent a way of coping with problems of identity and personal control.
Eliot, Alexandra O.; Baker, Christina Wood
Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…
Although commonly associated with girls and women, eating disorders do not discriminate. School nurses need to be aware that male students also can suffer from the serious health effects of anorexia nervosa, bulimia, anorexia athletica, and eating disorders not otherwise specified. Sports that focus on leanness and weight limits can add to a…
The thesis focuses on knowledge of eating disorders by students of University of South Bohemia. The theoretical part defines particular types of eating disorders and the causes related with this problems. There are possible treatment methods for eating disorders mentioned at the end of this part. The practical part deals with students? awareness of eating disorders. It focuses on students? knowledge of eating disorders and orthorexia nerovosa. The research is based on questionnaire constructi...
Fakra, Eric; Belzeaux, R; Azorin, J M; Adida, M
Epidemiologic studies show a frequent co-occurence of affective and eating disorders. The incidence of one disorder in patients suffering from the other disorder is well over the incidence in the general population. Several causes could explain this increased comorbidity. First, the iatrogenic origin is detailed. Indeed, psychotropic drugs, and particularly mood stabilizers, often lead to modification in eating behaviors, generally inducing weight gain. These drugs can increase desire for food, reduce baseline metabolism or decrease motor activity. Also, affective and eating disorders share several characteristics in semiology. These similarities can not only obscure the differential diagnosis but may also attest of conjoint pathophysiological bases in the two conditions. However, genetic and biological findings so far are too sparse to corroborate this last hypothesis. Nonetheless, it is noteworthy that comorbidity of affective and eating disorders worsens patients'prognosis and is associated with more severe forms of affective disorders characterized by an earlier age of onset in the disease, higher number of mood episodes and a higher suicidality. Lastly, psychotropic drugs used in affective disorders (lithium, antiepileptic mood stabilizers, atypical antipsychotics, antidepressants) are reviewed in order to weigh their efficacy in eating disorders. This could help establish the best therapeutic option when confronted to comorbidity. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.
Khalil, Rami Bou; El Hachem, Charline
To elucidate the possible role of adiponectin, an adipokine secreted by white adipose tissue that plays an important role in the neuromodulation of food intake, in the pathogenesis of eating disorders. A comprehensive review of the available literature via MedLine is done using the term "adiponectin" in association with one of the following terms: "anorexia nervosa", "bulimia nervosa", "binge eating disorder" or "eating disorders". The majority of studies evaluating serum adiponectin levels in patients with eating disorders show that serum adiponectin levels are increased in patients with anorexia nervosa. After refeeding, adiponectin levels tend to rejoin the levels of healthy individuals. Data concerning serum adiponectin levels in patients with bulimia nervosa show that these levels can be equal, higher or lower than those found in healthy controls and lower than those found in anorexia nervosa patients. Binge eating disorder is accompanied with lower serum adiponectin levels than normal. Adiponectin receptor type 1 seems to be more related to the central pathological effect of adiponectin on eating behavior. The potential role that plays adiponectin in the pathogenesis of eating disorders needs to be elucidated by further studies.
Juli, Maria Rosaria
The origin and course of eating disorders and nutrition have a multifactorial etiology and should therefore take into consideration: psychological factors, evolutionary, biological and socio-cultural (Juli 2012). Among the psychological factors we will focus on violence (in any form) and in particular on the consequences that they have on women, which vary in severity. Recent studies show that women get sick more than men, both from depression and eating disorders, with a ratio of 2:1; this difference begins in adolescence and continues throughout the course of life (Niolu 2010). The cause of this difference remains unclear. Many studies agree that during adolescence girls have negative feelings more frequently and for a longer duration caused by stressful life events and difficult circumstances, such as abuse or violence. This results in an increased likelihood of developing a symptom that will be connected to eating disorders and/or depression. As far as the role of food is concerned in eating disorders, it has a symbolic significance and offers emotional comfort. Eating means to incorporate and assimilate, and even in an ideal sense, the characteristics of the foods become part of the individual. Feelings that lead to binges with food are normally a result of feelings related to abuse or violence and lead to abnormal behavior which leads to binging and the final result being that the person is left feeling guilty and ashamed. Research confirms that 30% of patients who have been diagnosed with eating disorders, especially bulimia, have a history of sexual abuse during childhood. Ignoring the significance of this factor can result in the unleashing of this disease as the patient uses the disorder as his expressive theater (Mencarelli 2008). Factors that contribute to the possibility of developing an eating disorder are both the age of the patient at the time of the abuse and the duration of the abuse. The psychological effects that follow may include dissociative
This thesis deals with nutritional therapy for eating disorders. It explores whether nutritional therapy has an irreplaceable role in treatment of these disorders or whether nutritional therapy has a marginal effect. I describe general issues of eating disorders in a theoretical part of my thesis such as etiology, epidemiology, therapy and nutrition therapy. I composed educational handout about eating in a practical part of my thesis containing fundamental dietary recommendations, menu for un...
Eating disorders are serious psychiatric conditions often demanding specialized psychiatric care. Several effective treatments have been developed and disseminated, but more needs to be done, as not all patients respond well to intervention, let alone achieve recovery. Obvious candidates such as eating disorder diagnosis, symptoms and psychiatric comorbidity have generally failed to explain variability in prognosis and outcome, warranting investigation of a wider range of relevant factors. Ac...
Clark-Stone, Sam; Joyce, Heidi
Eating disorders can be severe and enduring mental illnesses that have serious physical, psychological and social consequences. They can also have a significant effect on the person's friends and family. In this patient group, control of body shape, weight or eating is over-valued and becomes the main or only way of judging self-worth. Eating disorders can be mild and self-limiting, but they commonly run a chronic course unless treatment is successful. Nurses play an important role in early detection, assessment and treatment.
Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa
Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…
Sharan, Pratap; Sundar, A Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations.
Sharan, Pratap; Sundar, A. Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646
Atalayer, Deniz; Gibson, Charlisa; Konopacka, Alexandra; Geliebter, Allan
There is growing evidence supporting a multifactorial etiology that includes genetic, neurochemical, and physiological components for eating disorders above and beyond the more conventional theories based on psychological and sociocultural factors. Ghrelin is one of the key gut signals associated with appetite, and the only known circulating hormone that triggers a positive energy balance by stimulating food intake. This review summarizes recent findings and several conflicting reports on ghrelin in eating disorders. Understanding these findings and inconsistencies may help in developing new methods to prevent and treat patients with these disorders. PMID:22960103
Moriarty, Dick; Moriarty, Mary
Since sports can sometimes lend themselves to eating disorders, coaches and sports administrators must get involved in the detection and treatment of this problem. While no reliable studies or statistics exist on the incidence of anorexia nervosa and/or bulimia among athletes, some research suggests that such disorders occur frequently among…
Full Text Available Ignacio Jáuregui-LoberaBehavioral Sciences Institute and Pablo de Olavide University, Seville, SpainAbstract: Neuroimaging techniques have been useful tools for accurate investigation of brain structure and function in eating disorders. Computed tomography, magnetic resonance imaging, positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy, and voxel-based morphometry have been the most relevant technologies in this regard. The purpose of this review is to update the existing data on neuroimaging in eating disorders. The main brain changes seem to be reversible to some extent after adequate weight restoration. Brain changes in bulimia nervosa seem to be less pronounced than in anorexia nervosa and are mainly due to chronic dietary restrictions. Different subtypes of eating disorders might be correlated with specific brain functional changes. Moreover, anorectic patients who binge/purge may have different functional brain changes compared with those who do not binge/purge. Functional changes in the brain might have prognostic value, and different changes with respect to the binding potential of 5-HT1A, 5-HT2A, and D2/D3 receptors may be persistent after recovering from an eating disorder.Keywords: neuroimaging, brain changes, brain receptors, anorexia nervosa, bulimia nervosa, eating disorders
Full Text Available Suicide associated mortality rates are notable for eating disorders. Crude mortality rate associated with suicide, varies between 0% and 5.3% in patients with eating disorders. Prominent risk factors for suicidal behavior among these patients are subtype of the eating disorders, comorbid psychiatric diagnosis (e.g. depression, alcohol and substance abuse, personality disorders, ultrarapid drug metabolism, history of childhood abuse and particular family dynamics. In this article, suicidal behavior and associated factors in eating disorders are briefly reviewed.
This thesis deals with the problems of eating disorders. Objective of the thesis is definition of eating disorder, a description of the individual faults an as a practical part there is an artistic creation of specific disorders. Theoretical part includes characteristics, division and insight into history. There are described four forms of eating disorders: anorexia, bulimia, obesity and bigorexia. In the practical part is the visual processing of transformation of two excessive eating disord...
Binge eating disorder is a common eating disorder that recently has received increasing attention. Goals in treating binge eating disorder typically include controlling binge eating and diminishing excess body weight. A variety of treatment approaches have been used, including diet/lifestyle modification, psychotherapy, and pharmacologic treatment. Diet and lifestyle interventions are somewhat effective in diminishing the binge eating behavior and lead to modest weight loss, but the weight ef...
The quality of the prevention of eating disorders represents in several last decades frequently discussed issue in the context of rapidly changing socio-economic conditions, a significant increase of influence of the media, new technologies and knowledge of risk factors. Primary prevention aims to reduce the risk of developing eating disorders, but secondary and tertiary prevention play the important role as well. Effective and coordinated prevention is still missing. Our experience of international cooperation of the last 20 years led to the development and evaluation of prevention programs. We are describing their fast development and ongoing programs following the new trends recommended by WHO.
... Reprints Where Can I Find More Information? Share Eating Disorders: About More Than Food Download PDF Download ePub ... you may have an eating disorder. What are eating disorders? Eating disorders are serious medical illnesses marked by ...
Full Text Available Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main findings in respect of EEG in eating disorders by means of a search conducted in PubMed. Despite the fact that weight gain tends to normalize some brain dysfunctions assessed by means of EEG, the specific effect of gaining weight remains controversial. Different studies have reported that cortical dysfunctions can be found in patients with anorexia nervosa even after weight gain, whereas others have reported a normalization of EEG in respect of the initial reduced alpha/increased beta power in those patients with refeeding. Findings of studies that have analyzed the possible relationship between eating disorders and depression, based on sleep EEG disturbances, do not support the idea of eating disorders as a variant of depression or affective disorders. Some EEG findings are very consistent with previous neuroimaging results on patients with anorexia nervosa, reporting neural disturbances in response to stimuli that are relevant to the pathology (eg, stimuli like food exposure, different emotional situations, or body images.Keywords: electroencephalography, event-related potentials, sleep, depression, refeeding, weight gain
Thaler, Lea; Steiger, Howard
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs). The chapter then summarizes the emerging body of literature on epigenetics and EDs-mainly studies on DNA methylation in samples of anorexia and bulimia. The available evidence base suggests that an epigenetically informed perspective contributes in valuable ways to the understanding of why people develop EDs.
Pike, Kathleen M.; Hoek, Hans W.; Dunne, Patricia E.
Purpose of review Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. Recent findings While historically, eating disorders were
Timofeeva, Elena; Calvez, Juliane
Eating disorders are devastating and life-threatening psychiatric diseases. Although clinical and experimental investigations have significantly progressed in discovering the neuronal causes of eating disorders, the exact neuronal and molecular mechanisms of the development and maintenance of these pathologies are not fully understood. The complexity of the neuronal substrate of eating disorders hampers progress in revealing the precise mechanisms. The present re...
Ray, Shannon L.
Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…
Sapia, Jennifer L.
This paper provides information for school psychologists regarding the necessity and benefits of school-based prevention programming for students at risk for developing eating disorders (i.e., females). School-based programming is a cost-effective means of reaching the largest number of individuals at once and identifying those individuals…
Schousboe, Birgitte Hartvig; Waaddegaard, Mette
Binge eating disorder kaldes også bulimi uden opkastning eller den tredje spiseforstyrrelse. Det er en udbredt, men mindre kendt spiseforstyrrelse end anoreksi og bulimi. Patienterne er ofte overvægtige og har ikke kompenserende adfærd over for overspisningen i form af opkastning eller brug af...
Satherley, R; Howard, R; Higgs, S
To systematically review evidence concerning disordered eating practices in dietary-controlled gastrointestinal conditions. Three key questions were examined: a) are disordered eating practices a feature of GI disorders?; b) what abnormal eating practices are present in those with GI disorders?; and c) what factors are associated with the presence of disordered eating in those with GI disorders? By exploring these questions, we aim to develop a conceptual model of disordered eating development in GI disease. Five key databases, Web of Science with Conference Proceedings (1900-2014) and MEDLINE (1950-2014), PubMed, PsycINFO (1967-2014) and Google Scholar, were searched for papers relating to disordered eating practices in those with GI disorders. All papers were quality assessed before being included in the review. Nine papers were included in the review. The majority of papers reported that the prevalence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls. Disordered eating patterns in dietary-controlled GI disorders may be associated with both anxiety and GI symptoms. Evidence concerning the correlates of disordered eating was limited. The presence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls, but the direction of the relationship is not clear. Implications for further research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Allison, Kelly C.; Grilo, Carlos M.; Masheb, Robin M.; Stunkard, Albert J.
The authors compared eating patterns, disordered eating, features of eating disorders, and depressive symptoms in persons with binge eating disorder (BED; n = 177), with night eating syndrome (NES; n = 68), and in an overweight comparison group without BED or NES (comparison; n = 45). Participants completed semistructured interviews and several…
Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG) are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main...
Goebel-Fabbri, Ann E.
The problem of insulin restriction is an important women's health issue in type 1 diabetes. This behavior is associated with increased rates of diabetes complications and decreased quality of life. Clinical and technological research is greatly needed to improve treatment tools and strategies for this problem. In this commentary, the author describes the scope of the problem of eating disorders and diabetes, as well as offers ideas about ways technology may be applied to help solve this compl...
Fitzsimmons-Craft, Ellen E; Keatts, Dara A; Bardone-Cone, Anna M
This study examined the relation between eating expectancies, assessed via the Eating Expectancy Inventory, and eating disorder recovery. Individuals formerly seen for an eating disorder were categorized as having an active eating disorder ( n = 53), as partially recovered ( n = 15), or as fully recovered ( n = 20). The expectancies of these groups were compared to each other and to 67 non-eating disorder controls. Results revealed that three of the five eating expectancies differed across groups. Non-eating disorder controls and fully recovered individuals endorsed similar levels of the expectancies that eating helps manage negative affect, eating is pleasurable and useful as a reward, and eating leads to feeling out of control. Partially recovered individuals looked more similar to active eating disorder cases on these expectancies. The other two expectancies did not differ across groups. Results provide some indication that certain eating expectancies may be associated with eating disorder recovery.
Mas-Manchón, Lluís; Rodríguez-Bravo, Ángel; Montoya-Vilar, Norminanda; Morales-Morante, Fernando; Lopes, Elaine; Añaños, Elena; Peres, Rafaella; Martínez, María Eugenia; Grau, Antoni
Advertising uses stereotyped body images to promote physical ideals and unhealthy eating habits related to food products which are targeted especially at young people. The purpose of this study, carried out in Barcelona (Spain) in May 2013, was to test the perception of 139 young people of university age - with and without eating disorders - regarding 25 values in seven food commercials that did and did not use body image strategies. Results show that only the group of young people with eating disorders considered commercials using body image strategies to have a very negative influence on values such as health, well-being, family and effort. In contrast, the assessment of the two groups regarding the rest of the commercials greatly coincided. These results show that todays university youth have accepted as normal a beauty canon based on the prevailing social and economic order, while young people in treatment for eating disorders have learned to denaturalize such messages.
Pike, Kathleen M; Hoek, Hans W; Dunne, Patricia E
Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. While historically, eating disorders were conceptualized as primarily afflicting Caucasian adolescent or young adult women within high-income, industrialized Western Europe and North America, eating disorders are increasingly documented in diverse countries and cultures worldwide. This study highlights recent trends that reflect the changing landscape of culture and eating disorders: stabilization of the incidence of anorexia nervosa and possibly lower incidence rates of bulimia nervosa in Caucasian North American and Northern European groups; increasing rates of eating disorders in Asia; increasing rates of eating disorders in the Arab region; and increasing rates of binge eating and bulimia nervosa in Hispanic and Black American minority groups in North America. The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.
Herpertz, S; Petrak, F; Kruse, J; Kulzer, B; Lange, K; Albus, C
Adolescent and young women with type 1 diabetes mellitus demonstrate a more than random coincidence with bulimia nervosa. However, the prevalence of eating disorders that do not fulfil the criteria of bulimia nervosa is also raised in women of this age group yet without diabetes mellitus. The comorbidity of type 1 diabetes and an eating disorder poses a risk factor in the development of diabetic follow-up diseases. Patients with an eating disorder and type 1 diabetes are characterized by an insufficient metabolic control and the early development of diabetic complications such as a retinopathy. The binge eating disorder, according to research aspects initially a new eating disorder entity, may especially be observed in overweight and obesity. Even if a binge eating disorder in persons with a type 2 diabetes does not occur more frequently than in those metabolically healthy persons, it does depict a risk factor for an accelerated weight gain which as rule involves an increase of insulin resistance.
In June 2015, the newspapers in England once again pointed at the media industry as responsible for the spread of eating disorders. This article reviews this argument and previous research on the role of the media industry in the perpetration of images that may foster eating disorders. It has been recently argued, coherently with previous research, that the media may be responsible for the spread of eating disorders. This article reviews this literature, and evaluates what the real role of the media in the spread of eating disorders is. The article argues that considering the portrait of thin models in the media industry as responsible for eating disorders is a misanalysis of the problem and evaluates some of the more profound reasons that may lead to the adoption of the disordered eating symptomatology.
Shaw, Heather; Stice, Eric; Becker, Carolyn Black
This article reviews eating disorder (ED) prevention programs, highlighting features that define successful programs and particularly promising interventions, and how they might be further refined. The field of ED prevention has advanced considerably both theoretically and methodologically compared with the earlier ED prevention programs, which were largely psychoeducational and met with limited success. Recent meta-analytic findings show that more than half (51%) of ED prevention interventions reduced ED risk factors and more than a quarter (29%) reduced current or future eating pathology (EP). A couple of brief programs have been shown to reduce the risk for future onset of EP and obesity. Selected interactive, multisession programs offered to participants older than 15 years, delivered by professional interventionists and including body acceptance or dissonance-induction content, produced larger effects. Understanding and applying these results can help inform the design of more effective prevention programs in the future.
Giel, Katrin Elisabeth; Hermann-Werner, Anne; Mayer, Jochen; Diehl, Katharina; Schneider, Sven; Thiel, Ansgar; Zipfel, Stephan
We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors. Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology. High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology. Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562). © 2016 Wiley Periodicals, Inc.
Gillett, Kyle S.; Harper, James M.; Larson, Jeffry H.; Berrett, Michael E.; Hardman, Randy K.
Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This…
Berkman, Nancy D; Bulik, Cynthia M; Brownley, Kimberly A; Lohr, Kathleen N; Sedway, Jan A; Rooks, Adrienne; Gartlehner, Gerald
OBJECTIVES The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), harms associated with treatments, factors associated with the treatment efficacy and with outcomes of these conditions, and whether treatment and outcomes for these conditions differ by sociodemographic characteristics. DATA SOURCES We searched MEDLINE, the Cumulative Index to Nursing and Applied Health (CINAHL), PSYCHINFO, the Educational Resources Information Center (ERIC), the National Agricultural Library (AGRICOLA), and Cochrane Collaboration libraries. REVIEW METHODS We reviewed each study against a priori inclusion/exclusion criteria. For included articles, a primary reviewer abstracted data directly into evidence tables; a second senior reviewer confirmed accuracy. We included studies published from 1980 to September 2005, in all languages. Studies had to involve populations diagnosed primarily with AN, BN, or BED and report on eating, psychiatric or psychological, or biomarker outcomes. RESULTS We report on 30 treatment studies for AN, 47 for BN, 25 for BED, and 34 outcome studies for AN, 13 for BN, 7 addressing both AN and BN, and 3 for BED. The AN literature on medications was sparse and inconclusive. Some forms of family therapy are efficacious in treating adolescents. Cognitive behavioral therapy (CBT) may reduce relapse risk for adults after weight restoration. For BN, fluoxetine (60 mg/day) reduces core bulimic symptoms (binge eating and purging) and associated psychological features in the short term. Individual or group CBT decreases core behavioral symptoms and psychological features in both the short and long term. How best to treat individuals who do not respond to CBT or fluoxetine remains unknown. In BED, individual or group CBT reduces binge eating and improves abstinence rates for up
Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel
A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.
Gabriel, C.; Waller, G.
Patients with eating disorder have relatively high rates of comorbid personality disorder diagnoses, including both anxiety-based personality disorders (obsessive-compulsive and avoidant) and borderline personality disorder. However, there is preliminary evidence that the core cognitions underlying personality pathology in the eating disorders are those related specifically to anxiety. This article builds on that evidence, replicating and extending the findings with a large sample of patients...
The bachelor degree work deals with disorders food intake, in particular, mental anorexia and mental bulimia in maturing period. The theoretical part is aimed at maturing problems and food intake disorders generally. There is characteristics and division of maturing period into early and late adolescence including psychological and physical changes which are typical for this period. Then food intake disorders, their causes, effects and their possible treatment are specified. The aim of the pr...
Pisetsky, Emily M; Thornton, Laura M; Lichtenstein, Paul; Pedersen, Nancy L; Bulik, Cynthia M
We evaluated whether the prevalence of lifetime suicide attempts/completions was higher in women with a lifetime history of an eating disorder than in women with no eating disorder and assessed whether eating disorder features, comorbid psychopathology, and personality characteristics were associated with suicide attempts in women with anorexia nervosa, restricting subtype (ANR), anorexia nervosa, binge-purge subtype (ANBP), lifetime history of both anorexia nervosa and bulimia nervosa (ANBN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Participants were part of the Swedish Twin study of Adults: Genes and Environment (N = 13,035) cohort. Lifetime suicide attempts were identified using diagnoses from the Swedish National Patient and Cause of Death Registers. General linear models were applied to evaluate whether eating disorder category (ANR, ANBP, ANBN, BN, BED, PD, or no eating disorder [no ED]) was associated with suicide attempts and to identify factors associated with suicide attempts. Relative to women with no ED, lifetime suicide attempts were significantly more common in women with all types of eating disorder. None of the eating disorder features or personality variables was significantly associated with suicide attempts. In the ANBP and ANBN groups, the prevalence of comorbid psychiatric conditions was higher in individuals with than without a lifetime suicide attempt. The odds of suicide were highest in presentations that included purging behavior (ANBN, ANBN, BN, and PD), but were elevated in all eating disorders. To improve outcomes and decrease mortality, it is critical to be vigilant for suicide and identify indices for those who are at greatest risk. PsycINFO Database Record (c) 2013 APA, all rights reserved.
... affects mood and some compulsive behaviors, may also play a role in binge eating. In most cases, the unhealthy overeating habits that develop into binge eating start during childhood. These habits might be a result of eating ...
Dalle Grave, Riccardo
Eating disorders are common health problems afflicting mainly female adolescents and young women. They are associated with important physical health and psychosocial morbidity, and carry increased risk of death. Their cause is not yet completely understood and their management is complex, with some patients resisting all available treatments. AIMS OF THIS REVIEW: To provide the readers with an update regarding our knowledge and understanding of eating disorders. Medline database has been used for searching articles on eating disorders published since 1980. The key words used were eating disorders, anorexia nervosa, bulimia nervosa, bulimia, and binge eating. Professional books published during this period has been also reviewed. In the last 30 years a substantial improvement has been achieved both in the understanding and management of eating disorders, but many problems still need to be resolved. Three principal priorities should be addressed. First, the actual classification of eating disorders should be revised, since about half the cases seen in clinical practice receive a diagnosis of eating disorder not otherwise specified, and it is common to observe a migration between eating disorder diagnoses. Second, the research on pathogenesis should better clarify the exact role of genetic and environmental risk factors, and how they interact and vary across the development and maintenance of eating disorders. Third, there is an urgent need both to disseminate the few evidence-based treatments available, and to develop more potent treatments for all the eating disorder diagnostic categories. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
O'Brien, Katie M; Whelan, Denis R; Sandler, Dale P; Weinberg, Clarice R
Eating disorders such as anorexia nervosa and bulimia nervosa affect overall and reproductive health and may also affect breast cancer risk. We studied the association between self-reported eating disorders and breast cancer risk in a prospective cohort study. In 2003-2009, the Sister Study enrolled women ages 35-74 years who had a sister with breast cancer but had never had it themselves. Using data from 47,813 women, we estimated adjusted HRs and 95% confidence intervals (CI) for the association between eating disorders and invasive breast cancer over a median of 5.4 years of follow-up. Three percent (n = 1,569) of participants reported a history of an eating disorder. Compared with women who never had an eating disorder, women who reported eating disorders in the past had reduced breast cancer risk (HR = 0.62; 95% CI, 0.42-0.92). In this large prospective, observational cohort study, we observed an inverse association between having a history of an eating disorder and invasive breast cancer. Historical eating disorders may be associated with a long-term reduction in breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(2); 206-11. ©2016 AACR. ©2016 American Association for Cancer Research.
Wilson, G. Terence; Fairburn, Christopher G.
Sees cognitive-behavioral therapy (CBT) as applicable to all eating disorders but most intensively studied in treatment of bulimia nervosa. Briefly reviews most commonly used cognitive treatments for eating disorders, provides critical evaluation of their effectiveness, and speculates about their mechanisms of action. Notes that CBT has not been…
Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.
Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy…
Davidsen, Annika Helgadóttir; Lau, Marianne Engelbrecht
Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment.......Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment....
Wagener, Amy M.; Much, Kari
This article focuses on the complex nature of eating disorders, specifically highlighting their use as coping mechanisms for underlying emotional and psychological concerns. Case examples of college counseling center clients are discussed in order to illustrate common ways in which eating disorders are utilized by clients with varying…
Slof-Op 't Landt, Margarita Cornelia Theodora
In this thesis, a series of studies on different aspects of the genetics of eating disorders is presented. The heritability of disordered eating behavior and attitudes in relation with body mass index (BMI) was evaluated in a large adolescent twin-family sample ascertained through the Netherlands
Abraham, Suzanne F; Brown, Tani; Boyd, Catherine; Luscombe, Georgina; Russell, Janice
There is a lack of measurements with predictive validity that are specific for quality of life (QOL) in patients with eating disorders. A total of 306 eating disorder patients treated as inpatients completed the Quality of Life for Eating Disorders (QOL ED): 109 at both admission and discharge from hospital, 65 at both admission and after 12 months. Patients also completed well-validated measures of eating disorders, psychological dysfunction and general physical and mental QOL. QOL ED consists of 20 self-report questions that provide scores for the domains of behaviour, eating disorder feelings, psychological feelings, effects on daily life, effects on acute medical status and body weight, and a global score. QOL ED domain scores correlated appropriately with previously validated well-known measures of eating disorders, psychological dysfunction, general QOL and behaviour and body weight (p eating disorder not specified (EDNOS) and no diagnosis. All no diagnosis (recovered) domain and global scores were significantly different from all diagnoses scores (p eating disorders, including outcome.
The eating disorders anorexia nervosa and bulimia nervosa traditionally have been viewed as sociocultural in origin. However, recent behavioral genetic findings suggest substantial genetic influence on these disorders. Molecular genetic research of these disorders is in its infancy, but initial results are promising. This article reviews findings from family, twin, and molecular genetic studies that support substantial genetic influences on disordered eating and highlights additional areas fo...
Latzer, Yael; Witztum, Eliezer; Stein, Daniel
Israel presents a unique opportunity to study the role of socio-cultural parameters in the development of mental disturbances because of the exceptional diversity of the Israeli society. In the present review, we aimed to analyse the current state of disordered eating in Israel by means of an extensive literature review. The following are the main findings of our review: The frequency of maladaptive eating among female and male Israeli Jewish adolescents is higher in comparison to many other Westernized countries. Among different Jewish sub-populations, Kibbutz women have been found until recently to show higher rates of disordered eating in comparison to other Israeli samples. Recent studies show no such difference between Kibbutz members and the general Israeli population. No clear-cut findings emerge with respect to the influence of immigration and degree of Jewish religious affiliation on the occurrence of disordered eating. In contrast, disordered eating is less prevalent in Israeli-Arabs compared with Israeli-Jews. Moreover, diverse Israeli-Arab groups show different rates of disordered eating. We discuss the high rate of disordered eating in Israeli youth in light of Israel being a culture in transition that is constantly exposed to the risk of terrorism. The changes in the rates of disordered eating in the Kibbutzim are discussed in light of the dramatic societal changes occurring in these communities within a relatively brief period of time. The low rates of disordered eating in Israeli-Arabs reflect the traditional non-Westernized characteristics of their society, whereas the differences between diverse Arab sub-populations depend upon the degree of exposure to Westernized influences and the presence of conflicts between modern and traditional values. (c) 2008 John Wiley & Sons, Ltd and Eating Disorders Association.
Peroutsi, A; Gonidakis, F
During the last 50 years, eating disorders have developed to a complicated and widespread medical and social issue. The latest research results indicate that eating disorders have a quite complicated and multifactorial etiology. According to the multifactorial etiological model, the impact of mass media can be regarded mainly as a precipitating factor. The literature review showed that mass media have a considerable impact on the development and perpetuation of eating disorders. Mass media contribute to the promotion of the thinness ideal as a way to achieve social approval, recognition and success. Mass media also promote dieting and food deprivation, as a successful way of life or as a socially agreeable practice. Furthermore, the literature review showed that mass media remain the main source of information about eating disorders. Considering the above result, mass media could play a major role in the promotion of prevention practices and early diagnosis and treatment of eating disorders.
Koefoed, Maja Schølarth; Clausen, Loa; Rokkedal, Kristian
Objective In general eating disorder pathology in men shows more similarities than differences compared to women though with an overall lower level of pathology. In community studies men have been found to have more excessive exercise and more binge eating and in clinical populations men have been...... found to have more vomiting. Eating Disorder Examination (EDE) is “the golden standard” of diagnostic interviewing in eating disorder but analysis of gender differences in scores on the EDE have never been reported. The present study aim to explore gender differences on the EDE among adolescents...
Wold, P N
Patients with Major Affective Disorder (MAD), Secondary Depression, Panic Disorder, and bulimia with and without MAD, were given the Eating Disorder Inventory, the Beck Depression Inventory, and the General Behavior Inventory at presentation. It was found that patients with MAD have a triad of eating disorder symptoms: a disturbance in interoceptive awareness, the sense of ineffectiveness, and a tendency toward bulimia. The data supported the concept that the sense of ineffectiveness is secon...
Aneta Michalska; Natalia Szejko; Andrzej Jakubczyk; Marcin Wojnar
Aim. The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). Method. The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbid...
Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments. To date there are no Food and Drug Administration-approved medications or procedures for anorexia nervosa, and only one Food and Drug Administration-approved medication each for bulimia nervosa (fluoxetine) and binge-eating disorder (lisdexamfetamine). While there is little primary interest in drug development for eating disorders, postmarket monitoring of medications and procedures approved for other indications has identified several novel treatment options for patients with eating disorders. In this review, I utilize searches of the PubMed and ClinicalTrials.gov databases to highlight emerging treatments in eating disorders.
Eating disorders frequently appear during the teen years or in young adulthood. Common eating disorders include nervosa, bulimia nervosa and binge-eating disorder. Eating disorders affect both men and women. Keywords: eating disorders, children, adults, female athletes ...
King, M B
A total of 748 patients who attended four south London group practices were screened using the eating attitudes test; 1% of women had bulimia nervosa and a further 3% a partial syndrome eating disorder. Eating and weight control behaviour and psychiatric indicators for an eating disorder were analysed. Patients with bulimia nervosa and partial syndromes were remarkably similar. They were mainly women, from the middle to upper classes, in the normal weight range but having had considerable weight fluctuation in the past, more likely to have had a history of menstrual irregularity, often psychologically troubled, and tended to have more family psychopathology. PMID:3099893
Keel, Pamela K; Brown, Tiffany A; Holland, Lauren A; Bodell, Lindsay P
Current diagnostic criteria for anorexia nervosa (AN) and bulimia nervosa (BN) account for a minority of individuals with clinically significant disorders of eating, raising concerns about the clinical utility of current definitions. This review examines evidence for the validity of current and alternative approaches to defining eating disorders and implications for draft criteria for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Although this review largely supports the predictive validity of distinctions among AN, BN, and the newly proposed binge eating disorder (BED), it also highlights that our tendency to "study what we define" has created a gap between the problems that people have and what we know about those problems. Future research on the causes and consequences of eating disorders should include more heterogeneous groups to enable identification of meaningful boundaries that distinguish between disorders based on etiological and predictive validity.
Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio
Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. "Sudden death" has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds) must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.
Most twin studies suggest a heritability of SO to 80% for liability to eating disorders. At least moderate heritability is further supported by family and adoption studies. Polymorphisms of the 5-HT2A and BDNF genes appear robust candidates for anorexia nervosa and bulimia nervosa, while linkage studies suggest loci for anorexia nervosa in chromosome 1 and a locus in chromosome 10 for bulimia nervosa. Contemporary Western culture has a salient role in the rising incidence of eating disorders, and epigenetic mechanisms are suggested to be involved. In the near future, GWAS will likely provide compelling new data of genetic etiology and mechanisms of eating disorders.
Lipsky, Rachele K; McGuinness, Teena M
Children and adolescents who eat unusually large amounts of food, feel guilty about it, and try to hide their overeating may be struggling with binge eating disorder (BED), a condition associated with suicidal ideation and other eating disorders. Although BED is new to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the syndrome is becoming increasingly recognized. The study of BED in children and adolescents is in its natal phase, but the importance of recognition and possible treatment strategies are discussed in the current article along with psychiatric nursing implications. Copyright 2015, SLACK Incorporated.
Kass, Andrea E; Kolko, Rachel P; Wilfley, Denise E
This review summarizes recent evidence on psychological treatments for eating disorders. Eating disorders are serious psychiatric conditions requiring evidence-based intervention. Treatments have been evaluated within each eating disorder diagnosis and across diagnoses. For adults with anorexia nervosa, no one specialist treatment has been shown to be superior. Cognitive behavioral therapy and interpersonal psychotherapy remain the most established treatments for bulimia nervosa and binge eating disorder, with stepped-care approaches showing promise and new behavioral treatments under study. Enhanced cognitive behavioral therapy has improved symptoms in adults and youth. Maudsley family-based therapy is the most established treatment for youth with anorexia nervosa and may be efficacious for youth with bulimia nervosa. Interpersonal psychotherapy for the prevention of excess weight gain may be efficacious for reducing loss of control eating and weight gain in overweight youth. Significant advances in treatments have been made, including evaluation of long-term outcomes, novel approaches, and tailored extension for specific patient profiles. However, widespread access to effective eating disorder treatments remains limited. Increasing the potency and expanding the implementation of psychological treatments beyond research settings into clinical practice has strong potential to increase access to care, thereby reducing the burden of eating disorders.
Allan, Steven; Goss, Ken
To test for differences between diagnostic groups on the severity of eating disorder beliefs and behaviours, evaluate the clinical significance of such differences, and assess the extent to which these beliefs and behaviours may be present at clinically significant levels across eating disorder diagnoses. 136 adult women outpatients (aged 18-65, with a BMI over 15) were diagnosed with an eating disorder and completed the Stirling Eating Disorder Scale. The expected pattern of statistically significant differences was found between diagnostic groups on anorexic dietary beliefs and behaviours and bulimic dietary beliefs and behaviours. A high percentage of participants in each diagnostic group scored above the clinical cut-off on the eating disorder belief and behaviour measures and a very high percentage of participants in each group reported clinically significant levels of restricting beliefs. Transdiagnostic or functional analytic approaches to treatment planning may lead to more effective interventions than current, diagnostically-based, care pathways. The high prevalence of restricting beliefs reported suggested that this may need to be a key focus for intervention for the majority of individuals presenting with an eating disorder. © 2013.
Álvarez Ruiz, Eva M; Gutiérrez-Rojas, Luis
The comorbidity of bipolar disorder and eating disorders has not been studied in depth. In addition, clinical implications involved in the appearance of both disorders are very important. A systematic literature review of MEDLINE published up to September 2013 was performed, analyzing all the articles that studied the comorbidity of both conditions (bipolar disorder and eating disorders) and others research that studied the efficacy of pharmacological treatment and psychotherapy to improve these illnesses. In this review we found a high comorbidity of bipolar disorder and eating disorders, especially of bulimia nervosa and binge eating disorder. Studies show that lithium and topiramate are 2 of the more effective pharmacological agents in the treatment of both disorders. There are a lot of studies that show evidence of comorbidity of bipolar disorder and eating disorders. However, further research is needed on assessment and treatment when these conditions co-exist, as well as study into the biopsychological aspects to determine the comorbid aetiology. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.
This thesis concerns addictive substance abuse in women suffering from eating disorders. In the theoretical part it defines the term eating disorder itself and furthermore briefly works with the cause of these disorders, patients' personality and commonly associating complicating diagnoses. Afterwards it defines the term addiction and illustrates some of the possible influences on development. Then it characterises commonly abused substances and their relation with eating disorders. The empir...
Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.
Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)
Wichmann, Susan; Martin, D. R.
Defines different eating disorders, discusses athlete eating problems, and presents the signs physicians should look for that signal the presence of an eating disorder. The article also discusses the tailoring of treatment programs, questions to ask athletes about eating habits, and society's influence on an athlete's eating behavior. (GLR)
Kaye, Walter H; Wagner, Angela; Fudge, Julie L; Paulus, Martin
This chapter reviews brain imaging findings in anorexia and bulimia nervosa which characterize brain circuitry that may contribute to the pathophysiology of eating disorders (EDs). Recent imaging studies provide evidence of disturbed gustatory processing in EDs which involve the anterior insula as well as striatal regions. These results raise the possibility that individuals with anorexia nervosa have altered appetitive mechanism that may involve sensory, interoceptive, or reward processes. Furthermore, evidence of altered reward mechanisms is supported by studies that suggest that individuals with anorexia nervosa and bulimia nervosa share a trait toward similar anterior ventral striatal pathway dysregulation. This shared trait disturbance of the modulation of reward and emotionality may create a vulnerability for dysregulated appetitive behaviors. However, those with anorexia nervosa may be able to inhibit appetite and have extraordinary self-control because of exaggerated dorsal cognitive circuit function, whereas individuals with bulimia nervosa are vulnerable to overeating when they get hungry, because they have less ability to control their impulses. Current therapeutic interventions have modest success. Better understanding of neurocircuits that may be related to altered appetite, mood, impulse control, and other symptoms underlying the pathophysiology of EDs might improve psychotherapeutic and drug treatment strategies.
Eating disorders, which include anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified, are psychiatric disorders with physical complications. Several factors may contribute to the onset of anorexia nervosa and bulimia nervosa, including a familial predisposition to these disorders as well as individual personality characteristics. Dissatisfaction with body shape and an overwhelming desire to be thin are considered as risk factors for the development of eating disorders. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and diuretics, and psychiatric morbidity. They include xerosis, lanugolike body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrheic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, acquired striae distensae, and acral coldness. The most characteristic cutaneous sign of vomiting is Russell sign (knuckle calluses). Symptoms due to laxative or diuretic abuse include adverse reactions to 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. Copyright © 2013 Elsevier Inc. All rights reserved.
Sansone, Randy A; Sansone, Lori A
Personality disorders are oftentimes comorbid with eating disorders. According to a review of the literature, obsessive-compulsive personality disorder is the most common Axis II disorder in eating-disordered individuals with restrictive eating behavior, whereas borderline personality disorder is the most common Axis II disorder in those with impulsive eating pathology. Because personality disorders developmentally precede eating disorders and the characteristics of the personality disorder oftentimes mirror the style of eating pathology (eg, highly controlled personality styles and highly controlled eating patterns; impulsive personality styles and impulsive eating pathology), it is reasonable to assume that personality disorders influence subsequent eating pathology. Therefore, it is likely that personality disorders function, to some degree, as risk factors for the development of specific types of eating disorders. The authors discuss the clinical implications of these relationships.
Vaz, F J; Alcaina, T; Guisado, J A
The food aversions of a group of anorexia nervosa patients, bulimia nervosa patients, and no eating disordered individuals (controls) were compared. An open questionnaire was used to obtain data on the eating aversions of each of the three populations. The foodstuffs were placed in categories according to their nutritional value. They were also converted into nutrients, and the average value for each population was calculated. With the exception of the 'legumes' and 'dry fruits' categories, the degree of aversion towards the other food groups detected in the individuals with eating disorders was significantly greater than that detected in controls. Aversion towards food with a high protein content (meat, fish, milk and eggs) was characteristic of patients with eating disorders and is a source of clinical problems, which are discussed in this article.
Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia
Wilson, G Terence; Shafran, Roz
January, 2004, marked the publication of NICE guidelines for the treatment of eating disorders, a series of recommendations from a multidisciplinary, comprehensive, and rigorous process. The recommendations are assigned a grade from A (strong empirical support from well-conducted randomised trials) to C (expert opinion without strong empirical data). Over 100 recommendations were made, most of which were given a C grade. No specific recommendations were made for anorexia nervosa. Cognitive behavioural therapy for bulimia nervosa was assigned grade A because of the evidence showing that it is superior to other psychological and drug treatments. Antidepressants for bulimia nervosa were given grade B. No specific recommendations were made for atypical eating disorders except for binge-eating disorder (cognitive behavioural therapy was recommended [A]). The methodological rigour of the NICE guidelines is in contrast with the current Practice Guideline for Eating Disorders (PGED) of the American Psychiatric Association. PGED does not detail criteria for evaluating supporting research. Instead of making clear recommendations, PGED is uncritically inclusive and emphasises subjective judgment of individual clinicians. The NICE guidelines balance recommending specific treatments against the importance of clinical judgment when guideline recommendations are not readily applicable. Evidence-based guidelines are limited by the quality of the available research and its clinical relevance. The NICE guidelines underscore the absence of sufficient evidence for guidance in several important areas, such as atypical eating disorders (eating disorders not otherwise specified) which are the most common. Research on the treatment of these atypical eating disorders is needed. Evidence-based psychological treatments are not routinely implemented in general practice. Dissemination of these demonstrably effective treatments poses a challenge, and learning how to implement evidence
Walsh, B. Timothy
A disturbance in eating behavior is the defining characteristic of the clinical eating disorders, Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Surprisingly little research has been devoted to assessing objectively the nature of the eating disturbances in these disorders, to elucidating what factors contribute to the development and persistence of these disturbances, or to describing how they change with treatment. This review, which is based on a Mars lecture delivered at the...
Hartmann, Armin; Zeeck, Almut; Barrett, Marna S
Eating disorders are often chronic in nature and lead to a number of problems among which interpersonal issues are suggested to be central. Although research has shown that individuals with disturbed patterns of eating consistently report problems in social interactions, this study is unique in assessing a range of interpersonal problems among patients with all types of eating disorders before and after intensive hospital-based treatment. A total of 208 patients receiving a primary diagnosis of restrictive anorexia nervosa, bulimia nervosa, or anorexia nervosa of the binge/purging-subtype were included in the study. Eating pathology, symptom severity, and interpersonal patterns were examined before and after treatment. Patients with eating disorders exhibited a generally nonassertive, submissive interpersonal style, with anorexic patients of the binge/purging-subtype reporting more difficulties with social inhibition and nonaffiliation. These patterns were found to change over the course of treatment with interpersonal problems at intake predictive of greater binge severity at discharge. Furthermore, issues of dominance and social avoidance predicted outcome for specific subgroups of patients. Results underscore the importance of interpersonal problems in eating disorders and suggest that interpersonal patterns remain a focus of treatment and future research. © 2009 by Wiley Periodicals, Inc.
Striegel-Moore, Ruth H.; Bulik, Cynthia M.
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…
Suokas, Jaana; Alenius, Heidi; Ebeling, Hanna; Haapasalo-Pesu, Kirsi-Maria; Järvi, Leea; Koskinen, Minna; Laukkanen, Eila; Meskanen, Katarina; Morin-Papunen, Laure; Ryöppönen, Anita; Salonen, Ulla; Tossavainen, Päivi; Vuorela, Piia
Early diagnosis with intervention is linked to better outcome. In primary care patients in risk for eating disorder should be screened and actively asked about eating disorder symptoms. Treatment is mainly out-patient care and should first be focused on gaining a normal nutritional status. It is important to involve the patient's family in the treatment. A confidential relationship between health care professionals and the patient is important. The patient's own motivation and readiness for recuperation are essential. Different therapeutic and psychosocial approaches are central in the treatment, as the disorders are psychiatric. Medical treatment may bring additional help in treating binge-eating disorder or bulimia nervosa, but it is seldom of help in treating anorexia nervosa.
This thesis deals with the eating disorders, focusing on two basic and currently the most important diseases - anorexia nervosa and bulimia nervosa. The theoretical part summarizes findings about the eating disorders. I give basic information about anorexia nervosa and bulimia nervosa, I devote the attention to their causes , symptoms and consequences. I also write about a prevention of the eating disorders in primary school. Based on the theoretical background, a questionnaire survey was con...
Fassino, Secondo; Abbate-Daga, Giovanni; Amianto, Federico; Facchini, Federico; Rovera, Giovanni Giacomo
The question of how many psychopathologic factors are involved in Anorexia Nervosa (AN) and Bulimia Nervosa (BN) has no definite answer. The combination of psychopathology and personality research may shed a light upon the determinants of eating pathology. The study consists in the administration of the Temperament and Character Inventory (TCI) and the Eating Disorder Inventory 2 (EDI-2) to 95 outpatient anorectic women (50 restrictive and 45 binge-purging) and to 92 bulimic outpatient women (78 with and 14 without purging behaviours). The respective scores of each DCA subgroup are compared. Restricter anorectics are characterised by lower novelty seeking on respect to all the other groups and by a higher self-directedness on respect to bingeing-purging anorectics and purging bulimics. Also psychopathologic differences between restricter anorectics and the other groups are extensive. Bingeing-purging anorexia shares many traits with bulimia. In their complex, data suggest and in-deep study aimed to a possible re-classification of EDs which would take impulsiveness in greater consideration. The differences in temperament and character traits may partially be responsible of the repression or discontrol of impulsive eating behaviours in different ED subtypes.
Walsh, B Timothy
A disturbance in eating behavior is the defining characteristic of the clinical eating disorders, Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Surprisingly little research has been devoted to assessing objectively the nature of the eating disturbances in these disorders, to elucidating what factors contribute to the development and persistence of these disturbances, or to describing how they change with treatment. This review, which is based on a Mars lecture delivered at the 2010 meeting of the Society for the Study of Ingestive Behavior, reviews objective information about the nature of the disturbances of eating behavior in eating disorders. These data suggest that more detailed knowledge of eating behavior is an essential component of a full understanding of eating disorders and may provide a foundation for studies of pathophysiology and for the development of new treatment methods. Copyright © 2011 Elsevier Inc. All rights reserved.
Haycraft, Emma; Blissett, Jackie
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. 2009 Elsevier Ltd. All rights reserved.
This study provides the result of a doctorate research into the impact of existential psychotherapeutic interventions with people experiencing chronic eating disorders. The results indicate that positive outcomes are correlated to therapeutic interventions which concentrate on the clients own perception of control and choice over their own eating habits. The research aim was to explore both the effects and the effectiveness of existential therapy in altering the individuals subjective int...
Amitabh Saha; Neha Sharma
This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetin...
Full Text Available This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetine, to which she responded poorly.
This thesis deals with students´ awareness about eating disorders and partly about their eating habits. It is focused mainly on children and early adolescents. The theoretical part describes the basic types of eating disorders, which are anorexia nervosa, bulimia nervosa and binge eating disorders, but also the less frequent drunkorexia, bigorexia and orthorexia. It also deals with history, prevalence and incidence of the eating disorders. Risk factors that may affect the development or the c...
Kravvariti, V; Gonidakis, Fr
Women suffering from eating disorders, present considerable retardation and difficulties in their psychosexual development during adolescence. This leads to primary or secondary insufficiencies in their adult sexual life. The cause of these difficulties seems to be a series of biological, family and psychosocial factors. The majority of the research findings indicate that eating disorders have a negative impact on the patient's sexual function. The factors related to eating disorders symptomatology that influence sexuality are various and differ among each eating disorder diagnostic categories. Considering anorexia nervosa, it has been reported that women have negative attitudes to sexual issues and their body. Their sexual motivation increases when they engage in psychotherapy and their body weight is gradually restored. Starvation and its consequences on the human physiology and especially on the brain function seem to be the main factor that leads to reduced sexual desire and scarce sexual activity. Moreover, personality traits that are common in patients suffering from anorexia nervosa such as compulsivity and rigidity are also related with difficulties initiating and retaining romantic and sexual relationships. Usually patients suffering from anorexia nervosa report impaired sexual behavior and lack of interest to engage in a sexual relationship. Considering Bulimia Nervosa, impulsivity and difficulties in emotion regulation that are common features of the individuals that suffer from bulimia nervosa are also related to impulsive and sometimes self-harming sexual behaviors. Moreover women sufferers often report repulsion, anger and shame towards their body and weight, mainly due to the distorted perception that they are fat and ugly. It is interesting that a number of research findings indicate that although patients suffering from bulimia nervosa are more sexually active and have more sexual experiences than patients suffering from anorexia nervosa, both
Bulik, Cynthia M; Kleiman, Susan C; Yilmaz, Zeynep
We capture recent findings in the field of genetic epidemiology of eating disorders. As analytic techniques evolve for twin, population, and molecular genetic studies, new findings emerge at an accelerated pace. We present the current status of knowledge regarding the role of genetic and environmental factors that influence risk for eating disorders. We focus on novel findings from twin studies, population studies using genetically informative designs, and molecular genetic studies. Over the past 2 years, research in this area has yielded insights into: comorbidity with other psychiatric and medical disorders and with metabolic traits; developmental factors associated with the emergence of eating disorders; and the molecular genetics of anorexia nervosa. Insights from genetic epidemiology provide an important explanatory model for patients with eating disorders, family members, and clinicians. Understanding core biological determinants that explain the severity and persistence of the illnesses, their frequent co-occurrence with other conditions, and their familial patterns raises awareness and increases compassion for individuals living with these disorders. Large-scale genomic studies are currently underway. Ultimately, this domain of research may pave the way to greater understanding of the underlying neurobiology and inform the development of novel and effective interventions.
Yi, Chun-Xia; Heppner, Kristy; Tschöp, Matthias H.
Ghrelin is the only known circulating hormone that acts on peripheral and central targets to increase food intake and promote adiposity. The present review focuses on the possible clinical relevance of ghrelin in the regulation of human feeding behavior in individuals with obesity and other eating
Podfigurna-Stopa, Agnieszka; Czyzyk, Adam; Katulski, Krzysztof; Smolarczyk, Roman; Grymowicz, Monika; Maciejewska-Jeske, Marzena; Meczekalski, Blazej
Eating disorders (EDs) are disturbances that seriously endanger the physical health and often the lives of sufferers and affect their psychosocial functioning. EDs are usually thought of as problems afflicting teenagers. However, the incidence in older women has increased in recent decades. These cases may represent either late-onset disease or, more likely, a continuation of a lifelong disorder. The DSM-5 classification differentiates 4 categories of eating disorder: anorexia nervosa, bulimia nervosa, binge-eating disorders and other specified feeding and eating disorders. The weight loss and malnutrition resulting from EDs have widespread negative consequences for physical, mental and social health. The main risk factors for developing long-term consequences are the degree of weight loss and the chronicity of the illness. Most of the cardiac, neurological, pulmonary, gastric, haematological and dermatological complications of EDs are reversible with weight restoration. EDs are serious illnesses and they should never be neglected or treated only as a manifestation of the fashion for dieting or a woman's wish to achieve an imposed standard feminine figure. Additionally, EDs are associated with high risk of morbidity and mortality. The literature concerning EDs in older, postmenopausal women is very limited. The main aim of this paper is to ascertain the epidemiology and prognosis of EDs in older women, and to review their diagnosis and management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Early diagnosis and treatment are important for the prognosis in eating disorders and will also reduce the burden on the patient as well as n his or her family. On the other hand, community studies show that less than half of clinical cases of eating disorders are identified in primary care; hence, better skills among general practitioners in this field are very important. On the basis of the literature and clinical experience, this article discusses various problems related to identifying, evaluating and treating patients with eating disorders in primary care. The most important tool for the general practitioner is an understanding of the nature of the disorder, but tools for identification and treatment are also useful. Attending the patient and collaboration with hospitals and outpatient clinics could be a challenge. There are guidelines for the treatment of eating disorders in specialised health care, including indications for hospitalisation, but no guidelines for referral to outpatient treatment or for the coordination between the general practitioner and specialised units. The proposed British guidelines might serve as a basis for Norwegian guidelines.
Patrick, Julie Hicks; Stahl, Sarah T.; Sundaram, Murali
The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress.…
Horesh, N; Apter, A; Ishai, J; Danziger, Y; Miculincer, M; Stein, D; Lepkifker, E; Minouni, M
To assess the relationship between abnormal psychosocial situations and eating disorders in adolescents. Twenty girls with eating disorders, 20 girls with major psychiatric conditions, and 20 healthy controls took part in the study. They were interviewed using a semistructured interview designed by the World Health Organization to diagnose the psychosocial situations included in the International Classification of Disease Axis 5 classification for child and adolescent psychiatry. All subjects were also given the Eating Attitudes Test. Many life events and psychosocial adversities differentiated significantly between the patients and controls. Inappropriate parental pressure was specific only for the subjects with eating disorders compared with the other psychiatric patients. In addition, Eating Attitudes Test scores correlated significantly with hostility toward child, sibling disability, parental overprotection, inappropriate parental pressures, and negative changes in family relationships. These results support the growing literature on the interrelationship between disordered family relationships and eating disorders. They point the way for developing treatment programs dealing with these issues.
Muuss, Rolf E.
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…
Sim, Leslie A; Lebow, Jocelyn; Weiss, Karen; Harrison, Tracy; Bruce, Barbara
Given that youth with chronic pain frequently experience disruptions in eating patterns that may place them at risk for disordered eating, the purpose of this study was to examine the clinical characteristics and illness course of adolescents with chronic pain and comorbid eating disorders. Using a retrospective chart review, 34 adolescents with chronic pain and concurrent eating disorders were identified. These adolescents were compared with 34 age-, gender-, and eating disorder symptom-matched adolescents who had an eating disorder without chronic pain. The majority of adolescents with chronic pain and an eating disorder had a primary medical diagnosis of abdominal pain (n = 14), followed by autonomic dysfunction (n = 10) and headache (n = 6). Although in 41.2% of teens with chronic pain, eating disorder symptoms developed after the onset of their pain, 35.3% reported having eating disorder symptoms before they experienced chronic pain. Body mass index did not differ between the groups, but the duration of eating disorder symptoms was significantly longer for the chronic pain group (p eating disorders are undetected for longer periods in patients with chronic pain, which may contribute to a poorer prognosis. Implications for eating disorder conceptualization, detection, and treatment are discussed. Copyright © 2016. Published by Elsevier Inc.
Levinson, Cheri A; Fewell, Laura; Brosof, Leigh C
Mobile phone and tablet usage has become a part of modern life. Mobile applications that count calories, such as My Fitness Pal, are frequently employed on a daily basis. Recent research has shown that in undergraduates, calorie tracking is associated with eating disorder pathology. In the current study (N=105 individuals diagnosed with an eating disorder), we assessed usage of My Fitness Pal to track calories. We also assessed perceptions that My Fitness Pal contributed to eating disorder symptoms and if these perceptions were associated with eating disorder symptoms. We found that a substantial percentage (~75%) of participants used My Fitness Pal and that 73% of these users perceived the app as contributing to their eating disorder. Furthermore, we found that these perceptions were correlated with eating disorder symptoms. This research suggests that My Fitness Pal is widely used in an eating disorder population and is perceived as contributing to eating disorder symptoms. Further research is needed to clarify the role calorie tracking applications play within a sample of individuals with eating disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.
Howell, Michael J; Schenck, Carlos H
Identifying abnormal nocturnal eating is critically important for patient care and public health. Obesity is a global pandemic and a leading cause of preventable mortality in the United States, with more than 100,000 deaths annually. Normally, nighttime energy homeostasis is maintained, despite an absence of food intake, through appetite suppression and alterations in glucose metabolism that result in stable energy stores. Two conditions break this nighttime fast and are associated with weight gain as well as medical and neuropsychiatric comorbidities. Sleep-related eating disorder (SRED) is characterized by isolated nocturnal eating, whereas the night-eating syndrome (NES) is a circadian delay in meal timing leading to evening hyperphagia, nocturnal eating, and morning anorexia. Recently, SRED has been associated with the benzodiazepine receptor agonist zolpidem. Both SRED and NES are treatable and represent potentially reversible forms of obesity. In SRED, the antiseizure medication topiramate and dopaminergics have both demonstrated promising results. Nocturnal eating associated with NES has responded well to sertraline.
Conason, Alexis H; Sher, Leo
Eating disorders, in particular bulimia nervosa and binge eating disorder are associated with co-morbid alcohol and drug abuse. School-based studies have shown significant associations between bulimic behaviors and various measures of alcohol, cigarette and other drug use and abuse. Amongst bulimic adolescents, substance use is related to an increased likeliness of high risk behaviors such as attempted suicide, stealing and sexual intercourse. In contrast with bulimics and binge eaters, restricting anorexics have low rates of co-morbid substance abuse. It appears that restricting anorexics, binge eaters and bulimics represent distinct subgroups within the eating disordered population and binge eaters and bulimics are more prone to alcohol use. It is possible that individuals with eating disorders turn to alcohol use/abuse as a way of coping with the problems caused by their eating disorder. Researchers have proposed that an addictive personality is an underlying trait, which predisposes individuals to both eating disorders and alcohol abuse. Eating disorders are often conceptualized as an addictive disorder. Opioid antagonists, such as naltrexone, may be useful in treating both eating and alcohol use disorders. There is also evidence that serotonin reuptake inhibitors, which are traditionally used to treat major depression, may be an effective treatment. Cognitive-behavioral therapy has been effective in treating alcohol use and eating disorders individually and may be an effective combined treatment for co-morbid eating disorders and alcohol use. Teaching healthy ways to cope with the stressful situations may also help decrease alcohol use and disordered eating behaviors.
This thesis explores the epidemiology and risk factors of eating disorders. It focuses on the impact of the political and cultural changes that occured in the Czech Republic in the early 1990s. The term eating disorders includes mental illnesses characterized by disturbances in eating behaviour: anorexia nervosa, bulimia nervosa and various eating disorders not otherwise specifieed. It appears that the incidence of anorexia nervosa was increasing until 1970s and remains stable since. The inci...
Full Text Available Norbert Dahmen, Julia Becht, Alice Engel, Monika Thommes, Peter TonnPsychiatry Department, University of Mainz, GermanyAbstract: Narcoleptic patients suffer frequently from obesity and type II diabetes. Most patients show a deficit in the energy balance regulating orexinergic system. Nevertheless, it is not known, why narcoleptic patients tend to be obese. We examined 116 narcoleptic patients and 80 controls with the structured interview for anorectic and bulimic eating disorders (SIAB to test the hypothesis that typical or atypical eating attacks or eating disorders may be more frequent in narcoleptic patients. No difference in the current prevalence of eating disorders bulimia nervosa, binge eating disorder, or anorexia nervosa was found, nor was the frequency of eating attacks higher in the narcolepsy group. We conclude that present eating disorders and eating attacks as defined in DSM IV are not the reason for the observed differences in body composition. Additional factors, such as basal metabolic rates and lifestyle factors need to be considered.Keywords: narcolepsy, eating disorder, SIAB, bulimia, anorexia, eating attack
Michalska, Aneta; Szejko, Natalia; Jakubczyk, Andrzej; Wojnar, Marcin
The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment. All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often. More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. Eating disorders frequently co-occur with…
Bachelor's thesis focuses on the awareness of adolescent eating disorders. It consists of theoretical and practical parts. The theoretical part focuses on the history of the development of ideal beauty and notions of self-concept and body image. It also discusses the topic of eating disorders, the definition of better- known and lesser known diseases, and resources that teachers and parents to tackle this problem use. The practical part contains the results of the survey questionnaires that w...
Webb, CM; Thuras, P; Peterson, CB; Lampert, J; Miller, D; Crow, SJ
Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fi...
Webb, C M; Thuras, P; Peterson, C B; Lampert, J; Miller, D; Crow, S J
Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fifty-three eating disorder outpatients were administered the Eating and Anxiety Questionnaire (EAQ) and the Eating Disorder Diagnostic Scale. Ratings indicated significant anxiety in most eating situations, whereas management strategies were more limited yet regularly employed. Factor analysis of the EAQ revealed a 6-factor solution for anxiety management strategies and a 4-factor solution for anxiety-eliciting situations. These results indicate patients with eating disorders report high levels of anxiety associated with eating behaviors but utilize limited yet consistent anxiety management strategies. Effective intervention strategies for managing eating-related anxiety should be incorporated into treatment and may need to be specified for different diagnostic subgroups.
Puhl, Rebecca; Suh, Young
Although research has consistently documented the prevalence and negative health implications of weight stigma, little is known about the stigma associated with eating disorders. Given that weight stigma is a risk factor associated with disordered eating, it is important to address stigma across the spectrum of eating and weight disorders. The aim of this review is to systematically review studies in the past 3 years evaluating stigma in the context of obesity and eating disorders (including binge eating disorder, bulimia nervosa, and anorexia nervosa). Physical and psychological health consequences of stigma for individuals with obesity and eating disorders are discussed. Recent studies on weight stigma substantiate the unique influence of stigma on psychological maladjustment, eating pathology, and physiological stress. Furthermore, research documents negative stereotypes and social rejection of individuals with eating disorder subtypes, while attributions to personal responsibility promote blame and further stigmatization of these individuals. Future research should examine the association of stigma related to eating disorders and physical and emotional health correlates, as well as its role in health-care utilization and treatment outcomes. Additional longitudinal studies assessing how weight stigma influences emotional health and eating disorders can help identify adaptive coping strategies and improve clinical care of individuals with obesity and eating disorders.
Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.
This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…
Donaldson, Abigail A; Gordon, Catherine M
Anorexia nervosa (AN) is a psychiatric illness with profound medical consequences. Among the many adverse physical sequelae of AN, bone health is impacted by starvation and can be permanently impaired over the course of the illness. In this review of skeletal complications associated with eating disorders, we discuss the epidemiology, neuroendocrine changes, adolescent vs. adult skeletal considerations, orthopedic concerns, assessment of bone health, and treatment options for individuals with AN. The focus of the review is the skeletal sequelae associated with anorexia nervosa, but we also briefly consider other eating disorders that may afflict adolescents and young adults. The review presents updates to the field of bone health in AN, and also suggests knowledge gaps and areas for future investigation. Copyright © 2015 Elsevier Inc. All rights reserved.
Sun, Bomin; Liu, Wei
EATING DISORDERS (EDS) ARE A GROUP OF SEVERELY IMPAIRED EATING BEHAVIORS, WHICH INCLUDE THREE SUBGROUPS: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future.
Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio
Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfact...
The research aims to establish the main characteristics of subjects prone to compulsive overeating (experimental group, EG), and the differences between them and the girls who are not prone to any kind of eating disorders (control group, CG). The results of the research are in accordance with the expectations. Girls from the EG exhibit personality characteristics which are signifficantly different from the girls in the CG. These characteristics may be either possible predispositions for devel...
Sayed Shahabuddin Hoseini
Full Text Available Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Sayed Shahabuddin Hoseini; Zhamak Khorgami; Ahmad Reza Dehpour; Nasrin Shoar; Mohammad Naderan; Saeed Shoar
Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Shoar, Saeed; Naderan, Mohammad; Shoar, Nasrin; Dehpour, Ahmad Reza; Khorgami, Zhamak; Hoseini, Sayed Shahabuddin
Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Breland, Jessica Y; Donalson, Rosemary; Dinh, Julie; Nevedal, Andrea; Maguen, Shira
Disordered eating, which includes subclinical and clinical maladaptive eating behaviors, is common among women, including those served by the Veterans Health Administration (VA). We used qualitative methods to determine whether and how women veterans want to receive treatment for disordered eating. Women veterans participated in one of seven focus groups/interviews and completed in-person demographic and psychological questionnaires. We used thematic analysis of focus groups/interviews to understand preferences for disordered eating treatment. Participants (n = 20) were mostly women of color (55%); mean age was 48 (SD = 15) and 65% had significant psychological symptoms. Few participants described being assessed for disordered eating, but all thought VA should provide treatment for disordered eating. Through thematic analysis, we identified six preferences: 1) treatment for disordered eating should be provided in groups, 2) treatment for disordered eating should provide concrete skills to facilitate the transition out of structured military environments, 3) treatment for disordered eating should address the relationship between eating and mental health, 4) disordered eating can be treated with mindfulness and cognitive-behavioral therapy, 5) disordered eating treatment providers should be experienced and take an interactive approach to care, but can come from diverse disciplines, and 6) referrals to treatment for disordered eating should be open ended, occur early, and allow for ongoing, flexible access to treatment. Women veterans are interested in treatment for disordered eating. Preferred treatments align with existing treatments, could be offered in conjunction with weight loss or primary care services, and should provide social support and interactive learning. Published by Elsevier Inc.
Schreiber-Gregory, Deanna N; Lavender, Jason M; Engel, Scott G; Wonderlich, Steve A; Crosby, Ross D; Peterson, Carol B; Simonich, Heather; Crow, Scott; Durkin, Nora; Mitchell, James E
The primary goal of this article is to examine and clarify characteristics of binge eating in individuals with binge eating disorder (BED), particularly the duration of binge eating episodes, as well as potential differences between individuals with shorter compared to longer binge eating episodes. Two studies exploring binge eating characteristics in BED were conducted. Study 1 examined differences in clinical variables among individuals (N = 139) with BED who reported a short (binge duration. Study 2 utilized an ecological momentary assessment design to examine the duration and temporal pattern of binge eating episodes in the natural environment in a separate sample of nine women with BED. Participants in Study 1 who were classified as having long duration binge eating episodes displayed greater symptoms of depression and lower self-esteem, but did not differ on other measures of eating disorder symptoms, compared to those with short duration binge eating episodes. In Study 2, the average binge episode duration was approximately 42 min, and binge eating episodes were most common during the early afternoon and evening hours, as well as more common on weekdays versus weekends. Past research on binge episode characteristics, particularly duration, has been limited to studies of binge eating episodes in bulimia nervosa. This study contributes to the existing literature on characteristics of binge eating in BED. Copyright © 2013 Wiley Periodicals, Inc.
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise; Marks, Saul; Sundgot-Borgen, Jorunn
Disordered eating behavior (DE) and eating disorders (EDs) are of great concern because of their associations with physical and mental health risks and, in the case of athletes, impaired performance. The syndrome originally known as the Female Athlete Triad, which focused on the interaction of energy availability, reproductive function, and bone health in female athletes, has recently been expanded to recognize that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective judgments of performance. The reported prevalence of DE and EDs in athletic populations, including athletes from aquatic sports, ranges from 18 to 45% in female athletes and from 0 to 28% in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behavior at all periods of development pathway, and coaches and members of the athletes' health care team should be able to recognize early symptoms indicating risk for energy deficiency, DE, and EDs. Coaches and leaders must accept that DE/EDs can be a problem in aquatic disciplines and that openness regarding this challenge is important.
Eiber, R; Mirabel-Sarron, C; Urdapilleta, I
to food cues indicates that bulimics were more responsive to sight, smell and taste of their favourite binge food, and a greater responsivity was associated with increasing -cue salience. Eating disorder patients appear to have internalised a mediated social rule concerning "good food" and make drastic selections thus removing the possibility of choice of foodstuffs. b) Experimental processes: temporal factors in the processing of threat seem to be of importance in patients with high levels of eating psychopathology. There is no evidence for preattentive processing biases among anorectics. Changes in information processing speed after treatment were not linked to treatment condition or treatment response. c) Judgement and emotions: in eating disorder patients, distortions of depressogenic nature are found that influence the cognitive style; thoughts about eating, weight and shape are characterised by negative affective tone; negative emotions could account for bulimic behaviour; anxiety and distress are correlated to thought control strategies. Information treating seems to be impaired in a non-homogeneous way. d) Cognitive schemas are seriously maladaptive and not well investigated. In eating disorder patients, core beliefs are absolute, unconditional and dichotomous cognitions about oneself and the world. There are only few studies in this field moreover showing controversial results. Core beliefs can explain links between personality disorders and eating psychopathology. Pathological core beliefs have to be taken in to account because they influence the outcome and the efficacy of cognitive behavioural therapy. Third, the last part of this paper summarises actually available rating scales eva-luating distorted cognitions in eating disorders. There are different methods for evaluation: specific and non-specific self-report questionnaires, thought-sampling procedures, -methods derived from cognitive psychology. The Mizes Anorectic Cognition questionnaire (MAC) is a
Munsch, S; Herpertz, S
Binge eating disorder is one of the most frequent comorbid mental disorders associated with overweight and obesity. Binge eating disorder patients often suffer from other mental disorders and longitudinal studies indicate a continuous weight gain during the long-term course. As in other eating disorders gender is a risk factor, but the proportion of male binge eating disorder patients is surprisingly high.In young women with type 1 diabetes the prevalence of subclinical types of bulimia nervosa is increased. In addition, insulin purging as a characteristic compensatory behavior in young diabetic women poses a considerable problem. In patients with type 1 diabetes, disturbed eating and eating disorders are characterized by insufficient metabolic control and early development of late diabetic sequelae. Patients with type 2 diabetes are often overweight or obese. Binge eating disorder does not occur more frequently in patients with type 2 diabetes compared to healthy persons. However, the comorbidity of binge eating disorder and diabetes type 2 is associated with weight gain and insulin resistance. Especially in young diabetic patients a screening procedure for disturbed eating or eating disorders seems to be necessary. Comorbid patients should be offered psychotherapy.
Dennard, E Eliot; Richards, C Steven
The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation. Published by Elsevier Ltd.
Eating disorders are severe and disabling mental disorders. The scientific study of eating disorders has expanded dramatically over the past few decades, and provided significant understanding of eating disorders and their treatments. Those significant advances notwithstanding, there is scant knowledge about key processes that are crucial to clinical improvement. The lack of understanding mechanisms that cause, maintain and change eating disorders, currently is the biggest problem facing the science of eating disorders. It hampers the development of really effective interventions that could be fine-tuned to target the mechanisms of change and, therefore, the development of more effective treatments. It is argued here that the science of eating disorders and eating disorder treatment could benefit tremendously from pure experimental studies into its mechanisms of change, that is, experimental psychopathology (EPP). To illustrate why eating disorders need more EPP research, some key symptoms - restriction of intake, binge eating and body overvaluation - will be discussed. EPP studies challenge some generally accepted views and offer a fresh new look at key symptoms. This will, consequently, better inform eating disorder treatments. Copyright © 2016. Published by Elsevier Ltd.
Gonçalves, Juliana de Abreu; Moreira, Emilia Addison M; Trindade, Erasmo Benício S de M; Fiates, Giovanna Medeiros R
To discuss eating disorders in children and adolescents regarding their characteristics and risk factors. Articles were searched in the PubMed and ScieLO databases, combining the terms 'children', 'adolescents', 'eating behavior', 'eating disorder', 'bulimia', and 'anorexia', both in Portuguese and in English. Studies published between 2007 and 2011 were retrieved and 49 articles that assessed eating behavior and disorders, nervous anorexia and bulimia, and non-specific eating disorders were selected. Eating disorders, especially non-specific ones, were common during childhood and adolescence. The presence of such disorders was attributed mainly to family environment and exposure to the media. Eating disorders were frequently followed by psychological comorbidities. Among the risk factors for eating disorders, social and family environment and the media were the most important ones. The influence of the media and social environment has been related to the worship of thinness. As to family environment, mealtimes appeared to be fundamental in shaping eating behavior and the development of disorders. Eating disorders were associated with nutritional problems (growing impairment and weight gain), oral health (cheilitis, dental erosion, periodontitis, and hypertrophy of salivary glands), and social prejudice.
Allison, Kelly; Berner,Laura A.
Laura A Berner,1 Kelly C Allison2 1Department of Psychology, Drexel University, 2Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Night eating syndrome (NES) is a form of disordered eating associated with evening hyperphagia (overeating at night) and nocturnal ingestions (waking at night to eat). As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. T...
Lydecker, Janet A.; Grilo, Carlos M.
Objective A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. Methods The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Results Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child’s weight, and more monitoring of their child’s eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child’s diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Conclusion Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. PMID:27302549
Lydecker, Janet A; Grilo, Carlos M
A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child's weight, and more monitoring of their child's eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child's diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. Copyright © 2016 Elsevier Inc. All rights reserved.
Functional gastrointestinal disorders (FGIDs) are very common (up to 98%) in patients with an eating disorder (ED). Boyd et al. discuss in this issue of Neurogastroenterology & Motility that FGIDs can persist independently on the outcome of the ED. Their findings leave room for speculation on the mechanisms underlying FGIDs in patients with an ED. FGIDs result from a complex interaction of biological, psychosocial and social factors. The altered eating behavior seen in EDs is strongly associated with disturbed gastrointestinal sensitivity and motor physiology. Moreover, psychiatric co-morbidities in ED patients are also frequently found in FGIDs. The motor and sensitivity disturbances together with psychiatric co-morbidities can lay the foundation of a FGID. Once established the psychological and physiological disturbances can perpetuate and strengthen each other resulting in a FGID that can persist independently of the ED that originally caused the motor and sensitivity disturbances.
Tölgyes, Tamás; Unoka, Zsolt
Author's aim is to give a comprehensive review of the behavioural and cognitive-behavioural psychotherapeutic development in the treatment of anorexia nervosa and bulimia nervosa, on the base of the literature as well as on own clinical experiences. Behavioural therapies, currently applied as part of integrative therapies mainly, will be shown, and theoretical background and techniques of classical cognitive behavioural therapy of anorexia and bulimia nervosa will be shortly summarized. Theory and therapeutic techniques of the schema-focused cognitive behavioural therapy, applied in the treatment of eating disorders more frequently in the last few years, will be made acquainted in details. Indications and contraindications of classic cognitive behavioural therapy and schema-focused cognitive behavioural therapy in eating disorders will be discussed. Stress will be laid on the fact, that schema-focused cognitive behaviour therapy is to be chosen mostly in the cases where comorbid dissociation, personality disorder, very low self-esteem or traumatic history diminishes the applicability of traditional cognitive behavioural therapy. Authors emphasize the importance of further controlled efficacy studies in the field of schema-focused cognitive behavioural therapy, to define the indication fields regarding different subgroups of eating disorders.
Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt
Purpose: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. Methods: The study included 159 patients...... diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment...... was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Results: Duration of illness significantly moderated the relationship between eating disorder severity and functional...
Díaz-Marsá, Marina; Alberdi-Páramo, Iñigo; Niell-Galmés, Lluis
Eating disorders (EDs) are a series of differentiated nosological entities sharing the common link of a continuous alteration in food intake or in food intake-related behavior. Within this classification, the following disorders are noteworthy: anorexia nerviosa (AN) and bulimia nerviosa (BN). Anorexia nervosa is a chronic disorder characterized mainly by negative or decreased food intake accompanied by a distortion of body image and intense accompanying fear of weight gain. The estimated vital prevalence of this disorder in adolescence is approximately 0.5%-1%.1 The primary feature of BN is the presence of binge eating accompanied by compensatory behavior (in the form of intense exercise and the use of laxatives and diuretics, etc.). The prevalence of BN is estimated to be between 2% and 4% in young women, and it generally starts at somewhat later stages than AN. It is believed that biological, psychological, and environmental factors, as well as genetic vulnerability, influence the pathogenesis of EDs. A variety of therapies exist, both biological and psychological, whose effectiveness is supported by the scientific literature. Nonetheless, we find these therapies only partially effective and new targets as well as new treatments should be sought. Although the etiopathogenesis of EDs is unclear, some of the neurobiological dysfunction found suggests that diet and nutrient supplementation could be relevant in their treatment. We review in this article new treatments focusing on nutritional deficits.
Dominé, F; Dadoumont, C; Bourguignon, J-P
Eating disorders (EDs) are conditions which are becoming more and more widespread among adolescents and they often lead them to seek the opinion of a professional health caregiver, including gynecologists and pediatricians. EDs, and particularly anorexia nervosa (AN), are usually classified as psychological or psychiatric disorders, but they may have major somatic implications and complications as osteoporosis, nutritional deficiencies, cerebral atrophy, cardiac and metabolic disorders. A key issue in the management is prevention or reduction of both the serious somatic consequences and the important mental health consequences (e.g. depression, psychosocial withdrawal, phobia and suicide), integrating different perspectives (psychological or psychiatric - individual and familial -, genetic, nutritional, pediatric, gynecological). Adolescence is a critical period for the onset of EDs though they may also involve younger children. In this case, the consequences on the development (height, weight, puberty) can also be significant. In this review, we will focus on eating disorders in adolescent girls with an emphasis on AN. We describe variations in ED characteristics and their management depending on age at occurrence. A possible ED should be considered by pediatricians consulted about delayed female growth and puberty as well as gynecologists in patients with primary or secondary amenorrhea or infertility. Copyright © 2012 S. Karger AG, Basel.
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W
Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
... talk to your son or daughter about healthy-eating habits. Eating disorders are serious conditions related to persistent ... normal Expressing depression, disgust, shame or guilt about eating habits To help prevent teen eating disorders, talk to ...
Full Text Available Carrie J McAdams,1,2 Whitney Smith1 1University of Texas at Southwestern Medical Center, 2Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, USA Abstract: Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions. Keywords: anorexia nervosa, bulimia nervosa, social cognition, reward processing, decision-making
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W.
Purpose of review Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Recent findings Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th
Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Purpose of reviewTo review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).Recent findingsThe residual category eating disorder not otherwise specified'
Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.
Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise M.; Marks, Saul; Sundgot, Jorunn
I Brage finner du siste tekst-versjon av artikkelen, og den kan inneholde ubetydelige forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på www.humankinetics.com: http://dx.doi.org/10.1123/ijsnem.2014-0029 / In Brage you'll find the final text version of the article, and it may contain insignificant differences from the journal's pdf version. The original publication is available at www.humankinetics.com: http://dx.doi.org/10.1123/ijsnem.2014-0029 Disordered eating beha...
Murphy, Rebecca; Straebler, Suzanne; Cooper, Zafra; Fairburn, Christopher G.
Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new ?enhanced? version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the ?transdiagnostic? theory that underpins the enhanced form of the treatme...
Full Text Available Eating disorders are some of the most severe and destructive of all psychological conditions. They are associated with restricted capacities in cognitive, emotional, physical, and spiritual development. This paper provides an examination of the practical application of Christian spirituality as a force for recovery from an eating disorder. Specifically, it expounds the transformative potential in the spiritual qualities of hope, trust, acceptance, surrender, and courage underpinning engagement with evidence-based therapeutic models of care in eating disorder recovery.
Konstantellou, Anna; Campbell, Mari; Eisler, Ivan; Simic, Mima; Treasure, Janet
Generalized anxiety disorder (GAD) is one of the most common comorbid disorders found in individuals with eating disorders. Despite this, little is known of shared vulnerability factors between the two disorders. The aim of the present study was to examine the four main components of a cognitive model for GAD in the eating disorders. One hundred and sixty-two females took part. Three groups were formed comprising of 19 participants with an eating disorder and GAD, 70 with an eating disorder without GAD and 73 healthy controls. All completed self-report questionnaires that measured eating attitudes, levels of GAD, intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Participants with an eating disorder and GAD scored the highest on all four components when compared to healthy individuals and on most components when compared to those with an eating disorder. Participants with an eating disorder without GAD scored higher on all components compared to healthy controls. Findings extend our understanding of shared vulnerability factors between the eating disorders and GAD. Copyright © 2011 Elsevier Ltd. All rights reserved.
Blodgett Salafia, Elizabeth H.; Jones, Maegan E.; Haugen, Emily C.; Schaefer, Mallary K.
Background In this study, we examined perceptions regarding the causes of eating disorders, both among those with eating disorders as well as those without. By understanding the differences in perceived causes between the two groups, better educational programs for lay people and those suffering from eating disorders can be developed. Method This study used open-ended questions to assess the beliefs of 57 individuals with self-reported eating disorders and 220 without. Participants responded ...
Mitchell, James E; King, Wendy C; Courcoulas, Anita; Dakin, George; Elder, Katherine; Engel, Scott; Flum, David; Kalarchian, Melissa; Khandelwal, Saurabh; Pender, John; Pories, Walter; Wolfe, Bruce
To describe eating patterns, prevalence of problematic eating behaviors, and determine factors associated with binge eating disorder (BED), before bariatric surgery. Before surgery, 2,266 participants (median age 46 years; 78.6% female; 86.9% white; median body mass index 45.9 kg/m(2) ) of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study completed eating behavior survey items in the self-administered LABS-2 Behavior form. Other measures included the Alcohol Use Disorder Identification Test, the LABS-2 Psychiatric and Emotional Test Survey, the Beck Depression Inventory, the Interpersonal Support Evaluation List-12, the Short Form-36 Health Survey, and Impact of Weight Quality of Life-Lite Survey. The majority (92.1%) of participants reported eating dinner regularly, whereas just over half (54.0%) reported eating breakfast regularly. Half of the participants reported eating at least four meals/week at restaurants; two meals/week were fast food. Loss of control eating was reported by 43.4%, night eating syndrome by 17.7%; 15.7% satisfied criteria for binge eating disorder (BED), 2% for bulimia nervosa. Factors that independently increased the odds of BED were being a college graduate, eating more times per day, taking medication for psychiatric or emotional problems, and having symptoms of alcohol use disorder, lower self-esteem and greater depressive symptoms. Before undergoing bariatric surgery a substantial proportion of patients report problematic eating behaviors. Several factors associated with BED were identified, most suggesting other mental health problems, including higher levels of depressive symptomotology. The strengths of this study include the large sample size, the multi-center design and use of standardized assessment practices. © 2014 Wiley Periodicals, Inc.
Poruchy příjmu potravy ve spojitosti s jinými diagnózami. Eating Disorders in Connection with other Diagnoses Bc. Marie Vavrušková The aim of this thesis, which focuses on the topic "Eating Disorders in Connection with Other Diagnoses," is to introduce the different types of eating disorders that have been previously diagnosed (anorexia nervosa, bulimia nervosa, psychogenic overeating and new forms of eating disorders), to specify the medical treatment offered to patients in the Czech Republi...
Eating disorders are a complex set of illnesses most commonly affecting white adolescent girls and young women. The most common eating disorders seen in the primary care setting are anorexia nervosa, bulimia nervosa, and binge eating disorder. Treatment in the primary care environment ideally involves a physician, therapist, and nutritionist, although complex cases may require psychiatric and other specialist care. Early diagnosis and treatment are associated with improved outcomes, whereas the consequences of untreated eating disorders, particularly anorexia nervosa, can be devastating, including death. Copyright © 2016 Elsevier Inc. All rights reserved.
Halmi, Katherine A
Treatment resistance is an omnipresent frustration in eating disorders. Attempts to identify the features of this resistance and subsequently develop novel treatments have had modest effects. This selective review examines treatment resistant features expressed in core eating disorder psychopathology, comorbidities and biological features. Novel treatments addressing resistance are discussed. The core eating disorder psychopathology of anorexia nervosa becomes a coping mechanism likely via vulnerable neurobiological features and conditioned learning to deal with life events. Thus it is reinforcing and ego syntonic resulting in resistance to treatment. The severity of core features such as preoccupations with body image, weight, eating and exercising predicts greater resistance to treatment. Bulimia nervosa patients are less resistant to treatment with treatment failure related to greater body image concerns, impulsivity, depression, severe diet restriction and poor social adjustment. For those with binge eating disorder overweight in childhood and high emotional eating predicts treatment resistance. There is suggestive data that a diagnosis of an anxiety disorder and severe perfectionism may confer treatment resistance in anorexia nervosa and substance use disorders or personality disorders with impulse control problems may produce resistance to treatment in bulimia nervosa. Traits such as perfectionism, cognitive inflexibility and negative affect with likely genetic influences may also affect treatment resistance. Pharmacotherapy and novel therapies have been developed to address treatment resistance. Atypical antipsychotic drugs have shown some effect in treatment resistant anorexia nervosa and topiramate and high doses of SSRIs are helpful for treatment of resistant binge eating disorder patients. There are insufficient randomized controlled trials to evaluate the novel psychotherapies which are primarily based on the core psychopathological features of the
Pinhas, Leora; Heinmaa, Margus; Bryden, Pier; Bradley, Susan; Toner, Brenda
To examine the presence and nature of disordered eating attitudes and behaviours among Jewish Canadian adolescents, as compared with non-Jewish Canadian adolescents in an urban community. A secondary goal was to examine whether rates of eating-disordered behaviour differed among the adolescents based on the degree of Jewish religious observance. High school students (n = 868) from the Toronto area completed a demographic and religious practice questionnaire together with the Eating Attitudes Test (EAT), a self-report test that discriminated adolescents with syndromal eating disorders from normal adolescents. Jewish females aged 13 to 20 years, but not males, reported significantly more disordered eating behaviours and attitudes, compared with their non-Jewish female counterparts. Twenty-five percent of Jewish females, as compared with 18% of non-Jewish females, scored above the clinical cut-off for the EAT. No differences in vulnerability to disordered eating were found within the group of Jewish females or males related to their degree of religious observance. Adolescent Jewish females, but not males, appear to be at greater risk for abnormal attitudes and behaviours related to eating, compared with their non-Jewish female peers. While the reasons for this finding are unclear, this study is a step toward improving understanding of the relations between sex, culture, religion, and the development of eating disorders. Culturally sensitive and sex-specific prevention strategies and treatment interventions are indicated.
Sawaoka, Takuya; Barnes, Rachel D; Blomquist, Kerstin K; Masheb, Robin M; Grilo, Carlos M
Research has consistently shown that anxiety disorders are common among individuals with eating disorders. Although social phobia has been found to be highly associated with eating disorders, less is known about social anxiety in individuals with binge eating disorder (BED). The present study examined associations between social anxiety and self-consciousness with body mass index (BMI) and eating disorder psychopathology in BED. Participants were 113 overweight or obese treatment-seeking men and women with BED. Participants were administered semistructural diagnostic clinical interviews and completed a battery of self-report measures. Social anxiety was positively and significantly correlated with shape and weight concerns and binge eating frequency. After accounting for depressive levels, social anxiety and self-consciousness accounted for significant variance in eating, shape, and weight concerns and overall eating disorder global severity scores (Eating Disorder Examination). Social anxiety also accounted for significant variance in binge eating frequency after covarying for depressive levels. Social anxiety and self-consciousness were not significantly associated with BMI or dietary restraint. Our findings suggest that greater social anxiety and heightened self-consciousness are associated with greater eating disorder psychopathology, most notably with greater shape and weight concerns and binge eating frequency in patients with BED. Social anxiety and self-consciousness do not appear to be merely functions of excess weight, and future research should examine whether they contribute to the maintenance of binge eating and associated eating disorder psychopathology. Copyright © 2012 Elsevier Inc. All rights reserved.
Williams, Gail A; Hawkins, Misty A W; Duncan, Jennifer; Rummell, Christina M; Perkins, Shannon; Crowther, Janis H
Eating pathology among bariatric surgery candidates is common and associated with adverse outcomes. However, its assessment is complicated by the inconsistent use of standardized measures. We addressed this by examining the use of the Eating Disorder Diagnostic Scale (EDDS) in a large bariatric sample (N = 343). To evaluate the EDDS among bariatric surgery candidates via examination of: (1) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and fifth edition (DSM-5) rates of binge eating disorder, bulimia nervosa, and maladaptive eating behaviors, and (2) the relationship between response biases and self-reported eating disorder symptoms. Participants were bariatric surgery candidates at a large public hospital in the Midwest. As part of a larger preoperative evaluation, 343 patients seeking bariatric surgery completed the EDDS and measures of problematic response bias. Approximately 16% of the sample met full threshold criteria for binge eating disorder using DSM-5 criteria. Using the DSM-IV-TR, rates were lower but still substantial at 13%. Rates for bulimia nervosa were 8% (DSM-5) and 6% (DSM-IV-TR). The majority (66.1%) of participants reported at least one binge-eating episode per week. The most commonly used compensatory behavior was fasting (20.4%), followed by excessive exercise (11.7%), laxative use (5.6%), and vomiting (1.8%). An inverse relationship between severity of the eating symptomatology and problematic response bias emerged. The EDDS shows promise as a screening tool that uses diagnostic criteria to provide rates of binge eating and eating psychopathology among surgical candidates. Our findings suggest that subsequent validation studies of this measure are needed, should address potential response bias concerns, and should employ clear definitions of binge eating to promote standardization of eating pathology assessment in the bariatric population. Copyright © 2017 American Society for Bariatric
Ung, E K
Anorexia nervosa, bulimia and binge-eating disorder are the three best recognised eating disorders. Eating disorders have been reported to affect some 1 to 3% of adolescent females in the West. Increasing reports from Asia suggest that it is no longer possible to view these illnesses as 'Western' diseases. Eating disorders are the third most common serious medical disorder in female adolescents, after asthma and depression. It poses a tremendous burden for individuals, families and society. Historical and current studies on eating disorders in Singapore are reviewed, and discussed in the light of available regional and worldwide research. Studies on anorexia nervosa and bulimia in Singapore were identified through a MEDLINE search (from 1979). Information from these studies were supplemented with relevant local monographs on eating disorders. Reports of eating disorders have increased over recent years in the local literature. The psychopathology of eating disorders in Singapore is very similar to that described in the Western literature, and in the two main current classification systems. Body dissatisfaction is prevalent among Singaporean Chinese schoolgirls and female undergraduates, with rates not dissimilar to the West. There is a link between 'Westernisation' (based on English being spoken as the main language at home) and body dissatisfaction.
Linna, Milla S; Raevuori, Anu; Haukka, Jari; Suvisaari, Jaana M; Suokas, Jaana T; Gissler, Mika
Eating disorders are common psychiatric disorders in women at childbearing age. Previous research suggests that eating disorders are associated with fertility problems, unplanned pregnancies, and increased risk of induced abortions and miscarriages. The purpose of this study was to assess how eating disorders are related to reproductive health outcomes in a representative patient population. Female patients (N = 2,257) treated at the eating disorder clinic of Helsinki University Central Hospital during 1995-2010 were compared with matched controls identified from the Central Population Register (N = 9,028). Patients had been diagnosed (ICD-10) with anorexia nervosa (AN), atypical AN, bulimia nervosa (BN), atypical BN, or binge eating disorder (BED, according to DSM-IV research criteria). Register-based data on number of children, pregnancies, childbirths, induced abortions, miscarriages, and infertility treatments were used to measure reproductive health outcomes. Patients were more likely to be childless than controls [odds ratio (OR) 1.86; 95% confidence interval (CI) 1.62-2.13, p health outcomes are compromised in women with a history of eating disorders across all eating disorder types. Our findings emphasize the importance of reproductive health counseling and monitoring among women with eating disorders. Copyright © 2013 Wiley Periodicals, Inc.
Reinblatt, Shauna P.
Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhib...
Smith, April R; Forrest, Lauren N; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph
The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors. © 2018 Wiley Periodicals, Inc.
Coelho, Gabriela Morgado de Oliveira; Gomes, Ainá Innocencio da Silva; Ribeiro, Beatriz Gonçalves; Soares, Eliane de Abreu
Eating disorders are serious mental diseases that frequently appear in female athletes. They are abnormal eating behaviors that can be diagnosed only by strict criteria. Disordered eating, although also characterized as abnormal eating behavior, does not include all the criteria for diagnosing eating disorders and is therefore a way to recognize the problem in its early stages. It is important to identify factors to avoid clinical progression in this high-risk population. Therefore, the purpose of this review is to discuss critical information for the prevention of eating disorders in female athletes. This review discusses the major correlates for the development of an eating disorder. We also discuss which athletes are possibly at highest risk for eating disorders, including those from lean sports and female adolescent athletes. There is an urgent need for the demystification of myths surrounding body weight and performance in sports. This review includes studies that tested different prevention programs' effectiveness, and the majority showed positive results. Educational programs are the best method for primary prevention of eating disorders. For secondary prevention, early identification is essential and should be performed by preparticipation exams, the recognition of dietary markers, and the use of validated self-report questionnaires or clinical interviews. In addition, more randomized clinical trials are needed with athletes from multiple sports in order for the most reliable recommendations to be made and for some sporting regulations to be changed.
Herpertz, S; Albus, C; Lohff, S; Michalski, K; Masrour, M; Lichtblau, K; Köhle, K; Mann, K; Senf, W
As part of a multicentre study on the comorbidity of diabetes mellitus and eating disorders, the following paper compares the psychological features of diabetic patients with and without an eating disorder. In a sample of 663 diabetic patients (type 1: n = 341 type 2: n = 322), eating disorder related variables, self-esteem, body acceptance and emotional distress, especially depression in diabetic patients with and without an eating disorder, were compared. A possible relationship to diabetic control was investigated. Type 2 diabetics revealed more pronounced psychopathology in comparison to type 1 diabetics. According to our assumption, diabetic patients with an eating disorder and diabetic patients who deliberately reduced insulin in order to loose weight (insulin purging) revealed a much more severe psychopathology compared to diabetics without an eating disorder. The type of diabetes was of no importance. With the exception of the variable body and figure satisfaction in the sample of type 1 diabetes and the variable self-acceptance in the sample of type 2 diabetes, no relationship to diabetic control could be found.
Full Text Available The research aims to establish the main characteristics of subjects prone to compulsive overeating (experimental group, EG, and the differences between them and the girls who are not prone to any kind of eating disorders (control group, CG. The results of the research are in accordance with the expectations. Girls from the EG exhibit personality characteristics which are signifficantly different from the girls in the CG. These characteristics may be either possible predispositions for development of overeating, or they may already be the consequences of the girls' struggles with overeating and their perception of being overweight. The responses given by the girls from the EG confirm the generaly accepted characteristics of overeating individuals. It can be said that the girls from the ES show the pre-clinical picture of overeating, while some of them have already developed the clinical picture. The results of the research strongly support the view that overeating must be defined as a form of eating disorder just as important as anorexia and bulimia nervosa.
Full Text Available Eating disorders should be understood in a multidimensional perspective, emphasizing a biopsicossocial context. In these pathologies it`s the body, in the first instance, that reveals the disease, being in this way the target of the conflict, revealing a disturbed body experience and as a consequence a weak conception of their personal body image. The body image is conceptualised as a subjective image that the individuals form in their own mind, about their body, in relation with differ- ent contexts of life. The intent of the studies is to comprehend the level of body image disturbance, which have concluded that in the majority of the cases, significant changes on perceptive capacity of the patients do not exist. In this way it`s important to study in a more effective and qualitative way the affective and personal factors. The authors pretend with this bibliographic revision, make a research of body image assessment to the Eating Disorders (Anorexia Nervosa and Bulimia Nervosa, and to reflect which are the best ones to adapt for Portuguese reality.
Jáuregui Lobera, I; Bolaños Ríos, P; Garrido Casals, O
The aim of the study was to analyse the parental bonding profiles in patients with eating disorders (ED), as well as the relationship among the different styles of parenting and some psychological and psychopathological variables. In addition, the association between the perceived parental bonding and different coping strategies was analysed. Perception of parenting styles was analysed in a sample of 70 ED patients. The Parental Bonding Instrument, Self-Esteem Scale of Rosenberg, Coping Strategies Inventory, State-Trait Anxiety Inventory, Beck Depression Inventory and Eating Disorders Inventory-2 were used. Kruskal-Wallis test (comparisons), Spearman correlation coefficients (association among different variables) and χ(2)-test (parental bonding profiles differences) were applied. The stereotyped style among ED patients is low care-high control during the first 16 years, and the same can be said about current styles of the mothers. Between 8.6% and 12.9% of the patients perceive their parents' styles as neglectful. The neglectful parenting is the style mainly involved in the specific ED symptoms as drive for thinness, body dissatisfaction and bulimia. In order to achieve a better balanced parents' role during the treatment, it would be necessary to improve the role of the mothers as caregivers, decreasing their role mainly based on the overprotection. © 2011 Blackwell Publishing.
Resch, Mária; Nagy, Agnes
Since the 1990s numerous international experts have reported about the somatic complications of eating disorders including those having a dental and stomatological nature. Several reports emphasised that deformations in the oral cavity resulting from this grave nutritional disease typical of the young generation could already appear in the early stage and, therefore, dentists are among the first to diagnose them. Dentists are still often unaware of the importance of their role in multidisciplinary treatment. Even if they knew what the disease was about and recognised it on the basis of deformations in the oral cavity in time, their advice that their patients should brush their teeth more often would fail to eliminate the root cause of the problem. Not only the earliest possible treatment of the complications of the bingeing-purging mechanism and the maintenance of oral hygiene are important, but controlling and curing pathological habits with active participation of psychiatrists are also required to ensure full recovery. Due to the multidisciplinary nature of the disease, manifold communication is required. For this reason, publishing the dental ramifications of organic and systemic diseases at dental conferences and in technical journals, as well as providing information about oral complications of eating disorders for general practitioners and specialists are particularly important.
Harvey, Kate; Rosselli, Francine; Wilson, G. Terence; DeBar, Lynn L.; Striegel-Moore, Ruth H.
Objective We sought to describe meal and snack frequencies of individuals with recurrent binge eating and examine the association between these eating patterns and clinical correlates. Method Data from 106 women with a minimum diagnosis of recurrent binge eating were utilized. Meal and snack frequencies were correlated with measures of weight, eating disorder features, and depression. Participants who ate breakfast every day (n=25) were compared with those who did not (n=81) on the same measures. Results Breakfast was the least, and dinner the most, commonly consumed meal. Evening snacking was the most common snacking occasion. Meal patterns were not significantly associated with clinical correlates; however, evening snacking was associated with binge eating. Discussion Our findings largely replicated those reported in earlier research. More research is needed to determine the role of breakfast consumption in binge eating. PMID:21661003
Zeeck, Almut; Stelzer, Nicola; Linster, Hans Wolfgang; Joos, Andreas; Hartmann, Armin
This study compares 20 binge eaters (BED), 23 obese patients (OB) and 20 normal weight controls (CO) with regard to everyday emotions and the relationship between emotions, the desire to eat and binge eating. Modified versions of the Differential Affect Scale and Emotional Eating Scale were used and the TAS-20 and Symptom-Check-List-27 administered to assess overall psychopathology and alexithymia. BED-subjects show a more negative pattern of everyday emotions, higher alexithymia scores and the strongest desire to eat, especially if emotions are linked to interpersonal aspects. The emotion most often reported preceding a binge was anger. Feelings of loneliness, disgust, exhaustion or shame lead to binge eating behaviour with the highest probability. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.
Bernardi, Fabiana; Harb, Ana Beatriz Cauduro; Levandovski, Rosa Maria; Hidalgo, Maria Paz Loayza
Este artigo tem como objetivo revisar aspectos relacionados a transtornos alimentares e suas relações com as alterações no ritmo circadiano. Realizou-se uma busca sistematizada das informações nas bases de dados PubMed usando os seguintes descritores: eating disorders, circadian rhythm, night eating syndrome, binge eating disorder e sleep patterns. Os transtornos alimentares, como a síndrome do comer noturno e o transtorno da compulsão alimentar periódica, têm sido considerados e relacionados...
Several reports show that stress and psychiatric ill health are increasing in adolescents. Eating disorders (ED) and related conditions such as depression, self-injurious behaviour and suicide attempts are becoming more common, especially among young women. Eating disorders include two main categories: anorexia nervosa (self-starvation) and bulimia nervosa (binge eating and compensatory actions). These disorders do not only involve deviations in eating behaviour, but also in...
Hawkins, Lana Lee Munro
Theorists and researchers have long debated as to whether the differences between subthreshold levels of eating disturbances and diagnosable eating disorders are a difference of degree (the continuum hypothesis) or a difference of kind (the discontinuity hypothesis). The present study investigated the relationship between level of eating disordered behaviour and the psychopathology associated with, and thought by some to be prodromal factors in, the development of clinically diagnosable eatin...
Watts, W. David; Ellis, Anne Marie
Explored relationship between drug and alcohol abuse and eating disorders in female adolescents (n=826). Eating Disorders Risk Scale was adopted and correlated with drug and alcohol use, other forms of deviance, family and peer relationships, and depression. Findings support concept of generalized theory of addictions based on psychosocial,…
Buser, Juleen K.
School counselors play an important role in identifying and intervening with students struggling with disordered eating (e.g., Bardick et al., 2004). Research has shown that American Indian adolescents report higher rates of certain disordered eating behaviors than other racial groups. The literature on the prevalence and etiology of disordered…
Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and…
Derenne, Jennifer L.; Beresin, Eugene V.
Objective: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The…
Tromp, Marilou Dp; Donners, Anouk Amt; Garssen, Johan; Verster, Joris C
OBJECTIVE: To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning. DESIGN: Survey. SETTING: The Netherlands. PARTICIPANTS: N=574 Dutch young adults (18-35 years old). MEASUREMENTS: Participants completed a survey on eating and sleep
Madsen, Ida Ringsborg; Hørder, Kirsten; Støving, René Klinkby
Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is of potential danger to both mother and child. There is, however, a tendency for remission of the eating disorder during pregnancy with improvement of symptoms such as restrictive dieting, binging and purgin...
In this review we synthesised current literature on the psychopharmacological management of eating disorders (EDs) in children and adolescents (C&As). We focus specifically on anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). The treatment of EDs is determined by physical and ...
Huke, Vanessa; Turk, Jeremy; Saeidi, Saeideh; Kent, Andy; Morgan, John F
Empirical research addressing cognitive processing deficits in eating disorders has noted an overlap with autism spectrum disorders. We conducted a systematic review investigating the prevalence of autism spectrum disorder in its entirety in eating disordered populations. A comprehensive search for relevant studies was performed on five electronic databases. Studies were not included if solely focused on specific traits of autism spectrum disorders, for instance, theory of mind, set shifting or central coherence. Titles, abstracts and full texts were screened by two members of the research team independently. Quantitative studies published in English were included. A total of eight studies were found to fit the inclusion criteria. Results showed significantly raised prevalence rates of autism spectrum disorder in eating disorder populations compared with those in healthy control participants. This discovery has clinical implications and may assist in deciphering poor responses to conventional treatment, facilitating new psychological interventions for eating disorders. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
Hanlan, Margo E; Griffith, Julie; Patel, Niral; Jaser, Sarah S
This review is focused on the prevalence of eating disorders and disordered eating behaviors in individuals with type 1 diabetes. Recent research indicates higher prevalence rates of eating disorders among people with type 1 diabetes compared with their peers without diabetes. Eating disorders and disordered eating behaviors-especially insulin omission-are associated with poorer glycemic control and serious risk for increased morbidity and mortality. Screening should begin in pre-adolescence and continue through early adulthood, as many disordered eating behaviors begin during the transition to adolescence and may persist for years. Available screening tools and treatment options are reviewed. Given the complexity of diabetes management in combination with eating disorder treatment, it is imperative to screen early and often, in order to identify those most vulnerable and begin appropriate treatment in a timely manner.
Hanlan, Margo E.; Griffith, Julie; Patel, Niral
This review is focused on the prevalence of eating disorders and disordered eating behaviors in individuals with type 1 diabetes. Recent research indicates higher prevalence rates of eating disorders among people with type 1 diabetes, as compared to their peers without diabetes. Eating disorders and disordered eating behaviors – especially insulin omission – are associated with poorer glycemic control and serious risk for increased morbidity and mortality. Screening should begin in pre-adolescence and continue through early adulthood, as many disordered eating behaviors begin during the transition to adolescence and may persist for years. Available screening tools and treatment options are reviewed. Given the complexity of diabetes management in combination with eating disorder treatment, it is imperative to screen early and often, in order to identify those most vulnerable and begin appropriate treatment in a timely manner. PMID:24022608
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte
OBJECTIVES: Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children...... and adolescents and that family history of these illnesses would be associated with eating disorders in probands. METHODS: In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all...... inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. RESULTS: We found significantly...
Davidsen, Annika Helgadóttir; Poulsen, Stig; Lindschou, Jane
Objective: To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders. Method: We conducted a randomized clinical trial with central randomization stratified for diagnosis and treatment type according to a computer...... outcome was rate of attendance to treatment sessions; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview. Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale, social......-generated allocation sequence concealed to the investigators. One-hundred and 59 adult participants, diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM-IV, were included. Eighty participants were allocated to the experimental group, and 79 participants...
Harshbarger, J L; Ahlers-Schmidt, C R; Atif, M; Allred, E; Carroll, M; Hauser, R
Twenty years ago, Price published a survey identifying knowledge deficits of school counselors regarding eating disorders. Our study surveys current school counselors to determine whether knowledge has increased and determine the availability of school-based prevention programming. School counselors from a single metropolitan area were surveyed prior to a mandatory in-service on eating disorders. Of the 109 respondents, 55% felt eating disorders were a problem in their school. Very few felt "very competent" identifying (6%) or helping (2%) students with eating disorders. Today's school counselors were more likely to know a symptom of anorexia nervosa (AN) is missing at least three consecutive menstrual cycles and malnutrition is not a common cause of death for bulimia nervosa (BN). While knowledge of AN and BN appear to have increased, school counselors still lack some basic understanding and report very low confidence in identifying and helping students with eating disorders.
Courbasson, Christine Marie; Rizea, Christian; Weiskopf, Nicole
Emotional eating occurs frequently in individuals with eating disorders and is an overlooked factor within addictions research. The present study identified the relationship between emotional eating, substance use, and eating disorders, and assessed the usefulness of the Emotional Eating Scale (EES) for individuals with concurrent eating disorders…
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M; Quaranta, Michela; Koch, Susanne Vinkel; Pisetsky, David; Mortensen, Preben Bo; Bulik, Cynthia M
Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands. In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets. Copyright © 2017 by the American Academy of Pediatrics.
O'Dea, Jennifer A.; Abraham, Suzanne
Used the Eating and Exercise Examination to investigate the eating, weight, shape, and exercise behaviors of 93 male college students. About 20 percent of respondents displayed eating attitudes and behaviors characteristic of eating disorders and disordered eating. They were similar to female students in eating attitudes, undereating, overeating,…
Fernández-Aranda, Fernando; Pinheiro, Andréa Poyastro; Thornton, Laura M; Berrettini, Wade H; Crow, Scott; Fichter, Manfred M; Halmi, Katherine A; Kaplan, Allan S; Keel, Pamela; Mitchell, James; Rotondo, Alessandro; Strober, Michael; Woodside, D Blake; Kaye, Walter H; Bulik, Cynthia M
We compared symptom patterns, severity of illness, and comorbidity in individuals with eating disorders with and without impulse control disorders (ICD), and documented the temporal pattern of illness onset. Lifetime ICD were present in 16.6% of 709 women with a history of eating disorders. The most common syndromes were compulsive buying disorder and kleptomania. ICD occurred more in individuals with binge eating subtypes, and were associated with significantly greater use of laxatives, diuretics, appetite suppressants and fasting, and with greater body image disturbance, higher harm avoidance, neuroticism, cognitive impulsivity, and lower self-directedness. In addition, individuals with ICD were more likely to have obsessive-compulsive disorder, any anxiety disorder, specific phobia, depression, cluster B personality disorder, avoidant personality disorder, and to use psychoactive substances. Among those with ICD, 62% reported the ICD predated the eating disorder and 45% reported the onset of both disorders within the same 3-year window. The presence of a lifetime ICD appears to be limited to eating disorders marked by binge eating and to be associated with worse eating-related psychopathology, more pathological personality traits, and more frequent comorbid Axis I and II conditions. Untreated ICD may complicate recovery from eating disorders.
Knapp, Jessica; Aerni, Giselle; Anderson, Jeffrey
Screening female athletes for eating disorders is not performed commonly even though the American College of Sports Medicine, National Athletic Trainer Association, and International Olympic Committee have guidelines recommending screening. Eating disorders are more prevalent in the female athlete population than in the general population and carry short-term and long-term consequences that can affect sport performance. There are several screening tools available that have been studied in the general population and fewer tools that were validated specifically in female athletes. Female athletes with eating disorder pathology often have different factors and environmental pressures contributing to their pathology that can be identified best with an athlete-specific screening tool. We will discuss various screening tools available and the evidence for each one. Screening for eating disorders in all female athletes is an important part of the preparticipation examination and should be done using a tool specifically validated for the female athlete.
Birmingham, C L; Hlynsky, J; Russell, B; Gritzner, S
There are no established treatment programs for shoplifting in eating disorder patients. Our objective was to observe the effect of an established behavioural treatment program in a series of eating disorder patients. Patients with eating disorders who shoplift voluntarily took part in an 8-week behavioral treatment program at the Elizabeth Fry Society of Greater Vancouver, British Columbia. They completed assessments at the first session, last session, and at 1 and 6 months post intervention. Six patients enrolled in the study and three patients completed the treatment program. Only one patient reported a decrease in shoplifting frequency. All subjects reported an increase in self-esteem and ability to control shoplifting impulses. Our findings suggest that behavioral therapy may be effective in treating shoplifting in eating disorders, but that longer sessions and follow-up may be necessary to show benefit. A randomized control trial with longer-term follow-up is needed to determine whether there is a benefit.
Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha
The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.
Blodgett Salafia, Elizabeth H; Jones, Maegan E; Haugen, Emily C; Schaefer, Mallary K
In this study, we examined perceptions regarding the causes of eating disorders, both among those with eating disorders as well as those without. By understanding the differences in perceived causes between the two groups, better educational programs for lay people and those suffering from eating disorders can be developed. This study used open-ended questions to assess the beliefs of 57 individuals with self-reported eating disorders and 220 without. Participants responded to the questions, "What do you think was (were) the cause(s) of your eating disorder?" and "What do you think is (are) the cause(s) of eating disorders?". A list of possible codes for the causes of eating disorders was created based on a thorough review of the literature. A manually-generated set of eight codes was then created from individuals' actual responses. Frequencies and chi square analyses demonstrated differences in rates of endorsement between those with eating disorders and those without. Participants with eating disorders most frequently endorsed psychological/emotional and social problems, with genetics/biology and media/culture ideals least endorsed. Participants without eating disorders most frequently endorsed psychological/emotional problems and media/culture ideals, with traumatic life events and sports/health least endorsed. There was a difference between groups in the endorsement of the media as a cause of eating disorders, suggesting that those without eating disorders may overly attribute the media as the main cause while those with eating disorders may not be fully aware of the media's impact. Additionally, while both groups highly endorsed psychological/emotional problems, there was a noticeable stigma about eating disorders among those without eating disorders. There were noteworthy differences between samples; such differences suggest that there is a need for more education on the topic of eating disorders. Furthermore, despite empirical support for the effects of
Lahortiga-Ramos, Francisca; De Irala-Estévez, Jokin; Cano-Prous, Adrián; Gual-García, Pilar; Martínez-González, Miguel Angel; Cervera-Enguix, Salvador
To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%. All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed. Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. We detected 90 new cases of eating disorders. Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8-6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0-6.3). The incidence of AN was 0.3% (95% CI: 0.2-0.5), while that of BN was also found to be 0.3% (95% CI: 0.2-0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8-6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16.
Wiss, David A.; Brewerton, Timothy D.
Although not formally recognized by the DSM-5, food addiction (FA) has been well described in the scientific literature. FA has emerged as a clinical entity that is recognized within the spectrum of disordered eating, particularly in patients with bulimia nervosa, binge-eating disorder and/or co-occurring addictive disorders and obesity. Integrating the concept of FA into the scope of disordered eating has been challenging for ED treatment professionals, since there is no well-accepted treatm...
Berner, Laura A; Allison, Kelly C
Night eating syndrome (NES) is a form of disordered eating associated with evening hyperphagia (overeating at night) and nocturnal ingestions (waking at night to eat). As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a "Feeding or Eating Disorder Not Elsewhere Classified," more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed.
Eating disorders (ED) are characterised as a severe disturbance in an individual's eating behaviours and are one of the most misdiagnosed and overlooked mental health conditions in the United Kingdom. Six- eight per cent of the general population are reported to be affected by an ED, although the number is rising. There are two main diagnostic categories of ED: anorexia nervosa and bulimia nervosa, though those that do not meet the specific criteria are categorised as having an'eating disorder not otherwise specified' (Dooner 2015). Eating disorders predominantly present in women of childbearing age and, although many women experience alleviation of their symptoms during pregnancy, they are at significant risk of relapse in the postpartum period. This article aims to explore the impact that an eating disorder has on the woman and her family, with a focus on the postnatal period, as well as the challenges that midwives may face in identifying and caring for women with the condition.
Selma Bozkurt Zincir
Full Text Available There are three basic pillars for the development of eating disorders: genetic predisposition, neuro-endocrine-molecular changes in the brain and metabolic response to it. As a result of neuroendocrine research, a close relationship has been found between neuroendocrine functions and symptom domains of psychiatric disorders such as eating disorders and mood disorders. Certain hormones, neurotransmitters and other molecules which might have effect on the basis of eating disorders can be listed as estrogen, serotonin, leptin, ghreline, alpha-melanocyte stimulating hormone, cholecystokinin, dopamine, noradrenaline, brain-derived neurotropic factor, agouti-related protein, neuropeptide-Y, opioids and their receptors, thiamine, zinc, omega-3 acids. In this review, main neuroendocrine-molecular changes and interactions that occur in the eating disorders have been discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 389-400
Gianini, Loren M.; White, Marney A.; Masheb, Robin M.
Objective The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED). Method The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED. Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery. Results A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect. Discussion Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED. PMID:23910772
Gianini, Loren M; White, Marney A; Masheb, Robin M
The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED). The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED. Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery. A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect. Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Gabriela Morgado de Oliveira Coelho,1 Ainá Innocencio da Silva Gomes,2 Beatriz Gonçalves Ribeiro,2 Eliane de Abreu Soares11Nutrition Institute, Rio de Janeiro State University, Maracanã, Rio de Janeiro, Brazil; 2Federal University of Rio de Janeiro, Macaé Campus, Granja dos Cavaleiros, Macaé, BrazilAbstract: Eating disorders are serious mental diseases that frequently appear in female athletes. They are abnormal eating behaviors that can be diagnosed only by strict criteria. Disordered eating, although also characterized as abnormal eating behavior, does not include all the criteria for diagnosing eating disorders and is therefore a way to recognize the problem in its early stages. It is important to identify factors to avoid clinical progression in this high-risk population. Therefore, the purpose of this review is to discuss critical information for the prevention of eating disorders in female athletes. This review discusses the major correlates for the development of an eating disorder. We also discuss which athletes are possibly at highest risk for eating disorders, including those from lean sports and female adolescent athletes. There is an urgent need for the demystification of myths surrounding body weight and performance in sports. This review includes studies that tested different prevention programs' effectiveness, and the majority showed positive results. Educational programs are the best method for primary prevention of eating disorders. For secondary prevention, early identification is essential and should be performed by preparticipation exams, the recognition of dietary markers, and the use of validated self-report questionnaires or clinical interviews. In addition, more randomized clinical trials are needed with athletes from multiple sports in order for the most reliable recommendations to be made and for some sporting regulations to be changed.Keywords: nutrition, disordered eating, sport, anorexia nervosa, bulimia nervosa
Mustelin, L.; Hedman, A.; Thornton, L.M.; Kuja-Halkola, R.; Keski-Rahkonen, A.; Cantor-Graae, E.; Almqvist, C.; Lichtenstein, P.; Mortensen, P.B.; Böcker Pedersen, C.; Bulik, C.M.
Objective: The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differ from native-born Danes and Swedes. Method: All individuals born 1984-2002 (Danish cohort) and 1989-1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the d...
HALMI, KATHERINE A.
The treatment of eating disorders is based on a multimodal model, recognizing that these disorders do not have a single cause or a predictable course. The treatment strategy is determined by the severity of illness and the specific eating disorder diagnosis. For the treatment of anorexia nervosa, the key elements are medical management, behavioral therapy, cognitive therapy and family therapy, while pharmacotherapy is at best an adjunct to other therapies. In bulimia nervosa...
Arzu Onal Sonmez
Full Text Available Eating disorders are relatively common and serious disorders in adolescent and pre-adolescent age. The aim of this review is to update new findings related with mostly seen feeding and eating disorders in child and adolescents. The article focuses specifically on anorexia nervosa and bulimia nervosa. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000: 301-316
Phillips, Lauren; Kemppainen, Jeanne K; Mechling, Brandy M; MacKain, Sally; Kim-Godwin, Yeounsoo; Leopard, Louisa
Associations were examined between eating disorder symptoms and spiritual well-being in a convenience sample of college students. Undergraduate nursing students at a university in a Mid-Atlantic coastal beach community were recruited for the study. A total of 115 students completed the Spiritual Well-Being Scale (SWBS); the Sick, Control, One Stone, Fat, Food (SCOFF) screening questionnaire; and the Eating Attitudes Test (EAT-26). Approximately one quarter of students had positive screens for an eating disorder, and 40% admitted to binging/purging. SWBS scores reflected low life satisfaction and a lack of clarity and purpose among students. A significant association was found between EAT-26 scores and SWBS Existential Well-Being (EWB) sub-scale scores (p = 0.014). SCOFF scores were significantly associated with SWBS EWB scores (p = 0.001). Symptoms of eating disorders were pervasive. Future research that assesses the impact of spiritual factors on eating disorders may help health care providers better understand the unique contributions to the development of eating disorders. [Journal of Psychosocial Nursing and Mental Health Services, 53(1), 30-37.]. Copyright 2015, SLACK Incorporated.
BackgroundFloorball is Sweden's third largest sport and in elite floorball eating disorders have increasingly been noted. This may partly depend on the attitudes and demands of coaches. Studies indicate that elite coaches lack the knowledge to manage an eating disorder. ObjectiveTo explore elite floorball coaches experience of eating disorders and what support they feel they need to help the players. MethodSemi-structured interviews were conducted with five elite floorball coaches. The recrui...
Uzun, Ozcan; Güleç, Nurdan; Ozşahin, Aytekin; Doruk, Ali; Ozdemir, Barbaros; Calişkan, Ufuk
It has been hypothesized that college women are particularly susceptible to the development and maintenance of disturbed eating behaviors. The purpose of this study was to determine the frequency of disordered eating attitudes and eating disorders in a sample of Turkish female college students. The Eating Attitudes Test was administered to a sample of 414 female college students. The subjects who had a score of 30 or higher were accepted as having disordered eating attitudes, and all of them have been examined using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for eating disorders. Of the overall sample, 17.1% of subjects were classified as having disordered eating attitudes. This subgroup of subjects was then compared with the remainder on all the other measures. The differences between students with disordered eating attitudes and those without on sociodemographic variables (except for age) were not statistically significant. The rate was 1% for eating disorders including anorexia nervosa (0.5%) and bulimia nervosa (0.5%). This study suggested that the prevalences of disordered eating attitudes and anorexia nervosa among female college students in Turkey were similar to those found in Western societies, but the rate for bulimia nervosa was lower compared with Western societies.
Murphy, Rebecca; Straebler, Suzanne; Cooper, Zafra; Fairburn, Christopher G
Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new "enhanced" version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the "transdiagnostic" theory that underpins the enhanced form of the treatment. It ends with an outline of the treatment's main strategies and procedures. Copyright 2010 Elsevier Inc. All rights reserved.
Elisaveta Pavlova; Mariana Arnaoudova; Ivan Aleksandrov; Yasen Yanev
Background: Eating Disorders (EDs) are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. EDs are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Their epidemiology is rising for the past decades, and EDs affect all races, social levels and both genders. Due to the long and expensive treatment, chronic course, and the fact that most of the ...
Nash, J.; Skinner, T. C.
There is some debate in the literature as to whether there is an increased risk of developing eating disorders in individuals with type 1 diabetes. This review located 12 empirical studies of eating pathology in females with type 1 diabetes. Review of these papers indicates that there is no evide......There is some debate in the literature as to whether there is an increased risk of developing eating disorders in individuals with type 1 diabetes. This review located 12 empirical studies of eating pathology in females with type 1 diabetes. Review of these papers indicates...... that there is no evidence for an increase in the rates of anorexia or bulimia, in females with type 1 diabetes. However, the data do suggest that eating disorders not otherwise specified (EDNOS) are more prevalent in individuals with type 1 diabetes. Key features of these articles are reviewed and discussed....
Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N
Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.
Herpertz, Stephan; Hagenah, Ulrich; Vocks, Silja; von Wietersheim, Jörn; Cuntz, Ulrich; Zeeck, Almut
Eating disorders are of major significance both in clinical medicine and in society at large. Anorexia and bulimia nervosa almost exclusively afflict young persons, severely impairing their physical and mental health. The peak ages for these diseases are in late adolescence and young adulthood; patients therefore suffer setbacks both in school and/or in their occupational careers. This scientifically based S3 guideline was developed with the intention of improving the treatment of eating disorders and motivating future research in this area. The existing national and international guidelines on the three types of eating disorders were synoptically compared, the literature on the subject was systematically searched, and meta-analyses on bulimia nervosa and binge-eating disorder were carried out. 15 consensus conferences were held, as a result of which 44 evidence-based recommendations were issued. Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Psychotherapy is the mainstay of treatment for all three disorders, and cognitive behavioral therapy is the form of psychotherapy best supported by the available evidence. The administration of selective serotonin reuptake inhibitors (SSRI) can be recommended as a flanking measure in the treatment of bulimia nervosa only. The evidence does not support any type of pharmacotherapy for anorexia nervosa or binge-eating disorder. Bulimia nervosa and binge-eating disorder can usually be treated on an outpatient basis, as long as they are no more than moderately severe; full-fledged anorexia nervosa is generally an indication for in-hospital treatment. This guideline contains evidence- and consensus-based recommendations for the diagnosis and treatment of eating disorders. If strictly implemented, it should result in improved care for the affected
Kamińska, Katarzyna; Rybakowski, Filip
Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful.
Witt, Ashley A; Lowe, Michael R
Hedonic hunger, the appetitive drive to eat to obtain pleasure in the absence of an energy deficit, is associated with overeating and with loss of control over eating, but has not been investigated among individuals with eating disorders. (1) to compare participants with anorexia nervosa, restricting type (AN-R), anorexia nervosa, binge-purge type (AN-B/P), and bulimia nervosa (BN) on scores on the Power of Food Scale (PFS), a self-report measure of hedonic hunger; (2) to examine the relation between PFS scores and frequency of binge eating; and (3) to examine whether pre-treatment PFS scores predict weight change during treatment. The PFS and measures of eating disorder symptomatology were administered to female patients with AN (N = 119) and BN (N = 144) at admission to residential treatment. Participants with BN scored higher on the PFS compared to participants with AN-R or AN-B/P; there was a trend for those with AN-B/P to score higher than those with AN-R. PFS scores were positively associated with binge eating frequency among participants with BN; these associations remained significant when controlling for restraint and weight suppression. A similar pattern was found among participants with AN. PFS scores predicted weight change in AN but not BN. Results suggest that hedonic processes may be important in stimulating binge eating. Furthermore, hedonic appetite may facilitate weight restoration in AN. Further research should investigate whether pre-treatment PFS scores have prognostic significance with respect to eating disorder symptoms. Copyright © 2013 Wiley Periodicals, Inc.
van Hoeken, Daphne; Burns, Jonathan K.; Hoek, Hans W.
Purpose of reviewThis is the first review of studies on the epidemiology of eating disorders on the African continent.Recent findingsThe majority of articles found through our search did not assess formal diagnoses, but only screened for eating attitudes and behaviors. Only four studies - including
Keywords: Males; Eating disorders; Age of onset and presentation; Body dissatisfaction; Weight control; Comorbidity; Sexual orientation; Social class; Socio-cultural ... result(ing) in out-of-control eating episodes, or binges, often followed by ... The DSM-IV-TR is a useful tool to use insofar as clinicians around the world are ...
Burckes-Miller, Mardie E.; Black, David R.
A review of research regarding athletes' eating habits suggests that they may practice eating disorder habits and poor weight management behaviors as well as have poor attitudes and knowledge regarding nutrition, indicating their immediate need for appropriate education about the possible detrimental effects of such practices. (CB)
Vanesa Carina Góngora
Full Text Available The interest for the systematic study of personality disorder in patients with eating disorders starts in 1980 with the edition of the DSM III multiaxial classification system. Since then, several publications have been focused on the prevalence and the effect on treatment of personality disorders in bulimic and anorexic patients. These researches showed inconsistent results due to conceptual and methodological divergences. In this paper, the more relevant findings of these studies are presented and the possible sources of discrepancy are analyzed. In general, there is a moderate comorbidity between personality disorders and eating disorders. The most frequent disorders are borderline, histrionic, obsessive-compulsive, dependent and avoidant personality disorders. Borderline and histrionic personality disorders are more frequently associated with bulimia, whereas avoidant and obsessive- compulsive personality disorders are more characteristic of anorexia nervosa. Nevertheless, the effect of the relationship between eating disorders and personality disorders in treatment remains uncertain, giving raise to several controversies and researches.
Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W
To review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The residual category 'eating disorder not otherwise specified' (EDNOS) was the most common DSM-IV eating disorder diagnosis in both clinical and community samples. Several studies have confirmed that the DSM-5 criteria for eating disorders effectively reduce the proportion of EDNOS diagnoses. The lifetime prevalence of DSM-5 anorexia nervosa among women might be up to 4%, and of bulimia nervosa 2%. In a cross-national survey, the average lifetime prevalence of binge eating disorder (BED) was 2%. Both anorexia nervosa and bulimia nervosa are associated with increased mortality. Data on long-term outcome, including mortality, are limited for BED. Follow-up studies of BED are scarce; remission rates in randomized controlled trials ranged from 19 to 65% across studies. On a community level, 5-year recovery rates for DSM-5 anorexia nervosa and bulimia nervosa are 69 and 55%, respectively; little is known about the course and outcome of BED in the community. Applying the DSM-5 criteria effectively reduces the frequency of the residual diagnosis EDNOS, by lowering the threshold for anorexia nervosa and bulimia nervosa, and adding BED as a specified eating disorder. Course and outcome studies of both anorexia nervosa and bulimia nervosa show that no significant differences exist between DSM-5 and DSM-IV definitions.
Yeh, Hui-Wen; Tzeng, Nian-Sheng; Lai, Tzu-Ju; Chou, Kuei-Ru
Eating disorders include anorexia nervosa and bulimia nervosa. The former is characterized by failure to maintain a minimum normal body weight, while the latter is typified by recurrent binge eating followed by inappropriate compensating behavior, which may include self-inducing vomiting; abuse of laxatives, diuretics or other medications; fasting; and over-exercise. Because eating disorders are difficult to detect in the early stages and patients frequently try to hide their condition and avoid seeking medical help, medical treatment is sometimes sought only once a patient's condition poses an immediate threat to his/her health, or even life. Some patients suffer from chronic and treatment-refractory disorders. Cognitive behavioral therapy, administered through partially-structured guidance and education, has been shown to treat eating disorders effectively by correcting associated maladaptive and distorted cognitions and behaviors. A review of articles published in the domestic and international literature over the past five years show that cognitive behavioral therapy is more effective in treating eating disorders than other traditional approaches. Therefore, we chose to focus this study on the cognitive behavioral therapy model. Nurses can employ cognitive behavioral therapy to help eating disordered patients address and overcome the core beliefs that underpin their disorder (e.g., compulsive concern about body weight or figure) and recover health.
Stanford, Stevie Chariese; Lemberg, Raymond
In a thorough review of literature of eating disorders in men, it is consistently shown that symptom presentation varies greatly by gender. However, almost all eating disorder instruments have been developed and validated on females. These critical differences between men and women in symptom presentation provoke the necessity to develop a male specific eating disorder assessment tool. The development of the EDAM is described, and in a study of 108 clients of residential treatment facilities, results of the preliminary version of the EDAM are shown. Internal consistency reliability is supported and factor analysis loadings are provided. Results from a logistical regression support the EDAM's ability to predict eating disorders in men.
McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; Keck, Paul E
Psychopharmacologic treatment is playing a greater role in the management of patients with eating disorders. In this paper, we review randomized, placebo-controlled trials (RCTs) conducted in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other eating disorders over the past 3 years. Fluoxetine remains the only medication approved for an eating disorder, that being BN. RCTs of antipsychotics in AN have had mixed results; the only agent with some evidence of efficacy is olanzapine. One study suggests dronabinol may induce weight gain in AN. Preliminary studies suggest lack of efficacy of alprazolam, dehydroepiandrosterone, or physiologic estrogen replacement in AN; erythromycin in BN; and the opioid antagonist ALKS-33 in BED. In BED with obesity or overweight, bupropion may cause mild weight loss without seizures, and chromium may improve glucose regulation. Also in BED, three RCTs suggest the stimulant prodrug lisdexamfetamine may reduce binge eating episodes, and another RCT suggests intranasal naloxone may decrease time spent binge eating. There remains a disconnection between the size of eating disorders as a public health problem and the lack of pharmacotherapy research of these conditions.
Tasca, Giorgio A
Prominent models of eating disorders tend to focus on cognitive and behavioral features, but tend not to consider important developmental issues related to affect regulation, interpersonal style, self concept, and mentalization-all of which are well conceptualized within attachment theory. Higher levels of attachment insecurity across diagnoses are related to greater eating disorder symptoms. Low parental care and early trauma may lead to attachment insecurity that then might lead to greater eating disorder symptoms. The association between insecure attachment and eating disorder severity is likely mediated by affect dysregulation and perfectionism. Recent research using the Adult Attachment Interview highlights the importance of reflective functioning in predicting treatment response and therapeutic processes, and on the utility of therapies that increase mentalization. Copyright © 2018 Elsevier Ltd. All rights reserved.
... cause serious health problems related to inadequate nutrition, overeating, bingeing and other factors. The type of health problems caused by eating disorders depends on the type and severity of the ...
'Take yourself back to the age of 15. What thoughts swirled around your head? Did you worry about how you looked or what your friends and teachers thought of you?' Wendy Clarke, specialist lead for eating disorders at Aneurin Bevan University Health Board in South Wales, believes nurses should be asking themselves these questions if they are to fully empathise, engage with and help young people with eating disorders.
Schousboe, Birgitte Hartvig
Mennesker med Binge Eating Disorder indtager større mængder mad uden at være sultne. Overspisningen kan dulme svære følelser, men medfører typisk ekstremt ubehag og skam. Mennesker, der lider af spiseforstyrrelsen Binge Eating Disorder (i daglig tale kaldet BED), har ofte problemer med overvægt, og...
Adolescence means an increased risk for eating disorders (ED) and the female gender is the most important risk factor. Empirical studies of the perceptions of gender ideals—as potential mediating factors between the socio-cultural context and ED—were this thesis’ primary goals. Further aims implied evaluating the psychometric properties of the Eating Disorders Inventory for Children (EDI-C) and providing normative data for boys and girls concerning self-assessed ED symptoms and related psycho...
Title of the bachelor's thesis: Eating Disorders - Causes, Treatment Options and Help Author: David Rudolf The bachelor's thesis focuses on eating disorders, especially on anorexia nervosa. It describes the causes leading to the disease, symptoms and features, risk factors as well as the dangers of diets and their consequences. It sums up standard treatments, contemporary options of specialized treatments, advisory, help and various forms of therapy. It mentions ways and possibilities of the ...
Seeman, Mary V
Psychotic disorders and eating disorders sometimes occur in the same person, and sometimes, but not always, at the same time. This can cause diagnostic confusion and uncertainty about treatment. This paper examines seven ways in which symptoms of both conditions can co-exist. The literature on this topic consists to a large extent of case reports, so that firm conclusions cannot be drawn from their examination. There is no consistent sequence in the co-occurrence of the two conditions-eating ...
Abstract This review aims to critically analyse the literature which considers the relationship between the media’s portrayal of the ‘ideal body image’ and adolescent eating disorders. Currently within Western society, the media endorses a thin-ideal for females and a lean, muscular-ideal for males. A critical review was chosen to deconstruct the evident debate within the literature as to whether the media is solely to blame for eating disorder development or whether other risk fact...
Rikani, Azadeh A; Choudhry, Zia; Choudhry, Adnan M; Ikram, Huma; Asghar, Muhammad W; Kajal, Dilkash; Waheed, Abdul; Mobassarah, Nusrat J
The development of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and atypical eating disorders that affect many young women and even men in the productive period of their lives is complex and varied. While numbers of presumed risk factors contributing to the development of eating disorders are increasing, previous evidence for biological, psychological, developmental, and sociocultural effects on the development of eating disorders have not been conclusi...
Lachenmeyer, Juliana Rasic; Muni-Brander, Paulette
Investigated prevalence of adolescent eating disorders across gender, cultural groupings, and socioeconomic status. Administered Eating Attitudes Test, Binge-Eating Questionnaire, and demographic questionnaire to 1,261 high school students. Results indicated high rate of eating disorders in nonclinical adolescent population. Eating disorders…
Walsh, Judith M E; Wheat, Mary E; Freund, Karen
OBJECTIVE To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications. DESIGN A review of literature from 1994 to 1999 identified by a medlinesearch on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa. MEASUREMENTS AND MAIN RESULTS Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia). CONCLUSION Primary care providers have an important role in detecting and managing eating disorders. PMID:10940151
Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B
The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (peating." BED patients were worst than OBS for "Relationship with food" and as dysfunctional as AN patients - besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes. Copyright © 2014 Elsevier Inc. All rights reserved.
Gerbasi, Margaret E.; Richards, Lauren K.; Thomas, Jennifer J.; Agnew-Blais, Jessica C.; Thompson-Brenner, Heather; Gilman, Stephen E.; Becker, Anne E.
Objective The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change. Method We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n=523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q). Results We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition—and where globalization is also influencing local social norms—may enrich etiologic models and inform strategies to mitigate risk. PMID:25139374
Gerbasi, Margaret E; Richards, Lauren K; Thomas, Jennifer J; Agnew-Blais, Jessica C; Thompson-Brenner, Heather; Gilman, Stephen E; Becker, Anne E
The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change. We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n = 523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q). We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p global scores in a fully adjusted linear regression model. Study findings support the possibility that peer influence as well as perceived social norms relevant to disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition--and where globalization is also influencing local social norms--may enrich etiologic models and inform strategies to mitigate risk. © 2014 Wiley Periodicals, Inc.
Mustelin, L; Hedman, A M; Thornton, L M; Kuja-Halkola, R; Keski-Rahkonen, A; Cantor-Graae, E; Almqvist, C; Birgegård, A; Lichtenstein, P; Mortensen, P B; Pedersen, C B; Bulik, C M
The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. All individuals born 1984-2002 (Danish cohort) and 1989-1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Saekow, Jenine; Jones, Megan; Gibbs, Elise; Jacobi, Corinna; Fitzsimmons-Craft, Ellen E.; Wilfley, Denise; Barr Taylor, C.
Objective: Eating disorders and subclinical eating disorders are serious and disabling diseases with high prevalence rates on college campuses. Many symptomatic students are never screened nor formally diagnosed with an eating disorder and do not receive mental health treatment. Method: This pilot study examines the feasibility, acceptability, and short-term efficacy of a 10-week online intervention, StudentBodies-Eating Disorders, designed to reduce eating disorder symptoms, related psych...
Anderson, Lisa M; Reilly, Erin E; Schaumberg, Katherine; Dmochowski, Sasha; Anderson, Drew A
Mindful eating and intuitive eating are promoted as means to circumvent potentially maladaptive dietary restraint while maintaining a healthy weight. Although theoretically related, no studies have examined the correlations between intuitive eating, mindful eating, and restraint in the same sample. This study sought to examine these constructs and their correlations with body mass index (BMI), eating-disordered behaviors, and meal consumption in a college sample. Participants (N = 125) completed a laboratory taste-test meal and measures of each eating-related construct using the EDDS, IES, MEQ, and TFEQ-Restraint Subscale. Mindful eating, intuitive eating, and restraint were not strongly correlated. Hierarchical multiple regression analyses indicated that restraint and intuitive eating accounted for significant variance in disordered eating and BMI. Elevated restraint was associated with increased BMI and disordered eating; elevated intuitive eating was associated with decreased BMI and disordered eating. Mindful eating did not correlate with any outcome variables. Follow-up analyses suggested that specific intuitive eating subscales accounted for unique variance in the relation between intuitive eating and disordered eating. Intuitive eating was the only construct that was significantly associated with meal consumption. Intuitive eating and restraint appear to be only weakly correlated, and each is differentially associated with meal consumption. Mindful eating does not appear to relate to outcome variables.
Alba, Patricio; Kes, Mariana Gabriela
Eating disorders are a growing problem in healthcare. Altered eating behaviors are a consequence of cognitions and emotions generated by low self-esteem and dissatisfaction with body image and schema. It is possible, that a negative body image, and in many cases, distorted, may be the most difficult feature to approach and improve in this disorders. But the dissatisfaction to one's own body would not be related only to altered eating behaviors. Several studies show that body image and one's own body perception are an essential feature in sexual experiences, especially in women's sexuality. This article describes the relation and influences between body image and women's sexuality, and the sexuality in women with eating disorders.
Keel, Pamela K; Forney, K Jean
One goal in identifying psychosocial risk factors is to discover opportunities for intervention. The purpose of this review is to examine psychosocial risk factors for disordered eating, placing research findings in the larger context of how etiological models for eating disorders can be transformed into models for intervention. A qualitative literature review was conducted focusing on psychological and social factors that increase the risk for developing eating disorders, with an emphasis on well-replicated findings from prospective longitudinal studies. Epidemiological, cross-cultural, and longitudinal studies underscore the importance of the idealization of thinness and resulting weight concerns as psychosocial risk factors for eating disorders. Personality factors such as negative emotionality and perfectionism contribute to the development of eating disorders but may do so indirectly by increasing susceptibility to internalize the thin ideal or by influencing selection of peer environment. During adolescence, peers represent self-selected environments that influence risk. Peer context may represent a key opportunity for intervention, as peer groups represent the nexus in which individual differences in psychological risk factors shape the social environment and social environment shapes psychological risk factors. Thus, peer-based interventions that challenge internalization of the thin ideal can protect against the development of eating pathology. Copyright © 2013 Wiley Periodicals, Inc.
Eating disorders in young women are often associated with a number of comorbid conditions, including mood disorders and cognitive problems. Although group therapy is often used as part of overall treatment for eating disorders in many types of settings, specific nutritional interventions used in such settings have rarely been evaluated. In this…
Eating disturbances are common amongst female athletes, especially those participating in dance. We investigated the prevalence and correlates of eating disorder risk symptoms amongst female student dancers. Fifty-eight female university dancers completed a self-report measure of eating disorders and eating disorder ...
Catalina Zamora, M L; Bote Bonaechea, B; García Sánchez, F; Ríos Rial, B
New eating behavior disorders such as bigorexia (muscle dysmorphia) and orthorexia are appearing in developed countries. These disorders have not been officially recognized so that they are not classified as independent entities. The term orthorexia comes from the Greek word orthos (straight, proper) and orexia (appetite). It is characterized by the pathological obsession for biologically pure food, which leads to important dietary restrictions. Orthorexic patients exclude foods from their diets that they consider to be impure because they have herbicides, pesticides or artificial substances and they worry in excess about the techniques and materials used in the food elaboration. This obsession leads to loss of social relationships and affective dissatisfactions which, in turn, favors obsessive concern about food. In orthorexia, that patient initially wants to improve his/her health, treat a disease or lose weight. Finally, the diet becomes the most important part of their lives. We present a clinical case that responds to the characteristics of orthorexia. The differential diagnosis with chronic delusional disorder, anorexia nervosa and obsessive-compulsive disorder is carried out.
Cartwright, Martina M
Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.
Schaumberg, Katherine; Welch, Elisabeth; Breithaupt, Lauren; Hübel, Christopher; Baker, Jessica H; Munn-Chernoff, Melissa A; Yilmaz, Zeynep; Ehrlich, Stefan; Mustelin, Linda; Ghaderi, Ata; Hardaway, Andrew J; Bulik-Sullivan, Emily C; Hedman, Anna M; Jangmo, Andreas; Nilsson, Ida A K; Wiklund, Camilla; Yao, Shuyang; Seidel, Maria; Bulik, Cynthia M
In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Maguen, Shira; Hebenstreit, Claire; Li, Yongmei; Dinh, Julie V; Donalson, Rosemary; Dalton, Sarah; Rubin, Emma; Masheb, Robin
To develop a primary care eating disorder screen with greater accuracy and greater potential for generalizability, compared to existing screens. Cross-sectional survey to assess discriminative accuracy of a new screen, Screen for Disordered Eating (SDE), compared to Eating Disorders Screen for Primary Care (EDS-PC) and SCOFF screener, using prevalence rates of Binge Eating Disorder (BED), Bulimia Nervosa (BN), Anorexia Nervosa (AN), and Any Eating Disorder (AED), as measured by the Eating Disorder Examination Questionnaire (EDE-Q). The SDE correctly classified 87.2% (CI: 74.3%-95.2%) of BED cases, all cases of BN and AN, and 90.5% (CI: 80.4%-96.4%) of AED cases. Sensitivity estimates were higher than the SCOFF, which correctly identified 69.6% (CI: 54.2%-82.3%) of BED, 77.8% (CI: 40.0%-97.2%) of BN, 37.5% (CI: 8.52%-75.5%) of AN, and 66.1% (CI: 53%-77.7%) of AED. While the EDS-PC had slightly higher sensitivity than the SDE, the SDE had better specificity. The SDE outperformed the SCOFF in classifying true cases, the EDS-PC in classifying true non-cases, and the EDS-PC in distinguishing cases from non-cases. The SDE is the first screen, inclusive of BED, valid for detecting eating disorders in primary care. Findings have broad implications to address eating disorder screening in primary care settings. Published by Elsevier Inc.
The primary objective of this review of literature was to examine the relationship of eating disorders and disordered eating among female collegiate athletes. Since the institution of Title IX in 1972, the Educational Amendment to the Civil Rights Act of 1964, female participation in sports has been consistently rising at all levels of…
Culbert, Kristen M; Racine, Sarah E; Klump, Kelly L
This review summarizes the current state of the literature regarding hormonal correlates of, and etiologic influences on, eating pathology. Several hormones (e.g., ghrelin, CCK, GLP-1, PYY, leptin, oxytocin, cortisol) are disrupted during the ill state of eating disorders and likely contribute to the maintenance of core symptoms (e.g., dietary restriction, binge eating) and/or co-occurring features (e.g., mood symptoms, attentional biases). Some of these hormones (e.g., ghrelin, cortisol) may also be related to eating pathology via links with psychological stress. Despite these effects, the role of hormonal factors in the etiology of eating disorders remains unknown. The strongest evidence for etiologic effects has emerged for ovarian hormones, as changes in ovarian hormones predict changes in phenotypic and genetic influences on disordered eating. Future studies would benefit from utilizing etiologically informative designs (e.g., high risk, behavioral genetic) and continuing to explore factors (e.g., psychological, neural responsivity) that may impact hormonal influences on eating pathology.
This thesis focuses on patients with Binge Eating Disorder. The thesis consists of three parts. In the first part the validity of the diagnosis of BED will be discussed. The results of two literature reviews and an empirical cross-sectional study suggested that BED is a distinct eating disorder and
Eddy, Kamryn T; Celio Doyle, Angela; Hoste, Renee Rienecke; Herzog, David B; le Grange, Daniel
To examine the frequency, type, and clinical severity of eating disorder not otherwise specified (EDNOS) in adolescents seeking treatment through an outpatient eating disorders service. Two hundred eighty-one consecutive referrals to an eating disorders program were assessed using the Eating Disorder Examination (EDE) and self-report measures of depression and self-esteem. The majority of adolescents presented with EDNOS (59.1%; n = 166) relative to anorexia nervosa (AN; 20.3%; n = 57) and bulimia nervosa (BN; 20.6%; n = 58). Most EDNOS youths could be described as subthreshold AN (SAN; 27.7%; n = 46), subthreshold BN (SBN; 19.9%; n = 33), EDNOS purging (27.7%; n = 46), or EDNOS bingeing (6.0%; n = 10); yet 31 (18.7%) could not be categorized as such (EDNOS "other"). Overall differences in eating disorder pathology, depressive symptoms, and self-esteem emerged between the EDNOS types, wherein adolescents with EDNOS bulimic variants (SBN, EDNOS purging, and EDNOS bingeing) had more pathology than youths with SAN or EDNOS "other." There were no differences in these variables between AN and SAN; in contrast, compared with BN, youths with EDNOS bulimic variants reported lower EDE scores and higher self-esteem, although there were no between-group differences in depression. As in adults with eating disorders, EDNOS predominates and is heterogeneous with regard to eating disorder pathology and associated features in an adolescent clinical sample. Lack of differences between AN and SAN suggests that the strict criteria for AN could be relaxed; differences between BN and EDNOS bulimic variants do not support their combination.
Rotella, Francesco; Fioravanti, Giulia; Ricca, Valdo
In the last decades, three main different personality domains have been investigated in the field of eating disorders: personality traits, temperament, and personality disorders. The use of a wide range of instruments and the presence of many different approaches in the definition of personality dimensions make it difficult to summarize the emerging results from different studies. The aim of this narrative review is to critically highlight and discuss all interesting developments in this field, as reflected in the recent literature. The study of personality and temperament in eating disorders seems to be in line with the recently suggested dimensional approach, which highlights the importance of symptoms aggregation, rather than the categorical diagnoses. Recent literature seems to confirm that specific personality and temperamental profiles can be drawn for patients with eating disorders, which can discriminate different eating disorders' diagnoses/symptoms. These observations have relevant clinical implications as treatment of eating disorders is largely based on psychotherapeutic interventions. However, large longitudinal studies are needed to better clarify the suggested relationships and to identify more defined therapeutic strategies.
Jones, William R; Saeidi, Saeideh; Morgan, John F
This study examined the eating disorder mental health literacy of psychiatrists. A sample of psychiatrists completed a questionnaire measuring knowledge of and attitudes towards eating disorders. Knowledge questions were based on the academic literature, standard diagnostic criteria and national guidelines on the management of eating disorders. Attitude items covered beliefs about the aetiology and treatment of eating disorders, confidence levels in diagnosis and management and the use of compulsory measures in anorexia nervosa. Psychiatrists’ knowledge of eating disorders was variable with specific gaps in both diagnosis and management. Psychiatrists felt more confident in diagnosing eating disorders than managing these conditions. Attitudes towards eating disorders were less stigmatizing than those seen in other health professionals. There is a clear need for greater education of psychiatrists regarding the diagnosis and management of eating disorders. Implementing training programmes and making information readily available could contribute to addressing these issues. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.
Rikani, Azadeh A; Choudhry, Zia; Choudhry, Adnan M; Ikram, Huma; Asghar, Muhammad W; Kajal, Dilkash; Waheed, Abdul; Mobassarah, Nusrat J
The development of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and atypical eating disorders that affect many young women and even men in the productive period of their lives is complex and varied. While numbers of presumed risk factors contributing to the development of eating disorders are increasing, previous evidence for biological, psychological, developmental, and sociocultural effects on the development of eating disorders have not been conclusive. Despite the fact that a huge body of research has carefully examined the possible risk factors associated with the eating disorders, they have failed not only to uncover the exact etiology of eating disorders, but also to understand the interaction between different causes of eating disorders. This failure may be due complexities of eating disorders, limitations of the studies or combination of two factors. In this review, some risk factors including biological, psychological, developmental, and sociocultural are discussed.
Verri, A P; Verticale, M S; Vallero, E; Bellone, S; Nespoli, L
The media, mainly TV, play a significant social and cultural role and may affect the prevalence and incidence of eating disorders such as bulimia and anorexia nervosa. Their influence acts mainly by favoring a tall and thin body as the only fashionable for female adolescents: your social success depends primarily and totally by your physical appearance and you can, (and must), shape your body as you like better. Our research aims t analyze the attitude of adolescent people toward the TV and to investigate on: 1) time spent watching TV programs; 2) the influence of TV on the personal choices of goods to buy; 3) the ideal body images; 4) choice of TV programs. Sixty-seven healthy adolescents (36 F-31 M) were included in our study as controls together with 24 female adolescents with eating disorders (DCA) diagnosed according to the DSM-IV and EAT/26 criteria. Our results show a psychological dependence of DCA adolescents from the TV (longer period of time spent watching TV programs, buying attitudes more influenced by TV advertising). The thin and tall body image is preferred by the DCA girls as well as by the controls; however the body appearance and proportions have a predominant and utmost importance only for the eating disorder females. The masculine subjects instead have a preference for a female and masculine opulent body appearance. To prevent the observed increase in prevalence and incidence of eating disorders among adolescents, it is appropriate to control the messages, myths and false hood propagated by media, TV in particular.
Full Text Available Laura A Berner,1 Kelly C Allison2 1Department of Psychology, Drexel University, 2Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Night eating syndrome (NES is a form of disordered eating associated with evening hyperphagia (overeating at night and nocturnal ingestions (waking at night to eat. As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 as a “Feeding or Eating Disorder Not Elsewhere Classified,” more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed. Keywords: night eating syndrome, cognitive-behavioral treatment, phototherapy, behavioral weight loss, behavior therapy
Bern, Elana M; O'Brien, Rebecca F
The authors examine the differential diagnosis for gastrointestinal disorders that should be considered in individuals who present with nonspecific gastrointestinal and nutritional complaints suggestive of an eating disorder. This review first identifies diseases with which eating disorders are often confused and then explores features in the history, physical examination, and laboratory studies, which can provide clues to the cause of the patient's symptoms. In addition, it discusses the recommended evaluation and treatments for the gastrointestinal diseases that most commonly mimic the presentation of eating disorders including Crohn disease (CrD), celiac disease, gastroesophageal reflux disease (GERD), and eosinophilic esophagitis (EoE). The ubiquitous nature of the gastrointestinal complaints requires the clinician to consider a broad differential diagnosis when evaluating a patient for an eating disorder.
Full Text Available Marilou DP Tromp,1 Anouk AMT Donners,1 Johan Garssen,1,2 Joris C Verster1,31Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 2Nutricia Research, Utrecht, the Netherlands; 3Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, AustraliaObjective: To investigate the relationship between eating disorders, body mass index (BMI, sleep disorders, and daytime functioning.Design: Survey.Setting: The Netherlands.Participants: N=574 Dutch young adults (18–35 years old.Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD, and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2 and positive (>2 on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4 and different BMI groups (ie, underweight, healthy weight, overweight, and obese were compared using nonparametric statistics.Results: Almost 12% (n=67 of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012, insomnia (7.7 versus 5.5, P<0.0001, CRD (2.9 versus 2.3, P=0.011, and impairment of daytime functioning (8.8 versus 5.8, P=0.0001. ESP scores were associated with insomnia (r=0.117, P=0.005, sleep apnea (r=0.118, P=0.004, sleep quality (r=−0.104, P=0.012, and daytime functioning (r=0.225, P<0.0001, but not with CRD (r=0.066, P=0.112. BMI correlated significantly with ESP scores (r=0.172, P<0.0001 and scores on sleep apnea (r=0.171, P<0.0001. When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015.Conclusion
S.M. de la Rie (Simone)
textabstractEating disorders (EDs) are rare, but very serious psychiatric disorders, with a low recovery rate (1,2). This warrants studies on treatment quality to improve the course and consequences of EDs and enhance recovery rates. Despite the increasing recognition of the value of patient
Van Son, Gabrielle E.; Van Hoeken, Daphne; Bartelds, Aad I. M.; Van Furth, Eric F.; Hoek, Hans W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response
Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response
Drosdzol-Cop, Agnieszka; Bąk-Sosnowska, Monika; Sajdak, Dominika; Białka, Agnieszka; Kobiołka, Agnieszka; Franik, Grzegorz; Skrzypulec-Plinta, Violetta
Eating disorders are an important factor in menstrual cycle disorders in girls. Moreover, low self-esteem among adolescent girls may be a risk factor for eating disorders. The aim of the study was to assess the menstrual cycle, eating habits and self-esteem of Polish adolescents. The study was conducted from January 2014 to March 2015 and included 623 girls, aged 15-19, from randomly selected junior high schools in Silesia, Poland, in which their menstrual cycle, risk of eating disorders and self-esteem were evaluated. A five-part questionnaire was used to assess basic demographic data, lifestyle and physical activity, gynecological history, as well as Rosenberg Self-Esteem Scale (SES) and Eating Attitude Test (EAT-26). Irregular menstrual cycles were observed in 236 (37.88%) girls; 5.20% presented secondary amenorrhea. Based on the EAT-26 test, 101 (16.21%) girls were indicated being at risk for an eating disorder. Low self-esteem was observed in 340 (54.57%) study girls on the base of SES. Girls with irregular menses had higher scores on the EAT-26 test in subscales: EAT-overall score, EAT-diet and EAT-bulimia, while lower scores on the SES. In our study, we did not observe a significant relationship between exercise intensity, body mass, BMI and menstrual cycle regularity. Low self-esteem among adolescent girls may be a risk factor for eating disorders which could interrupt the menstrual cycle.
Long, Randall; Allison, Stephen
The objective of this study was to describe the history of South Australian Government eating disorder service from the perspective of changing leadership, health policies and politics. The history reveals a foundation of early expert academic clinical leadership changing into a centralised managerial bureaucracy correlating with a diminution of services. A threat to the survival of the service led to a solution involving reinvigoration of expert clinical and academic leadership. Expert leadership was shown to be an important part of an eating disorder service. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Eating disorders are a complex phenomenon, which has a negative effect on many areas of individual's life. It's a very complex issue, which hides in the background much more profound reasons, than the person’s wishes of becoming thinner and more beautiful. Although a lot has been said on this topic, I think that society still lacks the awareness and knowledge for a successful fight against this problem in order to diminish it. In theoretical part I defined eating disorders and their types,...
In the first part of this decade, many reviews of the impact of treatments for the eating disorders were conducted, with broadly similar conclusions. This review provides an update on progress (or otherwise) in the field over the past three years.
Part I gives a general introduction and overview of the research with a naturalistic design that has been done in Amarum. Amarus is a specialized public health centre for the treatment of people with eating disorders where the development of Evidence Based Mental Health (EBMH) and the use of
Bowden, David J; Kilburn-Toppin, Fleur; Scoffings, Daniel J
Eating disorders are a major challenge for health professionals, with many patients receiving ineffective care due to underdiagnosis or poor compliance with treatment. The incidence of eating disorders is increasing worldwide, producing an increasing burden on healthcare systems, and they most often affect young patients, with significant long-term complications. The effects of long-term malnutrition manifest in almost every organ system, and many can be detected radiologically, even without overt clinical findings. Musculoskeletal complications including osteoporosis result in a high incidence of insufficiency fractures, with long-term implications for bone health and growth, while respiratory complications are often recognized late due to disordered physiologic responses to infection. Gastrointestinal complications are numerous and in extreme cases may result in fatal outcomes after acute gastric dilatation and rupture subsequent to binge eating. In patients with severely disordered eating, in particular anorexia nervosa, marked derangement of electrolyte levels may result in refeeding syndrome, which requires emergent management. Recognition of such complications is critical to effective patient care and requires radiologists to be aware of the spectrum of imaging abnormalities that may be seen. Since many patients are reluctant to disclose their underlying condition, radiologists also play a critical role in identifying previously undiagnosed eating disorders. ©RSNA, 2013.
van Hoeken, Daphne; Burns, Jonathan K; Hoek, Hans W
This is the first review of studies on the epidemiology of eating disorders on the African continent. The majority of articles found through our search did not assess formal diagnoses, but only screened for eating attitudes and behaviors. Only four studies - including only one recent study - provided specific epidemiological data on anorexia nervosa, bulimia nervosa, and/or eating disorder not otherwise specified (EDNOS). No cases of anorexia nervosa according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria were found among a total of 1476 (young) females. The combined point-prevalence rate of bulimia nervosa is 0.87% (95% CI 0.22-1.51) and of EDNOS is 4.45% (95% CI 2.74-6.16) in young women in Africa. The epidemiological study of eating disorders in Africa is still in its infancy. Over time in total four studies providing epidemiological data on specific, formally assessed eating disorders were found. No cases of anorexia nervosa were reported in African epidemiological studies, which concurs with the very low prevalence rates of anorexia nervosa in Latin Americans and in African Americans in the USA. With the DSM-5 criteria for anorexia nervosa, some women in the African studies would have fulfilled the criteria for anorexia nervosa. The prevalence rate of bulimia nervosa in women in Africa is within the range reported for western populations, as well as African Americans and Latin Americans.
Danner, Unna N; Dingemans, Alexandra E; Steinglass, Joanna
This review compares the literature on cognitive remediation therapy (CRT) for eating disorders with findings in the field of schizophrenia, and discusses future directions for CRT for eating disorders. First studies using a randomized controlled trial design show the added value of CRT for eating disorders. Patients reported lessened symptoms and further improvements in quality of life and cognitive flexibility. Furthermore, the acceptability of the intervention was good and attrition rates for CRT itself were low. Research into the use of cognitive remediation for schizophrenia is extensive and the results on global cognition appeared to be robust at post-treatment and durable at follow-up, with small to medium effect sizes. Recent articles within the field of schizophrenia emphasize the necessity of intrinsic motivation to translate cognitive gains into actual changes in everyday life. A next step is to examine the impact of CRT for eating disorders on motivation. It is also important to focus on the transdiagnostic use of CRT, considering the overlap in cognitive inefficiencies between eating disorders. Another important step may be to develop effective personalized methods of CRT by taking into account individual differences in cognitive processes most relevant to improvement in outcome.
Full Text Available A sample of female undergraduates completed a packet of questionnaires consisting of the Arizona Life History Battery, a modified version of the Eating Disorders Inventory, the Behavioral Regulation scales from the Behavior Rating Inventory of Executive Function, and two measures of Female Intrasexual Competitiveness that distinguished between competition for mates and competition for status. As predicted, Executive Functions completely mediated the relation between Slow Life History Strategy and Disordered Eating Behavior. Surprisingly, however, the relation between Female Intrasexual Competitiveness (competition for mates and competition for status and Disordered Eating Behavior was completely spurious, with executive functions serving as a common cause underlying the inhibition of both Disordered Eating Behavior and Female Intrasexual Competitiveness. The protective function of Slow Life History Strategy with respect to Disordered Eating Behavior apparently resides in a higher degree of Behavioral Regulation, a type of Executive Function. The enhanced Behavioral Regulation or self-control, of individuals with a Slow Life History Strategy is also protective against hazardously escalated levels of Female Intrasexual Competitiveness.
Gibson, Dennis; Drabkin, Anne; Krantz, Mori J; Mascolo, Margherita; Rosen, Elissa; Sachs, Katherine; Welles, Christine; Mehler, Philip S
Eating disorders are unique in that they inherently have much medical comorbidity both as a part of restricting-type eating disorders and those characterized by purging behaviors. Over the last three decades, remarkable progress has been made in the understanding and treatment of the medical complications of eating disorders. Yet, unfortunately, there is much research that is sorely needed to bridge the gap between current medical knowledge and more effective and evidence-based medical treatment knowledge. These gaps exist in many different clinical areas including cardiology, electrolytes, gastrointestinal and bone disease. In this paper, we discuss some of the knowledge gap areas, which if bridged would help develop more effective medical intervention for this population of patients.
Morgan, J F; Marsden, P; Lacey, J H
We describe the cases of four patients with eating disorders in whom complex interactions occurred among religious faith, pathogenesis of the eating disorder, and clinical management. In some of the cases, religious beliefs seemed to provide a containment of maladaptive behaviors, partly through prayer and through a sense of belonging to the religious community. In other cases, it proved difficult to separate the concept of a punitive God from the illness process. The cases are discussed with reference to a limited empirical literature. Similarities are noted between some religious institutions and eating disorder treatment regimes. This paper explores management issues, including the use of pastoral counseling and the ethics of addressing religious beliefs in therapy. We note the benefits of a rapprochement between psychiatry and religion. Copyright 2000 by John Wiley & Sons, Inc.
Hepworth, Natasha S
The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.
Coelho, Gabriela Morgado de Oliveira; Gomes, Ainá Innocencio da Silva; Ribeiro, Beatriz Gonçalves; Soares, Eliane de Abreu
Gabriela Morgado de Oliveira Coelho,1 Ainá Innocencio da Silva Gomes,2 Beatriz Gonçalves Ribeiro,2 Eliane de Abreu Soares11Nutrition Institute, Rio de Janeiro State University, Maracanã, Rio de Janeiro, Brazil; 2Federal University of Rio de Janeiro, Macaé Campus, Granja dos Cavaleiros, Macaé, BrazilAbstract: Eating disorders are serious mental diseases that frequently appear in female athletes. They are abnormal eating behaviors that can ...
Mayara Freitas Monteiro
Full Text Available Objective: To describe the prevalence of eating disorders symptoms among classical ballet dancers. Methods: This is an analytical, observational, cross-sectional study, conducted in 2009, that investigated eating disorder symptoms using the Eating Attitudes Test (EAT-26 and Bulimic Investigatory Test, Edinburgh (BITE. The body image of the study population was assessed by the Body Shape Questionnaire (BSQ. In addition, the anthropometric assessment was performed – measurement of weight, height and skin folds, calculation of body mass index (BMI and body fat percentage. Results: Of all the 139 emale adolescents assessed, 4.4% (n=6 had nutrition problems and 23% (n=23 presented abnormal values of body fat. The analysis of the EAT concluded that 12.3% (n=17 of the girls presented positive results for anorexia nervosa (AN. The BITE results showed that 13.7% (n=19 ofthe girls had unusual eating habits and 6.5% (n=9 presented subclinical bulimia nervosa (BN. As for severity, 3.6% (n=5 of the girls presented clinically significant results and 1.4% (n=2 were diagnosed with high severity. Concerning the results of the BSQ, 15.7% (n=21 of the girls were slightly concerned about body image; 5.2% (n=7 were moderately worried, and 6.7% (n=9 were severely concerned about it. Conclusion: This study did not diagnose the occurrence of eating disorders but found symptoms of AN (Anorexia Nervosa and BN (Bulimia Nervosa. Its main purpose was to alert about the prevalence of the possible development of eating disorders due to the influences of the environment where the teenagers are inserted – under a model defined by the classic ballet dance and the psychological turmoil of adolescence. doi:10.5020/18061230.2013.p396
Korinth, Anne; Schiess, Sonja; Westenhoefer, Joachim
Sometimes the suspicion is put forward that nutrition students show more disordered eating patterns, which may be among the motivating factors to study nutrition. At the same time, it is not clear whether the students' increasing knowledge about diet and nutrition is associated with a more healthy eating behaviour or with an unhealthy obsession with food choices. Cross-sectional comparison of nutrition students from German universities during the first year of their studies (n 123) and during higher semesters (n 96), with a control group from other study programmes (n 68 and n 46, respectively). Dietary restraint, disinhibition, the tendency towards orthorexia nervosa and healthy food choices were assessed using a questionnaire. Nutrition students showed higher levels of dietary restraint than the control group. Disinhibition and orthorexia nervosa did not differ between nutrition students and controls. Orthorexic tendencies were lower in the more advanced nutrition students. Healthy food choices did not differ among students in the first year. More advanced nutrition students showed healthier food choices, whereas the corresponding controls showed slightly more unhealthy food choices. Nutrition students, more than other students, tend to restrict their food intake in order to control their weight, but they do not have more disturbed or disordered eating patterns than other students. Moreover, during the course of their studies, they adopt slightly more healthy food choices and decrease their tendency to be obsessive in their eating behaviour.
Calvo Viñuela, I; Aroca Palencia, J; Armero Fuster, M; Díaz Gómez, J; Rico Hernández, M A
To identify the eating habits and lifestyles of patients with eating behaviour disorders (TCA in its Spanish acronym) who attended our out-patients' clinic at the "La Paz" Teaching Hospital for the first time. A questionnaire was drafted to which patients responded freely and anthropometric data were assessed. The sample comprised 94 patients who were subsequently distributed into two groups: the first group contained 43 offspring of working mothers (HMTF) and the second 46 offspring of mothers who did not work outside the home (HMNTF in its Spanish acronym). In the case of the 5 remaining patients, their mothers had deceased. The results from the group as a whole showed the following lifestyles for Monday-Friday: 34.4% eat alone, 72% watch television while they eat and 68.1% use restrictive behaviour in their eating habits. When assessing the existence of a friend with TCA, the results were significantly higher among those under the age of 20 years (53.7%) versus those older than 20 (26.9%) (p eat outside the home on weekdays and 44.9% of them eat alone, 20.5% of the HMNTF group eat outside the home on weekdays and 22.7% of them eat alone. The age of onset of TCA was significantly earlier among the HMTF group (16.6 years) than in the HMNTF group (19.0 years) (p friend with TCA in their close environment and this situation was more frequent among the youngest ones in the group. Some mistaken ideas regarding food have favoured unhealthy eating: in our group a large majority of people eat while watching TV. The development of TCA occurs earlier in connection with a particular family structure: where the mother works outside the home.
Holland, Lauren A; Brown, Tiffany A; Keel, Pamela K
The current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution. Cross-sectional epidemiological study. A community-based sample of men (n=592) and women (n=1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms. Compulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women. Including the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.
Abraham, Suzanne; Kellow, John
Functional gastrointestinal-like disorders (FGIDs) are prevalent among eating disorder (ED) patients. The aims are to explore the relationship between quality of life related to eating disorders (QOL ED) and FGIDs. Consecutive ED patients, 18-45 years old, completed the Rome II, QOL ED, Irritable Bowel Syndrome QOL (IBS-QOL) and Bowel Symptom Severity Index (BSSI) questionnaires on admission to hospital for treatment of their ED. Despite the high prevalence of FGIDs (93%), only IBS is clearly correlated with QOL ED scores. The QOL ED subscores significantly related are ED feelings, psychological feelings and effect on daily living. These subscores contain items such as fearing loss of control over your body and feelings, being preoccupied with thoughts of body weight and shape, feeling confused and that eating and exercise have a negative effect on work/study. There were no relationships between QOL ED behavior and individual FGIDs or categories of FGIDs. The QOL ED and IBS-QOL are highly correlated, and there is a positive linear relationship between the QOL ED global and IBS-QOL total and BSSI scores. The presence of IBS (but not other FGIDs) in ED patients is strongly related to eating disordered and psychological feelings. The poorer the QOL ED is, the poorer the IBS-QOL is and the more severe the IBS symptoms are. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
Sato, Yasuhiro; Fukudo, Shin
The two most clinically serious eating disorders are anorexia nervosa and bulimia nervosa. A drive for thinness and fear of fatness lead patients with anorexia nervosa either to restrict their food intake or binge-eat then purge (through self-induced vomiting and/or laxative abuse) to reduce their body weight to much less than the normal range. A drive for thinness leads patients with bulimia nervosa to binge-eat then purge but fail to reduce their body weight. Patients with eating disorders present with various gastrointestinal disturbances such as postprandial fullness, abdominal distention, abdominal pain, gastric distension, and early satiety, with altered esophageal motility sometimes seen in patients with anorexia nervosa. Other common conditions noted in patients with eating disorders are postprandial distress syndrome, superior mesenteric artery syndrome, irritable bowel syndrome, and functional constipation. Binge eating may cause acute gastric dilatation and gastric perforation, while self-induced vomiting can lead to dental caries, salivary gland enlargement, gastroesophageal reflux disease, and electrolyte imbalance. Laxative abuse can cause dehydration and electrolyte imbalance. Vomiting and/or laxative abuse can cause hypokalemia, which carries a risk of fatal arrhythmia. Careful assessment and intensive treatment of patients with eating disorders is needed because gastrointestinal symptoms/disorders can progress to a critical condition.
To determine the prevalence of binge eating disorder (BED) and night eating syndrome (NES) among applicants to the Look AHEAD (Action for Health in Diabetes) study. The Eating Disorders Examination-Questionnaire (EDE-Q) and the Night Eating Questionnaire (NEQ) were used to screen patients. Phone int...
Friborg, Oddgeir; Martinussen, Monica; Kaiser, Sabine; Øvergård, Karl Tore; Martinsen, Egil W; Schmierer, Phöbe; Rosenvinge, Jan Harald
A meta-analysis was conducted to identify the proportion of comorbid personality disorders (PDs) in patients with eating disorder not otherwise specified (EDNOS) and binge eating disorder (BED). A search identified 20 articles in the period of 1987 to 2010. For EDNOS and BED, the comorbid proportions for any PD were 0.38 and 0.29, respectively; for cluster C PDs, 0.38 and 0.30, respectively (avoidant PD, 0.18 and 0.12, and obsessive-compulsive PD, 0.11 and 0.10, respectively); and for cluster B PDs, 0.25 and 0.11, respectively (borderline, 0.12 and 0.10). This pattern converged with findings on anorexia nervosa and bulimia nervosa, except being lower. Because the comorbidity profiles for EDNOS and BED were highly similar, their underlying PD pathology seems similar. Few moderators were significant, except for interviews yielding lower estimates than that of questionnaires. The variance statistic for any PD comorbidity was wide for EDNOS and narrow for BED, thus partly supporting BED as a distinct eating disorder category and EDNOS as a potentially more severe condition than BED.
Turton, Robert; Chami, Rayane; Treasure, Janet
The objective of this paper is to review the role that hedonic factors, emotions and self-regulation systems have over eating behaviours from animal models to humans. Evidence has been found to suggest that for some high-risk individuals, obesity/binge eating may develop as an impulsive reaction to negative emotions that over time becomes a compulsive habit. Animal models highlight the neural mechanisms that might underlie this process and suggest similarities with substance use disorders. Emotional difficulties and neurobiological factors have a role in the aetiology of eating and weight disorders. Precise treatments targeted at these mechanisms may be of help for people who have difficulties with compulsive overeating.
Knoll, Susanne; Föcker, Manuel; Hebebrand, Johannes
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) resulted in substantial changes with regard to the classification of Eating Disorders. In DSM-5, Feeding and Eating Disorders are for the first time subsumed in a single category. The Binge Eating Disorder (BED) was established as the third classical eating disorder in addition to Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The criteria for AN changed remarkably, whereas there were only minor changes to the BN criteria. The criteria for BED differ only marginally from the DSM-IV research criteria. There are now subtypes of AN, BN, and BED in the new category "Other Specific Feeding and Eating Disorders." The rest category "Eating Disorders Not Otherwise Specified" has been renamed to "Unspecified Feeding or Eating Disorders." The practicability of the DSM-5 criteria for Eating Disorders, and for AN in particular, for both clinical practice and research remains to be seen.
Schreiber, Liana R N; Odlaug, Brian Lawrence; Grant, Jon E
BACKGROUND AND AIMS: Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5...... for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD). METHODS: The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance...... use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching. RESULTS: BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress...
Bauer, Stephanie; Kindermann, Sally Sophie; Moessner, Markus
Eating disorders are severe mental illnesses that are challenging to treat and often follow a chronic course. They are associated with immense impairment on the psychological, physical, interpersonal, and social level as well as signifi cant direct and indirect cost. Therefore, prevention and early intervention are of utmost importance. Based on a qualitative literature review, we summarized the empirical evidence for the effi cacy of universal and selective prevention of eating disorders. Programs available in German and/or English were included in the review. In addition to research on effi cacy and effectiveness, the areas of implementation, dissemination, and reach were identifi ed as key issues for future studies. Furthermore, more research is needed on the relationship of cost, benefi t, and risks of eating disorder prevention.
Winkler, Laura Vad; Christiansen, Erik; Lichtenstein, Mia Beck
not otherwise specified (EDNOS) and binge eating disorder (BED) and used the Medical Outcomes Study Short Form-36 Health Survey (SF-36) as a measure of HRQoL. Of the 102 citations identified, 85 abstracts were reviewed and seven studies were included in the meta-analysis. AN patients were included in five......Eating disorders (EDs) comprise a variety of symptoms and have a profound impact on everyday life. They are associated with high morbidity and mortality. The objective of this study was to analyse published data on health-related quality of life (HRQoL) in EDs so as to compare the results...... to general population norm data and to investigate potential differences between ED diagnostic groups. A systematic review of the current literature was conducted using a keyword-based search in PubMed and PsychInfo. The search covered anorexia nervosa (AN), bulimia nervosa (BN), eating disorders...
Norbert Dahmen; Julia Becht; Alice Engel; Monika Thommes; Peter Tonn
Norbert Dahmen, Julia Becht, Alice Engel, Monika Thommes, Peter TonnPsychiatry Department, University of Mainz, GermanyAbstract: Narcoleptic patients suffer frequently from obesity and type II diabetes. Most patients show a deficit in the energy balance regulating orexinergic system. Nevertheless, it is not known, why narcoleptic patients tend to be obese. We examined 116 narcoleptic patients and 80 controls with the structured interview for anorectic and bulimic eating disorders (SIAB) to te...
Lewis, Stephen P; Klauninger, Laura; Marcincinova, Ivana
Pro eating disorder websites often contain celebrity-focused content (e.g., images) used as thinspiration to engage in unhealthy eating disorder behaviours. The current study was conducted to examine whether news media stories covering eating disorder disclosures of celebrities corresponded with increases in Internet searches for pro eating disorder material. Results indicated that search volumes for pro eating disorder terms spiked in the month immediately following such news coverage but only for particularly high-profile celebrities. Hence, there may be utility in providing recovery-oriented resources within the search results for pro-eating disorder Internet searches and within news stories of this nature.
Klump, K L; Kaye, W H; Strober, M
Data described earlier are clear in establishing a role for genes in the development of eating abnormalities. Estimates from the most rigorous studies suggest that more than 50% of the variance in eating disorders and disordered eating behaviors can be accounted for by genetic effects. These high estimates indicate a need for studies identifying the specific genes contributing to this large proportion of variance. Twin and family studies suggest that several heritable characteristics that are commonly comorbid with AN and BN may share genetic transmission with these disorders, including anxiety disorders or traits, body weight, and possibly major depression. Moreover, some developmental research suggests that the genes involved in ovarian hormones or the genes that these steroids affect also may be genetically linked to eating abnormalities. Molecular genetic research of these disorders is in its infant stages. However, promising areas for future research have already been identified (e.g., 5-HT2A receptor gene, UCP-2/UCP-3 gene, and estrogen receptor beta gene), and several large-scale linkage and association studies are underway. These studies likely will provide invaluable information regarding the appropriate phenotypes to be included in genetic studies and the genes with the most influence on the development of these disorders.
Seeman, Mary V
Psychotic disorders and eating disorders sometimes occur in the same person, and sometimes, but not always, at the same time. This can cause diagnostic confusion and uncertainty about treatment. This paper examines seven ways in which symptoms of both conditions can co-exist. The literature on this topic consists to a large extent of case reports, so that firm conclusions cannot be drawn from their examination. There is no consistent sequence in the co-occurrence of the two conditions-eating disorders sometimes precede, and sometimes follow the onset of psychosis. The advent of the psychosis, and sometimes the treatment of the psychosis can cure the eating disorder, but it can sometimes aggravate it. Psychosis is not necessarily a mark of severity in the course of an eating disorder, and food refusal can occur independent of severity in psychotic illness, but it can be a cause of death. There is some genetic association and some overlap of physiologic, cognitive and brain structure deficits in the two types of disorder. The connection between the two, however, remains speculative. The area of comorbidity and overlapping symptoms in psychiatry requires more research. Clinical recommendations include attention to the different individual ways in which these two disparate conditions often overlap.
The past few years have seen a steep increase in journal articles relating to feeding and eating disorders in children, making a succinct overview timely. The relevance of this review is enhanced by the recent publication of revised feeding and eating disorder diagnostic criteria in DSM-5. These have significant implications for younger patients, in particular through the inclusion of the new diagnostic category Avoidant/Restrictive Food Intake Disorder (ARFID). It is likely that this will encourage increased research interest in this field. Recent publications included in this article cover a broad range of topics relevant to childhood feeding and eating disorders, to include: presentation, diagnosis and classification; epidemiology; risk factors; assessment measures; treatment, prognosis and outcome. The area of feeding and eating disorders in children remains relatively under-researched, with significant gaps in knowledge about epidemiology, course and prognosis as well as a limited evidence base for treatment. However, important and promising avenues are increasingly being explored. In relation to clinical practice, there is now a much better recognition of these disorders and a greater awareness of their complexity, severity and potential impact in both the short and the longer term if not appropriately managed.
Suokas, Jaana T; Suvisaari, Jaana M; Grainger, Marjut; Raevuori, Anu; Gissler, Mika; Haukka, Jari
The aim of this study is to explore the prevalence of hospital-treated suicide attempts in a large clinical population of eating disorder patients. Follow-up study of adults (N=2462, 95% women, age 18-62 years) admitted to the Eating Disorder Clinic of Helsinki University Central Hospital in the period 1995-2010. For each patient, four controls were selected and matched for age, sex and place of residence. The end point events were modeled using Cox's proportional hazard model, taking matching into account. We identified 156 patients with eating disorder (6.3%) and 139 controls (1.4%) who had required hospital treatment for attempted suicide. Of them, 66 (42.3%) and 37 (26.6%) had more than one attempt. The rate ratio (RR) for suicide attempt in patients with eating disorder was 4.70 [95% confidence interval (CI) 1.41-15.74]. In anorexia nervosa, RR was 8.01 (95% CI 5.40-11.87), and in bulimia nervosa, it was 5.08 (95% CI 3.46-7.42). In eating disorder patients with a history of suicide attempt, the risk of death from any cause was 12.8%, suicide being the main cause in 45% of the deaths. Suicide attempts and repeated attempts are common among patients with eating disorders. Suicidal ideation should be routinely assessed from patients with eating disorders. Copyright © 2014 Elsevier Inc. All rights reserved.
Szczegielniak, Anna; Pałka, Karol; Krysta, Krzysztof; Krupka-Matuszczyk, Irena
Modern media have a huge impact on eating habits, which result in pathologies among young people, especially females. Fashion models have become a pattern for ordinary women, however the difference in a mean weight between these two groups is increasing. The aim of the study was to assess the correlation between school students' results in EAT-26 self-report questionnaire and their daily diet behavior and to analyze the occurrence of eating disorders among students in schools of the region of Silesia in Poland. Our survey was based on the EAT-26 (Eating Attitude Test) and Behavioral Four Questions Test. 150 questionnaires were given to students of Secondary Schools, 116 were filled out correctly. The interviewed group consisted of 85 girls and 31 boys. Average age was 17.24±1.18. All of the data were analyzed statistically. Average BMI was 21,06; half of the recruited subjects had correct BMI whereas over 40% of them presented underweight. Within 116 responses from the EAT-26 nearly 93% belonged to the group with a small risk of the development of future eating disorders. Nevertheless, over 6% of the survey participants were in the group at high risk. In the Behavioral Four Questions Test 10% participants turned out to be in the compulsive overeating group, other ones in the group of a probable development of anorexia (7%) or bulimia nervosa (3%). There is a strong correlation between particular daily activities and the score achieved in EAT-26, however there is no significant correlation between the calculated BMI and EAT-26 results. Specific socio-cultural factors are faced by public services. They refer both to health promotion programs and the organization of spare time spent by teenagers outside schools.
Phillips, Katharine A; Kaye, Walter H
Body dysmorphic disorder (BDD) and eating disorders are body image disorders that have long been hypothesized to be related to obsessive-compulsive disorder (OCD). Available data suggest that BDD and eating disorders are often comorbid with OCD. Data from a variety of domains suggest that both BDD and eating disorders have many similarities with OCD and seem related to OCD. However, these disorders also differ from OCD in some ways. Additional research is needed on the relationship of BDD and eating disorders to OCD, including studies that directly compare them to OCD in a variety of domains, including phenomenology, family history, neurobiology, and etiology.
Tomotake, Masahito; Ohmori, Tetsuro
The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger's personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research.
Tolosa-Sola, Iris; Gunnard, Katarina; Giménez Muniesa, Cristina; Casals, Laura; Grau, Antoni; Farré, Josep Maria
Body dissatisfaction is a relevant aspect in both eating disorders and sexuality. Using Stice's model, this study aimed to evaluate the relationship between these variables in eating disorder patients compared with healthy controls. Statistically significant correlations between body dissatisfaction and sexuality were found in the whole sample. The clinical group had higher rates of body dissatisfaction and sexual impairment. Within the clinical group, the participants with a greater drive for thinness showed higher sexual dysfunctions. These results suggest that sexuality should be systematically explored in eating disorders. Higher rates of drive for thinness may be associated with greater sexual impairment.
Gerlinghoff, M; Backmund, H
The most important eating disorders are anorexia and bulimia, which most frequently occur for the first time during adolescence and continue into adulthood. Medical complications and accompanying psychological disturbances cause a significant mortality rate of up to 6% in anorexia and up to 3% in bulimia. The pathogenesis of eating disorders is still unclear. Current etiological concepts are multidimensional including biological, individual, familial, and sociocultural factors. In spite of a great variety of therapeutic possibilities, the prognosis for eating disorders is quite poor. In the long term, only about 50% of the persons affected overcome their illness. Preventive measures are therefore indispensable.
Beauchamp, Marshall T; Lundgren, Jennifer D
Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should
Heesacker, Roberta S.; Neimeyer, Greg J.
Investigated relation between eating disorder and disturbances in object relations and cognitive structure in undergraduate female college students (n=183). Results indicated that eating disorder was predicted by measures of object relations disturbance and cognitive structure. (Author/ABL)
Nowakowski, Matilda E; McFarlane, Traci; Cassin, Stephanie
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.
Robinson, Lauren; Micali, Nadia; Misra, Madhusmita
Eating Disorders are psychiatric disorders associated with a high risk for low bone mineral density (BMD) and fractures. Low BMD is a consequence of undernutrition, changes in body composition, and hormonal alterations. This review summarizes recent findings regarding novel strategies for assessing bone outcomes in patients with eating disorders, factors contributing to altered bone metabolism, and possible therapeutic strategies. Emerging research in this field suggests that not only anorexia nervosa, but also bulimia nervosa results in lower BMD compared to controls. To date studies of bone structure, and all randomized controlled trials examining the impact of various therapies on bone outcomes in anorexia nervosa, have focused on adolescent girls and women. We discuss the impact of anorexia nervosa on bone structure, and associations of resting energy expenditure, marrow adipose tissue (including the ratio of saturated to unsaturated fat), and cold activated brown adipose tissue with BMD and bone structure. Promising strategies for treatment include physiological estrogen replacement (rather than oral contraceptives) in adolescent girls with anorexia nervosa, and bisphosphonates, as well as teriparatide, in adult women with anorexia nervosa. Recent data on (i) BMD and bone structure in adolescent girls and women with eating disorders, (ii) factors that contribute to altered bone metabolism, and (iii) randomized controlled trials reporting positive effects of physiologic estrogen replacement, bisphosphonates and teriparatide on bone health, provide us with a greater understanding of the impact of eating disorders on bone and novel management strategies.
Park, Emma C; Waller, Glenn; Gannon, Kenneth
The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.
Sala, Margarita; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.; Bardone-Cone, Anna
We investigated racial/ethnic stereotyping in the recognition and referral of eating disorders with 663 university students. We explored responses to problem and eating disorder recognition, and health care referral after reading a vignette concerning a patient of different race/ethnic background presenting with eating disorders. A series of three 4 × 3 ANOVAs revealed significant main effects for eating disorder across all three outcome variables. There were no significant main effects acros...
Danielsen, Marit; Bjørnelv, Sigrid; Rø, Øyvind
Objective: Compulsive exercise is a well-known feature in eating disorders. The Exercise and Eating Disorder (EED) self-report questionnaire was developed to assess aspects of compulsive exercise not adequately captured by existing instruments. This study aimed to test psychometric properties and the factor structure of the EED among women with eating disorders and a control group. Method: The study included 449 female participants, including 244 eating disorders patients and...
Okuda, Satomi; Okamoto, Yuko
This article presents research completed on eating disorders. First of all, symptom changes from eating disorders are shown with over time. Secondly, it takes a general view of epidemiology in eating disorders and realities at the present time. Thirdly, it takes a general view of the research on the appearance of diseases on subjects with eating disorders. The appearance of disease factor is divided into preparation and causal factors. In addition, the preparation factors are divided into the...
Full Text Available Background: Eating Disorders (EDs are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. EDs are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Their epidemiology is rising for the past decades, and EDs affect all races, social levels and both genders. Due to the long and expensive treatment, chronic course, and the fact that most of the sufferers do not realize the need for therapy or do not seek treatment, the demand on developing prevention programs, early detection and assessment is essential. Despite the fact, that many new EDs screening tools were developed already, there is a great lack of validated screening instruments, adapted to the Bulgarian conditions. Objects and methods: Our study aimed at eliciting a comprehensive battery for screening of not only specific ED pathology, but also some risk factors, such as negative body image, weight and depressive symptoms. The object of our study consisted of 201 females, aged 18 to 45 (mean 24.65. SCOOF- questionnaire, Eating Disorder Diagnostic Scale (EDDS-5, Body Image Questionnaire-34 and Beck Depression Inventory (BDI were applied. Results: Our preliminary results show that approximately 45% of the tested subjects show some of the: negative body image, eating disorders’ clinical pathology, distorted eating patterns, subclinical eating disorders pathology, overweight/obesity, or depressive symptoms. Conclusion: Our ongoing efforts in area of research also are aimed at developing and refining strategies for preventing and treating ED among adolescents and adults.
Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne
Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.
de Zwaan, M; Bach, M; Mitchell, J E; Ackard, D; Specker, S M; Pyle, R L; Pakesch, G
Eighty-three obese subjects with binge eating disorder (BED) were compared with 99 obese subjects not meeting criteria for BED on the Toronto Alexithymia Scale (TAS). Overall, the subjects in our sample were not significantly alexithymic, the mean global TAS score being 62.8 (SD = 10.2) which is comparable with the values found in non-patient control samples. Furthermore, the mean TAS scores did not differ between obese subjects with and without BED. However, we found a slightly higher prevalence of alexithymia (TAS total score 74 and above) in BED subjects compared with non-BED subjects (24.1% and 11.1%, respectively). A series of stepwise multiple regression analyses were run, exhibiting a significant relationship between the TAS and educational level and the Eating Disorder Inventory (EDI) subscales Interpersonal Distrust and Ineffectiveness. Age, body mass index, measures of depression, and eating pathology did not predict TAS scores.
Jones, Candace; Pearce, Brad; Barrera, Ingrid; Mummert, Amanda
Fetal programming describes the process by which environmental stimuli impact fetal development to influence disease development later in life. Our analysis summarizes evidence for the role of fetal programming in eating disorder etiology through review of studies demonstrating specific obstetric complications and later eating risk of anorexia or bulimia. Using Pubmed, we found thirteen studies investigating obstetric factors and eating disorder risk published between 1999 and 2016. We then discuss modifiable maternal risk factors, including nutrition and stress, that influence anorexia or bulimia risk of their offspring. Translation of these findings applies to preventative strategies by health organizations and physicians to provide optimal health for mothers and their children to prevent development of medical and psychiatric illnesses. Copyright © 2017 Elsevier Ltd. All rights reserved.
Efforts aimed at the prevention of eating disorders need to consider the context within which these disorders develop and aim to promote not only healthy eating and physical activity but also address mental health factors, such as body image. Exploring the relationship between body image and eating disorders will provide a foundation and further…
Sjostedt, John P.; Schumaker, John F.; Nathawat, S. S.
Investigates the influx of western-style eating disorders into India, Asia, and the southern Pacific region. Predicted Australian students would have more eating disorder symptoms, but instead, the Indian students showed more symptoms. Concludes substantial evidence of western-style eating disorders appear in the privileged socioeconomic class of…
Bryla, Karen Y.
Disordered eating among American adolescent females represents a significant health issue in our current cultural climate. Disordered eating receives insufficient attention, however, due to the public's unfamiliarity with symptoms and consequences, absence of treatment options, and unreliable instrumentation to detect disordered eating. Disordered…
Talleyrand, Regine M.
There is little attention devoted to studying eating disorder symptoms in racially and ethnically diverse groups despite the fact that the prevalence rates among women of color for eating disorder symptoms are similar to those of European American women. This article reviews research related to eating disorders in women of color, including a…
Shelton, Virginia L.; Valkyrie, Karena T.
Eating disorders are compulsive behaviors that can consume a person's life to the point of becoming life threatening. Previous research found stress associated with eating disorders. College can be a stressful time. If stress predicted precursor behaviors to eating disorders, then counselors would have a better chance to help students sooner. This…
Peck, Lisa D.; Lightsey, Owen Richard
Among 261 undergraduate women, increased severity of eating disorders along a continuum was associated with decreased self-esteem, increased perfectionism, and increased scores on 7 subscales of the Eating Disorders Inventory-2. Women with eating disorders differed from both symptomatic women and asymptomatic women on all variables, whereas…
Elgin, Jenna; Pritchard, Mary
Previous research on gender differences between males and females on the risk factors leading to disordered eating is sparse, especially on males and eating disorders using attachment theory. This study examined the relationship between adult attachment style and disordered eating in men and women. Secure attachment scores were significantly…
de Bruin, A.P.; Bakker, F.C.; Oudejans, R.R.D.
Objectives: To examine the relationships between disordered eating in female gymnasts and dancers and their perspective towards achievement in sport and dance, respectively. With an emphasis on outperforming others (ego involvement), more disordered eating was expected than when personal progress
Masuda, Akihiko; Price, Matthew; Latzman, Robert D
Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale=208; nmale=70) aged 18-24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors.
Riva, G; Bacchetta, M; Baruffi, M; Defrance, C; Gatti, F; Galimberti, C; Nugues, P; Ferretti, G S; Tonci, A
Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation (VREPAR) are two European Community funded projects (Telematics for health-HC 1053/HC 1055-http://www.psicologia.net) whose aim is (a) to develop a PC based virtual reality system (PC-VRS) for the medical market that can be marketed at a price that is accessible to its possible endusers (hospitals, universities, and research centres) and that would have the modular, connectability and interoperability characteristics that the existing systems lack; and (b) to develop three hardware/software modules for the application of the PC-VRS in psychoneurophysiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia, and obesity), movement disorders (Parkinson's disease and torsion dystonia), and stroke disorders (unilateral neglect and hemiparesis). In particular, the VREPAR 2 project is now testing the eating disorders module on a clinical sample.
Oakley, Thomas James; Dey, Indranil; Discombe, Sandra; Fitzpatrick, Lynn; Paul, Siba Prosad
Eating disorders form a group of mental health conditions characterised by abnormal eating habits and are associated with high mortality rates. This article provides nurses working in various settings with evidence-based strategies to identify, manage and refer children and young people with eating disorders. It explores what eating disorders are, and their association with physical and psychiatric co-morbidities. Eating disorders have a significant effect on children and young people's health and development, and nurses have a vital role in managing them. This article presents a case study that illustrates some of the challenges nurses may experience when managing children and young people with eating disorders. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
McCanne, Lynn P. Fisher
Recent research indicates that a significant number of college-age women suffer from bulimarexia (also called the gorging-purging syndrome, the binge-purge cycle, bulimia or bulimia nervosa). To examine the relationship of three personality variables (anxiety, assertiveness, and locus of control) to eating disorders, 46 college students…
present in cultures not traditionally associated with such conditions. This would appear to be the case in certain. Asian countries; and it also appears that eating disorders are becoming more common among Afro-Americans." This has specific implications for South Africa, given our heterogeneous population, comprising ...
Abbate-Daga, Giovanni; Quaranta, Michela; Marzola, Enrica; Cazzaniga, Giovanna; Amianto, Federico; Fassino, Secondo
Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. We recruited 87 families with daughters affected by an ED, aiming to assess the…
Halmi, Katherine A.
Background: Etiological hypotheses of eating disorders, anorexia nervosa and bulimia nervosa have not produced informative research for predictably effective treatment. Methods: The rationale for applying a model of allostasis, a dysregulation of reward circuits with activation of brain and hormonal stress responses to maintain apparent stability,…
Favazza, Armando R.; And Others
Presents evidence from literature review, patient interviews, responses to Self-Harm Behavior Survey, and case reports that patients with eating disorders are at high risk for self-mutilation. In lieu of dual diagnosis, postulates that combination of self-mutilation, anorexia, bulimia, and other symptoms may be manifestations of impulse control…
In the treatment of eating disorders, patients in either the acute or chronic stage are generally treated on outpatient basis as much as possible in the living condition of daily life. This paper describes the flow of diagnosis and treatment, first examination and introduction into treatment, way of parents treating their child, parental counseling, criteria for admission (immediate hospitalization or not), and outpatient therapy.
Full Text Available Zeynep Yilmaz,1 J Andrew Hardaway,1 Cynthia M Bulik1–3 1Department of Psychiatry, 2Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Eating disorders (EDs are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa, bulimia nervosa, and binge eating disorder. We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of anorexia nervosa, bulimia nervosa, and binge eating disorder, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate-gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. Keywords: anorexia nervosa, binge eating disorder, bulimia nervosa, animal models, genome-wide association studies, high-throughput sequencing
Price, Joy A.; And Others
Findings from 337 school counselors revealed 11 percent rated themselves as very competent in helping students with eating disorders (anorexia and bulimia nervosa), 49 percent considered themselves moderately competent, 40 percent believed they were not very competent; 75 percent did not believe it was their role to treat students with eating…
Gredysa, Dana M.; Altman, Myra; Wilfley, Denise E.
Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models. PMID:22707016
Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urbanlife is a potenti...
textabstractEating disorders (EDs) are rare, but very serious psychiatric disorders, with a low recovery rate (1,2). This warrants studies on treatment quality to improve the course and consequences of EDs and enhance recovery rates. Despite the increasing recognition of the value of patient input, few studies address how ED patients evaluate the illness, its consequences and treatment, and how their views are related to scientific evidence and expert opinions.
Wagner, Allison F; Stefano, Emily C; Cicero, David C; Latner, Janet D; Mond, Jonathan M
This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
Davidsen, Annika Helgadóttir; Hoyt, William T; Poulsen, Stig; Waaddegaard, Mette; Lau, Marianne
The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.
Cygankiewicz, Patrycja; Solecka, Dorota; Pilecki, Maciej Wojciech; Józefik, Barbara
The article discusses the preliminary results of a follow-up study carried out in 2009-2010 on former patients with a diagnosis of anorexia nervosa and bulimia nervosa, first seen in 2001-2004 at the Department of Child and Adolescent Psychiatry, the Jagiellonian University Medical College in Krakow. At that time they had been taking part in a research project, whose aim was to define the relationships among the psychopathological picture of eating disorders, self-image and family relations and also the influence of socio-cultural factors. The aim of the current study is to attempt to define factors influencing the course and prognosis of eating disorders in the studied group. Results from the Eating Disorder Inventory Questionnaire (EDI) and the Polish version of Family Assessment Measure (KOR) in the first study were juxtaposed with the clinical state and parameters of psychosocial functioning of the studied women assessed on the basis of the follow-up study. In the studied group, 13 girls suffered from anorexia nervosa--restricting type, 6 from anorexia nervosa binge-eating/purging type, and 6 from bulimia. In the studied group, there was complete symptomatic improvement in 12 persons (48%), subclinical symptoms continued to be observed in 9 persons (36%), and 4 persons (16%) met full diagnostic criteria for eating disorders. The most favourable course was observed in the group with a diagnosis of anorexia nervosa restricting type. The least favourable was observed in the group with a diagnosis of bulimia. Results. In the studied group, 13 girls suffered from anorexia nervosa - restricting type, 6 from anorexia nervosa binge-eating/purging type, and 6 from bulimia. In the studied group, there was complete symptomatic improvement in 12 persons (48%), subclinical symptoms continued to be observed in 9 persons (36%), and 4 persons (16%) met full diagnostic criteria for eating disorders. The most favourable course was observed in the group with a diagnosis of
Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny
Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise
-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective...... availability, reproductive function and bone health in female athletes, has recently been expanded to recognise that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness...... judgements of performance. The reported prevalence of DE and EDs in athletic populations including athletes from aquatic sports ranges from 18-45 % in female athletes and 0-28 % in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behaviour at all periods of development pathway...
Olstad, Siri; Solem, Stian; Hjemdal, Odin; Hagen, Roger
The aim of the study was to compare a clinical sample with eating disorders to different control samples on self-report measures of metacognition and eating disorder symptoms, in order to investigate the role of metacognition in eating disorders. The clinical group consisted of 53 female patients with eating disorders who completed the Metacognitions Questionnaire-30 and the Eating Disorder Examination Questionnaire 6.0. One-hundred and fifty women who served as a control group completed the questionnaires as an Internet survey. This control group was divided into three groups based on self-reported history of eating and psychiatric problems (N=47), other psychiatric problems (N=37), or no such problems (healthy controls: N=66). The clinical group scored significantly higher on dysfunctional metacognition than healthy controls, especially on "negative beliefs about uncontrollability and danger", "need to control thoughts", and total MCQ-30 score. Eating disorder symptomatology was positively correlated with metacognition. Metacognition explained 51% of the variance in eating disorder symptoms after controlling for age and BMI, with "need to control thoughts" as the most important factor. Metacognitive beliefs may be central in understanding eating disorders, and metacognitive treatment strategies could be a promising approach in developing new psychological treatments for eating disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.
Goldschmidt, Andrea B.; Le Grange, Daniel; Powers, Pauline; Crow, Scott J.; Hill, Laura L.; Peterson, Carol B.; Crosby, Ross D.; Mitchell, Jim E.
Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ2 analyses. After con...
McGee, Brandy J; Hewitt, Paul L; Sherry, Simon B; Parkin, Melanie; Flett, Gordon L
A specific model for eating disorder symptoms involving perfectionistic self-presentation and two different moderators (i.e., body image evaluation and body image investment) was tested. Participants completed measures of perfectionistic self-presentation, body image dysfunction, and eating disorder symptoms. Findings indicated that all three dimensions of perfectionistic self-presentation were associated with eating disorder symptoms. Results also showed that perfectionistic self-presentation predicted eating disorder symptoms in women who were dissatisfied with their bodies, but that it did not predict eating problems in women who liked their bodies and felt there was little or no discrepancy between their actual and ideal appearances. Body image investment did not moderate the relationship between perfectionistic self-presentation and eating disorder symptoms, suggesting that ego-involvement alone is insufficient to promote eating disturbance in the context of perfectionism. The importance of self-presentation components of perfectionism and specific body image difficulties in predicting eating disorder symptoms are discussed.
Toni, Giada; Berioli, Maria Giulia; Cerquiglini, Laura; Ceccarini, Giulia; Grohmann, Ursula; Principi, Nicola; Esposito, Susanna
Eating problems in adolescents with type 1 diabetes (T1D) can be divided into two groups. The first includes the diagnosed eating disorders (EDs), i.e., diseases specifically identified by defined signs and symptoms for which a degree of severity has been established, such as anorexia nervosa, bulimia nervosa, binge-eating disorder, pica, and rumination. The second is the group of disordered eating symptoms (DES), which include behaviors such as dieting for weight loss, binge eating, self-induced vomiting, excessive exercise, and laxative or diuretic use; these behaviors cannot be categorized as complete diseases, and, although apparently mild, they must be closely evaluated because they can evolve into true EDs. In this review, present knowledge about the clinical relevance of EDs and DES and the possible preventive and therapeutic measures used to reduce their impact on the course of T1D will be discussed. As adolescents with diabetes are at higher risk of eating disturbances and consequently for higher rates of disease complications, care providers should pay attention to clinical warning signs that raise suspicion of disturbed eating to refer these patients early to an expert in nutrition and mental health disorders. To ensure the best care for adolescents with T1D, diabetes teams should be multidisciplinary and include a pediatric diabetologist, a skilled nurse, a dietician, and a psychologist.
Amin, Reena; Strauss, Clara; Waller, Glenn
Different body-related behaviours and cognitions (checking, avoidance, comparison, display) have been shown to be related to unhealthy eating attitudes in a non-clinical sample. This study tested whether the use of body-related behaviours is higher in eating-disordered women than in non-clinical women. It also examined whether the use of body-related behaviours is associated with psychological characteristics (particularly anxiety, depression and narcissistic characteristics), controlling for age and eating pathology. Ninety-nine adult women with diagnosed eating disorders (mean age = 30.4 years, SD = 9.44; mean body mass index = 21.9, SD = 6.39) completed standardized measures of eating pathology, anxiety and depression, narcissistic characteristics, and body-related behaviours and cognitions. The Body-Related Behaviours Scale (BRBS) had acceptable levels of internal consistency in this group, and its scales were only weakly to moderately correlated with each other. There were no differences between diagnostic groups, but the clinical group had higher scores that a previous non-clinical sample on three of the scales. The four body-related behaviours had different patterns of association with eating pathology, depression and narcissistic features. However, anxiety was not associated with BRBS scores. The findings support the importance of a wide range of body-related behaviours and cognitions in understanding the eating disorders. However, the lack of an association with anxiety is counter to the suggestion that the various behaviours measured by the BRBS reflect safety behaviours on the part of sufferers. Depression and narcissistic features might be more important in maintaining such behaviours.
Bardone-Cone, Anna M; Butler, Rachel M; Balk, Margaret R; Koller, Katherine A
Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031). © 2016 Wiley Periodicals, Inc.
Full Text Available The study aimed to evaluate oral health in women with eating disorders. The clinical study covered 30 patients aged 14-36 years suffering from diagnosed eating disorders and treated in closed psychiatric institutions. The control group comprised 30 healthy women at the mean age corresponding to that of the patient group. No relationships were confirmed between eating disorders and the intensity of dental caries. Eating disorders contribute to increased loss of dental hard tissues. In women suffering from eating disorders non-specific lesions in oral cavity are more common than in healthy women.
von Brachel, Ruth; Hötzel, Katrin; Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja
One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. The aim of the present study was to identify predictors of dropout from this Web program. A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.
Olguin, Pablo; Fuentes, Manuel; Gabler, Guillermo; Guerdjikova, Anna I; Keck, Paul E; McElroy, Susan L
To gain further understanding of the general medical comorbidity of binge eating disorder (BED) beyond its association with obesity. We reviewed studies of general medical comorbidity in people with BED or clinically significant binge eating behavior beyond obesity. We also reviewed studies of BED in specific medical conditions. Three broad study categories of medical comorbidity in BED were found: cross-sectional studies of medical conditions in BED; prospective studies of medical conditions in BED; and studies of BED in specific medical conditions. Cross-sectional epidemiologic data suggest that BED is associated with medical conditions related to obesity, including diabetes, hypertension, dyslipidemias, sleep problems/disorders, and pain conditions, and that BED may be related to these conditions independent of obesity and co-occurring psychiatric disorders. Prospective data suggest that BED may be associated with type 2 diabetes and metabolic syndrome. BED or binge eating behavior is also associated with asthma and gastrointestinal symptoms and disorders, and among women, menstrual dysfunction, pregnancy complications, intracranial hypertension, and polycystic ovary syndrome. BED is associated with substantial medical comorbidity beyond obesity. Further study of the general medical comorbidity of BED and its relationship to obesity and co-occurring psychiatric disorders is greatly needed.
Solano Pinto, Natalia; Cano Vindel, Antonio
Scientific literature shows that anxiety is an important factor in eating disorders. The aim of this case-control study was to compare the anxiety manifestations obtained by means of the Anxiety Situations and Responses Inventory of in a clinical sample of 74 females (46, anorexia nervosa; 28, bulimia) to those obtained by a control group (130 girls without disorders). The between-group ANOVA results showed higher anxiety scores in the clinical group with a medium effect size for the anxiety trait, finding a flat profile (within-group ANOVA) for the three response systems (cognitive, physiological and motor) and the four specific anxiety traits (test, interpersonal, phobic, and daily life situations). Moreover, high scores in anxiety involved a greater risk of being diagnosed with an eating disorder in the 8 bivariate comparisons. The estimations were more precise for cognitive anxiety and for the specific interpersonal anxiety trait.
Hogan, Marjorie J; Strasburger, Victor C
Adolescence is a time of tremendous change in physical appearance. Many adolescents report dissatisfaction with their body shape and size. Forming one's body image is a complex process, influenced by family, peers, and media messages. Increasing evidence shows that the combination of ubiquitous ads for foods and emphasis on female beauty and thinness in both advertising and programming leads to confusion and dissatisfaction for many young people. Sociocultural factors, specifically media exposure, play an important role in the development of disordered body image. Of significant concern, studies have revealed a link between media exposure and the likelihood of having symptoms of disordered eating or a frank eating disorder. Pediatricians and other adults must work to promote media education and make media healthier for young people. More research is needed to identify the most vulnerable children and adolescents.
岡本, 百合; 三宅, 典恵; 神人, 蘭; 矢式, 寿子; 内野, 悌司; 磯部, 典子; 高田, 純; 小島, 奈々恵; 二本松, 美里; 松山, まり子; 石原, 令子; 杉原, 美由紀; 古本, 直子; 玉田, 美江; 高橋, 涼子
Objective: The aim of this study was to investigate the clinical and psychological features of patients who recovered from eating disorder. Subjects: Subjects were 10 patients who recovered from eating disorder and continued being in good condition for more than one year (recovery group). We chose 10 eating disorder patients who were under treatment as control group. Method: We compared clinical and psychological features of recovery group and control group. We used GAF (DSM-IV), Eating Attit...
Most people envision eating disorders occurring in young women with anorexia or bulimia. Today, disordered eating is increasingly prevalent in males and in every age group, along with new terms: binge eating, bigorexia, orthorexia, and diabulimia. Healthcare providers aware of and knowledgeable about eating disorders, signs and symptoms, risk factors, and treatment are better able to screen patients, assist them in receiving help earlier, and increase the likelihood of successful outcomes.
O. N. Komarova; A. I. Khavkin
Eating disorder is observed in infants at different developmental stages. This condition may be caused by comorbidities, organic diseases, or psychogenic causes. After birth, a child’s eating behavior evolves, which largely depends on the relations arising between him, his mother, and other family members. Eating disorders may be caused by an impaired child-mother relationship: inadequate maternal behavior, excessive or poor parenteral attention. The treatment of eating disorders involves a c...
Castellini, Giovanni; Lo Sauro, Carolina; Rotella, Carlo M.; Faravelli, Carlo
Objective. Binge eating disorder is a serious, prevalent eating disorder that is associated with overweight. Zonisamide is an antiepileptic drug that can promote weight loss. We evaluated the efficacy and safety of zonisamide as augmentation to individual cognitive behavioral therapy in the treatment of binge eating disorder patients. Design: controlled open study. Participants: Twenty four threshold and subthreshold binge eating disorder patients were enrolled in the cognitive behavioral therapy treatment group, and 28 patients in the cognitive behavioral therapy plus zonisamide group. Measurements: At the beginning (T0), at the end (T1) of treatment, and one year after the end of treatment (T2), body mass index was measured and Eating Disorder Examination-Questionnaire, Binge Eating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory were administered. Results. At T1 the cognitive behavioral therapy plus zonisamide group showed a higher mean reduction of body mass index, Eating Disorder Examination-Questionnaire, Beck Depression Inventory, and Binge Eating Scale scores. At T2, the cognitive behavior therapy group regained weight, while the cognitive behavioral therapy plus zonisamide group reduced their body mass and showed a higher reduction in binge eating frequency and Binge Eating Scale, Eating Disorder Examination-Questionnaire Restraint, and State and Trait Anxiety Inventory scores. Conclusion. The zonisamide augmentation to individual cognitive behavior therapy can improve the treatment of binge eating disorder patients, reducing body weight and the number of binge eating episodes. These results are maintained one year after the end of treatment. PMID:20049147
Rodríguez Lazo, María; Hernández Camacho, Juan Diego; Bolaños Ríos, Patricia; Ruiz-Prieto, Inmaculada; Jáuregui Lobera, Ignacio
factors related to food, shape, weight and exercise, transmitted from parents to children, and media sociocultural factors, such as social networks, also influence the development of Eating Disorders (ED). to analyse the influence of family eating habits and the parents perception about the influence of social networks on the development and maintenance of ED. 30 parents of ED patients participated voluntarily in this study fulfilling a series of questionnaires, as well as reporting their weight and height. it is observed an underestimation of weight in the case of overweight (33.33%) and obesity (35%) without considering the fact of going on diet in the future (χ2 = 11.31; p habits seem to be more relevant (e.g. snacking, intake of a single dish) (p eating habits of ED patients' families improve by means of the nutrition education included in the treatment. Relatives do not perceive adequately the risk of the social networks in their children, which might contribute to the maintenance and future relapses of ED. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
O'Brien, Amy; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J; Anderson, Rebecca A; Hamilton, Matthew J; Shu, Chloe; McCormack, Julie
The factor structure of the eating disorder examination (EDE) has never been tested in a clinical pediatric sample, and no normative data exist. The factor structure of an adapted EDE was examined in a clinical sample of 665 females aged 9-17 years with anorexia nervosa spectrum (70%), bulimia nervosa spectrum (12%), purging disorder (3%), and unspecified feeding and eating disorders (15%). The original four-factor model was a good fit in a confirmatory factor analysis as well a higher order model with three dimensions of restraint, eating concern, and combined weight concern/shape concern. Normative data are reported for clinicians to identify the percentiles in which their patients' score. The findings support dimensions of restraint, eating concern, weight concern, and shape concern in a clinical pediatric sample. This supports the factorial validity of the EDE, and the norms may assist clinicians to evaluate symptoms in females under 18 years. © 2015 Wiley Periodicals, Inc.
Díaz-Marsa, M; Lozano, C; Herranz, A S; Asensio-Vegas, M J; Martín, O; Revert, L; Saiz-Ruiz, J; Carrasco, J L
This work describes the rational bases justifying the use of acute tryptophan depletion technique in eating disorders (ED) and the methods and design used in our studies. Tryptophan depletion technique has been described and used in previous studies safely and makes it possible to evaluate the brain serotonin activity. Therefore it is used in the investigation of hypotheses on serotonergic deficiency in eating disorders. Furthermore, and given the relationship of the dysfunctions of serotonin activity with impulsive symptoms, the technique may be useful in biological differentiation of different subtypes, that is restrictive and bulimic, of ED. 57 female patients with DSM-IV eating disorders and 20 female controls were investigated with the tryptophan depletion test. A tryptophan-free amino acid solution was administered orally after a two-day low tryptophan diet to patients and controls. Free plasma tryptophan was measured at two and five hours following administration of the drink. Eating and emotional responses were measured with specific scales for five hours following the depletion. A study of the basic characteristics of the personality and impulsivity traits was also done. Relationship of the response to the test with the different clinical subtypes and with the temperamental and impulsive characteristics of the patients was studied. The test was effective in considerably reducing plasma tryptophan in five hours from baseline levels (76%) in the global sample. The test was well tolerated and no severe adverse effects were reported. Two patients withdrew from the test due to gastric intolerance. The tryptophan depletion test could be of value to study involvement of serotonin deficits in the symptomatology and pathophysiology of eating disorders.
Ciao, Anna C; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors' descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.
Ciao, Anna C.; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors’ descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research. PMID:24821099
Goebel-Fabbri, Ann E
Girls and women with type 1 diabetes have increased rates of disturbed eating behaviors and clinically significant eating disorders than their nondiabetic peers. Type 1 diabetes is strongly associated with several empirically supported eating disorder risk factors (eg, higher body mass index, increased body weight and shape dissatisfaction, low self-esteem and depression, and dietary restraint). It may be that specific aspects of diabetes treatment increase the risk for developing disordered eating. Disturbed eating behaviors and clinical eating disorders predispose women with diabetes to many complex medical risks and increase risk of morbidity and mortality. For this reason, it is critical that diabetes clinicians understand more about eating disorders to improve the likelihood of early risk detection and access to appropriate treatment. This article presents a review of the current scientific literature on eating disturbances in type 1 diabetes and synthesizes the existent findings into recommendations for screening and treatment.
Maguen, Shira; Cohen, Beth; Cohen, Greg; Madden, Erin; Bertenthal, Daniel; Seal, Karen
Individuals with mental health problems are at elevated risk for eating disorders. Veterans serving in support of the conflicts in Afghanistan and Iraq (OEF/OIF) have a high prevalence of deployment-related mental health problems, but little is known about their risk for eating disorders. Our aim was to determine rates of eating disorder diagnoses among OEF/OIF veterans with mental health problems, particularly among those with comorbid mental health problems. This retrospective, cross-sectional analysis of nationwide VA healthcare facilities used descriptive statistics and regression analyses to determine eating disorder rates in OEF/OIF veterans who were new users of VA healthcare from October 7, 2001 to December 31, 2010 (N = 593,739). Although the prevalence of eating disorder diagnoses was 0.007% (n = 465) in women and problems were significantly more likely to have an eating disorder than those without mental health diagnoses. Eating disorders were significantly more common in women with depression, posttraumatic stress disorder, and alcohol and/or drug use disorders than in women veterans without these mental health disorders. Among men, the associations between eating disorder diagnoses and comorbid mental health diagnoses closely paralleled those observed in women. Rates of eating disorders are significantly higher among returning veterans with comorbid mental health problems compared with those without mental health diagnoses. Further research should examine methods to improve detection and treatment of eating disorders in this population. Published by Elsevier Inc.
Yamaguchi, N; Kobayashi, J; Tachikawa, H; Sato, S; Hori, M; Suzuki, T; Shiraishi, H
We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.
Gearhardt, Ashley N.; White, Marney A.; Potenza, Marc N.
Binge eating disorder (BED) shares many characteristics with addictive behaviors (e.g., diminished control, continued use despite negative consequences), and a body of scientific literature is building to support addiction conceptualizations of problematic eating. Despite similarities, BED and “food addiction” may represent unique yet overlapping conditions. Although the exploration of food addiction is relatively new, understanding the relationship between food addiction and BED may be informative in understanding the mechanisms underlying the development and maintenance of problematic eating. In the following paper, we 1) examine the theoretical similarities and differences between BED and addiction, 2) review recent empirical evidence that speak to the relationship between BED and food addiction and 3) discuss the implications of associations between BED and food addiction with respect to clinical interventions. PMID:21999695
Klump, Kelly L
This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty. Copyright © 2013 Elsevier Inc. All rights reserved.
Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Cronemeyer, Catherine
Through focus groups, we examined the development and maintenance of an eating disorder in 16 females with type 1 diabetes and an eating disorder. The quotes and qualitative data summaries provide rich insights into understanding why those with type 1 diabetes are at increased risk for eating disorders. Content analyses revealed five themes pertinent to the dual diagnosis (feeling different, difficulty with control/coping, body image, feelings, and quality of life) of which four themes were relevant to eating disorder development. Findings support early identification of those at risk and inform interventions to mitigate development of an eating disorder. © The Author(s) 2015.
Sepulveda, Ana R; Kyriacou, Olivia; Treasure, Janet
Abstract Background Families of people with eating disorders are often caught up in rule bound eating and safety behaviours that characterise the illness. The main aim of this study was to develop a valid and specific scale to measure family accommodation in the context of having a relative with an eating disorder. Methods A new scale, the Accommodation and Enabling Scale for Eating Disorders (AESED), was jointly generated by professionals and expert carers through qualitative analysis. In th...
Montebarocci, O; Codispoti, M; Surcinelli, P; Franzoni, E; Baldaro, B; Rossi, N
Previous studies indicate that patients with eating disorders have alexithymic characteristics, as revealed by the Toronto Alexithymia Scale (TAS). The aim of the present study was to investigate the role of negative affect (anxiety and depression) in the relationship between eating disorders and alexithymia. In addition, we have evaluated whether the relationship between negative affect and alexithymia varies according to the type of eating disorder (anorexia and bulimia). Eighteen female patients and 16 female patients who met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria for restrictive anorexia nervosa and bulimia nervosa, respectively, and 18 healthy female controls matched by age and education were submitted to Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory to assess depression and anxiety and the Toronto Alexithymia Scale (TAS-20) and the Bermond Vorst Alexithymia Questionnaire (BVAQ) to evaluate alexithymic characteristics. The findings indicated that, although anorexic and bulimic patients showed higher alexithymia scores compared to controls, this result could be mainly related to negative affect. In fact, taking negative affect into account, anorexic and bulimic patients did not show higher TAS-20 and BVAQ scores compared to controls. The only variable useful to discriminate among anorexics, bulimics and controls is the perceived inability to experience emotional feelings, which is higher in anorexic patients compared to the other two groups.
Pawłowska, Beata; Małaj, Grzegorz; Szpakowska, Aneta; Buczyjan, Alina
The aim of the study was to compare of the D.M. Garner, M.P. Olmsted and J. Polivy Eating Disorders Inventory (EDI) results obtained by healthy lower secondary, secondary and college students versus the results obtained with their peers with eating disorders. The examined group consisted of 379 girls attending Lublin lower secondary schools (123 persons), secondary schools (50 persons) and college students (206 persons) as well as 90 girls undergoing medical treatment due to eating disorders (30 lower secondary school students and 30 college students). All these persons were administered the D.M. Garner, M.P. Olmsted and J. Polivy Eating Disorders Inventory (EDI). The tests conducted revealed significant statistical differences between the Eating Disorders Inventory (EDI) results obtained by secondary school students and college students with eating disorders and those obtained by their healthy peers as well as the lack of significant differences between healthy and ill lower secondary school students. 1. Age is a significant factor related to eating disorders. 2. As regards their attitude in relation to eating and their own body, healthy lower secondary school students are not much different from their peers diagnosed with eating disorders. 3. Incorrect attitudes in relation to eating and their own body in girls with eating disorders increase in a significant way at secondary school and at college periods.
The Eating Disorder Inventory and the Three-Factor Eating Questionnaire's cognitive dietary restraint subscale were used to measure disordered eating behaviour. Body composition was measured with dual-energy X-ray absorptiometry. Estimated energy availability (estEA) was determined from a three-day diet and ...
Schaffner, Angela D.; Buchanan, Linda Paulk
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…
Talleyrand, Regine M.
Given the recent focus on eating disorders in children, it is imperative that counselors consider eating concerns that affect children of all racial and ethnic groups and hence are effective in working with this population. The author discusses risk factors that potentially contribute to eating disorders in African American girls given their…
Thomas, Jennifer J; Lee, Sing; Becker, Anne E
This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions. Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia. Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.
Lee, Darrin J; Elias, Gavin J B; Lozano, Andres M
Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity.
Myers, Laura L.; Wiman, Allison M.
In 1994, binge eating disorder (BED) was introduced as a disorder requiring further study in the "American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders", fourth edition ("DSM-IV"). It is now listed as a distinct eating disorder in the "DSM-5", along with bulimia nervosa and anorexia…
Part I gives a general introduction and overview of the research with a naturalistic design that has been done in Amarum. Amarus is a specialized public health centre for the treatment of people with eating disorders where the development of Evidence Based Mental Health (EBMH) and the use of guidelines is of importance. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Guidelines...
Full Text Available
Background: Our aim was to study the relationship between hormonal disturbances and psychopathology in Eating Disorders (ED.
Methods: Forty-nine women diagnosed as Eating Disorders according to DSM-IV were subjected to control plasma levels of TSH, FT3, FT4, LH, FSH, 17beta-estradiol, prolactin, cortisol, DHEAS, GH and IGF-1. They were also administered by SCL-90R, BAT, DES II questionnaires. We applied multivariate regression models.
Results: Our results highlight a statistically significant relation between LH, FSH and prolactin decreased levels, mood and thought disturbances (subscales 3, 5, 7, 8 and 9 of SCL-90r which are associated to Body Attitude ( BAT total scale and Dissociative Experiences (DES II total scale.
Conclusions: Decreased sexual hormones levels could have a role in ED psychological disturbances, not inquired yet
Bryant-Waugh, Rachel; Markham, Laura; Kreipe, Richard E; Walsh, B Timothy
To review the literature related to the current DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood; pica; rumination disorder; and other childhood presentations that are characterized by avoidance of food or restricted food intake, with the purpose of informing options for DSM-V. Articles were identified by computerized and manual searches and reviewed to evaluate the evidence supporting possible options for revision of criteria. The study of childhood feeding and eating disturbances has been hampered by inconsistencies in classification and use of terminology. Greater clarity around subtypes of feeding and eating problems in children would benefit clinicians and patients alike. A number of suggestions supported by existing evidence are made that provide clearer descriptions of subtypes to improve clinical utility and to promote research.
Full Text Available Studies on Emotional Intelligence (EI have demonstrated the concept’s potential in accounting for a broad range of health-related outcomes. Preliminary evidence associates measures of EI with disordered eating and other related behaviors. This study proposed a mediation effect of perceived control in the above association. We hypothesized that (a EI will positively associate with perceived control and (b perceived control will associate positively with Anorexia and negatively with Bulimia symptomatology. One hundred and thirty young adults residing in Israel filled out measures assessing Anorexia (drive for thinness, Bulimia, perceived control, and EI (two measures. The results lent only partial support to the hypotheses: EI showed a nonlinear association with control, which in turn showed nonlinear association with Anorexia scores, and contrary to our hypothesis, positive association with Bulimia scores. A Sobel test supported the mediation models for both eating disorder measures. The results are discussed and future research is proposed to further examine this hypothesized mechanism.
Pollert, Garrett A; Engel, Scott G; Schreiber-Gregory, Deanna N; Crosby, Ross D; Cao, Li; Wonderlich, Stephen A; Tanofsky-Kraff, Marian; Mitchell, James E
Binge eating, defined as the consumption of large amounts of food during which a sense of loss of control (LOC) is experienced, is associated with negative affect. However, there are no data on the experience of LOC after accounting for the effects of negative affect and caloric intake. Nine adult patients with binge eating disorder (BED) and 13 obese nonbinge eating disorder (NBED) participants carried a palmtop computer for 7 days, rating momentary mood and sense of LOC multiple times each day. Electronic food logs were collected once daily. After removing the effects of caloric intake and negative affect, a significant group difference was observed for ratings of LOC between BED and NBED participants. These findings suggest the experience of LOC in adults with BED is a salient feature of binge episodes, beyond that explained by caloric intake and momentary affect. Copyright © 2012 Wiley Periodicals, Inc.
Kennedy, Grace A; Wick, Madeline R; Keel, Pamela K
Avoidant-restrictive food intake disorder (ARFID) is a current diagnosis in the "Feeding and Eating Disorders" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) and captures a heterogeneous presentation of eating disturbances. In recent years, ARFID has been studied primarily within the context of eating disorders despite having historical roots as a feeding disorder. The following review examines ARFID's similarities with and differences from feeding disorders and eating disorders, focusing on research published within the last three years. Implications of this differentiation for treatment are discussed.
MacGregor, Michael Wm; Lamborn, Paige
Background Eating disorders are complex disorders that involve medical and psychological symptoms. Understanding the psychological factors associated with different eating disorders is important for assessment, diagnosis, and treatment. Methods This study sought to determine on which of the 22 Personality Assessment Inventory (PAI) scales patients with anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) differed, and whether the PAI can be used to classify e...
Schmidt, Ricarda; Tetzlaff, Anne; Hilbert, Anja
A sizeable body of research has documented Expressed Emotion (EE) to predict clinical outcomes in various psychiatric disorders, including eating disorders. Patients’ perceptions of relative’s EE, however, were found to play an important role in the processing of EE. This study aimed to examine the level of perceived EE in adolescent binge-eating disorder (BED) and its impact on eating disorder psychopathology. Adolescents (12 – 20 years) seeking treatment for BED (n = 40) were compared to...
Bruni, R; Ferrazzoli, F; Binetti, P
The increase of disorders connected to eating behaviours arises serious problems in the social and health-care setting. These require long-term therapeutic interventions, which have to be strongly integrated on the pharmacological, psychotherapeutic, social and cultural aspects. At present the issues develops itself on three levels: a) increase of the number of subjects, especially adolescents, b) protraction of the illness, with frequent critical relapses, c) always less defined evolution of the pathology with a tendency to become chronic and develop other kinds of illnesses. OUTLINE OF THE SURVEY: The Clinical Psychology Service of the CBM University Hospital examined 300 records of adolescents with various forms of eating disorders. Some of these interventions were requested by various clinical departments while other cases were directly taken care of and offering pharmacological as well as therapeutic interventions. The analysis of adolescents' dynamics allows an interpretation of modern eating disorders as one of the issues characteristic of the always more difficult body-mind integration. For adolescents corporeality is a weight, some kind of foreign body they don't like, and it is not thought as the basic way to get in contact with others so to express one's own feelings and wishes. Eating disorders are very strong symptoms of personal and social malaise. For this reason they require an integrated intervention starting from the family environment, reaching the child in its uniqueness as well as the larger social context. Actually the latter sends messages to young people which are strongly destabilizing from an ethical point of view as well as for body aesthetics. A counseling service offered at first to parents becomes an effective way of preparing both sides to more complex and articulated types of treatment. These can be more expensive but can build up again a disturbed or not properly developed psychological balance in adolescents.
Soh, Nerissa Li-Wey; Touyz, Stephen; Dobbins, Timothy A; Surgenor, Lois J; Clarke, Simon; Kohn, Michael R; Lee, Ee Lian; Leow, Vincent; Rieger, Elizabeth; Ung, Ken Eng Khean; Walter, Garry
To investigate eating disorder psychopathology, restraint and eating concern in young women with and without an eating disorder from two different ethnic groups in Australia and Singapore. The relationship of Eating Disorder Examination Questionnaire Global, Restraint and Eating Concern scores to cultural orientation and sociocultural factors was analysed in 154 women with and without an eating disorder. Participants were from the following backgrounds: North European Australian, East Asian Australian, Singaporean Chinese and North European expatriates in Singapore. Women with eating disorders had similar psychopathology across the cultural groups. Among controls, Singaporean Chinese reported significantly greater overall eating disorder psychopathology than other cultural groups and greater restraint than North European Australians/expatriates. Eating concern was not associated with cultural group overall or acculturation to Western culture. Dissatisfaction with family functioning, socioeconomic status and education level were not significantly associated with any of the eating disorder measures. In eating disorder psychopathology, the specific symptom of eating concern may transcend cultural influences.
Brownley, Kimberly A.; Berkman, Nancy D.; Peat, Christine M.; Lohr, Kathleen N.; Cullen, Katherine E.; Bann, Carla M.; Bulik, Cynthia M.
Background The best treatment options for binge-eating disorder are unclear. Purpose To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. Data Sources English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. Study Selection 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. Data Extraction 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. Data Synthesis Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], −6.50 [CI, −8.82 to −4.18]) and SGAs (MD, −3.84 [CI, −6.55 to −1.13]) reduced binge-eating–related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, −1.97 [CI, −3.67 to −0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. Limitations Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely
Brechan, Inge; Kvalem, Ingela Lundin
The purpose of this study was to investigate the hypothesis that the effect of body dissatisfaction on disordered eating behavior is mediated through self-esteem and depression. If the effect of body dissatisfaction on disordered eating can be explained by self-esteem and depression, treatment may benefit from focusing more on self-esteem and depression than body dissatisfaction. We also hypothesized body image importance to be associated with lower self-esteem, stronger symptoms of depression, and more disordered eating. The results showed that the effect of body dissatisfaction on disorder eating was completely mediated, whereas the effect of body image importance was partly mediated. Both self-esteem and depression were significant mediators. Body image importance and self-esteem had a direct effect on restrained eating and compensatory behavior. Depression had a direct effect on binge eating. This effect was significantly stronger among women. Depression also had a direct effect on restrained eating. This effect was positive among women, but negative among men. The results support emotion regulation and cognitive behavioral theories of eating disorders, indicating that self-esteem and depression are the most proximal factors, whereas the effect of body dissatisfaction is indirect. The results point out the importance of distinguishing between different symptoms of bulimia. Depression may cause binge eating, but compensatory behavior depends on self-esteem and body image importance. The results suggest that women may turn to both binge eating and restrained eating to escape awareness of negative emotions, whereas men focus on eating to a lesser extent than women. Existing treatment focuses on eating behavior first and mechanisms such as self-esteem and depression second. The results from this study suggest that an earlier focus on self-esteem and depression may be warranted in the treatment of disordered eating. Copyright © 2015 Elsevier Ltd. All rights
Steward, Trevor; Mestre-Bach, Gemma; Vintró-Alcaraz, Cristina; Agüera, Zaida; Jiménez-Murcia, Susana; Granero, Roser; Fernández-Aranda, Fernando
Evidence points to eating disorder patients displaying altered rates of delay discounting (one's degree of preference for immediate rewards over larger delayed rewards). Anorexia nervosa (AN) patients are believed to have an increased capacity to delay reward, which reflects their ability to override the drive to eat. Contrarily, binge eating disorder (BED) patients are associated with a reduced predisposition to delay gratification. Here, we investigated monetary delay discounting and impulsivity in 80 adult women with EDs (56 AN and 24 BED), diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, and 80 healthy controls. AN-restrictive (AN-R) subtype patients showed less steep discounting rates than BED and AN-bingeing/purging subtype patients. Compared with healthy controls and AN-R patients, BED and AN-bingeing/purging patients presented higher delay discounting and positive and negative urgency levels. Our findings suggest that restriction in AN-R patients is associated with disproportionate self-control, whereas bingeing behaviours could be more driven by emotional states and impulsivity traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Fairweather-Schmidt, A Kate; Wade, Tracey D
In the DSM-5 diagnostic criteria for eating disorders, two main groups appear, threshold eating disorders (TED; anorexia nervosa, bulimia nervosa, and binge eating disorder), and other specified feeding and eating disorders (OSFED). In addition to calculating prevalence of these two groups, we examined the degree to which they could be differentiated in terms of impairment and risk factors. Adolescent female twins (N = 699) were interviewed with the Eating Disorder Examination on three occasions spanning 12.70-19.84 years of age. Assessments also included self-report measures related to impairment and risk. Prevalence of DSM-5 ED in this adolescent population was 10.4%; 5.4% for TED and 5% for OSFED. Impairment levels did not distinguish TED and OSFED groups at any wave. Examination of latent risk factors showed TED and OSFED groups to share a common genetic basis; however, largely nonoverlapping unique environmental influences contributed to the two groups. Specific risk factors commonly differentiated the no ED and TED groups, but not OSFED. The findings suggest that TED and OSFED groups cannot be discriminated by prevalence or impairment or genetic risk factors. It is anticipated that OSFED will possess limited clinical utility for adolescents. Future research should examine clinical cases of these two groups in terms of meaningful differences, and a research focus should be maintained on both groups. Further examination of specific environmental risk factors that may attenuate the level of symptoms between the two groups may provide useful information for prevention efforts. © 2014 Wiley Periodicals, Inc.
Masheb, Robin M; Grilo, Carlos M
The current study examined emotional overeating in overweight patients with binge eating disorder (BED). A new measure--the Emotional Overeating Questionnaire (EOQ)--was developed to measure the frequency of overeating in response to emotions. The internal consistency, test-retest reliability, and factor structure of this measure were examined, and its associations with eating disorder psychopathology, depression, and gender were explored. Two hundred twenty consecutive overweight (body mass index [BMI] > or = 25) treatment-seeking BED patients (48 men and 172 women) were administered the EOQ, which assesses overeating frequency in response to six emotions (anxiety, sadness, loneliness, tiredness, anger, and happiness). A subset of patients (n = 83) completed the measure again approximately 1 week later. BMI was measured, and participants completed measures of eating disorder psychopathology. The EOQ was internally consistent (alpha =.85), its items were significantly and moderately correlated (range .32 to .70) with each other, and principal components analysis revealed one factor accounting for 58% of the variance. The EOQ items and total score were characterized by good test-retest reliability (intraclass correlation coefficients [ICCs] ranged from .62 to .73). Significant correlations were found between the emotional overeating items and total score, and binge frequency, eating disorder features, and depressive symptomatology. Emotional overeating was unrelated to BMI, and men and women reported similar rates of emotional overeating. Emotional overeating was significantly associated with binge frequency, eating disorder features, and depression, but was not related to BMI or gender.
Rush, Christina C; Curry, John F; Looney, John G
The authors investigated binge drinking, alcohol expectancies, and risky and protective drinking behaviors in relation to disordered eating behaviors in male and female college students. The full sample consisted of 7,720 undergraduate students, 18 to 22 years of age. Drinking behaviors were analyzed in 4,592 recent drinkers. Participants anonymously completed a survey as part of a universal alcohol abuse prevention program between September 2007 and April 2008. Co-occurring disordered eating behaviors and binge drinking characterized 17.1% of males and 19.0% of females. Rates of binge drinking were higher in those with disordered eating behaviors. Students with disordered eating behaviors also had more positive and negative alcohol expectancies and engaged in more risky and fewer protective drinking behaviors than their counterparts. Students with disordered eating behaviors have outcome expectancies and behavior patterns associated with problematic drinking. These findings may enhance prevention and intervention programs.
Guilbaud, O; Corcos, M; Chambry, J; Paterniti, S; Loas, G; Jeammet, P
Patients suffering from eating disorder show elevated rates of alexithymia and depression. We compared alexithymia and depression ratings for non-hospitalized women meeting DSM IV criteria for anorexia nervosa (n = 32) and bulimia nervosa (n = 32) to healthy women (n = 74). Alexithymia was evaluated by the Toronto Alexithymia Scale (TAS-20) and depression by the Hospital Anxiety and Depression Scale (HAD). We found that TAS and HAD scores were significantly higher in anorexic compared to bulimic patients, although alexithymia and depression, as evaluated, were significantly and positively correlated with each other (r = 0.53, p = 0.001). Finally, a logistic regression with alexithymia and depression as independent variables showed a strong correlations between the HAD ratings and anorexia, but no correlations between TAS score and the eating disorder subgroups. In eating disorder patients, alexithymia, as evaluated by the Toronto Alexithymia Scale, seems to exhibit a thymo-dependent component which could be secondary to concurrent depression. Through recent studies and results of our research, we analyze and give several interpretations which may explain this correlation between alexithymia and depression.
Donofry, Shannon D.; Roecklein, Kathryn A.; Rohan, Kelly J.; Wildes, Jennifer E.; Kamarck, Marissa L.
Eating pathology in Seasonal Affective Disorder (SAD) may be more severe than hyperphagia during winter. Although research has documented elevated rates of subclinical binge eating in women with SAD, the prevalence and correlates of BED in SAD remain largely uncharacterized. We examined the prevalence and correlates of binge eating, weekly binge eating with distress, and BED as defined by the DSM-IV-TR in SAD. We also tested whether binge eating exhibits a seasonal pattern among individuals w...
Crow, Scott J; Peterson, Carol B; Swanson, Sonja A; Raymond, Nancy C; Specker, Sheila; Eckert, Elke D; Mitchell, James E
Anorexia nervosa has been consistently associated with increased mortality, but whether this is true for other types of eating disorders is unclear. The goal of this study was to determine whether anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified are associated with increased all-cause mortality or suicide mortality. Using computerized record linkage to the National Death Index, the authors conducted a longitudinal assessment of mortality over 8 to 25 years in 1,885 individuals with anorexia nervosa (N=177), bulimia nervosa (N=906), or eating disorder not otherwise specified (N=802) who presented for treatment at a specialized eating disorders clinic in an academic medical center. Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified. All-cause standardized mortality ratios were significantly elevated for bulimia nervosa and eating disorder not otherwise specified; suicide standardized mortality ratios were elevated for bulimia nervosa and eating disorder not otherwise specified. Individuals with eating disorder not otherwise specified, which is sometimes viewed as a "less severe" eating disorder, had elevated mortality risks, similar to those found in anorexia nervosa. This study also demonstrated an increased risk of suicide across eating disorder diagnoses.
Karjalainen, Louise; Gillberg, Christopher; Råstam, Maria; Wentz, Elisabet
Little is known about the prevalence and incidence of traditional eating disorders (EDs, e.g., anorexia nervosa (AN), bulimia nervosa and binge eating disorder (BED)) in individuals with childhood onset neuropsychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). The aim of the present study was to examine the prevalence of EDs and eating pathology in young adults and adults with ADHD and/or ASD, and to investigate the relationship between EDs and associated symptoms, on the one hand, and other psychiatric disorders, intelligence, and BMI, on the other hand, in this population. In an outpatient setting, 228 consecutively referred adults were neuropsychiatrically evaluated and assessed with regard to intelligence (WAIS-III), psychiatric comorbidities (SCID-I), personality disorders (SCID-II), eating disorders (SCID-I) and eating pathology (Eating Attitudes Test (EAT)). For the entire sample, a total of 18 individuals (7.9%) had a current or previous eating disorder, with AN and BED being the most frequent. The male:female ratio was 1:2.5. According to EAT, 10.1% of the individuals scored within the range of severely disturbed eating behavior, and 13% moderately disturbed eating behavior. Individuals with ADHD more often affirmed eating pathology such as focusing on thoughts of calories and body dissatisfaction compared to individuals with ASD. Eating disorder symptomatology seems to be overrepresented in adults with neuropsychiatric disorders compared with the general population. The gender ratio for EDs in adults with neuropsychiatric disorders is not nearly as skewed as in the general population. Copyright © 2016 Elsevier Inc. All rights reserved.
Mitchell, James E; Redlin, Jennifer; Wonderlich, Steve; Crosby, Ross; Faber, Ron; Miltenberger, Ray; Smyth, Joshua; Stickney, Marci; Gosnell, Blake; Burgard, Melissa; Lancaster, Kathy
Compulsive buying has received increased research attention in the last decade. The disorder has high rates of comorbidity for other disorders, including eating disorders. This study explored the possible relationship between compulsive buying and eating disorders. Twenty women who scored in the pathological range on a measure of compulsive buying and 20 controls were recruited via the media. Various measures of psychopathology and eating disorder symptoms were administered to both groups. Compulsive buyers were significantly more likely to have a higher lifetime history of substance abuse or dependence. No differences existed between normal controls and compulsive buyers in prevalence of current or lifetime eating disorders, nor were there differences in scores of eating-related psychopathology. This work failed to demonstrate an increased risk for eating disorder in compulsive buyers, although a higher rate of substance dependence or abuse and higher scores on pathological personality dimension scales were seen.
Klump, Kelly L.
Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty. PMID:23998681
Knightsmith, P; Treasure, J; Schmidt, U
Eating disorders have a high rate of onset in school-aged children. School staff are in an excellent position to spot the early warning signs and offer support during recovery. This article explores the findings from focus groups conducted with 63 members of staff from 29 UK schools with the aims of (i) understanding whether they are in a good position to support students with eating disorders and (ii) to generate recommendations regarding school staff's training needs for spotting and supporting eating disorders. Participants took part in semi-structured focus groups. These were transcribed and analysed using content analysis principles. Five key themes emerged: (i) many staff do not have a basic understanding of eating disorders, (ii) eating disorders are taboo in the staffroom, (iii) staff do not feel comfortable talking to students about eating disorders, (iv) support is needed to ensure the teacher-parent relationship is a positive one and (v) school staff would welcome practical ideas for how they can best support students during the recovery period. The findings show that school staff currently feel ill-equipped to support students with eating disorders and endorse a need for focused training for school staff to better enable them to support students with eating disorders.
Sanlier, Nevin; Navruz Varli, Semra; Macit, M Sedanur; Mortas, Hande; Tatar, Tugba
It was aimed to determine the prevalence of high disordered eating tendencies and its relationship with food addiction, emotional eating and self esteem in participants at 18 and 33 years age group. This study was planned as a cross-sectional study and conducted with 1359 young adult volunteers (M = 386, F = 973) with an average age of 22.4 ± 2.84 years. Eating Attitudes Test-26 (EAT-26), Yale Food Addiction Scale (YFAS), Emotional Appetite Questionnaire (EMAQ) and Rosenberg Self-Esteem Scale (RSES) were used. EAT-26 score above 20 was considered as eating disorders risk cutoff. Participants with disordered eating tendencies have higher rates (22.4%) of food addiction compared to participants without high disordered eating tendencies (7.2%). There is no difference for EMAQ and YFAS scores; however, there is a significant difference for RSES and EAT-26 scores according to gender. A positive association of EAT-26 with YFAS and EMAQ-negative scores and a negative association of EAT-26 with RSES and EMAQ-positive were found. There is association among EAT-26, YFAS, and Rosenberg Self-Esteem Scale, and Emotional Appetite Questionnaire scores. This study provides information for future studies about high disordered eating tendencies, food addiction and mood that are thought to be important in young adults. Level V (cross-sectional descriptive study).
Haines, Jess; Neumark-Sztainer, Dianne; Eisenberg, Marla E; Hannan, Peter J
To assess whether weight-related teasing predicts the development of binge eating, unhealthy weight control behaviors, and frequent dieting among male and female adolescents. A prospective study was conducted with an ethnically and socioeconomically diverse sample of 2516 adolescents who completed surveys at both time 1 (1998-1999) and time 2 (2003-2004) of the Project EAT (Eating Among Teens) study. In 1998-1999, approximately one fourth of participants reported being teased about their weight at least a few times a year. After adjustment for age, race/ethnicity, socioeconomic status (SES), and BMI, boys who were teased about their weight were more likely than their peers to initiate binge eating with loss of control and unhealthy weight control behaviors 5 years later. The predicted prevalence for incident binge eating behaviors with loss of control among boys who were teased was 4.1% as compared with 1.4% for those who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. For unhealthy weight control behaviors at time 2, the predicted prevalence was 27.5% among boys who were teased and 19.3% for boys who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. Girls who were teased were more likely than their peers to become frequent dieters. The predicted prevalence for incident frequent dieting among girls who were teased was 18.2% as compared with 11.0% for those who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. Weight teasing in adolescence predicts disordered eating behaviors at 5-year follow-up. The patterns of these associations differ by gender. Reducing teasing through educational interventions and policies may reduce the level of disordered eating behaviors among youths.
Lennkh, C; Strnad, A; Bailer, U; Biener, D; Fodor, G; de Zwaan, M
We investigated the prevalence of obsessive compulsive disorder (OCD) among patients with eating disorders (ED). 66 female inpatients who met the DSM-IV criteria for anorexia nervosa (AN) or bulimia nervosa (BN) participated in the study. The Structured Clinical Interview for DSM III-R diagnoses (SCID), the Eating Disorder Inventory (EDI), the revised 90-item Symptom-Checklist (SCL-90-R), the Beck Depression Inventory (BDI), and the Toronto Alexithymia Scale (TAS-20) were carried out. Twelve patients (18.2%) met the DSM-III-R criteria for lifetime OCD: 7 had a current OCD and 5 had a past history of OCD. These patients had significantly higher (more pathological) mean scores on the EDI and the SCL-90-R total scales. Analyses of the EDI subscales revealed significantly higher scores for ineffectiveness, perfectionism, interoceptive awareness, and maturity fears. As expected, analyses of the SCL-90-R subscales revealed significantly higher scores for OCD. In addition, there was a trend towards higher somatization scores in patients with comorbid OCD. We could not find any significant differences in the BDI and the TAS total scores. In addition, patients with comorbid OCD showed a significantly higher lifetime prevalence of bipolar disorder, simple phobia, and somatoform disorders. Our results confirm previous reports of a strong association between ED and OCD and suggest that the prevalence of OCD may be correlated with a higher severity of the eating disorder and general psychopathological parameters.
Lavender, Jason M; Brown, Tiffany A; Murray, Stuart B
There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males. Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature. Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.
This retrospective study explored the experience of recovery from anorexia nervosa and bulimia nervosa without professional treatment. A nine-question open-ended electronic survey was posted for a period of four months at a mid-western university. Sixteen female and two male respondents reported recovery from adolescent-onset full syndrome anorexia nervosa or bulimia nervosa. All respondents reported onset factors supporting a sociocultural etiology. Recovery was initiated through the empathic, participatory efforts of parents and friends, or was self-initiated. Respondents with the shortest disorder duration and most complete recovery reported early parental intervention. Onset factors similar to those in research with a clinically treated population were found. Implications of the findings are discussed.
Jasik, Carolyn Bradner
Eating behavior in adolescents can be as high risk as other behaviors that arise during this period and can have serious health consequences. This article presents a framework for screening and treatment of abnormal adolescent eating behavior by the primary care provider. A review of the types of disordered eating is presented along with suggested ways to screen. Indications for subspecialty eating disorder referrals and key aspects of screening and intervention in adolescent obesity and eating disorders are also reviewed. Specific attention is paid to the aspects of care that can be provided in primary care and multidisciplinary care. Copyright © 2014 Elsevier Inc. All rights reserved.
Goldschmidt, Andrea B; Le Grange, Daniel; Powers, Pauline; Crow, Scott J; Hill, Laura L; Peterson, Carol B; Crosby, Ross D; Mitchell, Jim E
Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ(2) analyses. After controlling for age and sex, normal-weight participants reported more frequent use of a range of healthy and unhealthy weight control behaviors compared to their obese peers, including eating fewer meals and snacks per day; exercising and skipping meals more frequently in the past month; and avoiding certain foods for weight control. They also endorsed more frequent attempts at dieting in the past year, and feeling more frequently distressed about their binge eating, at a trend level. There were no group differences in binge eating frequency in the past month, age at onset of binge eating, overvaluation of shape/weight, or likelihood of having used certain weight control behaviors (e.g., vomiting, laxative use) or having sought treatment for an eating disorder in the past. Based on our findings, normal-weight individuals appear to be a behaviorally distinct subset of the BED population with significantly greater usage of both healthy and unhealthy weight control behaviors compared to their obese peers. These results refute the notion that distress and impairment in BED are simply a result of comorbid obesity.
Goldschmidt, Andrea B.; Le Grange, Daniel; Powers, Pauline; Crow, Scott J.; Hill, Laura L.; Peterson, Carol B.; Crosby, Ross D.; Mitchell, Jim E.
Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ2 analyses. After controlling for age and sex, normal-weight participants reported more frequent use of a range of healthy and unhealthy weight control behaviors compared to their obese peers, including eating fewer meals and snacks per day; exercising and skipping meals more frequently in the past month; and avoiding certain foods for weight control. They also endorsed more frequent attempts at dieting in the past year, and feeling more frequently distressed about their binge eating, at a trend level. There were no group differences in binge eating frequency in the past month, age at onset of binge eating, overvaluation of shape/weight, or likelihood of having used certain weight control behaviors (e.g., vomiting, laxative use) or having sought treatment for an eating disorder in the past. Based on our findings, normal-weight individuals appear to be a behaviorally distinct subset of the BED population with significantly greater usage of both healthy and unhealthy weight control behaviors compared to their obese peers. These results refute the notion that distress and impairment in BED are simply a result of comorbid obesity. PMID:21331066
Full Text Available Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD and other common anxiety disorders. Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups. Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group. Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population.
Conviser, Jenny H; Fisher, Sheehan D; McColley, Susanna A
Pediatric chronic illnesses (CI) can affect a child's mental health. Chronic illnesses with treatment regimens that specify a therapeutic diet may place the child at increased risk for disordered eating and specific eating disorders (ED). The aim of this review is to examine the relation between diet-treated CI and disordered eating and to determine the order of onset to infer directionality. Diet-treated CI is hypothesized to precede and to be associated with disordered eating. A comprehensive search of empirical articles that examine the relation between diet-treated CI (diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and inflammatory bowel diseases) and disordered eating was conducted in Medline and PsycINFO using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A table of the sample's characteristics, ED measures, major pertinent findings, and the onset of CI in relation to ED were provided. Diet-treated CI was associated with disordered eating and ED. Diet-treated CI had onset prior to disordered eating in most studies, except for inflammatory bowel diseases. Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes. Interventions for diet-treated CI require a focus on diet and weight, but may increase the risk for disordered eating. Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers. © 2018 Wiley Periodicals, Inc.
Avena, Nicole M.; Bocarsly, Miriam E.
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...
Gáti, Agnes; Abrahám, Ildikó; Arkovits, Amaryl
Recently the integrative approach has been applied in the treatment of eating disorders with multicausal origin. In order to achieve long-term therapeutic effect, the psychodynamic interpretation is often needed and favoured as a part of the personal, multimodal therapeutic strategy. The present paper focuses on body image distortion as one of the most decisive and least influenceable symptom of the disorder. The symptom is interpreted along the body image distortion-body boundaries-self boundaries-autonomy line. With illustrative therapy details of dreams, imaginations, the authors aim to demonstrate the therapeutic use of dynamically oriented therapy and dynamically oriented hypnotherapy.
Smink, Frédérique R E; van Hoeken, Daphne; Oldehinkel, Albertine J; Hoek, Hans W
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a considerably revised eating disorder section. The aim of this study was to establish the prevalence and severity of eating disorders based on the new DSM-5 criteria in a community cohort of adolescents. This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch cohort study on mental health and social development from preadolescence into young adulthood. At baseline, the participants (n = 2,230) were about 11 years old. Body mass index was measured at all four assessment waves. At age 19, the Composite International Diagnostic Interview was administered to 1,584 of the participants. A two-stage screening approach was used to estimate the prevalence of DSM-5 eating disorders. Adolescents at high risk for eating disorders (n = 312) were selected for an additional interview administered by eating disorder experts. Of the high-risk group n = 296 (95%) could be interviewed. Among the women, the lifetime prevalence of DSM-5 anorexia nervosa was 1.7%, of bulimia nervosa 0.8% and of binge eating disorder 2.3%. Eating disorders were relatively rare among the men. The severity of most cases was mild to moderate and detection and treatment rates depended on the level of severity. The most common DSM-5 eating disorder diagnoses in adolescents in the community are anorexia nervosa and binge eating disorder. Severity ratings for eating disorders seem valid in terms of both the distribution in the community and the correlation with detection and treatment by health care services. © 2014 Wiley Periodicals, Inc.
Talbot, Lisa S; Maguen, Shira; Epel, Elissa S; Metzler, Thomas J; Neylan, Thomas C
The present study investigated the relationship between posttraumatic stress disorder (PTSD) and emotional eating in a sample of medically healthy and medication-free adults. Participants with PTSD (n = 44) and control participants free of lifetime psychiatric history (n = 49) completed a measure of emotional eating. Emotional eating is the tendency to eat or overeat in response to negative emotions. PTSD participants exhibited greater emotional eating than control participants (η(2) = .20) and emotional eating increased with higher PTSD symptom severity (R(2) = .11). Results supported the stress-eating-obesity model whereby emotional eating is a maladaptive response to stressors. Over time, this could lead to weight gain, particularly abdominal stores, and contribute to higher risk for comorbid medical disorders. Findings suggest the importance of future longitudinal research to understand whether emotional eating contributes to the high rates of obesity, diabetes, and heart disease in PTSD. Copyright © 2013 International Society for Traumatic Stress Studies.
Satherley, R-M; Higgs, S; Howard, R
The need for dietary-management in coeliac disease may lead to the development of disordered eating patterns. A theoretical model of disordered eating has been proposed to explain disordered eating in coeliac disease. The aim of this study was to explore the experiences of typical and disordered eating in coeliac disease to gain a greater understanding of these processes and explore specific pathways within this model. We interviewed 21 individuals with coeliac disease, recruited from a previous database, about their experiences with food and food environments. Information about disordered eating status was assessed via questionnaire. The interviews were analysed qualitatively using Framework analysis, which was underpinned by the theoretical model of disordered eating in coeliac disease. Experiences differed between participants scoring high on measures of disordered eating and those who scored low (typical eaters). Participants scoring high on measures of disordered eating were concerned about the consequences of their gluten-free diet on body image and they described eating patterns similar to binge/restrict cycles. Typical eaters reported being able to integrate their dietary self-management into their daily lives; however, general concerns around food and cross-contamination were associated with a restriction in food intake. Coeliac disease has a varied impact on eating patterns. The need to follow a gluten-free diet and to be vigilant around food has to be balanced with concerns around food availability and cross-contamination which have the potential to contribute towards disordered eating attitudes and behaviours. The findings suggest that the theoretical model of disordered eating provides an adequate explanation of disordered eating patterns in coeliac disease. © 2017 The British Dietetic Association Ltd.
Hilbert, Anja; Pike, Kathleen M; Goldschmidt, Andrea B; Wilfley, Denise E; Fairburn, Christopher G; Dohm, Faith-Anne; Walsh, B Timothy; Striegel Weissman, Ruth
This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs. Copyright © 2014. Published by Elsevier Ireland Ltd.
Derenne, Jennifer L; Beresin, Eugene V
Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The authors attempt to explain the historical context of the problem and explore potential avenues for change. The authors review changes in ideal female body type throughout history, comment on current attitudes toward shape and weight in both men and women, and outline interventions aimed at increasing healthy habits and fostering self-esteem in youth. Throughout history, the ideal of beauty has been difficult to achieve and has been shaped by social context. Current mass media is ubiquitous and powerful, leading to increased body dissatisfaction among both men and women. Parents need to limit children's exposure to media, promote healthy eating and moderate physical activity, and encourage participation in activities that increase mastery and self-esteem. Funding for high-quality, visible advertising campaigns promoting healthy life styles may increase awareness.
Capasso, Anna; Putrella, Claudio; Milano, Walter
This review focuses on Eating Disorders (ED), the role played by neurotransmitters and peptides in ED phenomena as well as the drugs used in the treatment of these diseases. For ED, we mean a syndrome characterized by persistent alteration of eating behavior and the conditions that cause an insufficient ingestion and/or adsorption of foods. There are three different ED diseases: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorders (BED). ED are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. The neuronal circuits that control the ingestion of food are mainly related to catecholaminergic, serotoninergic and peptidergic systems. In this respect, while serotonin, dopamine and prostaglandin promote the ingestion of food, by contrast, neuropeptide Y, norepinephrine, GABA and opioid peptides inhibit food ingestion, thus, causing the occurence of ED. The drugs mainly used in the treatment of ED are antidepressants such as selective serotonin reuptake inhibitors and tricyclic antidepressants. Additionally, mood stabilizers (lithium), anxiolytics, serotonin and noradrenalin reuptake inhibitors and antipsychotic drugs are often used in the treatment of ED.
Shomaker, Lauren B; Furman, Wyndol
Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys' and girls' symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16-19 years of age (N=199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents', mothers' and friends' reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents' perceptions and friends' reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys.
Sala, Margarita; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M; Bardone-Cone, Anna
We investigated racial/ethnic stereotyping in the recognition and referral of eating disorders with 663 university students. We explored responses to problem and eating disorder recognition and health care referrals after subjects read a vignette concerning a patient of a different race/ethnic background presenting with eating disorders. A series of three 4 × 3 ANOVAs revealed significant main effects for eating disorders across all three outcome variables. There were no significant main effects across the four different race/ethnicity conditions and no significant race by condition interactions. Lack of general eating disorder recognition and health care referrals by student participants were found. [Supplemental files are available for this article. Go to the publishers's online edition of Eating Disorders for the following free supplemental resource: online appendix containing vignettes 1-3, as described in the "Methods" section].
Spettigue, Wendy; Henderson, Katherine A.
Introduction This paper provides a review of the role of the media in the development, maintenance, prevention, and treatment of eating disorders. Method The literature on gambling in youth on the internet was reviewed. It explores: (1) the role of the media in providing a social context for the development of eating disorders, (2) the role of the media in the etiology of eating disorder pathology, (3) the ways in which the media is used by patients suffering from eating disorders, and (4) the role that awareness of the media can have in the treatment and prevention of eating disorders. Results This review demonstrates that the media does contribute to the development of eating disorders. Conclusion This review highlights the need for media literacy and media activism to help change the current normative body discontent of women in the Western world. PMID:19030149
Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja
INTRODUCTION: This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first...... and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. MATERIAL AND METHODS: Hospital-diagnosed eating disorders among 42 915 women in the Danish National ART cohort (DANAC......), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42 644 women and an age-matched background population of 215 290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders...
Spettigue, Wendy; Henderson, Katherine A
This paper provides a review of the role of the media in the development, maintenance, prevention, and treatment of eating disorders. The literature on gambling in youth on the internet was reviewed. It explores: (1) the role of the media in providing a social context for the development of eating disorders, (2) the role of the media in the etiology of eating disorder pathology, (3) the ways in which the media is used by patients suffering from eating disorders, and (4) the role that awareness of the media can have in the treatment and prevention of eating disorders. This review demonstrates that the media does contribute to the development of eating disorders. This review highlights the need for media literacy and media activism to help change the current normative body discontent of women in the Western world.
Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.
Iles, Irina A; Atwell Seate, Anita; Waks, Leah
This research explores the intended and unintended consequences of eating disorder public service announcements. We assessed participants' attitudes toward eating disorders and people with eating disorders, willingness to interact with people with eating disorders, and experience with eating disorders (covariate) at Time 1. At Time 2, participants were randomly assigned to watch a stigmatizing or a non-stigmatizing eating disorder public service announcement. Exposure to the stigmatizing public service announcement resulted in more negative attitudes toward eating disorders and in less willingness to interact with people with eating disorders, but not in significantly more negative attitudes toward people with eating disorders. The discussion highlights the practical implications for health communication campaigns.
Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.
Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…
The study deals with eating disorders. It tries to bring the most comprehensive overview of the two majority eating disorders, anorexia nervosa and bulimia nervosa, respectively. Both diseases have a lot in common, but also some of its specifics which are pointed out in the study. The study is conceived to make the reader in the early chapters acquainted with the various eating disorders according to international diagnostic criteria. Then there is a brief history, epidemiology and etiology a...
Individuals with type 1diabetes are at increased risk of developing an eating disorder, the effects of which can be physically and psychologically damaging. Early detection of an eating disorder and appropriate treatment is therefore essential. This article explores the possible factors that may increase the risk of people with type 1 diabetes developing an eating disorder, and highlights the signs and symptoms to help healthcare professionals detect people at risk so they can encourage them to accept appropriate help.
Machado, Paulo P. P.; Machado, Bárbara César; Gonçalves, Sónia; Hoek, Hans W.
Objective: Eating Disorders Not Otherwise Specified (EDNOS) represent the most common eating disorder diagnosed in specialized treatment settings. The purpose of the current study is to assess the prevalence of EDNOS in a nationwide community sample. Method: Participants were 2028 female students, aged 12 to 23, attending public schools in the 9th to 12th grades in Portugal. Participants completed the Eating Disorder Examination Questionnaire in Stage 1 of the study. In Stage 2, we selected a...
Smink, Frédérique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increas...
Johnson, Cleverick D; Koh, Sheila H; Shynett, Betty; Koh, Jason; Johnson, Claudette
Pica is a compulsive eating disorder involving non-nutritive substances. The etiology of this eating disorder is unknown but it often is associated with subclinical mineral deficiencies. This article focuses on the simultaneous occurrence of two types of eating disorders, the co-existence of depression during four pregnancies, and the resulting dental clinical implications. The literature is substantial enough to support a possible etiological association between these eating disorders and depression during pregnancy. Associations between eating psychopathology, depression, and anxiety have been described consistently. The diagnosis of pica and the dental treatment related to it are not a common part of most dental practices; knowing the clinical features and detecting the condition depend on careful questioning and diligence. At present, no one has described the physiologic or psychological basis for pica. This article reviews the published literature pertaining to pica, specifically pagophagia.
Averett, Susan; Terrizzi, Sabrina; Wang, Yang
Eating disorders are currently the deadliest mental disorder in the United States, affecting an estimated 12%-25% of all college women. Previous research has found a positive correlation between sorority membership and eating disorders, but the causal link has not been firmly established. We contribute to the literature by investigating a possible causal link among sororities and diagnosed eating disorders, measurable weight outcomes, and disordered-eating behaviors using data from the American College Health Association Survey. We handle the potential endogeneity of sorority membership using propensity score matching and instrumental variable methods to determine whether joining a sorority is a cause of the weight-related outcomes we study. We find that sorority members exhibit worse weight-related outcomes than those not in a sorority. However, our propensity score matching and instrumental variable results suggest that, other than BMI, this is merely a correlation, and there is little evidence that sorority membership is a cause of the outcomes we study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Wiss, David A; Brewerton, Timothy D
Although not formally recognized by the DSM-5, food addiction (FA) has been well described in the scientific literature. FA has emerged as a clinical entity that is recognized within the spectrum of disordered eating, particularly in patients with bulimia nervosa, binge-eating disorder and/or co-occurring addictive disorders and obesity. Integrating the concept of FA into the scope of disordered eating has been challenging for ED treatment professionals, since there is no well-accepted treatment model. The confusion surrounding the implications of FA, as well as the impact of the contemporary Westernized diet, may contribute to poor treatment outcomes. The purpose of this review is twofold. The first is to briefly explore the relationships between EDs and addictions, and the second is to propose a new model of conceptualizing and treating EDs that incorporates recent data on FA. Since treatment for EDs should vary based on individual assessment and diagnosis, the Disordered Eating Food Addiction Nutrition Guide (DEFANG) is presented as a tool for framing treatment goals and helping patients achieve sustainable recovery.
Full Text Available Debate continues regarding the nosological status of binge eating disorder (BED and the specific diagnostic criteria, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by body image disturbances in addition to abnormal eating behaviour. The aims of this article are: a to concisely review the main points of the literature that has developed on diagnosis and treatment (especially pharmacological of BED and b to present the results of an original research on body image in obese patients with BED. The study was aimed to verify the following hypothesis: in persons with obesity, BED is associated with greater body uneasiness independently of some possible modulating factors. We studied a clinical sample of 159 (89 females and 70 males adult obese patients who fulfilled DSM-IV-TR diagnostic criteria for BED matched to 159 non-BED obese patients for gender, ethnicity, BMI class, age, weight, stature, onset age of obesity, education level, and marital status. We used the Body Uneasiness Test (BUT, a valuable multidimensional tool for the clinical assessment of body uneasiness in subjects suffering from eating disorders and/or obesity. Obese patients with BED reported higher scores than non-BED patients in the General Severity Index (BUT-A GSI and in every BUT-A subscale. All differences were statistically significant in both sexes. As expected women obtained higher scores than men. According to some other studies, our findings suggest that a negative body image should be included among diagnostic criteria for BED. Consequently, treatment should be focused not simply on eating behaviour and outcome studies should evaluate changes of body image as well.
Gratwick-Sarll, Kassandra; Mond, Jonathan; Hay, Phillipa
Self-recognition of eating-disordered behavior was examined among female college students (n = 94) with a high level of bulimic-type eating disorder symptoms. A vignette was presented describing a fictional young woman with bulimia nervosa. Participants were asked whether they might currently have a problem such as the one described, while also completing self-report measures of eating disorder symptoms, general psychological distress, and functional impairment. Less than half (47.9%) of participants believed that they currently had a problem with their eating. In both bivariate and multivariable analysis, the variables most strongly associated with self-recognition were overall levels of eating disorder psychopathology, prior treatment for an eating problem, and the use of self-induced vomiting as a means of controlling weight or shape. No other eating disorder behaviors were independently associated with self-recognition. The findings support the hypothesis that young women with eating disorder symptoms may be unlikely, or at least less likely, to recognize a problem with their eating behavior when that behavior does not entail self-induced vomiting. Health promotion and early intervention programs for eating disorders may need to address the perception that, among young women of normal or above-average body weight, only problems with eating that involve self-induced vomiting are pathological.
Conclusions: There was a correlation between the Eating Disorder Symptoms and Obsessive Compulsive in pregnant women. It is recommended to eliminate or decrease Eating Disorder Symptoms and Obsessive Compulsive among Iranian pregnant women through preventive measures.
Mond, J. M.; Hay, P. J.; Darby, A.; Paxton, S. J.; Quirk, F.; Buttner, P.; Owen, C.; Rodgers, B.
Variables associated with the use of health services were examined in a prospective, community-based study of women with bulimic-type eating disorders who did (n = 33) or did not (n = 58) receive treatment for an eating problem during a 12-month follow-up period. Participants who received treatment for an eating problem differed from those who did…
Utzinger, Linsey M; Gowey, Marissa A; Zeller, Meg; Jenkins, Todd M; Engel, Scott G; Rofey, Dana L; Inge, Thomas H; Mitchell, James E
This study assessed loss of control (LOC) eating and eating disorders (EDs) in adolescents undergoing bariatric surgery for severe obesity. Preoperative baseline data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) multisite observational study (n = 242; median BMI = 51 kg/m 2 ; mean age= 17; 76% female adolescents; 72% Caucasian) included anthropometric and self-report questionnaires, including the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R), the Night Eating Questionnaire (NEQ), the Beck Depression Inventory (BDI-II), and the Impact of Weight on Quality of Life-Kids (IWQOL-Kids) RESULTS: LOC eating (27%) was common and ED diagnoses included binge-eating disorder (7%), night eating syndrome (5%), and bulimia nervosa (1%). Compared to those without LOC eating, those with LOC eating reported greater depressive symptomatology and greater impairment in weight-related quality of life. Before undergoing bariatric surgery, adolescents with severe obesity present with problematic disordered eating behaviors and meet diagnostic criteria for EDs. LOC eating, in particular, was associated with several negative psychosocial factors. Findings highlight targets for assessment and intervention in adolescents before bariatric surgery. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:947-952). © 2016 Wiley Periodicals, Inc.
Presents a prose-poetry tale which examines the use of writing as a pathway out of an eating disorder. Highlights the need for persons with an eating problem to find their own voice and describe their experiences in their own words rather than the restrictive narrative of an eating problem. Stresses the value of eliciting reflective, as well as…
Yanase, Maya; Sugihara, Genichi; Murai, Toshiya; Noma, Shun'ichi
To explore the characteristics of eating disorders related to shoplifting behavior and identify the risk and protective factors related to shoplifting among patients with eating disorders. Eighty females with eating disorders were recruited from an eating disorders clinic. They were asked to complete anonymous self-report questionnaires on demographic characteristics, shoplifting behavior, psychological characteristics and eating disorder symptomology. We investigated differences in clinical characteristics between those with and without shoplifting history or a current drive to shoplift. The response rate was 92.5%. Of the respondents, 37.8% reported a history of shoplifting and 16.2% a current drive for shoplifting. The patients with shoplifting history had lower socioeconomic status (SES), higher impulsivity and higher symptom severity of eating disorders compared with those without this history. The patients with a current drive for shoplifting had more depressive symptoms, more severe anxiety, more obsessional traits, and higher symptom severity of eating disorders. Severity of illness and SES seem to have a serious impact on shoplifting behavior among eating disordered patients. These findings may suggest risk and protective factors related to shoplifting among eating disordered patients.
Tan, Jacinta Oon Ai; Calitri, Raff; Bloodworth, Andrew; McNamee, Michael J
Eating disorders and disordered eating are more common in high performance sports than the general population, and particularly so in high performance aesthetic sports. This paper presents some of the conceptual difficulties in understanding and diagnosing eating disorders in high performance gymnasts. It presents qualitative and quantitative data from a study designed to ascertain the pattern of eating disorder symptoms, depressive symptoms and levels of self-esteem among national and international level gymnasts from the UK in the gymnastic disciplines of sport acrobatics, tumbling, and rhythmic gymnastics. Copyright © 2016 Elsevier Inc. All rights reserved.
Quick, Virginia M; Byrd-Bredbenner, Carol; Neumark-Sztainer, Dianne
This paper describes the prevalence of eating disorders and disordered eating behaviors, the reasons why these practices are endorsed, and the potential consequences in youths and young adults with selected diet-related chronic health conditions (DRCHCs) and provides recommendations for eating disorder prevention interventions and research efforts. Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population, overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment. Thus, health care providers should be aware that young people with DRCHCs may be at risk of eating disorders and carefully monitor psychological changes and the use of unhealthy weight control methods. It is also important to develop and evaluate theory-based interventions and disease-specific eating disorder risk screening tools that are effective in halting the progression of eating disorders and negative health outcomes in young people with chronic health conditions.
Saul, Jennifer S; Rodgers, Rachel F
The proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Here, the authors review different types of online content and how they are relevant to eating disorders within different theoretic frameworks, before examining the empirical evidence for the risks posed by online content in the development and maintenance of eating disorders. They describe pro-eating disorder content specifically and examine the research related to it, before considering its implications, and considering directions for future research, and prevention and intervention strategies. Copyright © 2017 Elsevier Inc. All rights reserved.
Baldofski, Sabrina; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Stroh, Christine; de Zwaan, Martina; Dietrich, Arne; Rudolph, Almut; Hilbert, Anja
Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study sought to investigate the prevalence of BED and NES and associations with various forms of nonnormative eating behavior and psychopathology in prebariatric patients. Within a consecutive multicenter registry study, patients in 6 bariatric surgery centers in Germany were recruited. Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Co-morbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge-eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Pengpid, Supa; Peltzer, Karl; Ahsan, Gias Uddin
As there is a lack of information on eating disorders in Bangladesh, the aim of this study was to explore the eating disorder attitudes and behaviors among undergraduate university students in the country. A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate students who were recruited randomly from classes. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes. The sample included 800 university students (56.6% men and 43.4% women), with a mean age of 21.0 years (SD=32.5). Using the EAT-26, 37.6% of the students were classified as being at risk for an eating disorder. In multivariate analysis, being a late adolescent (17-19 years), high religious involvement, overweight body perception, low body appreciation, having had cosmetic surgery, and current binge drinking were found to be associated with an eating disorder risk. Very high rates of eating disorder risk were found. This result calls for increased awareness and understanding of eating disorders, and related risk factors and interventions in university students in Bangladesh.
Padierna, A; Quintana, J M; Arostegui, I; Gonzalez, N; Horcajo, M J
This study investigated the perception of health-related quality of life (HRQoL) in ambulatory patients with eating disorders in relation to the severity of eating symptomatology and psychological comorbidity. One hundred ninety-seven study patients were consecutively recruited at the Eating Disorders Outpatient Clinic. Short Form-36 items (SF-36), a generic HRQoL questionnaire, the Eating Attitudes Test (EAT-40), and the Hospital Anxiety and Depression Scale (HAD) were used to measure different aspects of HRQoL. The results of the SF-36 were compared with the norms of the Spanish general population for women 18-34 years of age. Patients with eating disorders were more dysfunctional in all areas of the SF-36 compared with women in the general population. There were no differences among the eating disorder diagnostic groups. Higher scores on the EAT-40 and the HAD were associated with a perception of greater impairment on all SF-36 subscales. The evaluation of HRQoL in these patients confirms the impact of these disorders on daily life in areas not directly related to eating disorders. The SF-36 is useful for discriminating among different levels of severity of eating disorders and other psychological comorbidities of these patients.
Unoka, Zsolt; Tölgyes, Tamás; Czobor, Pál; Simon, Lajos
To examine relationship between Eating Disorder Behaviors (EDB) and Early Maladaptive Schemas (EMS) across eating disorder (ED) subgroups. EMS and ED behaviors were measured by Young Schema Questionnaire and Eating Behavior Severity Scale, respectively, among patients diagnosed with Restrictive or Binge/purging Anorexia, or bulimia nervosa. Canonical component analysis showed significant association between ED behaviors and EMSs. Canonical factor-pairs (EDB and EMS) revealed specific associations between certain patterns of EDBs, including binge-purging and physical exercise, and certain patterns of maladaptive cognitive schema, including Emotional deprivation, Abandonment, Enmeshments, Subjugation, and Emotional inhibition. ED subgroups significantly differred between the EMS and EDB canonical factors, respectively. Our findings indicate that EMS and EDB are associated, and that the factors that potentially mediate the association differ significantly among ED subgroups. These results are consistent with the notion that EMSs play a specific role in the development and maintenance of ED behaviors.
Rancourt, Diana; McCullough, Mary Beth
While eating disorders and obesity have traditionally been conceptualized as separate conditions, recent research suggests important overlap in several areas including etiology, comorbidity, risk factors, and prevention approaches. Examining the commonality among these conditions is particularly important as adolescents who present with both eating disorder symptomology and obesity demonstrate poorer outcomes within weight control treatments and are at greater risk for future development of full threshold eating disorders and additional weight gain. The purpose of this paper is to review the research examining the overlap in prevalence rates for eating disorders and obesity in adolescents, as well as shared etiology, risk factors, and psychiatric and medical comorbidities. Current preventive and treatment approaches also will be discussed, while highlighting the need for more integrated assessment, prevention, and treatment efforts that focus on maladaptive eating and activity patterns shared by both eating disorders and obesity.
Abstract The rates of paediatric obesity have risen dramatically. Given the challenge of successful weight loss and maintenance, preventive interventions are sorely needed. Furthermore, since a substantial proportion of individuals do not respond to traditional behavioural weight loss therapy, alternative approaches are required. Psychological treatments for binge eating disorder have been generally effective at reducing binge episodes and producing weight maintenance or modest weight loss in obese adults. Given the strong link between loss of control eating and obesity in youths, binge eating disorder treatment may serve as a viable form of excess weight gain prevention. An adapted version of interpersonal psychotherapy for binge eating disorder is one such intervention that we have considered. A description of the theoretical basis and proposed mechanism is described. Adaptations of interpersonal psychotherapy and other established therapies for binge eating disorder may serve as platforms from which to develop and disseminate obesity and eating disorder prevention programs in children and adolescents.
Treasure, J; Sepulveda, A R; MacDonald, P; Whitaker, W; Lopez, C; Zabala, M; Kyriacou, O; Todd, G
The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined. We describe in detail the pattern of interpersonal reactions that can result when a family member has an eating disorder. Shared traits such as anxiety, compulsivity and abnormal eating behaviours contribute to some of the misperceptions, misunderstandings and confusion about the meaning of the eating disorder for family members. Unhelpful attributions can fuel a variety of emotional reactions (criticism, hostility, overprotection, guilt and shame). Gradually these forces cause family members to accommodate to the illness or be drawn in to enable some of the core symptoms. Copyright 2008 John Wiley & Sons, Ltd and Eating Disorders Association.
Svedlund, Nils Erik; Norring, Claes; Ginsberg, Ylva; von Hausswolff-Juhlin, Yvonne
Background Very little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a...
Bydlowski, Sarah; Corcos, Maurice; Jeammet, Philippe; Paterniti, Sabrina; Berthoz, Sylvie; Laurier, Catherine; Chambry, Jean; Consoli, Silla M
First, we measured both emotional awareness and alexithymia to understand better emotion-processing deficits in eating disorder patients (EDs). Second, we increased the reliability of the measures by limiting the influence of confounding factors (negative affects). Seventy females with eating disorders were compared with 70 female controls. Participants completed the Beck Depression Inventory (BDI; depression), the Hospital and Anxiety Depression Scale (HADS; anxiety), the Toronto Alexithymia Scale (TAS; alexithymia), and the Level of Emotional Awareness Scale (LEAS). EDs exhibited higher alexithymia scores and lower LEAS scores, with an inability to identify and describe their own emotions, as well as an impairment in mentalizing others' emotional experience. Whereas alexithymia scores were related to depression scores, LEAS scores were not. After controlling for depression, alexithymia scores were similar in EDs and controls. The marked impairment in emotion processing found in EDs is independent of affective disorders. Thus, the joint use of TAS and LEAS suggests a global emotion-processing deficit in EDs. Copyright 2005 by Wiley Periodicals, Inc
Hicks, R A; Rozette, E
To measure the relationship between habitual sleep duration and eating disorders, the responses of groups of 34 short- and 43 longer-sleeping college students to the EAT-26 Test were compared. The short-sleepers scored twice as high and were five times more likely to exhibit abnormal eating patterns than the longer-sleeping group.
Snow, Janeanne T.; Harris, Mary B.
Investigated incidence of eating disorders in Pueblo Indian and Hispanic high school students (N=95). Found no ethnic differences. Majority of girls reported wanting to lose weight, being worried about weight, and indulging in binge eating. Nine girls reported eating habits consistent with bulimia. Few boys indicated concerns about weight or…
Masuda, Akihiko; Price, Matthew; Latzman, Robert D.
Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based s...
Mischoulon, David; Eddy, Kamryn T; Keshaviah, Aparna; Dinescu, Diana; Ross, Stephanie L; Kass, Andrea E; Franko, Debra L; Herzog, David B
We examined the course of major depressive disorder (MDD) and predictors of MDD recovery and relapse in a longitudinal sample of women with eating disorders (ED). 246 Boston-area women with DSM-IV anorexia nervosa-restricting (ANR; n=51), AN-binge/purge (ANBP; n=85), and bulimia nervosa (BN; n=110) were recruited between 1987 and 1991 and interviewed using the Eating Disorders Longitudinal Interval Follow-up Evaluation (LIFE-EAT-II) every 6-12 months for up to 12 years. 100 participants had MDD at study intake and 45 developed MDD during the study. Psychological functioning and treatment were assessed. Times to MDD onset (1 week-4.3 years), recovery (8 weeks-8.7 years), and relapse (1 week-5.2 years) varied. 70% recovered from MDD, but 65% subsequently relapsed. ANR patients were significantly less likely to recover from MDD than ANBP patients (p=0.029). Better psychological functioning and history of MDD were associated with higher chance of MDD recovery. Higher baseline depressive severity and full recovery from ED were associated with greater likelihood of MDD relapse; increased weight loss was somewhat protective. Adequate antidepressant treatment was given to 72% of patients with MDD and generally continued after MDD recovery. Time on antidepressants did not predict MDD recovery (p=0.27) or relapse (p=0.26). Small ED diagnostic subgroups; lack of non-ED control group. The course of MDD in EDs is protracted; MDD recovery may depend on ED type. Antidepressants did not impact likelihood of MDD recovery, nor protect against relapse, which may impact on treatment strategies for comorbid MDD and EDs. Copyright © 2010 Elsevier B.V. All rights reserved.
Mahn, Heather Mciver; Lordly, Daphne
The diet industry and media have a powerful influence over women, leading many to believe that they must modify their appearance for societal acceptance. Dietetics, as one of many predominantly female professions, may be particularly vulnerable to these pressures. An integrative review process was used to examine eating disorders and disordered eating within the dietetics profession with the aim to both synthesize existing data and develop questions for future research. Seventeen articles were reviewed using broad search terms and dates because of the dearth of available literature. Given nutrition programs and dietetic practice often involve significant exposure to food, ideas and opinions about food, weight, and its place in health and dietetic practice researchers were compelled to ask "why". Findings were organized under 3 categories including thinness ideology, implications of food and body associated with nutrition or dietetic education, and establishment of a continuum. This review serves as a platform to inspire future research in an understudied but important topic related to dietetic education and practice. Minimally as a profession, baseline data need to be collected to understand the prevalence of disordered eating and eating disorders along the continuum of practice in Canada.
Grilo, Carlos M.; Crosby, Ross D.; Peterson, Carol B.; Masheb, Robin M.; White, Marney A.; Crow, Scott J.; Wonderlich, Stephen A.; Mitchell, James E.
Despite the widespread use of the Eating Disorder Examination (EDE) as a primary assessment instrument in studies of eating and weight disorders, little is known about the psychometric aspects of this interview measure. The primary purpose of this study was to evaluate the factor structure of the EDE interview in a large series of patients with binge-eating disorder (BED). Participants were 688 treatment-seeking patients with BED who were reliably administered the EDE interview by trained research clinicians at three research centers. Exploratory factor analysis (EFA) performed on EDE interview data from a random split-half of the study group suggested a brief 7-item 3-factor structure. Confirmatory factor analysis (CFA) performed on the second randomly selected half of the study group supported this brief 3-factor structure of the EDE interview. The three factors were interpreted as Dietary Restraint, Shape/Weight Overvaluation, and Body Dissatisfaction. In this series of patients with BED, factor analysis of the EDE interview did not replicate the original subscales but revealed an alternative factor structure. Future research must further evaluate the psychometric properties, including the factor structure, of the EDE interview in this and other eating-disordered groups. The implications of these factor analytic findings for understanding and assessing the specific psychopathology of patients with BED are discussed. PMID:19798064
MacGregor, Michael Wm; Lamborn, Paige
Eating disorders are complex disorders that involve medical and psychological symptoms. Understanding the psychological factors associated with different eating disorders is important for assessment, diagnosis, and treatment. This study sought to determine on which of the 22 Personality Assessment Inventory (PAI) scales patients with anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) differed, and whether the PAI can be used to classify eating disorder subtypes. Because we were interested in both whether the PAI could be used to differentiate eating disorder subtypes from each other, as well as from other disorders, we also included a group of patients with major depression. The three eating disorder groups did differ significantly from each other, and from the patients with depression, on a number of the PAI scales. Only two PAI scales (Anxiety and Depression), however, exceeded a T-score of 70 for the patients with anorexia nervosa, no scales exceeded a T-score of 70 for the patients with bulimia nervosa or EDNOS, and only two exceeded a T-score of 70 for the patients with depression (Depression and Suicide). A discriminant function analysis revealed an overall correct classification between the groups of 81.6%. The PAI helps to understand the psychological factors associated with eating disorders and can be used to assist with assessment. Continued investigation using the PAI in an eating disordered population is supported.
Gorgulho, Alessandra A; Pereira, Julio L B; Krahl, Scott; Lemaire, Jean-Jacques; De Salles, Antonio
Extremes of eating disorders (ED) have become prevalent in both developed and developing countries. Available therapies, though largely effective, fail in a substantial number of patients and carry considerable side effects. Morbid obesity and anorexia nervosa (AN) represent important causes of morbidity and mortality among young adults. Morbid obesity affects disproportionate numbers of children. AN is also important for its high mortality in young adults. The challenges of effectively treating AN are well recognized. In this article, important aspects of ED are reviewed in detail and novel approaches to the treatment of ED are proposed. Copyright © 2014 Elsevier Inc. All rights reserved.
Corcos, M; Guilbaud, O; Speranza, M; Paterniti, S; Loas, G; Stephan, P; Jeammet, P
We compared alexithymia and depression ratings for non-hospitalized women meeting DSM-IV criteria for anorexia nervosa (n=32) and bulimia nervosa (n=32) to ratings for healthy women (n=74). Alexithymia was evaluated by the Toronto Alexithymia Scale (TAS-20) and depression by the Hospital Anxiety and Depression Scale (HAD). TAS and HAD scores were significantly higher in anorexic compared to bulimic patients, although these two scales were significantly and positively correlated (r=0.53, P=0.001). After taking depression into account as a confounding variable, rates of alexithymia did not vary according to the type of eating disorder (anorexia or bulimia).
Tan, Tina; Kuek, Angeline; Goh, Shih Ee; Lee, Ee Lian; Kwok, Victor
Eating disorders are associated with significant morbidity and mortality. The Internet is a popular medium for individuals with eating disorders to discuss and reinforce their affliction. However, the available literature on Internet usage and eating disorders is scarce, especially in the area of social media and smartphone application ("app") usage. This study looked at the Internet and smartphone app usage patterns of participants who presented with an eating disorder in Singapore, and whether it corresponded to severity of illness. Individuals who presented to the Eating Disorders clinic at the Singapore General Hospital completed a self-reported questionnaire on Internet and app usage. They also completed the EDE-Q, EAT-26 and CIA 3.0. 55 participants completed the study. 41.8% had anorexia nervosa, 34.5% had bulimia nervosa, and 9.1% were ED-NOS. 41.8% felt that apps helped to perpetuate their illness while 32.7% felt that the apps were helpful for recovery. Overall, any smartphone application usage was associated with younger age and greater eating disorder psychopathology and psychosocial impairment. While 30.9% had encountered eating disorder-related content on Facebook, only 12.7% visited Facebook groups related to eating disorders. For YouTube, "Cooking and Food" and "Beauty and Fashion" videos were among the top 3 types of videos that participants watched. In conclusion, Internet and smartphone app usage is significant, and they are associated with greater severity of illness. It is necessary to include interventions in this aspect as part of treatment of eating disorders. Copyright © 2015 Elsevier B.V. All rights reserved.
White, Marney A; Masheb, Robin M; Grilo, Carlos M
This study tested the psychometric properties of two commonly used measures of dietary restraint, the Three Factor Eating Questionnaire and the Eating Disorder Examination Questionnaire. Restraint data from 512 overweight/obese participants with binge eating disorder (BED) were subjected to exploratory and confirmatory factor analyses. Factor analyses of the restraint variables indicated a two-factor solution, interpreted as "Regimented" and "Lifestyle" restraint. Stepwise regression analyses revealed that Regimented restraint was more predictive of eating pathology, whereas Lifestyle restraint appeared to be protective of eating problems. Neither type of restraint was related to binge eating. Cluster analysis of the restraint dimensions yielded three distinct subgroups of patients who differed significantly on several important eating- and weight-related features. Future research is needed to test the significance of these restraint constructs over time in both the development of obesity and binge eating problems as well as their treatment.
van Dyck, Zoé; Herbert, Beate M; Happ, Christian; Kleveman, Gillian V; Vögele, Claus
Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.
Schulz, S; Laessle, R G
The present study was planned to investigate differences in psychopathological features, eating behaviour and eating habits between obese women with and without BED. It also aimed to identify specific relationships between affective symptoms and eating behaviour in obese women with BED. Eighty-four obese women were studied (40 with BED, 44 non-BED). Psychiatric comorbidities were assessed with the structured diagnostic interview for DSM-IV (SCID). Depressive symptoms were measured with the Beck Depression Inventory (BDI) and anxiety with the state-trait anxiety inventory (STAI). Eating habits (emotional and restrained eating) were assessed by the Dutch eating behaviour questionnaire (DEBQ). Food diaries were used for assessing naturalistic eating behaviour (food intake) and mood before and after food intake. BED subjects exhibited higher levels of comorbidity (in particular mood disorders, anxiety disorders and substance-related disorders), higher depressive symptoms, trait anxiety, external and emotional eating scores than non-BED subjects. Regression analyses revealed that anxiety and emotional eating were significant predictors for BED status. In the BED group, depressive symptoms were significantly related to emotional eating and food intake and negatively related to restraint. Anxiety was significantly related to emotional eating. In general, food intake significantly enhanced mood. Mood was worse on the days with self-reported binge eating episodes than on nonbinge days. These results are discussed with regard to aetiological models for BED and for BED being a distinct diagnostic category separate from obesity.
Allen, Karina L; Byrne, Susan M; Crosby, Ross D
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
Allen, Karina L; Byrne, Susan M; Oddy, Wendy H; Schmidt, Ulrike; Crosby, Ross D
To (1) determine whether childhood risk factors for early onset binge eating and purging eating disorders also predict risk for later-onset binge eating and purging disorders, and (2) compare the utility of childhood and early adolescent variables in predicting later-onset disorders. Participants (N = 1,383) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to age 20. Eating disorders were assessed when participants were aged 14, 17, and 20. Risk factors for early onset eating disorders have been reported previously (Allen et al., J Am Acad Child Psychiat, 48, 800-809, 2009). This study used logistic regression to determine whether childhood risk factors for early onset disorders, as previously identified, would also predict risk for later-onset disorders (n = 145). Early adolescent predictors of later-onset disorders were also examined. Consistent with early onset cases, female sex and parent-perceived child overweight at age 10 were significant multivariate predictors of binge eating and purging disorders with onset in later adolescence. Eating, weight, and shape concerns at age 14 were also significant in predicting later-onset disorders. In the final stepwise multivariate model, female sex and eating, weight, and shape concerns at age 14 were significant in predicting later-onset eating disorders, while parent-perceived child overweight at age 10 was not. There is overlap between risk factors for binge eating and purging disorders with early and later onset. However, childhood exposures may be more important for early than later onset cases. © 2014 Wiley Periodicals, Inc.
Weltzin, Theodore E; Cornella-Carlson, Tracey; Fitzpatrick, Mary E; Kennington, Brad; Bean, Pamela; Jefferies, Carol
The aim of this article is to discuss critical issues in treating males with eating disorders, and to present assessment and treatment outcome data for 111 males who received residential treatment for moderate to severe eating disorders. Males with eating disorders are often not included in eating disorder research as the population of individuals with eating disorders has historically been predominantly female. Whether this is due to actual lower prevalence of this disorder among males or to fewer males seeking treatment is not clear. In any case, there is limited empirical research on the particular treatment issues of males, and in treatment environments males are frequently in the minority. We have found that an all-male treatment environment is helpful in allowing males to benefit from treatment with less stigma. Data are presented which characterize psychiatric co-morbidity, excessive exercise, body image, sexuality, and spirituality in males. Treatment outcomes for males in this environment are positive.
Stice, Eric; Shaw, Heather
Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.
Rapps, Nora; Becker, Sandra; Teufel, Martin; Zipfel, Stephan
A 30-year-old obese female patient with binge eating behaviour, depressive symptoms and poorly regulated diabetes mellitus was admitted to the department of psychosomatic medicine and psychotherapy The body mass index at time of admission was 38 kg/m(2). Fasting and postprandial blood glucose values were markedly increased. HbA(1c) level was 10.2%. Psychological diagnostic showed a binge eating disorder and a major depressive syndrome. After diagnosis, the patient was treated within a psychosomatic concept considering psychotherapeutic and diabetological aspects, including exercises and nutrition. In course of the treatment, the binge eating ceased and connections between binge-eating and depressive symptoms on the one hand as well as life story and psychiological conflicts on the other hand could be drawn. The poorly regulated diabetes improved in parallel. Given that overweight and obesity may be associated with somatic (e.g., diabetes mellitus) and psychic (e.g., eating disorder, depression) diseases, a respective screening and an interdisciplinary treatment are required. Georg Thieme Verlag KG Stuttgart * New York.
Owens-Gary, Michelle; Shea, Laura
Eating disorders are more common in youth with diabetes, especially females, and not only interfere with diabetes management but can increase the risk for diabetes-related complications. School nurses may be the first to recognize eating disorders among students with diabetes. They are an integral part of a multidisciplinary team, connecting students and families to both health care and community resources, ensuring that mental, physical, and social needs are addressed.
Owens-Gary, Michelle; Shea, Laura
Eating disorders are more common in youth with diabetes, especially females, and not only interfere with diabetes management but can increase the risk for diabetes-related complications. School nurses may be the first to recognize eating disorders among students with diabetes. They are an integral part of a multidisciplinary team, connecting students and families to both health care and community resources, ensuring that mental, physical, and social needs are addressed.
Araujo, Daniele Marano Rocha; Santos, Giovana Fonseca da Silva; Nardi, Antonio Egídio
The purpose of this systematic literature review is to examine previous studies that investigated the relation between depression and binge eating disorder (BED). Medline/PubMed published data from 1980 through 2006 was tracked using the following keywords: "binge eating disorder and depression", "periodic binge eating and depression", "binge eating disorder" and "periodic binge eating". The findings of 14 studies were successfully highlighted: one cohort, four cross-sectional and nine case-control studies. Most studies (7/14) were conducted in the United States, with missing data varying between 2.3 and 44.32%, and seven studies emphasizing the most important variables. The majority of the studies (10/14) showed an association between depression and binge eating disorder, but carefully designed studies are required to minimize the limitations found in these studies.
Anderluh, M; Tchanturia, K; Rabe-Hesketh, S; Collier, D; Treasure, J
Aetiological studies of eating disorders would benefit from a solution to the problem of instability of eating disorder symptoms. We present an approach to defining an eating disorders phenotype based on the retrospective assessment of lifetime eating disorders symptoms to define a lifetime pattern of illness. We further validate this approach by testing the most common lifetime categories for differences in the prevalence of specific childhood personality traits. Ninety-seven females participated in this study, 35 with a current diagnosis of restricting anorexia nervosa, 32 with binge/purging subtype of anorexia nervosa and 30 with bulimia nervosa. Subjects were interviewed by a newly developed EATATE Lifetime Diagnostic Interview for a retrospective assessment of the lifetime course of eating disorders symptoms and childhood traits reflecting obsessive-compulsive personality. The data illustrate the extensive instability of the eating disorders diagnosis. Four most common lifetime diagnostic categories were identified that significantly differ in the prevalence of childhood traits. Perfectionism and rigidity were more common in groups with a longer duration of underweight status, longer episodes of severe food restriction, excessive exercising, and shorter duration of binge eating. The assessment of lifetime symptoms may produce a more accurate definition of the eating disorders phenotype. Obsessive-compulsive traits in childhood may moderate the course producing longer periods of underweight status. These findings may have important implications for nosology, treatment and future aetiological studies of eating disorders.
Keel, Pamela K.; Haedt, Alissa
Eating disorders represent a significant source of psychological impairment among adolescents. However, most controlled treatment studies have focused on adult populations. This review provides a synthesis of existing data concerning the efficacy of various psychosocial interventions for eating disorders in adolescent samples. Modes of therapy…
Studies from recent decades indicate that the ideal of thinness can be discerned in a growing dissatisfaction with weight and an increase of the prevalence of disordered eating at an earlier age of onset. The purpose of this study is to evaluate the prevalence of disordered eating (above the cutoff point of 30 on the EAT-40) among a normal population of school students in Israel. The study sample was composed of Israeli (Jewish) adolescents in grades 7 to 12 from four schools. Of 326 students approached (181 females and 142 males), 323 completed the self-report EAT-40 and a structured questionnaire that provided socio-demographic and other information. 41.5% of adolescents were not satisfied with their weight and 45.3% want to lose weight. A third of the sample engages in dieting behavior frequently; 6.1% of the adolescents have pathologic EAT-40 scores, with about three times as many girls as boys exhibiting disordered eating; 8.2% of the girls and 2.8% of the males show disordered eating (Ø=0.115, p times more with pathologic EAT scores than those who are satisfied with their weight (Ø=0.220; p times more pathologic EAT scores among adolescents who wish to lose weight than among those who do not wish to reduce their weight (Ø=0.237; p EAT scores were found among adolescents from different ethnic backgrounds or levels of religious observance. The prevalence of disordered eating among adolescents in Israel is higher than other countries in general, and among males in particular. There is a need for increased efforts to detect adolescents at risk for developing eating disorders, with the assistance of clinical tools. In addition an educational policy for disordered eating prevention should be instituted.
Full Text Available Eating disorders are quite common in clinical practice and can include out-of-control behaviours and thoughts that powerfully reinforce unhealthy eating patterns. They include anorexia nervosa and bulimia nervosa and Binge Eating Disorder. We conducted a trial on 102 patients (89 females and 13 males to investigate the efficacy of “DCD method” (appropriate dietary education associated to New-Electrosculpture on patients with obesity and eating disorders. The study underlines the efficacy of “DCD method”, especially when supported by behavioural therapy, in obese and overweight patients.
O. N. Komarova
Full Text Available Eating disorder is observed in infants at different developmental stages. This condition may be caused by comorbidities, organic diseases, or psychogenic causes. After birth, a child’s eating behavior evolves, which largely depends on the relations arising between him, his mother, and other family members. Eating disorders may be caused by an impaired child-mother relationship: inadequate maternal behavior, excessive or poor parenteral attention. The treatment of eating disorders involves a comprehensive approach, including behavioral and dietary correction that is considered in this paper.
Yilmaz, Zeynep; Hardaway, J. Andrew; Bulik, Cynthia M.
Eating disorders (EDs) are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of AN, BN, and BED, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. PMID:27013903
Full Text Available Introduction: Topiramate was serendipitously synthesized in 1979 during research aimed at developing a fructose-1,6-diphosphatase inhibitor that might be used in the treatment of diabetes mellitus. Some investigators have suggested it might be used in the treatment of binge eating disorder (BED. The aim of this review was to evaluate current knowledge and opinions on this topic. Materials and methods: We conducted a search of five electronic databases (PubMed, Embase, Nice, Cochrane, Cinahl using the search strategy ‘‘topiramate’’ AND ‘‘binge’’, ‘‘binge eating disorder.’’ No time limits were applied, and only reports of randomized controlled trials were included in our analysis. Results: In clinical studies, topiramate use has been associated with significant weight loss mediated by reductions in the frequency of bingeing episodes. The most common side effects of the drug are paresthesias, but nephrolithiasis, oligohydrosis, and dizziness have also been described. Conclusions: Available data are limited, but the literature we reviewed suggests that topiramate can be useful in the medical treatment of BED, reducing both body weight and binge episodes. Side effects are not negligible. Before topiramate can be regarded as a good tool for the treatment of BED, further data must be obtained from longer, methodologically correct studies of larger populations.
Mayhew, Alexandra J; Pigeyre, Marie; Couturier, Jennifer; Meyre, David
Eating disorders (ED) including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) affect up to 5% of the population in Western countries. Risk factors for developing an ED include personality traits, family environment, gender, age, ethnicity, and culture. Despite being moderately to highly heritable with estimates ranging from 28 to 83%, no genetic risk factors have been conclusively identified. Our objective was to explore evolutionary theories of EDs to provide a new perspective on research into novel biological mechanisms and genetic causes of EDs. We developed a framework that explains the possible interactions between genetic risk and cultural influences in the development of ED. The framework includes three genetic predisposition categories (people with mainly AN restrictive gene variants, people with mainly BED variants, and people with gene variants predisposing to both diseases) and a binary variable of either the presence or absence of pressure to be thin. We propose novel theories to explain the overlapping characteristics of the subtypes of AN (binge/purge and restrictive), BN, and BED. For instance, mutations/structural gene variants in the same gene causing opposite effects or mutations in nearby genes resulting in partial disequilibrium for the genes causing AN (restrictive) and BED may explain the overlap of phenotypes seen in AN (binge/purge). © 2017 S. Karger AG, Basel.