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Sample records for bulimia

  1. Bulimia

    MedlinePlus

    Bulimia nervosa; Binge-purge behavior; Eating disorder - bulimia ... Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She ...

  2. [Bulimia nervosa].

    PubMed

    Zeeck, A; Hartmann, A; Sandholz, A; Joos, A

    2006-08-01

    Bulimia nervosa is characterized by episodes of binge eating and compensatory behaviours (self-induced vomiting, laxative misuse, dietary restriction). It has a complex aetiology and is mostly found in young women. Bulimia leads to substantial physical and psychosocial morbidity. Bulimia nervosa needs specialized psychotherapeutic treatment. In most cases outpatient treatment is sufficient, but comorbidity with other psychiatric disturbances has to be taken into account. Additional psychopharmacological interventions might be helpful. After 5 to 10 years about 50% of the patients show complete remissions, 30% partial remissions and about 20% a chronic course of the illness. General practitioners, dentists and gynaecologists should be informed about typical signs of the disorder that is often hidden by the patients.

  3. [Bulimia during adolescence].

    PubMed

    de Tournemire, R

    2013-11-01

    Binge eating, bulimia nervosa, binge eating disorder, anorexia-bulimia are terms often used without really knowing what precisely one is referring to. Otherwise, there are many articles concerning anorexia nervosa in medical literature, a disease, which can be seen and fascinates. These eating disorders are frequent in today's society; medical, psychological and social consequences are important. PMID:24090668

  4. [Bulimia during adolescence].

    PubMed

    de Tournemire, R

    2013-11-01

    Binge eating, bulimia nervosa, binge eating disorder, anorexia-bulimia are terms often used without really knowing what precisely one is referring to. Otherwise, there are many articles concerning anorexia nervosa in medical literature, a disease, which can be seen and fascinates. These eating disorders are frequent in today's society; medical, psychological and social consequences are important.

  5. Adolescent Eating Disorder: Bulimia.

    ERIC Educational Resources Information Center

    Muuss, Rolf E.

    1986-01-01

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

  6. Bulimia Nervosa - medical complications.

    PubMed

    Mehler, Philip S; Rylander, Melanie

    2015-01-01

    As with anorexia nervosa, there are many medical complications associated with bulimia nervosa. In bulimia nervosa, these complications are a direct result of both the mode and the frequency of purging behaviours. For the purposes of this article, we will review in detail the many complications of the two major modes of purging, namely, self-induced vomiting and laxative abuse; these two account for more than 90% of purging behaviours in bulimia nervosa. Some of these complications are potentially extremely dangerous and need to be well understood to effectively treat patients with bulimia nervosa. Other methods of purging, such as diuretic abuse, are much less frequently utilized and will only be mentioned briefly. In a subsequent article, the treatments of these medical complications will be presented.

  7. The Group Treatment of Bulimia.

    ERIC Educational Resources Information Center

    Weinstein, Harvey M.; Richman, Ann

    1984-01-01

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

  8. Cognitive hypnotherapy with bulimia.

    PubMed

    Barabasz, Marianne

    2012-04-01

    Research on the efficacy of hypnosis in the treatment of bulimia nervosa has produced mixed findings. This is due in part to the interplay between the characteristics of people with bulimia and the wide variety of hypnosis interventions that have been employed. Several authors have noted that methodological limitations in hypnosis research often make evaluation of treatment efficacy difficult. Many of the studies extant provide insufficient information regarding the specifics of participants' hypnotizability, the hypnotic induction, or the hypnotic suggestion(s) employed. Such limitations preclude replication and clinical implementation. This article reviews the literature with replicable methodologies and discusses the implications for evaluating treatment efficacy.

  9. Bulimia: The Transgenerational View.

    ERIC Educational Resources Information Center

    Roberto, Laura Giat

    1986-01-01

    Within families with bulimia, certain interactional patterns enable and perpetuate the patient's binge-eating and purging symptoms. A transgenerational treatment method is proposed, which intervenes in ongoing dysfunctional patterns, and provides a frame for creating a therapeutic metaphor ("legacy") to direct the therapy. Rationale and stages of…

  10. Anorexia Nervosa and Bulimia.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1987-01-01

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

  11. Symptom Management of Bulimia.

    ERIC Educational Resources Information Center

    Johnson, Craig; And Others

    1987-01-01

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

  12. Bulimia: A Medical Portrait.

    ERIC Educational Resources Information Center

    Santomango, Gloria Jean

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

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

    PubMed

    Vindreau, C; Ginestet, D

    1987-01-01

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

  14. The School Counselor and Bulimia.

    ERIC Educational Resources Information Center

    Hendrick, Susan S.

    1985-01-01

    Describes the symptoms, outcome, etiology and treatment for bulimia. Discusses the school counselor's role regarding prevention and intervention with bulimic students, and suggests individual counseling techniques to use with bulimics. (BH)

  15. Adolescent bulimia nervosa.

    PubMed

    Hoste, Renee Rienecke; Labuschagne, Zandre; Le Grange, Daniel

    2012-08-01

    Onset of bulimia nervosa (BN) typically occurs in adolescence and is frequently accompanied by medical and psychiatric sequelae that may have detrimental effects on adolescent development. Potentially serious medical consequences and high comorbid rates of mood disorders and suicidality underscore the need for early recognition and effective treatments. Research among adolescents with BN has lagged behind that of adults, although evidence is accumulating to support the efficacy of family-based interventions and cognitive behavioral treatments that are adapted for use with adolescent populations. The aim of the current article is to provide an overview of recent research on epidemiology, risk factors, diagnostic issues, and treatment interventions focusing on adolescent BN, and to highlight areas for future research.

  16. Physiological Bases of Bulimia, and Antidepressant Treatment.

    ERIC Educational Resources Information Center

    Getzfeld, Andrew R.

    This paper reviews the literature on the physiological causes of bulimia and investigates the rationale behind the usage of antidepressant medication in the treatment of bulimia nervosa. No definite conclusions can be stated regarding the physiology of bulimia, but a number of hypotheses are suggested. It appears that the hypothalamus is involved…

  17. Bulimia and Interpersonal Relationships: A Longitudinal Study.

    ERIC Educational Resources Information Center

    Thelen, Mark H.; And Others

    1990-01-01

    Assessed changes in bulimia in female college students (N=44) and in relation between bulimia and interpersonal relationships over time. Found (1) stable symptomology for normals and bulimics; (2) strong negative correlations between bulimia measures and interpersonal relationships with men; and (3) improvement in symptomology and relationships…

  18. The Bulimia Test--Revised: Validation with "DSM-IV" Criteria for Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Thelen, Mark H.; And Others

    1996-01-01

    The Bulimia Test--Revised (BULIT-R) was given to 23 female subjects who met the criteria for bulimia in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) and 124 female controls. The BULIT-R appears to be a valid instruction for identifying individuals who meet DSM-IV criteria for bulimia. (SLD)

  19. Medical Complications of Anorexia Nervosa and Bulimia.

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Thompson, G. Sue

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

  1. Bulimia: A Coping Response to Societal Pressures.

    ERIC Educational Resources Information Center

    Hodges, Patricia A. M.; And Others

    1985-01-01

    This article discusses bulimia and illustrates how the problem develops as a coping response to societal pressures. The incidence, physiological complications, personality characteristics, food behavior diagnosis, and treatment of bulimia are reviewed to show the complexity of the problem and the proposed treatment. (CT)

  2. Anorexia Nervosa and Bulimia: A Research Review.

    ERIC Educational Resources Information Center

    Sweeten, Mary K.

    1985-01-01

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

  3. Bulimia: Growing Awareness of an Eating Disorder.

    ERIC Educational Resources Information Center

    Yudkovitz, Elaine

    1983-01-01

    Describes bulimia, a disorder involving binge eating and purging increasingly prevalent in young women. Reviews the literature and describes symptoms, etiological factors, and treatment considerations and approaches for the disorder. (Author)

  4. Bulimia: Estimate of Incidence and Relationship of Shyness.

    ERIC Educational Resources Information Center

    Segal, Shirley Ann; Figley, Charles R.

    1985-01-01

    Surveyed 160 college women to examine the incidence of bulimia and its relationship to shyness. Results indicated 23 percent of the participants were bulimic. A significant relationship was found between bulimia and fear of rejection (private shyness). (JAC)

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

    ERIC Educational Resources Information Center

    Cesari, Joan P.

    1986-01-01

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

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

    ERIC Educational Resources Information Center

    Zimpfer, David G.

    1990-01-01

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

  7. Treating Women with Bulimia from a Sociocultural Perspective.

    ERIC Educational Resources Information Center

    Hotelling, Kathy

    1986-01-01

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

  8. Parotid hypertrophy with bulimia: a report of surgical management.

    PubMed

    Berke, G S; Calcaterra, T C

    1985-05-01

    Benign hypertrophy of the salivary glands can occur in patients with anorexia nervosa. This enlargement has been related to nutritional deficiencies and bulimia, which is a form of episodic binge eating followed by vomiting. The surgical management of a patient with bulimia and benign bilateral parotid enlargement secondary to bulimia will be discussed. Superficial parotidectomy may be a useful adjunct in managing the cosmetic and psychological aspects of patients with anorexia nervosa and bulimia complicated by massive parotid hypertrophy intractable to medical management.

  9. Gonadotropin secretion in bulimia nervosa.

    PubMed

    Schweiger, U; Pirke, K M; Laessle, R G; Fichter, M M

    1992-05-01

    Twenty-two normal weight women with bulimia nervosa (BN) were studied (mean age, 25 +/- 5 yr; body mass index, 20.2 +/- 2.6 kg/m2). Sixteen of them reported menstrual cycles in the range of 21-42 days, and 6 had experienced absence of menstruation for at least 3 months. Twenty-one healthy women with regular menstrual cycles (mean age, 23 +/- 2 yr; body mass index, 20.7 +/- 1.4) served as the control subjects. Frequent morning blood samples for estradiol (E2) and progesterone (P4) determinations were obtained for the duration of 1 menstrual cycle or for 6 weeks in the case of amenorrhea. LH, FSH, cortisol, and insulin secretion were studied on day 3, 4, or 5 after the onset of a menstrual cycle or on a random day in the 6 BN women with amenorrhea. Blood samples were collected at 15-min intervals from 1800-0600 h for LH and FSH and at 30-min intervals from 2400-0600 h for cortisol and insulin. Nineteen of the 21 controls, but only 10 of the 22 BN women, fulfilled the following standard criteria: maximum E2 above 440 pmol/L, maximum P4 above 19 nmol/L, and luteal phase length of 9 days or more. The 10 BN women with normal menstrual cycles had lower mean insulin concentrations than the controls (70 +/- 20 vs. 120 +/- 30 pmol/L; P less than 0.01), but gonadotropin secretion, cortisol, and T3 concentrations were similar. The 8 BN women with amenorrhea or ovulatory dysfunction (maximum E2, less than 440 pmol/L; maximum P4, less than 6 nmol/L) displayed decreased mean LH pulse frequency (2.6 +/- 2.4 vs. 5.7 +/- 2.0 pulses/12 h; P less than 0.01), increased mean cortisol (120 +/- 40 vs. 80 +/- 20 nmol/L; P less than 0.01), decreased mean insulin (90 +/- 40 vs. 120 +/- 30 pmol/L; P less than 0.05), and decreased mean T3 concentrations (1.5 +/- 0.3 vs. 1.8 +/- 0.2 nmol/L; P less than 0.01). The data suggest that BN in normal weight women is associated with an increased rate of ovarian dysfunction; decreased pulsatile LH secretion seems to be an important mechanism. Increased

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

    ERIC Educational Resources Information Center

    Tillmann, Lisa M.

    2009-01-01

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

  11. Using the Health Belief Model for Bulimia Prevention.

    ERIC Educational Resources Information Center

    Grodner, Michele

    1991-01-01

    Discusses application of the Health Belief Model to the prevention of bulimia, describing each model component. The article considers the individual's beliefs about bulimia and bulimic-like behaviors as a means of predicting the likelihood of behavior change to prevent clinically diagnosable bulimia. (SM)

  12. Thyroid function in bulimia nervosa.

    PubMed

    Altemus, M; Hetherington, M; Kennedy, B; Licinio, J; Gold, P W

    1996-04-01

    Basal thyroid-stimulating hormone (TSH) and thyroid hormone levels were evaluated in 18 women with bulimia nervosa during a period of active binging and vomiting and again after 7 weeks of abstinence from these behaviors and compared to measures in 27 control women. In 10 of the patients and 11 of the controls, the TSH nocturnal surge was calculated from hourly TSH measurements obtained in the afternoon from 1500 to 1900 h and in the night from 2300 to 0400 h. During the binging phase of the illness patients had lower total triiodothyronine (T3) values than controls (p < .001). After 7 weeks without binge eating or purging, patients had lower T3, total thyroxine (T4), free triiodothyronine, free thyroxine (FT4), reverse triiodothyronine and thyroid-binding globulin (TBG) values compared to controls (p < .01) and significant reductions in T3, T4, FT4 and TBG compared to themselves in the active phase of the illness (p < .02). The reduction in thyroid hormone levels was not due to a reduction in the nocturnal thyrotropin surge, since surge values did not differ between normals and patients at either phase of the illness. Bulimics in the binging phase of the illness showed a positive correlation between caloric intake and TSH values (p < .01), suggesting that food binging may stimulate thyroid activity. In sum, these results show a substantial reduction in thyroid hormone levels after 7 weeks of abstinence from binging and vomiting behaviors.

  13. Food addiction and bulimia nervosa.

    PubMed

    Meule, Adrian; von Rezori, Vittoria; Blechert, Jens

    2014-09-01

    In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

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

    PubMed

    Greetfeld, M; Cuntz, U; Voderholzer, U

    2012-01-01

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

  15. Enlargement of salivary glands in bulimia.

    PubMed

    Vavrina, J; Müller, W; Gebbers, J O

    1994-06-01

    We report a unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.

  16. [Bulimia nervosa, a pathology with multiple complications].

    PubMed

    Mignot-Bedetti, Mathilde; Blanchet-Collet, Corinne; Moro, Marie Rose

    2015-01-01

    Bulimia nervosa is an eating disorder associating binge eating with inappropriate compensatory methods. Patients suffer from multiple organic, psychological and social complications. Of these, the somatic consequences are numerous and of varying degrees of seriousness. Regular monitoring is therefore essential in order to identify them and treat them.

  17. Bulimia: Book for Therapist and Client.

    ERIC Educational Resources Information Center

    Bauer, Barbara G.; And Others

    This book was written for practitioners working with bulimic clients and for clients themselves. Bulimia is presented as a multidimensional problem requiring a multidisciplinary team approach to treatment. An introductory chapter presents six treatment sessions with a bulimic client which provide an overview of the experiences and attitudes of the…

  18. Binging & Purging: Youth Who Suffer Bulimia.

    ERIC Educational Resources Information Center

    Strodel, Donna

    1990-01-01

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

  19. Bulimia: A Model for Group Therapy.

    ERIC Educational Resources Information Center

    Bauer, Barbara G.

    Bulimia, an eating disorder characterized by binge eating followed by purging and intense feelings of guilt and failure, is increasing among young women. The eating behavior is only a symptom of more complex underlying problems such as feelings of inadequacy, social isolation, depression, rigid thinking, self-defeating thoughts, and perfectionism.…

  20. Interpersonal Group Therapy for Women Experiencing Bulimia

    ERIC Educational Resources Information Center

    Choate, Laura

    2010-01-01

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

  1. Bulimia, anorexia nervosa, and diabetes. Deadly combinations.

    PubMed

    Hillard, J R; Hillard, P J

    1984-06-01

    Bulimia, anorexia nervosa, and diabetes often coexist, and eating disorders among diabetics frequently go unrecognized. This combination of conditions can have life-threatening effects. Consequently, diagnosis and the medical and psychological management of these patients is of critical importance. The authors outline the complex interactions among the biologic, psychological, and social factors involved in these disorders.

  2. Helping Clients Uncover Metaphoric Understandings of Bulimia.

    ERIC Educational Resources Information Center

    Cummings, Anne L.

    1998-01-01

    Written responses of three women with bulimia were analyzed for instances of metaphoric understanding of their difficulties with food during 20 to 24 therapy sessions. Results show a gradual deepening of the metaphoric understanding of what the troubled eating represented for each client. Metaphoric understanding included ways of dealing with self…

  3. A Multifaceted Group Treatment of Bulimia.

    ERIC Educational Resources Information Center

    Katzman, Melanie; Weiss, Lillie

    In spite of growing attention to the negative psychological and physiological consequences of bulimia, little has been written on its treatment. A comprehensive group treatment program was developed to increase the bulimic's comfort with herself and her body. Subjects were five single females (four college students and a nurse) who participated in…

  4. Subclinical bulimia predicts conduct disorder in middle adolescent girls.

    PubMed

    Viinamäki, Anni; Marttunen, Mauri; Fröjd, Sari; Ruuska, Jaana; Kaltiala-Heino, Riittakerttu

    2013-01-01

    This study investigates the comorbidity and longitudinal associations between self-reported conduct disorder and subclinical bulimia in a community-based sample of Finnish adolescents in a 2-year prospective follow-up study. There are 2070 adolescents who participated in the survey as ninth graders (mean age 15.5) and followed-up 2 years later. The Youth Self-Report Externalizing scale was used to measure conduct disorder and DSM-IV-based questionnaire to measure bulimia. Co-occurrence of female conduct disorder and subclinical bulimia was found at ages 15 and 17. Subclinical bulimia among girls at age 15 was a risk factor for conduct disorder at age 17, but conduct disorder at age 15 was not predictive of subclinical bulimia at age 17. The pathway from bulimia to conduct disorder may be suggestive of an association with future borderline personality disorder among girls.

  5. A case of hyperemesis in bulimia nervosa.

    PubMed

    Pedrolli, Carlo; Sacchi, Manuela C; Togni, Michele; Cereda, Emanuele

    2015-05-01

    Bulimia nervosa is an eating disorder defined by recurrent episodes of binge eating followed by compensatory behaviors, primarily self-induced vomiting. Most common complications are due to purge behaviors and are frequently responsible for hospitalization. These include electrolyte disturbances, dehydration, hypovolemia, stomatitis, esophageal diseases, and functional impairment of the colon. However, an obstruction-like syndrome has never been reported. We report the case of a middle-age woman suffering from bulimia nervosa and referring at the emergency department with a 7-day story of hyperemesis responsible for an acute renal failure. During hospitalization, after the most important and common medical causes of hyperemesis were excluded, an upper gastrointestinal endoscopy was performed. The endoscopist reported the presence of an impressive bezoar, which underwent to mechanical fragmentation and biopsy sampling, revealing it was made up exclusively of liquorice wheels. An endoscopy performed few days after showed the complete dissolution of the bezoar, and the patient was discharged without any further gastrointestinal complaint.

  6. [Bulimia, bulimia-anorexia and nocturnal secretion of melatonin and cortisol].

    PubMed

    Parienti, V; Kennedy, S H; Brown, G M; Costa, D

    1988-01-01

    The authors compared nocturnal variations of melatonin (MT) and cortisol levels in subjects with bulimia (n = 12), 6 with a normal body weight and 6 with anorexia nervosa, as well as 6 control subjects. The hypothesis, formulated for anorexia nervosa, that a decrease of noradrenergic activity induces a decrease of pineal activity, therefore a decrease of melatonin secretion, was not confirmed by our study. Moreover, in subjects with bulimia in the absence of anorexia nervosa, no significant decrease of nocturnal melatonin secretion was reported. Significant differences were due to cortisol variations when comparing MTmax/Cmin ratios. Melatonin did not add any complementary biological cue for diagnostic assessment for subjects with eating disorder and depression. The results of this study suggest that melatonin does not appear to be a useful biological marker in bulimia.

  7. A cognitive model of bulimia nervosa.

    PubMed

    Cooper, Myra J; Wells, Adrian; Todd, Gillian

    2004-03-01

    This paper describes a new cognitive model of bulimia nervosa. It provides a detailed account of the development of the disorder and explains, in detail and encompassing cognition, behaviour, emotion, and physiology, how binge eating is maintained. Relevant maintaining factors include positive beliefs about eating, negative beliefs about weight and shape, permissive thoughts, and thoughts of no control. Relevant developmental factors include negative early experiences, negative self-beliefs, schema compensation processes, and different types of underlying assumption. Recent empirical findings on which the new model is based, and which support the model, are described. Existing observations and findings are also presented, and their consistency with the new model is confirmed. Novel features of the model are highlighted, and phenomena unexplained by existing cognitive models of bulimia nervosa, including treatment failure and relatively poor outcome following treatment with cognitive therapy, are assessed in the light of the new model. The relationship to recent findings on the role of dieting in bulimia nervosa and to developments in the understanding or normal eating is considered. Implications for basic and treatment-related research are then discussed. Finally, the clinical implications of the new model, including the use of schema-focused techniques, are briefly discussed.

  8. Dental aspects of anorexia and bulimia nervosa.

    PubMed

    Roberts, M W; Tylenda, C A

    1989-01-01

    Anorexia nervosa and bulimia nervosa are both psychosocial pathological eating disorders. An intense preoccupation with food, weight and a distorted body image coupled with a morbid fear of becoming obese are common elements in both syndromes. Self-starvation with extreme weight loss is associated with anorexia nervosa. Bulimia nervosa is characterized by unrestrained eating sprees followed by purging, fasting or vomiting. Approximately 50% of anorexia nervosa patients also practice bulimia. The impact of eating disorders on the oral soft and hard tissues depends upon the diet as well as the duration and frequency of binge-purge behavior. Erosion of the teeth due to frequent regurgitation of highly acidic stomach contents is a common finding. Dental caries development is less predictable and appears to be diet- and oral hygiene-dependent. Painless enlargement of the parotid salivary glands is a common sequela of chronic vomiting but the pathophysiological cause has not been firmly established. The dehydration of the oral soft tissues due to salivary gland impairment in addition to dietary deficiencies and poor oral hygiene can adversely impact the health of the periodontal tissues and oral mucosa. Initial dental care is focused on discouraging behavior that is destructive to the oral tissues. Improved oral hygiene, the use of gastric acid-neutralizing antacid rinses and the daily application of topical fluorides can be useful in reducing enamel erosion. Extensive restorative oral rehabilitation should be postponed until the underlying psychiatric components of the disorder are stabilized.

  9. Choosing Assessment Instruments for Bulimia Practice and Outcome Research

    ERIC Educational Resources Information Center

    Sandberg, Katie; Erford, Bradley T.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Bayer, Alan E.; Baker, Daniel H.

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

  11. Development and Validation of a Test for Bulimia.

    ERIC Educational Resources Information Center

    Smith, Marcia C.; Thelen, Mark H.

    1984-01-01

    Developed the Bulimia Test (BULIT) based on responses of clinically identified females (N=18) and normal female college students (N=119) to preliminary test items. Results showed that the BULIT provided an objective, reliable, and valid measure by which to identify individuals with symptoms of bulimia. (Instrument is appended.) (LLL)

  12. The Assessment of Bulimia in High School Students.

    ERIC Educational Resources Information Center

    Maceyko, Sandra J.; Nagelberg, Daniel B.

    1985-01-01

    This study attempted to estimate the prevalence of bulimia among a sample of high school students and to identify demographic variables associated with the disorder and possible personality variables associated with bulimia. Results are discussed in the context of mental health needs among adolescents and high school students. (Author/CB)

  13. Bulimia and Perfectionism: Developing the Courage to Be Imperfect.

    ERIC Educational Resources Information Center

    Brouwers, Mariette; Wiggum, Candice D.

    1993-01-01

    Notes that perfectionism often accompanies bulimia and contributes to maintaining bulimic behaviors. Cites unrealistic expectations and dichotomous thinking as two areas of perfectionism particularly prevalent among women with bulimia. Offers treatment suggestions to help clients challenge unrealistic expectations, identify and express fears…

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

    ERIC Educational Resources Information Center

    Hill, Laura

    1989-01-01

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

  15. Bulimia: A Self-Psychological and Ego-Developmental View.

    ERIC Educational Resources Information Center

    Brenner-Liss, Deborah

    1986-01-01

    Discusses key clinical issues in the treatment of bulimia with clinical examples from a self-psychological and ego-developmental point of view. Identifies three developmental issues for bulimia: self-regulatory, differentiation, and self-esteem. (Author/ABB)

  16. Treatment of Body Image Dissatisfaction among Women with Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Brouwers, Mariette

    1990-01-01

    Sees body image dissatisfaction as contributing to development and maintenance of bulimia nervosa and bulimic's desire for thinness breeding low self-esteem, feelings of inadequacy, and resistance to recovery. Offers treatment suggestions for body image dissatisfaction as it relates to bulimia. Advises counselors to be satisfied with their own…

  17. Defining recovery in adult bulimia nervosa.

    PubMed

    Yu, Jessica; Agras, W Stewart; Bryson, Susan

    2013-01-01

    To examine how different definitions of recovery lead to varying rates of recovery, maintenance of recovery, and relapse in bulimia nervosa (BN), end-of-treatment (EOT) and follow-up data were obtained from 96 adults with BN. Combining behavioral, physical, and psychological criteria led to recovery rates between 15.5% and 34.4% at EOT, though relapse was approximately 50%. Combining these criteria and requiring abstinence from binge eating and purging when defining recovery may lead to lower recovery rates than those found in previous studies; however, a strength of this definition is that individuals who meet this criteria have no remaining disordered behaviors or symptoms.

  18. The Group Treatment of Bulimia: Assumptions and Recommendations.

    ERIC Educational Resources Information Center

    Mines, Robert A.; Merrill, Cheryl A.

    1986-01-01

    Discusses the use of group approaches when treating bulimia and outlines recommendations for more efficacious group treatment. Recommends a comprehensive approach to assessment and treatment. Notes that a cognitive-behavioral approach seems viable. (Author/ABB)

  19. Bulimia: Using Fantasy-Imagery and Relaxation Techniques.

    ERIC Educational Resources Information Center

    Gunnison, Hugh; Renick, T. F.

    1985-01-01

    The rationale and theoretical foundations for fantasy relaxation and fantasy imagery procedures, designed to contact right hemisphere functions, are presented for specific use in the treatment of bulimia. (BL)

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

    ERIC Educational Resources Information Center

    Garner, David M.; Davis, Ron

    1986-01-01

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

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

    PubMed

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

    2015-01-01

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

  2. Neural signature of behavioural inhibition in women with bulimia nervosa

    PubMed Central

    Skunde, Mandy; Walther, Stephan; Simon, Joe J.; Wu, Mudan; Bendszus, Martin; Herzog, Wolfgang; Friederich, Hans-Christoph

    2016-01-01

    Background Impaired inhibitory control is considered a behavioural phenotype in patients with bulimia nervosa. However, the underlying neural correlates of impaired general and food-specific behavioural inhibition are largely unknown. Therefore, we investigated brain activation during the performance of behavioural inhibition to general and food-related stimuli in adults with bulimia nervosa. Methods Women with bulimia and healthy control women underwent event-related fMRI while performing a general and a food-specific no-go task. Results We included 28 women with bulimia nervosa and 29 healthy control women in our study. On a neuronal level, we observed significant group differences in response to general no-go stimuli in women with bulimia nervosa with high symptom severity; compared with healthy controls, the patients showed reduced activation in the right sensorimotor area (postcentral gyrus, precentral gyrus) and right dorsal striatum (caudate nucleus, putamen). Limitations The present results are limited to adult women with bulimia nervosa. Furthermore, it remains unclear whether impaired behavioural inhibition in patients with this disorder are a cause or consequence of chronic illness. Conclusion Our findings suggest that diminished frontostriatal brain activation in patients with bulimia nervosa contribute to the severity of binge eating symptoms. Gaining further insight into the neural mechanisms of behavioural inhibition problems in individuals with this disorder may inform brain-directed treatment approaches and the development of response inhibition training approaches to improve inhibitory control in patients with bulimia nervosa. The present study does not support greater behavioural and neural impairments to food-specific behavioural inhibition in these patients. PMID:27575858

  3. The swallowed toothbrush: a radiographic clue of bulimia.

    PubMed

    Riddlesberger, M M; Cohen, H L; Glick, P L

    1991-01-01

    Swallowed toothbrushes were noted in the esophagus of one teenager and the stomach of two others with bulimia. The presence of a toothbrush in the lumen of the gastrointestinal tract should make the radiologist suspicious of bulimia/anorexia nervosa. A toothbrush shows a characteristic radiographic image with parallel rows of short metallic radiodensities due to the metallic plates that hold the bristles in place.

  4. [Eating disorders: anorexia nervosa, bulimia, binge eating].

    PubMed

    Langenbach, M; Huber, M

    2003-06-01

    We present an overview of three different eating disorders which seem to have an increasing prevalence, especially among young women between 12 and 20 years of age. Anorexia and bulimia nervosa are "threshold disorders" which usually become manifest for the first time during the transition from childhood to early adult life. Eating disorders are chronic disorders and often take a course of 6 or more years. Remission, improvements and symptom change can be expected even after many years of the disorder. Psychiatric comorbidity which occurs in more than 50% of eating disordered patients is of prime importance for prognosis. Depression, anxiety disorders, obsessive-compulsive disorders, and personality disorders are most common. There is a variety of complex in- and outpatient treatments with different components which have to be chosen according to the individual case.

  5. Implicit self-esteem in bulimia nervosa.

    PubMed

    Cockerham, Elaine; Stopa, Lusia; Bell, Lorraine; Gregg, Aiden

    2009-06-01

    Implicit and explicit self-esteem were compared in a group of female participants with bulimia nervosa or binge eating disorder (n=20) and a healthy control group (n=20). Lower explicit and a less positive implicit self-esteem bias in the clinical group was predicted. Participants completed a self-esteem implicit association test and two explicit self-esteem measures. The eating disordered group had lower explicit self-esteem, but a more positive implicit self-esteem bias than controls. The results are discussed in relation to the idea that discrepancies between implicit and explicit self-esteem reflect fragile self-esteem and are related to high levels of perfectionism, which is associated with eating disorders.

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

    PubMed

    Alex Sánchez, María Dolores

    2015-01-01

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

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

    PubMed

    Alex Sánchez, María Dolores

    2015-01-01

    The Information and Communication Technologies (ICT) have an increasing influence on the way we relate and in shaping personal identity. The phenomenon of online social networking emerges strongly and contributes to the development of new spaces breaking with the official discourse that marks the scientific evidence on health. This paper analyzes the impact of ICT in relation to the identity of the digital natives and eating disorders (ED). Particular attention to how the network society determines the response of young people in situations of social tension is dedicated. To do this, provides a perspective on the concept of interaction from the analysis of the discourse on anorexia and bulimia in the network, and how to care nurses should consider these factors to improve efficiency and quality in clinical care and patient care. PMID:26448996

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

    ERIC Educational Resources Information Center

    Brown, Michael H.

    1991-01-01

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

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

    ERIC Educational Resources Information Center

    Richards, P. Scott

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

  10. Bulimia: A Review of the Literature with an Emphasis on Treatment and the Dynamic Perspective.

    ERIC Educational Resources Information Center

    Coull, Charles Edward

    This paper presents a dynamic perspective of some of the major issues surrounding the eating disorder of bulimia. The focus is specifically on the relationship of the bulimia nervosa syndrome to the historical dynamics of the developmental process of the individual. Three major aspects of bulimia are discussed. First, there is a discussion of…

  11. Validity of the Eating Attitudes Test and the Eating Disorders Inventory in Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Gross, Janet; And Others

    1986-01-01

    Assessed criterion and concurrent validity of the Eating Attitudes Test and the Eating Disorder Inventory in 82 women with bulimia nervosa. Both tests demonstrated criterion validity by discriminating bulimia nervosa subjects from normals. Only weak support was found for concurrent validity within bulimia subjects. Recommends combination of…

  12. Genetic findings in anorexia and bulimia nervosa.

    PubMed

    Hinney, Anke; Scherag, Susann; Hebebrand, Johannes

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Ordman, Arnold M.; Kirschenbaum, Daniel S.

    1985-01-01

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

  14. Depressive Thought Content Among Female College Students With Bulimia.

    ERIC Educational Resources Information Center

    Brouwers, Mariette

    1988-01-01

    Compared overall depression scores on Beck Depression Inventory between women with and without bulimia and examined differences in specific depression items. Results indicated that bulimics were more depressed than controls and had distorted thoughts regarding body image, self-blame, somatic preoccupation, guilt, and suicidal ideation. (Author/NB)

  15. The Treatment of Bulimia Nervosa through Adventure Therapy.

    ERIC Educational Resources Information Center

    Maguire, Rebecca; Priest, Simon

    1994-01-01

    Describes how adventure therapy can be adapted to help individuals suffering from bulimia develop effective coping mechanisms, increase self-esteem, and gain appreciation for their bodies. Goal is for participants to recognize compulsive behavior in relation to their attitudes and to understand underlying processes that lead to those behaviors and…

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

    PubMed

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

    2004-11-01

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

  17. Biological Aspects of Anorexia Nervosa and Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Kaplan, Allan S.; Woodside, D. Blake

    1987-01-01

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

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

    ERIC Educational Resources Information Center

    Gross, Karen B. W.; And Others

    1990-01-01

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

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

    ERIC Educational Resources Information Center

    Cullari, Salvatore; Redmon, William K.

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

  20. Weight Suppression Predicts Time to Remission from Bulimia Nervosa

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. A Naturalistic Investigation of Eating Behavior in Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Davis, Ron; And Others

    1988-01-01

    Investigated parameters of eating behavior in subjects with bulimia nervosa (BN). BN and female comparison (FC) subjects monitored hourly over several days their food intake, mood, hunger, social circumstances, and experiences of unpleasant events. BN subjects reported more positive moods prior to consuming a meal, and more negative moods prior to…

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

    MedlinePlus

    ... treatment options may include mental health therapy, nutritional counseling, and medicines. One largescale study suggests an online- ... teens with anorexia and bulimia. In family-based therapy, parents play an ... to adult couples in which one partner has anorexia nervosa. Because ...

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

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

    ERIC Educational Resources Information Center

    Mallick, M. Joan

    1984-01-01

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

  5. Neurobiology of anorexia and bulimia nervosa.

    PubMed

    Kaye, Walter

    2008-04-22

    Anorexia nervosa (AN) and bulimia nervosa (BN) are related disorders of unknown etiology that most commonly begin during adolescence in women. AN and BN have unique and puzzling symptoms, such as restricted eating or binge-purge behaviors, body image distortions, denial of emaciation, and resistance to treatment. These are often chronic and relapsing disorders, and AN has the highest death rate of any psychiatric disorder. The lack of understanding of the pathogenesis of this illness has hindered the development of effective interventions, particularly for AN. Individuals with AN and BN are consistently characterized by perfectionism, obsessive-compulsiveness, and dysphoric mood. Individuals with AN tend to have high constraint, constriction of affect and emotional expressiveness, ahendonia and asceticism, whereas individuals with BN tend to be more impulsive and sensation seeking. Such symptoms often begin in childhood, before the onset of an eating disorder, and persist after recovery, suggesting they are traits that create a vulnerability for developing an ED. There is growing acknowledgement that neurobiological vulnerabilities make a substantial contribution to the pathogenesis of AN and BN. Considerable evidence suggests that altered brain serotonin (5-HT) function contributes to dysregulation of appetite, mood, and impulse control in AN and BN. Brain imaging studies, using 5-HT specific ligands, show that disturbances of 5-HT function occur when people are ill, and persist after recovery from AN and BN. It is possible that a trait-related disturbance of 5-HT neuronal modulation predates the onset of AN and contributes to premorbid symptoms of anxiety, obsessionality, and inhibition. This dysphoric temperament may involve an inherent dysregulation of emotional and reward pathways which also mediate the hedonic aspects of feeding, thus making these individuals vulnerable to disturbed appetitive behaviors. Restricting food intake may become powerfully

  6. Ilse, a patient with bulimia nervosa on integrative painting therapy. Bulimia nervosa. manifestation of avoiding conflicts?

    PubMed

    Steinbrenner, B; Steinbauer, M; Schönauer-Cejpek, M; Martischnig, A

    2002-06-01

    Over the past few years, the incidence of bulimia has markedly increased, perhaps also as an expression of social changes. We here document the case of Ilse, a bulimic patient treated in the framework of a multidimensional concept based on integrative painting and behavioural therapy. The pictures made in the Painting Group reflect a patient's innermost experience, and are the point of departure for our therapeutic regimen. Ilse's pictures show that she is confronted with the underlying conflicts of her disorder, particularly her relationship to her father and her mis-routed corporealisation. At the same time, we used Beck's Depression Inventory, the State-Trait Anxiety Inventory, and recorded the frequency of episodes of bingeing, insatiable appetite and purging using behavioural protocols. Painting, individual and family therapy, and exercises designed to improve bodily awareness were all integrated in a helically-shaped process; the patient was ultimately able to rid herself of her bulimic symptoms, dissociate herself from her birth family, and gain new access to herself and her body.

  7. Self-forgiveness in anorexia nervosa and bulimia nervosa.

    PubMed

    Watson, Michelle J; Lydecker, Janet A; Jobe, Rebecca L; Enright, Robert D; Gartner, Aubrey; Mazzeo, Suzanne E; Worthington, Everett L

    2012-01-01

    This study investigated whether low levels of self-forgiveness were associated with eating disorder symptomatology. Participating women (N = 51) had diagnoses of anorexia nervosa, bulimia nervosa, or no eating disorder diagnosis. They completed 3 measures of self-forgiveness. Women with eating disorders had lower levels of self-forgiveness compared with control participants. Results suggest that incorporating self-forgiveness interventions into current eating disorder treatments should be evaluated in future research as they might enhance clinical outcomes.

  8. [Drug treatment of anorexia nervosa and bulimia nervosa. A review].

    PubMed

    Fichter, M M

    1993-01-01

    With the apparent increase in prevalence of anorexic and bulimic eating disorders, the search for effective treatments for these disorders has been intensified in recent years. In this review the results of psychopharmacological studies of patients with anorexia or bulimia nervosa are presented and analysed. The focus of this review is on controlled studies. Although a variety of psychopharmacological substances has been tested in patients with anorexia nervosa, the outcome of controlled studies has been generally disappointing. A possible differential therapy effect of cyproheptadine needs replication: in one study it enhanced body weight gain in non-bulimic anorexics, while it appeared to hinder weight gain in bulimic anorexics. The issue of prophylaxis of osteoporosis in chronic low-weight anorexics has received increasing attention in recent years, and pharmacological prophylaxis appears indicated in this patient group. The results of psychopharmacological treatment studies of patients with bulimia nervosa have overall been more favourable than those of anorexic patients. Statistically significant effects concerning the reduction of bulimic or depressive symptoms in bulimia nervosa has been demonstrated for tricyclic antidepressants (imipramine, desipramine), serotonergic agents (fluoxetine, d-fenfluramine), non-selective monoamine-oxydase-inhibitors (isocarboxazide, phenelzine) and trazodone. The antibulimic effect appears not to be associated with the antidepressant effect. Theoretical, methodological and practical issues concerning pharmacological treatment of anorexic and bulimic eating disorders are presented and discussed.

  9. A Comparison of Behavioral and Cognitive-Behavioral Interventions for Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Thackwray, Donna E.; And Others

    1993-01-01

    Examined the relative efficacy of different treatment approaches for bulimia nervosa. Follow-up of a study using cognitive-behavioral, behavioral, and placebo groups show six-month abstinence highest in the cognitive behavioral group. Results support conceptualization of bulimia nervosa as a multifaceted disorder best treated with an approach that…

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

    ERIC Educational Resources Information Center

    Killian, Kyle D.

    1994-01-01

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

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

    ERIC Educational Resources Information Center

    Halasz, Hisako, Comp.

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

  12. Bulimia: A Comment on an Old Case Report by Sir Thomas Browne

    PubMed Central

    Higgins, Gerald L.

    1989-01-01

    This paper offers a brief review of recent literature on the incidence and age of onset of bulimia in the light of a 17th century description of a female centenarian with bulimia, together with a brief account of the physician, Sir Thomas Browne (1605-1682), and the etymology and early usage of the term. PMID:21248899

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

    ERIC Educational Resources Information Center

    Geslak, Lisa

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

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

    ERIC Educational Resources Information Center

    Anderson, Drew A.; Simmons, Angela M.

    2008-01-01

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

  15. Intervention with Adolescents: The Identification of Bulimia Nervosa, and a Possible Treatment Modality.

    ERIC Educational Resources Information Center

    Getzfeld, Andrew R.

    Bulimia represents a major health problem in the United States, especially in high schools, colleges, and universities. This paper reviews literature on the definition, etiology, and therapeutic approaches for bulimia. The literature points to potential physiological bases for the disorder since some researchers reported similarities between it…

  16. Correlates of Bulimia in College Students: Anxiety, Assertiveness, and Locus of Control.

    ERIC Educational Resources Information Center

    McCanne, Lynn P. Fisher

    1985-01-01

    Examined the relationship of anxiety, assertiveness, and locus of control to bulimia in college students. Those in therapy for bulimia (N=23) scored lower in assertivenss than did other clients in therapy (N=15) or those in the nonclient control group (N=18). All clients showed greater anxiety than did controls. (Author/BH)

  17. Bulimia and Binge Eating in College Women: A Comparison of Personality and Behavioral Characteristics.

    ERIC Educational Resources Information Center

    Katzman, Melanie A.; Wolchik, Sharlene A.

    1984-01-01

    Assessed several behavioral and personality characteristics that have been implicated in studying the onset of bulimia in female college students (N=80) classified into bulimia, binge eating, and control groups. Results indicated that bulimics and binge eaters differed significantly on all but a few variables. (LLL)

  18. Aspects of Childhood Physical Punishment and Family Environment Correlates in Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Rorty, Marcia; And Others

    1995-01-01

    This study compared childhood parental physical punishment among 80 women with and 40 women without a lifetime history of bulimia nervosa. Although the women with bulimia reported more and harsher physical punishment than the control group, they did not differ in the extent to which they believed the punishment was deserved or whether they were…

  19. Dyscontrol evoked by erotic and food images in women with bulimia nervosa.

    PubMed

    Rodríguez, Sonia; Mata, José L; Lameiras, María; Fernández, M Carmen; Vila, Jaime

    2007-05-01

    The present study examined the emotional reactivity to erotic and food images of women with and without bulimia nervosa using the picture-viewing paradigm. A non-clinical student sample made up of 48 women, 24 diagnosed with bulimia nervosa and 24 healthy controls, aged between 18 and 27 years (M=21.79), participated in the study. Diagnosis was based on questionnaires and a structured interview following DSM-IV criteria. Participants assessed a set of food, erotic, neutral and unpleasant pictures using the Self-Assessment Manikin scales of valence, arousal and control. The women with bulimia nervosa rated as less pleasant the erotic and food pictures, which evoked greater dyscontrol, in comparison with the women without bulimia nervosa. No significant differences were found in the ratings for the remaining pictures. These results suggest that women with bulimia nervosa experience reduced pleasure and control over both food and sexual impulses. PMID:17676693

  20. Psychoanalytic psychotherapy with a client with bulimia nervosa.

    PubMed

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

    2016-06-01

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

  1. [Group therapy of bulimia nervosa and other related disorders].

    PubMed

    Torrente, Fernando M; Crispo, Rosina

    2003-01-01

    The aim of this article is to present a brief group intervention model for the initial phase of the treatment of bulimia nervosa and other related eating disorders. The model combines elements from cognitive-behavioral and psychoeducational approaches. Along the article we will describe the theoretical foundations of the model, a review of the empirical evidence that supports it, and afterwards, the group procedure developed by us in our clinical experience. Later on, the clinical results of an uncontrolled study of a sample of patients who participated in the group will be introduced. Finally, we will discuss the scope and limitations of this experience.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-08-01

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

  5. Russell's sign. Subtle hand changes in patients with bulimia nervosa.

    PubMed

    Daluiski, A; Rahbar, B; Meals, R A

    1997-10-01

    Bulimia nervosa is a common eating disorder, affecting between 1% to 10% of adolescent girls and college aged women. Because excessive weight loss and amenorrhea are not significant features, as they are in anorexia, bulimia is much harder to diagnose. Orthopaedic surgeons have a unique opportunity to detect one of the few physical signs of the disease, which is skin lesions, consisting of abrasions, small lacerations, and callosities on the dorsum of the hand overlying the metacarpophalangeal and interphalangeal joints. These nondescript dorsal lesions are caused by repeated contact of the incisors to the skin of the hand that occur during self induced vomiting. This finding, known as Russell's sign, may be seen by orthopaedic surgeons during examinations for other reasons. Because eating disorders are recognized as a component of the female athlete triad of osteoporosis, amenorrhea, and eating disorders and because orthopaedic surgeons routinely care for female athletes susceptible to these disorders, recognizing this sign and its implications may have profound influence on the patient's musculoskeletal system and general health. PMID:9345215

  6. [Anesthesia in patients with anorexia nervosa and bulimia nervosa].

    PubMed

    Zenker, J; Hagenah, U; Rossaint, R

    2010-03-01

    Eating disorders are typical diseases of adolescence and early adulthood. About 1-3% of female juveniles suffer from anorexia nervosa (AN) or bulimia nervosa (BN). Today AN is still the psychiatric disease with the highest mortality rate. The peri-operative mortality rate of patients suffering from AN is in the range up to 15%. The beginning of AN is a lingering process and the majority of patients show increasingly restrictive eating habits ending in cachexia. Patients are obsessed by the predominant idea of being obese in spite of having a significant underweight. Patients suffering from bulimia break the strict regimen by eating enormous amounts of high calorie food. Such eating attacks are followed by weight reducing measures, mostly vomiting. Most of the physical changes caused by AN are due to starvation and loss of weight. The most significant medical complications are alterations of the cardiovascular system accompanied by decreasing contractility of the heart, bradycardia, electrocardiographic changes as well as disequilibrium of electrolytic and water balance. Most of these symptoms can be reversed by putting on weight.

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

    PubMed

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

    2016-08-01

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

  8. Symptoms of psychosis in anorexia and bulimia nervosa.

    PubMed

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

    2010-02-28

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

  9. Management of bulimia nervosa: a case study with the Roy adaptation model.

    PubMed

    Seah, Xin Yi; Tham, Xiang Cong

    2015-04-01

    Bulimia nervosa is a crippling and chronic disorder, with individuals experiencing repeated binge-purge episodes. It is not widely understood by society. The use of the Roy adaptation model for the management of bulimia nervosa is examined in this article. Nursing models are utilized to provide a structure for planning and implementation of patient management. The Roy adaptation model focuses on the importance of individuals as able to adapt well to their changing surrounding environments. This model can be useful in managing patients with bulimia nervosa.

  10. [Prevalence of bulimia among secondary school students in Casablanca].

    PubMed

    Ghazal, N; Agoub, M; Moussaoui, D; Battas, O

    2001-01-01

    During the two last decades, several epidemiological studies have been conducted on bulimia nervosa. According to recent studies, prevalence rates were estimated to be 1%. There are a very few studies on eating behaviour conducted in Arab countries. The aims of the current study were to assess prospectively the prevalence of Bulimia Nervosa and its characteristics in a Moroccan context in a randomly selected and representative sample of students attending six secondary schools in Casablanca. A second group composed of the students of the French secondary school of Casablanca was included in the survey in order to verify the influence of socio-cultural factors. Subjects completed a sociodemographic questionnaire and the Bulimic Investigatory Test of Edinburgh (BITE), a 33-item self-report measure of both the symptoms and severity of bulimia nervosa. A score of 25 or higher suggests a bulimic syndrome; 2,044 subjects returned their questionnaires (participation rate = 75.8%). The group of Moroccan school included 1,887 subjects and the French school 157 subjects. Females were preponderant (59%). The mean age was 18.3 +/- 1.2 years (15-22 years). For the first group, at least one substance was taken by 290 (15.3%) students: 12.7% were addicted to tobacco and 5.7% consumed occasionally alcohol. 16.3% reported a familial history of disturbed eating behaviour. According to the BITE, the overall prevalence of bulimia was 0.8% (1.2% in female and 0.1 in male subjects). The mean age of bulimic subjects was 18.6 +/- 1.7 years (16-24 years). The only male case in our sample was aged 24 years, without personal nor familial psychiatric history, consumed regularly tobacco and alcohol. His BITE symptoms score was 20 and severity score was 17, the highest score in our sample. Analyses of correlates of bulimia nervosa in the Moroccan sample showed that the group of bulimic subjects did not differ from the non bulimic with regard to any sociodemographic characteristics except sex

  11. [Erythema ab igne in a patient with bulimia nervosa].

    PubMed

    Beneke, Johannes; Koerner, Michael; de Zwaan, Martina

    2014-05-01

    Erythema ab igne (EAI) is a skin lesion, which is characterized by a localized netlike erythema. For the occurrence of the dermatosis a continuous or regular heat exposure and infrared radiation to a skin area is necessary. The reticulated maculae could fade after stopping the heat exposure, persist as hyperpigmentation and in single cases a malignant transformation is possible. We present a patient with bulimia nervosa (BN), who developed an EAI after consequent use of a hot-water bottle. In the context of the eating disorder the patient reported a general feeling of cold. She avoided the contact with the abdomen to prevent a stimulation of the digestion. Therefore the EAI was located predominantly on the medial thighs. After stopping the heat application the EAI faded slightly in the periphery und turned browner.

  12. Temperament, character, and personality disorder in bulimia nervosa.

    PubMed

    Bulik, C M; Sullivan, P F; Joyce, P R; Carter, F A

    1995-09-01

    In a sample of 76 women participating in a clinical treatment trial for bulimia nervosa, we examined the clinical differences between subjects with and without concurrent personality disorders and the ability of "self-directedness" (a character scale of Cloninger's Temperament and Character Inventory) to predict the presence of personality disorder. Sixty-three percent of the sample had at least one personality disorder diagnosis. Fifty-one percent of personality disorders were in cluster C, 41% were in cluster B, and 33% were in cluster A. The presence of personality disorder was associated with greater depressive symptoms, worse global functioning, laxative use, greater body dissatisfaction, higher harm avoidance, and lower self-directedness. As hypothesized, low self-directedness scores were associated with a markedly increased probability of a personality disorder. PMID:7561822

  13. Altered Striatal Response to Reward in Bulimia Nervosa After Recovery

    PubMed Central

    Wagner, Angela; Aizenstein, Howard; Venkatraman, Vijay K.; Bischoff-Grethe, Amanda; Fudge, Julie; May, J. Christopher; Frank, Guido K.; Bailer, Ursula F.; Fischer, Lorie; Putnam, Karen; Kaye, Walter H.

    2014-01-01

    Objective It is possible that disturbances of systems modulating reward may contribute to a vulnerability to develop an eating disorder. Method This hypothesis was tested by assessing functional magnetic resonance brain imaging response to a monetary reward task known to activate the anterior ventral striatum (AVS), a region implicated in motivational aspects toward stimuli. To avoid the confounding effects of malnutrition, 10 women who had recovered from bulimia nervosa (BN) were compared with 10 healthy comparison women (CW). Results For the AVS, CW distinguished positive and negative feedback, whereas recovered BN women had similar responses to both conditions. In addition, these groups had similar patterns of findings for the dorsal caudate. Discussion We have previously shown that individuals recovered from anorexia nervosa (AN) also had altered striatal responses and difficulties in differentiating positive and negative feedback. Thus BN and AN individuals may share a difficulty in discriminating the emotional significance of a stimulus. PMID:19434606

  14. Anorexia nervosa and bulimia nervosa: brains, bones and breeding.

    PubMed

    Starr, Taylor B; Kreipe, Richard E

    2014-05-01

    Recent research has modified both the conceptualization and treatment of eating disorders. New diagnostic criteria reducing the "not otherwise specified" category should facilitate the early recognition and treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Technology-based studies identify AN and BN as "brain circuit" disorders; epidemiologic studies reveal that the narrow racial, ethnic and income profile of individuals no longer holds true for AN. The major organs affected long term-the brain and skeletal system-both respond to improved nutrition, with maintenance of body weight the best predictor of recovery. Twin studies have revealed gene x environment interactions, including both the external (social) and internal (pubertal) environments of boys and of girls. Family-based treatment has the best evidence base for effectiveness for younger patients. Medication plays a limited role in AN, but a major role in BN. Across diagnoses, the most important medicine is food. PMID:24705938

  15. [Nurses and clientele with anorexia and bulimia: a case study].

    PubMed

    Martins, Claudia Regina Carvalho; Caccavo, Paulo Vaccari

    2012-01-01

    The research aimed to identify the interaction of nurses and clients suffering from bulimia and anorexia. We use the case study as a resource in which we collect clinical data and did interviews with eight of fourteen nurses, who have been our subject-object. According to the nurses, clients are isolated from the world living in a world without hunger and mirrors reflecting a body always above the "ideal weight", they were lonely people, personnel who have lost their shine, sending signals that could extinguish their lives at any time. In the study, was possible to identify the manner in which nurses interacted and perceived customers and, as a result, we elucidate a peculiar practice in nursing. PMID:23032342

  16. [Nurses and clientele with anorexia and bulimia: a case study].

    PubMed

    Martins, Claudia Regina Carvalho; Caccavo, Paulo Vaccari

    2012-01-01

    The research aimed to identify the interaction of nurses and clients suffering from bulimia and anorexia. We use the case study as a resource in which we collect clinical data and did interviews with eight of fourteen nurses, who have been our subject-object. According to the nurses, clients are isolated from the world living in a world without hunger and mirrors reflecting a body always above the "ideal weight", they were lonely people, personnel who have lost their shine, sending signals that could extinguish their lives at any time. In the study, was possible to identify the manner in which nurses interacted and perceived customers and, as a result, we elucidate a peculiar practice in nursing.

  17. Family perception of anorexia and bulimia: a systematic review.

    PubMed

    Espíndola, Cybele Ribeiro; Blay, Sérgio Luís

    2009-08-01

    A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia nervosa patients. Articles were critically reviewed and a meta-synthesis analysis was carried out based on a meta-ethnographic method to analyze and summarize data. Of a total of 3,415 studies, nine met the study inclusion and exclusion criteria. Reciprocal translation was used for data interpretation allowing to identifying two concepts: disease awareness and disease impacts. Feelings of impotence were often described in family reorganization. The study results point to distortions in the concept of disease associated with family involvement, resulting in changes in communication, attitudes, and behaviors in a context of impotence.

  18. [Affective disorders in patients with anorexia nervosa and bulimia nervosa].

    PubMed

    Briukhin, A E; Onegina, E Iu

    2011-01-01

    Authors studied 109 patients with eating disorders, including 49 with anorexia nervosa (AN) and 60 with bulimia nervosa (BN), using psychopathological and experimental/psychological methods, psychometric scales and follow-up. Four variants (2 AN and 2 BN) of clinical presentations and dynamics of affective disorders were singled out. It has been shown that many features of their symptoms and responses of patients to the complex therapy (diet-, psycho- and pharmacotherapy) depend on the belonging of AN or BN to a group of borderline mental disorders or to endogenous diseases. Taking into account the revealed features of affective disorders, the authors have formulated recommendations for treatment tactics and prevention measures for these groups of patients.

  19. Anorexia nervosa and bulimia nervosa: brains, bones and breeding.

    PubMed

    Starr, Taylor B; Kreipe, Richard E

    2014-05-01

    Recent research has modified both the conceptualization and treatment of eating disorders. New diagnostic criteria reducing the "not otherwise specified" category should facilitate the early recognition and treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Technology-based studies identify AN and BN as "brain circuit" disorders; epidemiologic studies reveal that the narrow racial, ethnic and income profile of individuals no longer holds true for AN. The major organs affected long term-the brain and skeletal system-both respond to improved nutrition, with maintenance of body weight the best predictor of recovery. Twin studies have revealed gene x environment interactions, including both the external (social) and internal (pubertal) environments of boys and of girls. Family-based treatment has the best evidence base for effectiveness for younger patients. Medication plays a limited role in AN, but a major role in BN. Across diagnoses, the most important medicine is food.

  20. Anorexia/bulimia-related sialadenosis of palatal minor salivary glands.

    PubMed

    Mignogna, M D; Fedele, S; Lo Russo, L

    2004-08-01

    In patients affected by alimentary disorders sialadenosis is frequently observed. This non-inflammatory condition is described to affect major salivary glands, leading to the characteristic parotid and/or submandibular swelling. Thus fine-needle aspiration cytology or parotid open biopsy are generally required to diagnose histologically the disorder. We report the case of a 28-year-old patient affected by bulimia/anorexia nervosa who presented, in addition to parotid enlargement, a bilateral symmetric painless soft swelling of the hard palate. The lesion was biopsied and histopathological examination showed the classical features of sialadenosis. To our knowledge, this is the first case of sialadenosis affecting palatal minor salivary glands. It underlines that when sialadenosis is clinically suspected, clinicians could check also patients' oral cavity for minor salivary glands involvement, in order to potentially avoid invasive extra-oral procedures and to easily confirm diagnosis with an intra-oral biopsy.

  1. Childhood Sexual and Physical Abuse as Risk Factors for the Development of Bulimia Nervosa: A Community-Based Case Control Study.

    ERIC Educational Resources Information Center

    Welch, Sarah L.; Fairburn, Christopher G.

    1996-01-01

    Young women (n=102) with bulimia nervosa were compared with 204 control subjects without an eating disorder and with 102 subjects with other psychiatric disorders. Results suggest that sexual and physical abuse are both risk factors for psychiatric disorders in general, including bulimia nervosa, but are not specific risk factors for bulimia. (DB)

  2. Cigarette smoking is associated with body shape concerns and bulimia symptoms among young adult females.

    PubMed

    Kendzor, Darla E; Adams, Claire E; Stewart, Diana W; Baillie, Lauren E; Copeland, Amy L

    2009-01-01

    Elevated rates of cigarette smoking have been reported among individuals with Bulimia Nervosa. However, little is known about eating disorder symptoms within non-clinical samples of smokers. The purpose of the present study was to compare the eating disorder symptoms of young adult female smokers (n=184) and non-smokers (n=56), to determine whether smokers were more likely to endorse bulimic symptoms and report greater body shape concern than non-smokers. Analyses indicated that smokers scored significantly higher than non-smokers on the Body Shape Questionnaire, p=.03, and the Bulimia Test-Revised, p=.006. In addition, a higher proportion of smokers than non-smokers scored > or = 85 on the Bulimia Test-Revised, p=.05, suggesting the possibility that Bulimia Nervosa diagnoses were more prevalent among smokers. No differences were found between smokers and non-smokers on other measures of eating behavior. Overall, findings suggest that smoking is specifically associated with symptoms of Bulimia Nervosa and body shape concern among young adult females.

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

    PubMed Central

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

    2008-01-01

    Bulimia nervosa is characterized by consuming large amounts of food over a defined period with a loss of control over the eating. This is followed by a compensatory behavior directed at eliminating the consumed calories, usually vomiting. Current treatments include antidepressants and/or behavioral therapies. Consensus exists that these treatments are not very effective and are associated with high relapse rates. We review evidence from literature and present original data to evaluate the hypothesis that bulimia involves alterations in vago-vagal function. Evidence in support of this include (1) Laboratory studies consistently illustrate deficits in meal size, meal termination, and satiety in bulimia; (2) Basic science studies indicate that meal size and satiation are under vagal influences; (3) Anatomical, behavioral and physiological data suggest that achieving satiety and the initiation of emesis involve common neural substrates; (4) Abnormal vagal and vago-vagal reflexive functions extend to non-eating activational stimuli; and (5) Studies from our laboratory modulating vagal activation have shown significant effects on binge/vomit frequencies and suggest a return of normal satiation. We propose a model for the pathophysiology of bulimia based upon de-stabilization of a bi-stable positive vago-vagal feedback loop. This model is not meant to be complete, but rather to stimulate anatomical, psychobiological, and translational neuroscience experiments aimed at elucidating the pathophysiology of bulimia and developing novel treatment strategies. PMID:18191425

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

    ERIC Educational Resources Information Center

    Lester, Regan; Petrie, Trent A.

    1998-01-01

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

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

    ERIC Educational Resources Information Center

    Zimmer, Marc

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

  6. Frontostriatal Circuits and the Development of Bulimia Nervosa

    PubMed Central

    Berner, Laura A.; Marsh, Rachel

    2014-01-01

    Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in part, defined by a sense of loss of control and compensatory behaviors to avoid weight gain. Impulsive behaviors are also common in individuals with BN, indicating more pervasive difficulties in behavioral self-regulation. Findings from functional and anatomical neuroimaging studies of individuals with BN suggest dysfunction in the dorsal frontostriatal circuits that support self-regulatory capacities and habit learning and in overlapping ventral circuits that support reward processing and reward-based learning. In this review, we describe the normal development of frontostriatal circuits and then present behavioral and neuroimaging data from adolescents and adults with BN. These data suggest that the abnormal maturation of frontostriatal circuits may contribute to the habitual binge-eating and purging behaviors of BN. Future longitudinal imaging studies will improve understanding of how these circuits contribute to the developmental trajectory of BN and will inform novel interventions that could target or prevent the impulsive and habit-like features of this disorder. PMID:25452718

  7. Neuropsychological correlates of decision making in patients with bulimia nervosa.

    PubMed

    Brand, Matthias; Franke-Sievert, Christiane; Jacoby, Georg E; Markowitsch, Hans J; Tuschen-Caffier, Brunna

    2007-11-01

    In addition to the core psychopathology of bulimia nervosa (BN), patients with BN often show impulsive behavior that has been related to decision making deficits in other patient groups, such as individuals with anorexia nervosa and pathological gamblers. However, it remains unclear whether BN patients also show difficulties in decision making. In this study, 14 patients with BN and 14 healthy comparison subjects, matched for age, gender, education, body mass index, and intelligence, were examined with the Game of Dice Task (M. Brand, E. Fujiwara, et al., 2005), a gambling task that has fixed winning probabilities and explicit rules for gains and losses, as well as with a neuropsychological test battery and personality questionnaires. On the task, the patients with BN chose the disadvantageous alternatives more frequently than did the comparison subjects. Performance on the Game of Dice Task was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. Thus, in patients with BN, decision making abnormalities and executive reductions can be demonstrated and might be neuropsychological correlates of the patients' dysfunctional everyday-life decision making behavior. Neurocognitive functions should be considered in the treatment of BN.

  8. Interoceptive sensitivity deficits in women recovered from bulimia nervosa

    PubMed Central

    Klabunde, Megan; Acheson, Dean; Boutelle, Kerri; Matthews, Scott; Kaye, Walter

    2013-01-01

    Self-report studies suggest that patients with Bulimia Nervosa (BN) evidence difficulties with interoceptive awareness. Indeed, interoceptive deficits may persist after recovery of BN and may be a biological trait that predisposes symptom development in BN. However, no studies to date have directly assessed interoceptive sensitivity, or accuracy in detecting and perceiving internal body cues, in patients with or recovered from BN. Nine women who had recovered from BN and 10 healthy control women completed the Heart Beat Perception Task (HBPT) in which individuals were required to estimate the number of heartbeats between intervals of time. Accuracy scores were compared between groups. Significant differences were found between the groups on the HBPT ((F 1,19)= 7.78, p=.013, Cohen’s d= 1.16) when controlling for age. These results suggest that deficits in interoceptive sensitivity are present in individuals recovered from BN. Thus interoceptive deficits may be one factor that bridges the gap between brain dysfunction and symptom presentation in BN. PMID:24183142

  9. Hypothalamic-pituitary-gonadal function in anorexia nervosa and bulimia.

    PubMed

    Devlin, M J; Walsh, B T; Katz, J L; Roose, S P; Linkie, D M; Wright, L; Vande Wiele, R; Glassman, A H

    1989-04-01

    Patients with anorexia nervosa (AN) exhibit neuroendocrine abnormalities that may result solely from emaciation or may reflect defective endocrine mechanisms which are intrinsic to disordered eating even in the absence of starvation. To distinguish these possibilities, we have studied indices of hypothalamic-pituitary-gonadal (HPG) function in 9 patients with AN, 12 normal weight patients with bulimia and recent or current oligomenorrhea, and 8 normal weight controls. Measurement of 24-hour luteinizing hormone (LH) secretion with 30-min sampling revealed significantly fewer LH secretory spikes and a trend toward lower mean 24-hour LH levels in both bulimic and anorectic patients than in controls. Stimulation with gonadotropin releasing hormone produced elevated LH responses in the bulimic group and blunted LH responses in the anorectic group. Stimulation with estradiol revealed diminished LH augmentative responses and a trend toward diminished follicle stimulating hormone augmentative responses among bulimic as well as AN patients compared to controls. In each instance, the bulimic group tended to show within-group heterogeneity, with some individuals falling within the AN range. These findings suggest that HPG axis abnormalities in eating disordered patients cannot entirely be attributed to emaciation and that factors other than subnormal weight contribute to disturbed hypothalamic-pituitary functioning in these patients.

  10. Bulimia nervosa in overweight and normal-weight women.

    PubMed

    Masheb, Robin; White, Marney A

    2012-02-01

    The aim of the present study was to examine overweight bulimia nervosa (BN) in a community sample of women. Volunteers (n = 1964) completed self-report questionnaires of weight, binge eating, purging, and cognitive features. Participants were classified as overweight (body mass index ≥25) or normal weight (body mass index <25). Rates of BN within the overweight and normal-weight classes did not differ (6.4% vs 7.9%). Of the 131 participants identified as BN, 64% (n = 84) were classified as overweight BN and 36% (n = 47) as normal-weight BN. The overweight BN group had a greater proportion of ethnic minorities and reported significantly less restraint than the normal-weight BN group. Otherwise, the 2 groups reported similarly, even in terms of purging and depression. In summary, rates of BN did not differ between overweight and normal-weight women. Among BN participants, the majority (two thirds) were overweight. Differences in ethnicity and restraint, but little else, were found between overweight and normal-weight BN. Findings from the present study should serve to increase awareness of the weight range and ethnic diversity of BN, and highlight the need to address weight and cultural sensitivity in the identification and treatment of eating disorders.

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

    PubMed

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

    2016-04-01

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

  12. Normal interoceptive accuracy in women with bulimia nervosa.

    PubMed

    Pollatos, Olga; Georgiou, Eleana

    2016-06-30

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

  13. Stressful task increases drive for thinness and bulimia: a laboratory study.

    PubMed

    Sassaroli, Sandra; Fiore, Francesca; Mezzaluna, Clarice; Ruggiero, Giovanni Maria

    2015-01-01

    The scientific literature has suggested that stress undergirds the development of eating disorders (ED). Therefore, this study explored whether laboratory induced stress increases self-reported drive for thinness and bulimic symptoms measured via self-report. The relationship between control, perfectionism, stress, and cognition related to ED was examined using correlational methodology. Eighty-six participants completed an experimental task using a personal computer (PC). All individuals completed a battery of tests before and after the stressful task. Analyses showed a significant statistical increase in average scores on the drive for thinness and bulimia measured before and after a stressful task, and path analysis revealed two different cognitive models for the mechanism leading to drive for thinness and bulimia. These findings suggest that stress is an important factor in the development of the drive for thinness and bulimia.

  14. Stressful task increases drive for thinness and bulimia: a laboratory study

    PubMed Central

    Sassaroli, Sandra; Fiore, Francesca; Mezzaluna, Clarice; Ruggiero, Giovanni Maria

    2015-01-01

    The scientific literature has suggested that stress undergirds the development of eating disorders (ED). Therefore, this study explored whether laboratory induced stress increases self-reported drive for thinness and bulimic symptoms measured via self-report. The relationship between control, perfectionism, stress, and cognition related to ED was examined using correlational methodology. Eighty-six participants completed an experimental task using a personal computer (PC). All individuals completed a battery of tests before and after the stressful task. Analyses showed a significant statistical increase in average scores on the drive for thinness and bulimia measured before and after a stressful task, and path analysis revealed two different cognitive models for the mechanism leading to drive for thinness and bulimia. These findings suggest that stress is an important factor in the development of the drive for thinness and bulimia. PMID:25999901

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

    PubMed

    Habermas, T

    1992-03-01

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

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

    NASA Astrophysics Data System (ADS)

    Laser, Eleanor; Sassack, Michael

    2012-03-01

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

  17. Sexual function of women suffering from anorexia nervosa and bulimia nervosa.

    PubMed

    Gonidakis, Fragiskos; Kravvariti, Vasilliki; Varsou, Eleftheria

    2015-01-01

    The cross-sectional study aimed at examining the sexual function of young adult women suffering from eating disorders. The authors interviewed 53 women (26 with anorexia nervosa and 27 with bulimia nervosa) and 58 female students. Each participant was administered the Female Sexual Function Index, the Eating Attitudes Test, the Body Shape Questionnaire, and the Beck Depression Inventory. Comparisons among the 3 groups showed that patients with anorexia nervosa scored lower in each Female Sexual Function Index subscale than did healthy controls. There was no significant difference between bulimia nervosa and healthy controls. Sexual functionality of patients with anorexia nervosa was correlated only with body mass index (r = 0.5, p =.01). Sexual functionality of patients with bulimia nervosa was correlated only with the Beck Depression Inventory (r = -0.4, p =.03) Patients with anorexia nervosa had more disturbed sexual function than did controls. Sexual function can be related to the level of starvation and symptoms of depression.

  18. [Oral symptoms and signs in patients with bulimia and anorexia nervosa].

    PubMed

    Panico, René L

    2006-01-01

    There are numerous general clinical manifestations in eating disorders, such as anorexia and nervous bulimia, which are fully described in the reading material. The objective of this study is to demonstrate that patients suffering from anorexia and nervous bulimia present manifestations in the oral mucosa and a proper anamnesis can lead to an early disease diagnosis. The clinical cases presented show some of the oral manifestations in patients suffering from these disorders. Abrasion of teeth enamel is a typical sign of this disease, specially in patients with nervous bulimia, caused by self-induced vomit acids. However, this sign does not help to make an early disease diagnosis, since the acid takes a long time to produce demineralization.

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

    SciTech Connect

    Wu, J.C.; Hagman, J.; Buchsbaum, M.S.; Blinder, B.; Derrfler, M.; Tai, W.Y.; Hazlett, E.; Sicotte, N. )

    1990-03-01

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

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

    PubMed

    Brambilla, F

    2001-01-01

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

  1. [Eating disorders in childhood and adolescence. Anorexia nervosa, bulimia nervosa, binge eating disorder].

    PubMed

    Gerlinghoff, M; Backmund, H

    2004-03-01

    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.

  2. An analysis of the role of overeaters anonymous in women's recovery from bulimia nervosa.

    PubMed

    Wasson, Diane H; Jackson, Mary

    2004-01-01

    This study presents a qualitative analysis of the role of the self-help group Overeaters Anonymous (OA) in the treatment experiences of women with bulimia nervosa. It specifies how various elements of OA facilitate or maintain recovery. Using focus groups and individual interviews, data were collected from 26 women who met the criteria for bulimia nervosa. Data analysis revealed that those participants used five OA skills or strategies. These included: (1) OA meeting attendance and participation, (2) interaction with a sponsor, (3) processing (i.e., writing and journaling), (4) spirituality (i.e., prayer and meditation), and (5) adherence to a food plan.

  3. [Adaptation of psychodrama in psychotherapy of patients with anorexia nervosa and bulimia nervosa].

    PubMed

    Izydorczyk, Bernadetta

    2011-01-01

    The aim of the article was an attempt to present selected theoretical motifs and moreover self experience in the adaptation of elements of psychodrama by Moreno in psychodynamic psychotherapy (individual and group psychotherapy) in a group of people with anorexia and bulimia nervosa. Psychodrama through own creativity, spontaneity and taking action on the "here and now" stage helps to attain and intensify therapeutic aims which concern the consciousness of inner conflict of persons with anorexia and bulimia nervosa, which is translocated on their body.

  4. A twin study of specific bulimia nervosa symptoms

    PubMed Central

    Mazzeo, S. E.; Mitchell, K. S.; Bulik, C. M.; Aggen, S. H.; Kendler, K. S.; Neale, M. C.

    2010-01-01

    Background Twin studies have suggested that additive genetic factors significantly contribute to liability to bulimia nervosa (BN). However, the diagnostic criteria for BN remain controversial. In this study, an item-factor model was used to examine the BN diagnostic criteria and the genetic and environmental contributions to BN in a population-based twin sample. The validity of the equal environment assumption (EEA) for BN was also tested. Method Participants were 1024 female twins (MZ n=614, DZ n=410) from the population-based Mid-Atlantic Twin Registry. BN was assessed using symptom-level (self-report) items consistent with DSM-IV and ICD-10 diagnostic criteria. Items assessing BN were included in an item-factor model. The EEA was measured by items assessing similarity of childhood and adolescent environment, which have demonstrated construct validity. Scores on the EEA factor were used to specify the degree to which twins shared environmental experiences in this model. Results The EEA was not violated for BN. Modeling results indicated that the majority of the variance in BN was due to additive genetic factors. There was substantial variability in additive genetic and environmental contributions to specific BN symptoms. Most notably, vomiting was very strongly influenced by additive genetic factors, while other symptoms were much less heritable, including the influence of weight on self-evaluation. These results highlight the importance of assessing eating disorders at the symptom level. Conclusions Refinement of eating disorder phenotypes could ultimately lead to improvements in treatment and targeted prevention, by clarifying sources of variation for specific components of symptomatology. PMID:19818201

  5. CCK response in bulimia nervosa and following remission.

    PubMed

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

    2013-10-01

    The core defining features of bulimia nervosa (BN) are repeated binge eating episodes and inappropriate compensatory (e.g., purging) behavior. Previous studies suggest an abnormal post-prandial response in the satiety-signaling peptide cholecystokinin (CCK) in persons with BN. It is unknown whether this altered response persists following remission or if it may be a potential target for the development of clinical treatment strategies. To examine the nature of this altered response, this study assessed whether CCK normalizes following remission from BN (RBN). This study prospectively evaluated the plasma CCK response and corresponding eating behavior-related ratings (e.g., satiety, fullness, hunger, urge to binge and vomit) in individuals with BN-purging subtype (n=10), RBN-purging subtype (n=14), and healthy controls (CON, n=13) at baseline, +15, +30, and +60 min following the ingestion of a standardized liquid test meal. Subject groups did not significantly differ in CCK response to the test meal. A significant relationship between CCK response and satiety ratings was observed in the RBN group (r=.59, p<.05 two-tailed). A new and unanticipated finding in the BN group was a significant relationship between CCK response and ratings of "urge to vomit" (r=.86, p<.01, two-tailed). Unlike previous investigations, CCK response did not differ in BN and CON groups. Thus the role of symptom severity remains an area of further investigation. Additionally, findings suggest that in this sample, CCK functioning following remission from BN-purging subtype is not different from controls. It remains unknown whether or not CCK functioning may be a protective or liability factor in the stabilization and recovery process. Replication studies utilizing a larger sample size are needed to further elucidate the role of CCK in recovery from BN and its potential target of related novel treatment strategies.

  6. Reward Abnormalities Among Women with Full and Subthreshold Bulimia Nervosa: A Functional Magnetic Resonance Imaging Study

    PubMed Central

    Bohon, Cara; Stice, Eric

    2010-01-01

    Objective To test the hypothesis that women with full and subthreshold bulimia nervosa show abnormal neural activation in response to food intake and anticipated food intake relative to healthy control women. Method Females with and without full/subthreshold bulimia nervosa recruited from the community (N = 26) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution. Results Women with bulimia nervosa showed trends for less activation than healthy controls in the right anterior insula in response to anticipated receipt of chocolate milkshake (versus tasteless solution) and in the left middle frontal gyrus, right posterior insula, right precentral gyrus, and right mid dorsal insula in response to consumptions of milkshake (versus tasteless solution). Discussion Bulimia nervosa may be related to potential hypo-functioning of the brain reward system, which may lead these individuals to binge eat to compensate for this reward deficit, though the hypo-responsivity might be a result of a history of binge eating highly palatable foods. PMID:21997421

  7. The Prevalence of Bulimia Nervosa in the US College Student Population.

    ERIC Educational Resources Information Center

    Drewnowski, Adam; And Others

    1988-01-01

    A phone survey of 1,007 male and female college students revealed that 1.1 percent of the women and 0.2 percent of the men were bulimic according to the revised (DSM IIIR) diagnostic criteria. At 2.2. percent, bulimia was most prevalent among undergraduate women living in group housing on campus. (Author/BJV)

  8. Weight-Loss Expectancies, Relative Weight, and Symptoms of Bulimia in Young Women.

    ERIC Educational Resources Information Center

    Thombs, Dennis L.; And Others

    1996-01-01

    A canonical correlation analysis of various weight concerns in a sample of college women revealed that strong expectations of weight loss benefits and a high relative body weight were positively correlated with the four major symptoms of bulimia. Expectations of increased self-worth and social confidence were linked to eating problems. (RJM)

  9. Gastroesophageal reflux disease and bulimia nervosa--a review of the literature.

    PubMed

    Denholm, M; Jankowski, J

    2011-02-01

    Bulimia nervosa and other eating disorders have been on the increase for the past half century. Self-induced vomiting is often practiced as a method of weight control in these patients, potentially causing acidic damage to the esophagus of the kind observed in cases of gastroesophageal reflux disease. To ascertain whether patients suffering from bulimia nervosa had an increased rate of reflux-related symptoms, potentially placing them at risk of developing sequelae such as Barrett's esophagus and esophageal adenocarcinoma, a literature review was performed via searches of databases including PubMed, Medline, OVID and PsycINFO and a recursive search of the literature. The search terms were: bulimia nervosa; reflux; esophageal adenocarcinoma; Barrett's esophagus; eating disorders; oral; dental; complications. Several case reports were identified detailing the occurrence of an esophageal tumor in patients with a history of bulimia. This was supported to some degree by studies detailing higher incidences of reflux symptoms in eating disordered patients compared to controls but there was large variability in study design, quality and results. From these results an association is suggested as possible but is far from being proved conclusively. Further investigation is required using larger patient groups, better study design controlling for confounding factors and symptom characterisation.

  10. Eating Disorders. What Parents Need to Know About Anorexia and Bulimia.

    ERIC Educational Resources Information Center

    Our Children, 1998

    1998-01-01

    Examines facts about eating disorders, which typically affect females in their teens, discussing the causes of anorexia and bulimia, describing their effects on the body, and explaining available treatment. Though eating disorders are very serious and potentially fatal, they are treatable. Treatment includes physician evaluation, possible…

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

    ERIC Educational Resources Information Center

    Levine, Michael P.

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

  12. Low Self-Esteem as a Treatment Issue in the Psychotherapy of Anorexia and Bulimia.

    ERIC Educational Resources Information Center

    Baird, Pryor; Sights, Judith R.

    1986-01-01

    Observation has indicated that low self-esteem is pervasive in clients with anorexia and bulimia. Possible origins of the self-esteem deficit, its relationship to eating problems, and psychotherapeutic strategies to counteract the deficits are explored. (Author/BL)

  13. Anorexia and Bulimia: An Inventory of Public Awareness and Popular Questions.

    ERIC Educational Resources Information Center

    Zimmer, Marc A.

    Prevention and early intervention in cases of anorexia and bulimia require that both professionals and the general public have knowledge about these eating disorders. A study was conducted to identify the questions about these disorders most often asked by the general public and to develop a guide to answer those questions for individuals of…

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

    ERIC Educational Resources Information Center

    Craighead, Linda W.; Agras, W. Stewart

    1991-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  16. Impact of fasting on food craving, mood and consumption in bulimia nervosa and healthy women participants.

    PubMed

    Moreno-Domínguez, Silvia; Rodríguez-Ruiz, Sonia; Fernández-Santaella, M Carmen; Ortega-Roldán, Blanca; Cepeda-Benito, Antonio

    2012-11-01

    Researchers have found that dietary restraint increases food cravings and may contribute to loss of control over eating. Negative mood states often precede food cravings and binge eating. In the present study, we tested the influence of a prolonged food deprivation period over emotional states and food cravings. Twenty-one bulimia nervosa participants and 20 healthy women participants were asked to refrain from any eating for 20 hours and reported, at baseline, after 6 hours and at the end of the fasting period, their mood and craving states. Food consumption was also measured. Fasting increased food cravings in both groups but increased negative mood in healthy women only. Bulimia nervosa participants reported improved mood following food deprivation. Whereas Bulimia nervosa and healthy women participants ate moderate and similar amounts of food following the 20-hour fasting period, food cravings were significantly associated with the number of calories ingested. These findings are congruent with self-regulation theories that predict that prolonged fasting may reduce negative emotions in women with bulimia nervosa.

  17. Prevalence of bulimic behaviors and bulimia among a sample of the general population.

    PubMed

    Warheit, G J; Langer, L M; Zimmerman, R S; Biafora, F A

    1993-03-01

    Data are presented on the prevalence of bulimic symptoms and bulimia among a sample of adults residing in north-central Florida (n = 2,075). The data were gathered between 1984 and 1986. The sample included 1,736 whites and 339 blacks, of whom 1,040 were females and 1,035 were males. A current diagnosis of bulimia was made using the criteria of the Diagnostic and Statistical Manual, Third Edition (DSM-III), of the American Psychiatric Association. Females had significantly higher rates than did males on nine of the 10 bulimic symptoms. Blacks had symptom rates equal to or greater than whites on eight of the 10 items, and those in the lowest socioeconomic groups (SES) had rates greater than those in the highest SES group on nine of the 10 symptoms. Eight persons, 0.4% of the total sample, met the DSM-III criteria for a diagnosis of bulimia. These included six white females and two black males. Five of the females were aged 18-29 years; one was over 45. Five of the females were in the lower middle SES group; one was in the upper middle SES group. Both of the black males were aged 30-44, and both were in the lowest SES group. The data emphasize the need to distinguish between bulimic type symptoms and bulimia when estimating the prevalence of eating-related problems in the general population. PMID:8465808

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

    ERIC Educational Resources Information Center

    Delinsky, Sherrie S.; Wilson, G. Terence

    2010-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Sullivan, Keri A.

    2001-01-01

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

  1. When Dieting Becomes Dangerous: A Guide to Understanding and Treating Anorexia and Bulimia.

    ERIC Educational Resources Information Center

    Michel, Deborah Marcontell; Willard, Susan G.

    This book about anorexia and bulimia is written for patients and the people who care about them. It describes the symptoms and warning signs of eating disorders, explains their presumed causes and complexities, and suggests effective treatments. The book emphasizes the critical role of psychotherapy and family therapy in recovery, explains how…

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  3. Client Pretreatment Characteristics as Predictors of Outcome in Brief Therapy for Bulimia.

    ERIC Educational Resources Information Center

    Guiffrida, Douglas A.; Barnes, Kristin L.; Hoskins, Christine M.; Roman, Lisa L.

    2001-01-01

    Presents an overview for college counselors of the literature on bulimia treatment outcomes for purposes of screening, treatment, and referral. Outlines pretreatment characteristics that seem amenable to success in brief therapy, as well as those that do not lead to a positive outcome. (Contains 37 references and 2 tables.) (Author/GCP)

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

    ERIC Educational Resources Information Center

    Sim, Leslie; Zeman, Janice

    2004-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Murray, Trish

    2003-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  9. Cognitive-behavioral therapy for subthreshold bulimia nervosa: A case series.

    PubMed

    Peterson, C B; Miller, K B; Willer, M G; Ziesmer, J; Durkin, N; Arikian, A; Crow, S J

    2011-09-01

    The extent to which cognitive-behavioral therapy (CBT) is helpful in treating individuals with bulimic symptoms who do not meet full criteria for bulimia nervosa is unclear. The purpose of this investigation was to examine the potential efficacy of CBT for eating disorder individuals with bulimic symptoms who do not meet full criteria for bulimia nervosa. Twelve participants with subthreshold bulimia nervosa were treated in a case series with 20 sessions of CBT. Ten of the 12 participants (83.3%) completed treatment. Intent-to-treat abstinent percentages were 75.0% for objectively large episodes of binge eating (OBEs), 33.3% for subjectively large episodes of binge eating (SBEs), and 50% for purging at end of treatment. At one year follow-up, 66.7% were abstinent for OBEs, 41.7% for SBEs, and 50.0% for purging. The majority also reported improvements in associated symptoms. This case series provides support for the use of CBT with individuals with subthreshold bulimia nervosa.

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

    ERIC Educational Resources Information Center

    Strober, Michael; Humphrey, Laura Lynn

    1987-01-01

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

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

    ERIC Educational Resources Information Center

    Peters, Carole; And Others

    1984-01-01

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

  12. The Role of BDNF, Leptin, and Catecholamines in Reward Learning in Bulimia Nervosa

    PubMed Central

    Grob, Simona; Milos, Gabriella; Schnyder, Ulrich; Eckert, Anne; Lang, Undine; Hasler, Gregor

    2015-01-01

    Background: A relationship between bulimia nervosa and reward-related behavior is supported by several lines of evidence. The dopaminergic dysfunctions in the processing of reward-related stimuli have been shown to be modulated by the neurotrophin brain derived neurotrophic factor (BDNF) and the hormone leptin. Methods: Using a randomized, double-blind, placebo-controlled, crossover design, a reward learning task was applied to study the behavior of 20 female subjects with remitted bulimia nervosa and 27 female healthy controls under placebo and catecholamine depletion with alpha-methyl-para-tyrosine (AMPT). The plasma levels of BDNF and leptin were measured twice during the placebo and the AMPT condition, immediately before and 1 hour after a standardized breakfast. Results: AMPT–induced differences in plasma BDNF levels were positively correlated with the AMPT–induced differences in reward learning in the whole sample (P=.05). Across conditions, plasma brain derived neurotrophic factor levels were higher in remitted bulimia nervosa subjects compared with controls (diagnosis effect; P=.001). Plasma BDNF and leptin levels were higher in the morning before compared with after a standardized breakfast across groups and conditions (time effect; P<.0001). The plasma leptin levels were higher under catecholamine depletion compared with placebo in the whole sample (treatment effect; P=.0004). Conclusions: This study reports on preliminary findings that suggest a catecholamine-dependent association of plasma BDNF and reward learning in subjects with remitted bulimia nervosa and controls. A role of leptin in reward learning is not supported by this study. However, leptin levels were sensitive to a depletion of catecholamine stores in both remitted bulimia nervosa and controls. PMID:25522424

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

    PubMed

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

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

  14. Low density and high affinity of platelet [3H]paroxetine binding in women with bulimia nervosa.

    PubMed

    Ekman, Agneta; Sundblad-Elverfors, Charlotta; Landén, Mikael; Eriksson, Tomas; Eriksson, Elias

    2006-06-15

    Impaired serotonin transmission has been suggested to be implicated in the pathophysiology of bulimia nervosa. As an indirect measure of brain serotonergic activity, the binding of tritiated ligands to platelet serotonin transporters has been studied in bulimia nervosa as well as in other putatively serotonin-related psychiatric disorders. In this study, the density and affinity of platelet serotonin transporters were assessed in 20 women meeting the DSM-IV criteria for bulimia nervosa and in 14 controls without previous or ongoing eating disorder using [(3)H]paroxetine as a ligand. In comparison to controls, women with bulimia nervosa had a significantly reduced number of platelet binding sites (B(max) = 721 +/- 313 vs. 1145 +/- 293 fmol/mg protein) and an increase in the affinity for the ligand demonstrated by a lower dissociaton constant (K(d) = 33 +/- 10 vs. 44 +/- 10 pM). A significant correlation between B(max) and K(d) values was found in patients but not in controls. Our results support the notion that bulimia nervosa is associated with a reduction in platelet serotonin transporter density. In addition, our study is the first to report that this reduced transporter density in women with bulimia nervosa is accompanied by an increase in the affinity of the transporter for the ligand.

  15. [Psychodynamik focal therapy of bulimia nervosa for female adolescents and young adults].

    PubMed

    Reich, Günter; Horn, Hildegard; Winkelmann, Klaus; Kronmüller, Klaus-Thomas; Stefini, Anette

    2014-01-01

    A manual for a disorder oriented psychodynamic treatment of bulimia nevosa and atypical bulimia nervosa of female adolescents and young adults is presented. This manual is applied in a therapy project, which started in 2007. The work on conflicts and structural dysfunctions is meant to lead to the removal or alleviation of the symptoms and an improvement of eating behavior and body image. The bulimic symptoms are contextualized and focussed according to the conflicts and ego-structural deficits of the patients. Typical patterns of interpersonal relationships, transference, conflict, defence and structural problems as well as therapeutic steps are described. The typical psychosocial situation of female adolescence and young adult age is taken into account. Special emphasis is laid on the limitedness of the therapy to 60 sessions and the active structuring of the final phase of he therapy by the therapist. PMID:24693801

  16. [Typology of disordered eating behaviour (anorexia nervosa with bulimia and vomitomanic disturbances) in children and adolescents].

    PubMed

    Balakireva, E E; Kozlova, I A; Iakupova, L P; Savost'ianova, O L

    2004-01-01

    Eighty children (66 girls and 14 boys), aged 6-16 years, with syndrome of anorexia nervosa (AN) have been studied. Two nosologic groups: pathological age crisis of childhood and adolescence (F50.0-F50.2 in ICD-10)--30 patients and slow-progressive schizophrenia (schizotypical disorder, F21.3-F21.4)--50 patients are determined. The latter group was divided according to syndrome types: syndrome of AN (28 patients); AN syndrome with predominant bulimia (11 patients); AN syndrome with dominating bulimia and vomitomanic disturbances (11 patients). Syndrome structure was determined by the stages of the course, syntropy character with other psychopathological disorders and process of their reduction. Psychotic disorders in patients of the third type were most pronounced. In each group, statistically significant EEG features, comparing to control age-matched group, were revealed. The severer were psychopathological symptoms, the less was an amount of organized and the more--desynchronized "flat" EEG.

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

    PubMed

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

    2014-11-01

    Acute gastric dilation is a rare but recognised complication in patients with bulimia and anorexia following binge episodes owing to decreased bowel motility. We present a rare case of acute gastric dilation secondary to bulimia in an otherwise healthy 18-year-old female patient that resulted in compression and complete occlusion of the abdominal aorta, leading to acute mesenteric and bilateral lower limb ischaemia. This resolved immediately following a laparotomy and gastric decompression. Management of these patients is very challenging owing to the lack of a successful precedent. To our knowledge, such a catastrophic complication has only ever been reported once in the literature and the outcome was fatal. Our case is of additional importance as it offers a successful management strategy for these patients.

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

    PubMed Central

    Kruger, S; Kennedy, SH

    2000-01-01

    Pharmacotherapy for anorexia nervosa is considered to be of limited efficacy. However, many studies suffer methodological limitations, and the utility of newer drugs in the treatment of anorexia has not been examined yet. Although there have been more fruitful investigations on the efficacy of medication in the management of bulimia nervosa, there are still many unresolved issues regarding the optimal management of partial remission during the acute treatment phase and the intensity and duration of pharmacotherapy to achieve optimal prophylaxis. Selective serotonin reuptake inhibitors (SSRIs) control the binge urges in binge-eating disorder, but more trials are required to investigate the utility of SSRIs and other agents in maintenance treatment. We review the current status of psychopharmacotherapy for anorexia nervosa, bulimia nervosa and binge-eating disorder and evaluate the merits of newer agents in the treatment of these disorders. PMID:11109300

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

    PubMed

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

    2016-01-01

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

  20. Negative affect and neural response to palatable food intake in bulimia nervosa.

    PubMed

    Bohon, Cara; Stice, Eric

    2012-06-01

    Binge eating is often preceded by reports of negative affect, but the mechanism by which affect may lead to binge eating is unclear. This study evaluated the effect of negative affect on neural response to anticipation and receipt of palatable food in women with bulimia nervosa (BN) versus healthy controls. We also evaluated connectivity between the amygdala and reward-related brain regions. Females with and without BN (n=26) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless solution. We measured negative affect just prior to the scan. Women with BN showed a positive correlation between negative affect and activity in the putamen, caudate, and pallidum during anticipated receipt of milkshake (versus tasteless solution). There were no significant relations between negative affect and receipt of milkshake. Connectivity analyses revealed a greater relation of amygdala activity to activation in the left putamen and insula during anticipated receipt of milkshake in the bulimia group relative to the control group. The opposite pattern was found for the taste of milkshake; the control group showed a greater relation of amygdala activity to activation in the left putamen and insula in response to milkshake receipt than the bulimia group. Results show that as negative affect increases, so does responsivity of reward regions to anticipated intake of palatable food, implying that negative affect may increase the reward value of food for individuals with bulimia nervosa or that negative affect has become a conditioned cue due to a history of binge eating in a negative mood.

  1. Outpatient management of electrolyte imbalances associated with anorexia nervosa and bulimia nervosa.

    PubMed

    Olson, Ann F

    2005-01-01

    Bulimia nervosa and anorexia nervosa are eating disorders with significant morbidity that often go undetected. Nurses and primary care providers are encouraged to recognize the early signs and symptoms of these disorders and to intervene appropriately. Several case reports in this article describe patients with these disorders and various related electrolyte abnormalities. Understanding electrolyte imbalances associated with both disorders may lead to earlier effective intervention and overall improved health outcomes.

  2. Family climates: family factors specific to disturbed eating and bulimia nervosa.

    PubMed

    Laliberté, M; Boland, F J; Leichner, P

    1999-09-01

    More than a decade of research has characterized the families of individuals with bulimia and bulimia anorexia (Anorexia Nervosa, Binge/Purging Type) as less expressive, less cohesive, and experiencing more conflicts than normal control families. This two-part study investigated variables believed more directly related to disturbed eating and bulimia as contributing to a "family climate for eating disorders." In Study 1. a nonclinical sample of 324 women who had just left home for college and a sample of 121 mothers evaluated their families. Principal-components analyses revealed the same factor structure for both students and mothers, with Family Body Satisfaction, Family Social Appearance Orientation, and Family Achievement Emphasis loading together, representing the hypothesized family climate for eating disorders: the remaining variables loaded with the more traditional family process variables (conflict, cohesion, expressiveness), representing a more general family dysfunction. As predicted, the family climate for eating disorders factor score was a more powerful predictor of disturbed eating. Study 2 extended these findings into a clin ical population, examining whether the family climate for eating disorders variables would distinguish individuals with bulimia from both depressed and healthy controls. Groups of eating-disordered patients (n = 40) and depressed (n = 17) and healthy (n = 27) controls completed family measures. The eating-disordered group scored significantly higher on family climate variables than control groups. Family process variables distinguished clinical groups (depressed and eating disordered) from healthy controls, but not from one another. Controlling for depression removed group differences on family process variables, but family climate variables continued to distinguish the eating-disordered group from both control groups. Indications for further research are discussed.

  3. Empirically-supported and non-empirically supported therapies for bulimia nervosa: retrospective patient ratings

    PubMed Central

    2013-01-01

    Background Empirically supported therapies for bulimia nervosa include cognitive behaviour therapy and interpersonal therapy. Whilst these treatments have been shown to be effective in multiple randomised controlled trials, little research has investigated how they are perceived by patients who receive them. This study investigated whether empirically-supported psychological therapies (ESTs) are associated with superior self-rated treatment outcomes in clients with Bulimia Nervosa (BN). Results 98 adults who had received psychological therapy for BN in the United Kingdom completed a questionnaire which retrospectively assessed the specific contents of their psychological therapy and self-rated treatment outcomes. Around half the sample, fifty three participants reported receiving an EST. Fifty of these received Cognitive Behaviour Therapy (CBT) and three Interpersonal Therapy (IPT). Where therapy met expert criteria for Cognitive Behaviour Therapy for Bulimia Nervosa (CBT-BN, an EST) participants reported superior treatment outcomes than those who appeared to receive non-specialist cognitive-behavioural therapy. However, self-rated treatment outcomes were similar overall between those whose therapy met criteria for ESTs and those whose therapy did not. Conclusions The findings offer tentative support for the perceived helpfulness of CBT-BN as evaluated in controlled research trials. Cognitive-behavioural therapies for BN, as they are delivered in the UK, may not necessarily be perceived as more beneficial by clients with BN than psychological therapies which currently have less empirical support. PMID:24999419

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

    PubMed

    Thompson-Brenner, Heather

    2016-06-01

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

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

    PubMed

    Thompson-Brenner, Heather

    2016-06-01

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

  6. "Diagnostic shift" from eating disorder not otherwise specified to bulimia nervosa using DSM-5 criteria: a clinical comparison with DSM-IV bulimia.

    PubMed

    MacDonald, Danielle E; McFarlane, Traci L; Olmsted, Marion P

    2014-01-01

    In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic threshold for binging and compensation in bulimia nervosa (BN) decreased from twice to once weekly for 3 months. This study investigates the validity of this change by examining whether BN patients and those whose diagnoses "shift" to BN with DSM-5 are similar in their psychological functioning. EDNOS patients whose symptoms met DSM-5 BN criteria (n=25) were compared to DSM-IV BN patients (n=146) on clinically relevant variables. No differences were found on: BMI; weight-based self-evaluation; perfectionism; depression and anxiety symptoms; or readiness for change. Differences were found on one Eating Disorder Inventory subscale (i.e., bulimia), with the BN group reporting higher scores, consistent with group definitions. These findings support the modified criteria, suggesting that psychopathology both directly and indirectly related to eating disorders is comparable between those with once weekly versus more frequent bulimic episodes.

  7. Eating and weight/shape criticism as a specific life-event related to bulimia nervosa: a case control study.

    PubMed

    Gonçalves, Sonia Ferreira; Machado, Bárbara César; Martins, Carla

    2014-01-01

    The present study aims to evaluate the occurrence of life events preceding the onset of eating problems in bulimia nervosa patients. A case-control design was used involving the comparison of 60 female subjects who meet DSM-IV criteria for bulimia nervosa with 60 healthy control subjects and 60 subjects with other psychiatric disorders. The RFI (Fairburn et al., 1998) subset of factors that represent exposure to life events in the 12 months immediately before the development of eating problems was used. Women with bulimia nervosa reported higher rates of major stress, criticism about eating, weight and shape and also a great number of antecedent life events during the year preceding the development of eating problems than the healthy control group. However, when compared with the general psychiatric control group only the exposure to critical comments about weight, shape, or eating emerged as a specific trigger for bulimia nervosa. Our findings support the fact that eating and shape/weight criticism in the year preceding the development of eating disturbance seems to be specifically related to bulimia nervosa.

  8. Recurrent aborted sudden cardiac death with seizures and rhabdomyolysis due to bulimia-induced hypokalemia: report of one case.

    PubMed

    Finsterer, Josef; Stöllberger, Claudia

    2014-06-01

    Recurrent vomiting due to bulimia associated with abuse of furosemide and laxatives causing severe hypokalemia may result in recurrent aborted sudden cardiac death (SCD) and seizures. We report a 25-year-old female with a history of bulimia associated with abuse of furosemide and laxatives since the age of 15 years, migraine since puberty, renal abscesses at age 20 y, and rhabdomyolysis of unknown cause at age 24 y. She experienced aborted SCD due to severe hypokalemia with symptomatic seizures at 21 and 25 years of age. Bulimia patients additionally taking laxatives or furosemide are at particular risk of SCD and rhabdomyolysis and require periodic determination of electrolytes, potassium substitution, and adequate psychiatric therapy and surveillance.

  9. Affect regulation and food intake in bulimia nervosa: emotional responding to food cues after deprivation and subsequent eating.

    PubMed

    Mauler, Birgit I; Hamm, Alfons O; Weike, Almut I; Tuschen-Caffier, Brunna

    2006-08-01

    Emotional responding to salient food cues and effects of food deprivation and consumption were investigated in 32 women with bulimia and 32 control women. One half of each group was food deprived before viewing unpleasant, neutral, pleasant, and food-related pictures. Then participants could eat from a buffet before viewing a parallel picture set. Women with bulimia showed a substantial potentiation of startle responses during viewing of food cues relative to control women. This startle potentiation was attenuated by food deprivation and augmented by increased food consumption. These data support the affective regulation model suggesting that food cues prompt negative affective states in women with bulimia, who are overwhelmed by fasting. The resulting deprivation increases the incentive value of food cues and may thus trigger binge eating.

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

    PubMed

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

    2013-08-01

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

  11. Effect of management of patients with Anorexia and Bulimia nervosa on symptoms and impulsive behavior.

    PubMed

    Sernec, Karin; Tomori, Martina; Zalar, Bojan

    2010-12-01

    The aim of the study was to provide further and up to date information on the evaluation of the management of Anorexia and Bulimia nervosa at the Eating Disorders Unit (EDU) of the Ljubljana Psychiatric Clinic, based upon detailed assessment of the eating disorders specific and non specific symptoms of impulsive behaviors, highly correlated with these entities. 34 female patients with anorexia (restrictive or purgative type) and 38 female patients with Bulimia nervosa (purgative or non-purgative type) undergoing hospital treatment at the EDU were evaluated upon admission, as well as upon discharge and three and six months after discharge, using the Eating Disorder Questionnaire. Upon discharge a marked decrease in the overall symptoms was noted. The differences in symptoms incidences between the two groups were significantly specific for the individual form of eating disorder, especially upon admission, and were more pronounced in anorexia group. In later measurements, performed during the period of three and six months after discharge, a mild trend of increase in the disorder specific symptoms was detected in both groups, but was not statistically significant. In addition to binging on food, striking, quarreling and spending sprees are characteristics of patients with eating disorders, which in particular apply to the Bulimia nervosa group. Apart from the disorder specific symptoms, impulsive behavior was also reduced during study period, while the difference in its occurrence between the two groups gradually became non-significant. The management of patients with eating disorders at the EDU was successful in both groups, confirmed by an intense reduction of the disorder specific symptoms, impulsive behavior and increased stability recorded three and six months after discharge. The study strongly suggests that the effect of treatment regime for eating disorders can be predicted by careful assessment of the relevant symptoms and impulsive behavioral patterns.

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

    PubMed

    McAdams, Carrie J; Krawczyk, Daniel C

    2013-01-01

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

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2015-05-01

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

  15. Efficacy of High-Dose Baclofen for Alcohol Use Disorder and Comorbid Bulimia: A Case Report.

    PubMed

    Weibel, Sébastien; Lalanne, Laurence; Riegert, Myriam; Bertschy, Gilles

    2015-01-01

    High-dose baclofen is a promising treatment for alcohol use disorder, with a specific action on craving. A more general action on craving in other addictive disorders has been suggested based on the hypothesis of a common neurobiological pathway in addictions. We report the case of a woman with both alcohol use disorder and bulimia nervosa. There was a positive response to high-dose baclofen on alcohol craving, but no response on food craving. The case illustrates that craving could be differentially responsive to anti-craving drugs.

  16. Efficacy of High-Dose Baclofen for Alcohol Use Disorder and Comorbid Bulimia: A Case Report.

    PubMed

    Weibel, Sébastien; Lalanne, Laurence; Riegert, Myriam; Bertschy, Gilles

    2015-01-01

    High-dose baclofen is a promising treatment for alcohol use disorder, with a specific action on craving. A more general action on craving in other addictive disorders has been suggested based on the hypothesis of a common neurobiological pathway in addictions. We report the case of a woman with both alcohol use disorder and bulimia nervosa. There was a positive response to high-dose baclofen on alcohol craving, but no response on food craving. The case illustrates that craving could be differentially responsive to anti-craving drugs. PMID:26457456

  17. Experiences of women with bulimia nervosa in a mindfulness-based eating disorder treatment group.

    PubMed

    Proulx, Kathryn

    2008-01-01

    The experience of 6 college-age women with bulimia nervosa was examined after they participated in an 8-week mindfulness-based eating disorder treatment group. This phenomenological study used individual interview and pre- and post-treatment self-portraits. Participants described their experience of transformation from emotional and behavioral extremes, disembodiment, and self-loathing to the cultivation of an inner connection with themselves resulting in greater self-awareness, acceptance, and compassion. They reported less emotional distress and improved abilities to manage stress. This treatment may help the 40% of women who do not improve with current therapies and might be useful to prevent symptoms in younger women.

  18. Guided Imagery Treatment to Promote Self-Soothing in Bulimia Nervosa: A Theoretical Rationale

    PubMed Central

    Esplen, Mary Jane; Garfinkel, Paul E.

    1998-01-01

    Bulimia nervosa (BN) has been described as involving impairment in affect regulation and in self-soothing. Such a conceptualization suggests the need to design treatments that specifically target these problems in order to assist individuals with BN in comforting themselves. A model of guided imagery therapy suggests that imagery therapy has multiple levels of action and can assist these individuals in the regulation of affect by providing an external source of soothing and also by enhancing self-soothing. The authors illustrate the model with a case example and report the results of a study in a clinical sample of BN. PMID:9527955

  19. Predictors of early change in bulimia nervosa after a brief psychoeducational therapy.

    PubMed

    Fernàndez-Aranda, Fernando; Alvarez-Moya, Eva M; Martínez-Viana, Cristina; Sànchez, Isabel; Granero, Roser; Penelo, Eva; Forcano, Laura; Peñas-Lledó, Eva

    2009-06-01

    We aimed to examine baseline predictors of treatment response in bulimic patients. 241 seeking-treatment females with bulimia nervosa completed an exhaustive assessment and were referred to a six-session psychoeducational group. Regression analyses of treatment response were performed. Childhood obesity, lower frequency of eating symptomatology, lower body mass index, older age, and lower family's and patient's concern about the disorder were predictors of poor abstinence. Suicidal ideation, alcohol abuse, higher maximum BMI, higher novelty seeking and lower baseline purging frequency predicted dropouts. Predictors of early symptom changes and dropouts were similar to those identified in longer CBT interventions.

  20. [Prevention and Treatment of Eating Disorders: The Health Care Network Anorexia and Bulimia nervosa].

    PubMed

    Weigel, Angelika; Gumz, Antje; Kästner, Denise; Romer, Georg; Wegscheider, Karl; Löwe, Bernd

    2015-07-01

    The "Health care network anorexia and bulimia nervosa", a subproject of psychenet - the Hamburg network for mental health - aims to decrease the incidence of eating disorders as well as the risk for chronic illness courses. One focal project, therefore, evaluates a school-based prevention manual in a randomized controlled trial. The other one examines the impact of a systemic public health intervention on early treatment initiation in anorexia nervosa. The present article provides an overview about study design and interventions in both focal projects as well as preliminary results.

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

    PubMed

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

    2015-05-01

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

  2. Sulphatoxy melatonin: an index of depression in anorexia nervosa and bulimia nervosa.

    PubMed

    Kennedy, S H; Brown, G M; Garfinkel, P E; McVey, G; Parienti, V

    1990-06-01

    Urinary excretion of the principal melatonin metabolite, sulphatoxy melatonin (aMT6s), was assessed both during the day and during the night in 38 female eating disorder patients (anorexia nervosa, n = 17; bulimia nervosa, n = 12; anorexia nervosa + bulimia nervosa, n = 9) and 14 female control subjects. Correlations between nocturnal serum melatonin and urinary aMT6s were also obtained. All patient groups and the controls showed a preservation of diurnal rhythm with elevated nocturnal urinary aMT6s values and no significant difference in amplitude between groups. However, patients with concurrent major depression had significantly lower levels of daytime and nighttime urinary aMT6s than the nondepressed group. Weight did not influence these findings. Correlations between nocturnal serum melatonin levels and urinary aMT6s were high for control subjects (r = 0.77) and moderate for the patient groups (r = 0.31). This may reflect differences in the rate of excretion of melatonin between patients and controls.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  5. Regional grey matter volume abnormalities in bulimia nervosa and binge-eating disorder.

    PubMed

    Schäfer, Axel; Vaitl, Dieter; Schienle, Anne

    2010-04-01

    This study investigated whether bulimia nervosa (BN) and binge-eating disorder (BED) are associated with structural brain abnormalities. Both disorders share the main symptom binge-eating, but are considered differential diagnoses. We attempted to identify alterations in grey matter volume (GMV) that are present in both psychopathologies as well as disorder-specific GMV characteristics. Such information can help to improve neurobiological models of eating disorders and their classification. A total of 50 participants (patients suffering from BN (purge type), BED, and normal-weight controls) underwent structural MRI scanning. GMV for specific brain regions involved in food/reinforcement processing was analyzed by means of voxel-based morphometry. Both patient groups were characterized by greater volumes of the medial orbitofrontal cortex (OFC) compared to healthy controls. In BN patients, who had increased ventral striatum volumes, body mass index and purging severity were correlated with striatal grey matter volume. Altogether, our data implicate a crucial role of the medial OFC in the studied eating disorders. The structural abnormality might be associated with dysfunctions in food reward processing and/or self-regulation. The bulimia-specific volume enlargement of the ventral striatum is discussed in the framework of negative reinforcement through purging and associated weight regulation.

  6. Electrocortical processing of food and emotional pictures in anorexia nervosa and bulimia nervosa.

    PubMed

    Blechert, Jens; Feige, Bernd; Joos, Andreas; Zeeck, Almut; Tuschen-Caffier, Brunna

    2011-06-01

    Objective To compare the electrocortical processing of food pictures in participants with anorexia nervosa (n = 21), bulimia nervosa (n = 22), and healthy controls (HCs) (n = 32) by measuring the early posterior negativity, an event-related potential that reflects stimulus salience and selective attention. Methods We exposed these three groups to a rapid stream of high- and low-calorie food pictures, as well as standard emotional and neutral pictures. Results Event-related potentials in the time range of 220 milliseconds to 310 milliseconds on posterior electrodes differed between groups: patients with eating disorders showed facilitated processing of both high- and low-calorie food pictures relative to neutral pictures, whereas HC participants did so only for the high-calorie pictures. Subjective palatability of the pictures was rated highest by patients with anorexia nervosa, followed by the HC and bulimia nervosa groups. Conclusions Patients with eating disorders show a generalized attentional bias for food images, regardless of caloric value. This might explain the persistent preoccupation with food in these individuals.

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

    PubMed

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

    2016-01-01

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

  8. Predictors of 12-Month Outcome in Bulimia Nervosa and the Influence of Attitudes to Shape and Weight.

    ERIC Educational Resources Information Center

    Fairburn, Christopher G.; And Others

    1993-01-01

    Patients with bulimia nervosa were treated with either cognitive behavioral, behavioral, or a form of interpersonal psychotherapy for 19 sessions in an 18-week period. Assessments were made at pretreatment; posttreatment; and 4-, 8-, and 12-month follow-up. The nature of the relationship between attitudinal disturbance and outcome was complex and…

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

    ERIC Educational Resources Information Center

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

    2002-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  12. The Production of "Everything You Always Wanted to Know about Anorexia and Bulimia, but Were Afraid to Ask".

    ERIC Educational Resources Information Center

    Zimmer, Marc A.

    This report describes the research study involved in developing a document on anorexia and bulimia for the lay population. Chapter I focuses on the basic areas that provided the foundation for the study: (1) the definitions of specific eating disorders; (2) the role of the mass media in affecting anorexics and bulimics, and in educating the public…

  13. Emotion Dysregulation and Affective Intensity Mediate the Relationship Between Childhood Abuse and Suicide-Related Behaviors Among Women with Bulimia Nervosa.

    PubMed

    Gordon, Kathryn H; Simonich, Heather; Wonderlich, Stephen A; Dhankikar, Swati; Crosby, Ross D; Cao, Li; Kwan, Mun Yee; Mitchell, James E; Engel, Scott G

    2016-02-01

    Self-harm and suicide attempts occur at elevated rates among individuals with bulimia nervosa, particularly among those who have experienced childhood abuse. This study investigated the potential mediating roles of emotion dysregulation and affective intensity in the relationship between these variables in 125 women with bulimia nervosa. Analyses revealed that emotion dysregulation mediated the relationship between sexual and emotional abuse with both self-harm and suicide attempts. Negative affective intensity mediated the relationship between abuse and suicide attempts. The findings may advance the understanding of mechanisms underlying suicide-related behaviors in women with bulimia nervosa who experienced abuse and suggest potential clinical targets.

  14. Association of CNR1 and FAAH endocannabinoid gene polymorphisms with anorexia nervosa and bulimia nervosa: evidence for synergistic effects.

    PubMed

    Monteleone, P; Bifulco, M; Di Filippo, C; Gazzerro, P; Canestrelli, B; Monteleone, F; Proto, M C; Di Genio, M; Grimaldi, C; Maj, M

    2009-10-01

    Endocannabinoids modulate eating behavior; hence, endocannabinoid genes may contribute to the biological vulnerability to eating disorders. The rs1049353 (1359 G/A) single nucleotide polymorphism (SNP) of the gene coding the endocannabinoid CB1 receptor (CNR1) and the rs324420 (cDNA 385C to A) SNP of the gene coding fatty acid amide hydrolase (FAAH), the major degrading enzyme of endocannabinoids, have been suggested to have functional effects on mature proteins. Therefore, we explored the possibility that those SNPs were associated to anorexia nervosa and/or bulimia nervosa. The distributions of the CNR1 1359 G/A SNP and of the FAAH cDNA 385C to A SNP were investigated in 134 patients with anorexia nervosa, 180 patients with bulimia nervosa and 148 normal weight healthy controls. Additive effects of the two SNPs in the genetic susceptibility to anorexia nervosa and bulimia nervosa were also tested. As compared to healthy controls, anorexic and bulimic patients showed significantly higher frequencies of the AG genotype and the A allele of the CNR1 1359 G/A SNP. Similarly, the AC genotype and the A allele of the FAAH cDNA 385C to A SNP were significantly more frequent in anorexic and bulimic individuals. A synergistic effect of the two SNPs was evident in anorexia nervosa but not in bulimia nervosa. Present findings show for the first time that the CNR1 1359 G/A SNP and the FAAH cDNA 385C to A SNP are significantly associated to anorexia nervosa and bulimia nervosa, and demonstrate a synergistic effect of the two SNPs in anorexia nervosa.

  15. Memory bias for schema-related stimuli in individuals with bulimia nervosa.

    PubMed

    Legenbauer, Tanja; Maul, Bärbel; Rühl, Ilka; Kleinstäuber, Maria; Hiller, Wolfgang

    2010-03-01

    This study investigates whether individuals with bulimia nervosa (BN) have a memory bias in relation to explicit memory (cued and free recall vs. verbal and pictorial recognition tasks). Twenty-five participants diagnosed with BN and 27 normal controls (NC) were exposed to body-related, food-related, and neutral TV commercials, and then recall and recognition rates were assessed. Poorer recognition and recall of body-related stimuli was found for BN in comparison to NC, suggesting a memory bias. Results are discussed in relation to previous studies, along with suggestions as to how future studies can gain more insight into dysfunctions in information processing that can lead to the maintenance of eating disorders. PMID:20099307

  16. Electrophysiological evidence for an attentional bias in processing body stimuli in bulimia nervosa.

    PubMed

    Mai, Sandra; Gramann, Klaus; Herbert, Beate M; Friederich, Hans-Christoph; Warschburger, Petra; Pollatos, Olga

    2015-05-01

    Empirical evidence suggests abnormalities in the processing of body stimuli in bulimia nervosa (BN). This study investigated central markers of processing body stimuli by means of event-related potentials in BN. EEG was recorded from 20 women with BN and 20 matched healthy controls while watching and evaluating underweight, normal and overweight female body pictures. Bulimics evaluated underweight bodies as less unpleasant and overweight bodies as bigger and more arousing. A higher P2 to overweight stimuli occurred in BN only. In contrast to controls, no N2 increase to underweight bodies was observed in BN. P3 was modulated by stimulus category only in healthy controls; late slow waves to underweight bodies were more pronounced in both groups. P2 amplitudes to overweight stimuli were correlated with drive for thinness and body dissatisfaction. We present novel support for altered perceptual and cognitive-affective processing of body images in BN on the subjective and electrophysiological level. PMID:25813122

  17. [Prosthetic rehabilitation of a traumatic occlusion due to bulimia nervosa. Case report].

    PubMed

    Bassetti, Renzo; Enkling, Norbert; Fahrländer, Fritz-Marc; Bassetti, Mario; Mericske-Stern, Regina

    2012-01-01

    Because of the typical localisation of erosions in anorectic/bulimic patients, the dentist is frequently the first medical person to discern this general illness (anorexia and bulimia nervosa). From the dental viewpoint, the aim should be to preserve sound dental tissue and to prevent further toothwear. A restorative treatment is to be carried out only after causal therapy and after resolving the basic disease. By means of this procedure a good long-term prognosis can be expected. Considering the patient's young age, dentistry should be preservative using the adhesive technique. This case report documents the systematic procedure of the functional and esthetic rehabilitation of an eroded dentition and shows factors essential to the treatment.

  18. Anorexia, bulimia, and obesity: shared decision making deficits on the Iowa Gambling Task (IGT).

    PubMed

    Brogan, Amy; Hevey, David; Pignatti, Riccardo

    2010-07-01

    The pathological eating behaviors in Anorexia Nervosa (AN), Bulimia Nervosa (BN), and obesity are characterized by a preference for high immediate reward, despite higher future losses in terms of both physical and psychological outcomes. The present study compared the decision making profile of females with a diagnosis of AN (n = 22), BN (n = 17), obesity (n = 18), and a healthy weight comparison group (n = 20) using a standardized neuropsychological test, the Iowa Gambling Task (IGT). The three clinical groups (AN, BN, obesity) were significantly impaired on the IGT compared with the comparison group on both overall task performance and task learning; however, the three clinical groups were not significantly different from each other. Sixty-one percent to 77% of the clinical groups reached the threshold for impairment on the IGT, compared with 15% of the comparison group. The potential basis for this shared decision making profile is discussed.

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

    PubMed

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

    2015-09-01

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

  20. From disordered eating to addiction: the "food drug" in bulimia nervosa.

    PubMed

    Umberg, Erin N; Shader, Richard I; Hsu, L K George; Greenblatt, David J

    2012-06-01

    The high prevalence of substance abuse in individuals with bulimia nervosa (BN) and the pervasive symptom substitution in many types of drug addiction suggest that a number of substances--including food--can impair an individual's self-control, even in the presence of negative consequences. Nonetheless, the neurobiological similarities between BN and drug addiction are not clearly established. This review explores how the specific eating patterns seen in BN (binge eating and purging, with intermittent dietary restriction) are particularly addictive and differentiate BN from other eating disorders and obesity. A number of peripheral and central biological aberrations seen in BN may result in altered reward sensitivity in these individuals, particularly through effects on the dopaminergic system. Neurobiological findings support the notion that BN is an addictive disorder, which has treatment implications for therapy and pharmacological manipulations.

  1. Intentional hypoglycemia to control bingeing in a patient with type 1 diabetes and bulimia nervosa.

    PubMed

    Moosavi, Mandana; Kreisman, Stuart; Hall, Lacresha

    2015-02-01

    Most cases of eating disorders associated with type 1 diabetes mellitus are categorized as diabulimia, a disorder of withholding insulin treatment to lose weight through sustained hyperglycemia. In this paper, we report a unique case of a patient with both type 1 diabetes and bulimia nervosa who has an atypical way of controlling her bingeing by keeping her blood sugars low. This pattern of intentionally sustained hypoglycemia has not been previously described in the literature to the best of our knowledge. Knowing various presentations of eating disorders in patients with type 1 diabetes can provide healthcare workers with enhanced ability in recognizing and educating at-risk patients, in the hope of preventing serious hypoglycemia or complications. Furthermore, a patient's awareness of complications associated with suboptimal control of diabetes, whether by overdosing or underdosing their insulin regimen, might lead to avoidance of disordered eating behaviours.

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

    PubMed Central

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

    2015-01-01

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

  3. Emotion recognition, emotional awareness and cognitive bias in individuals with bulimia nervosa.

    PubMed

    Legenbauer, Tanja; Vocks, Silja; Rüddel, Heinz

    2008-06-01

    Difficulties recognizing emotion have been reported for eating disordered individuals in relation to perception of emotions in others and emotional self-awareness. It remains unclear whether this is a perceptual or cognitive-affective problem. Clarification is sought and the question of a cognitive bias is addressed when interpreting facially expressed emotions. Twenty participants with bulimia nervosa (BN) and 20 normal controls (NC) were assessed for ability to recognize emotional and neutral expressions. Emotional self-awareness was also assessed. Significant differences were found for emotional self-awareness. For emotional faces, only a poorer recognition of the emotion, surprise, for BN was found. Problems with emotional self-awareness suggest a cognitive-affective disturbance in emotion recognition. Implications for therapy are discussed.

  4. Memory bias for schema-related stimuli in individuals with bulimia nervosa.

    PubMed

    Legenbauer, Tanja; Maul, Bärbel; Rühl, Ilka; Kleinstäuber, Maria; Hiller, Wolfgang

    2010-03-01

    This study investigates whether individuals with bulimia nervosa (BN) have a memory bias in relation to explicit memory (cued and free recall vs. verbal and pictorial recognition tasks). Twenty-five participants diagnosed with BN and 27 normal controls (NC) were exposed to body-related, food-related, and neutral TV commercials, and then recall and recognition rates were assessed. Poorer recognition and recall of body-related stimuli was found for BN in comparison to NC, suggesting a memory bias. Results are discussed in relation to previous studies, along with suggestions as to how future studies can gain more insight into dysfunctions in information processing that can lead to the maintenance of eating disorders.

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

    PubMed

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

    2016-01-01

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

  6. Neural correlates of the processing of self-referent emotional information in bulimia nervosa.

    PubMed

    Pringle, A; Ashworth, F; Harmer, C J; Norbury, R; Cooper, M J

    2011-10-01

    There is increasing interest in understanding the roles of distorted beliefs about the self, ostensibly unrelated to eating, weight and shape, in eating disorders (EDs), but little is known about their neural correlates. We therefore used functional magnetic resonance imaging to investigate the neural correlates of self-referent emotional processing in EDs. During the scan, unmedicated patients with bulimia nervosa (n=11) and healthy controls (n=16) responded to personality words previously found to be related to negative self beliefs in EDs and depression. Rating of the negative personality descriptors resulted in reduced activation in patients compared to controls in parietal, occipital and limbic areas including the amygdala. There was no evidence that reduced activity in patients was secondary to increased cognitive control. Different patterns of neural activation between patients and controls may be the result of either habituation to personally relevant negative self beliefs or of emotional blunting in patients. PMID:21843538

  7. Observed Connection and Individuation: Relation to Symptoms in Families of Adolescents with Bulimia Nervosa

    PubMed Central

    Thomas, Sarah A.; Hoste, Renee Rienecke; Le Grange, Daniel

    2012-01-01

    Objective To examine the relation between observed familial connection and individuation and adolescent bulimia nervosa (BN) symptoms. Method As part of a treatment study for adolescent BN, adolescents (n = 54) and their parents participated in a videotaped semi-structured interview. Participants were rated on observed connection and individuation from these interviews using the Scale of Intergenerational Relationship Quality and two measures of connection. Results There was a significant negative relation between individuation from parents and adolescent BN symptoms. Connection both to and from mothers and adolescents was negatively associated with BN symptoms. Increased eating concern was significantly associated with a greater likelihood of expressing a desire for more connection with the family. Discussion Investigating and understanding family factors present at the time of adolescent BN may assist in providing treatment specific to the needs of the family to best aid the adolescent’s recovery process. PMID:22593023

  8. Dieting in bulimia nervosa is associated with increased food restriction and psychopathology but decreased binge eating.

    PubMed

    Lowe, Michael R; Witt, Ashley A; Grossman, Stephanie L

    2013-08-01

    The cognitive behavioral model of bulimia nervosa (BN) suggests that dieting is central to the maintenance of binge eating. However, correlational and experimental studies suggest that additional clarification is needed about the nature of this relationship. Dieting, weight, eating disorder psychopathology, and depression were assessed at admission among 166 patients with BN presenting for residential treatment. As in past research, a significant fraction (43%) of patients with BN reported not currently dieting. A comparison of weight loss dieters and non-dieters found greater food restriction and eating disorder psychopathology among weight loss dieters. However, dieters reported less frequent binge eating. There were no significant group differences in depression. Results suggest that 1) while many individuals with BN are attempting to restrict their food intake, the goal of losing weight fundamentally alters the effect of such restriction on binge eating, and 2) treatment may benefit from helping patients to establish a healthier approach to achieving long-term weight stability.

  9. Evaluation of a functional treatment for binge eating associated with bulimia nervosa.

    PubMed

    Giddings, T D; Miltenberger, R G

    2010-01-01

    Binge-eating disorders (BED) are a common problem affecting up to 5 percent of the American population in any given 6-month period. Currently, the most widely accepted treatment is some variation of Cognitive Behavior Therapy, although the abstinence rates following this type of treatment are only around 50%. A recent study by Bosch et al. explored the effects of extinction with four women who engaged in binge-eating behavior associated with BED and bulimia nervosa (BN). The treatment was successful, with three of the four participants obtaining abstinence. To date, this has been the only study examining this procedure. The purpose of the current study was to further evaluate extinction of binge eating with four young women who met diagnostic criteria for BN. The results showed that the treatment decreased binge eating to zero for all four women, although one dropped out of the study shortly after beginning the intervention.

  10. Food cravings discriminate between anorexia and bulimia nervosa. Implications for "success" versus "failure" in dietary restriction.

    PubMed

    Moreno, Silvia; Warren, Cortney S; Rodríguez, Sonia; Fernández, M Carmen; Cepeda-Benito, Antonio

    2009-06-01

    Food cravings are subjective, motivational states thought to induce binge eating among eating disorder patients. This study compared food cravings across eating disorders. Women (N=135) diagnosed with anorexia nervosa, restrictive (ANR) or binge-purging (ANBP) types, or bulimia nervosa, non-purging (BNNP) or purging (BNP) types completed measures of food cravings. Discriminant analysis yielded two statistically significant functions. The first function differentiated between all the four group pairs except ANBP and BNNP, with levels of various food-craving dimensions successively increasing for ANR, ANBP, BNNP, and BNP participants. The second function differentiated between ANBP and BNNP participants. Overall, the functions improved classification accuracy above chance level (44% fewer errors). The findings suggest that cravings are more strongly associated with loss of control over eating than with dietary restraint tendencies.

  11. Trail making task performance in inpatients with anorexia nervosa and bulimia nervosa.

    PubMed

    Vall, Eva; Wade, Tracey D

    2015-07-01

    Set-shifting inefficiencies have been consistently identified in adults with anorexia nervosa (AN). It is less clear to what degree similar inefficiencies are present in those with bulimia nervosa (BN). It is also unknown whether perfectionism is related to set-shifting performance. We employed a commonly used set-shifting measure, the Trail Making Test (TMT), to compare the performance of inpatients with AN and BN with a healthy control sample. We also investigated whether perfectionism predicted TMT scores. Only the BN sample showed significantly suboptimal performance, while the AN sample was indistinguishable from controls on all measures. There were no differences between the AN subtypes (restrictive or binge/purge), but group sizes were small. Higher personal standards perfectionism was associated with better TMT scores across groups. Higher concern over mistakes perfectionism predicted better accuracy in the BN sample. Further research into the set-shifting profile of individuals with BN or binge/purge behaviours is needed.

  12. Towards a physiologically based diagnosis of anorexia nervosa and bulimia nervosa.

    PubMed

    Hatch, Kent A; Spangler, Diane L; Backus, Elizabeth M; Balagna, Jonathan T; Burns, Keven S; Guzman, Brooke S; Hubbard, Matthew J; Lindblad, Stephanie L; Roeder, Beverly L; Ryther, Natalie E; Seawright, Max A; Tyau, Jaymie N; Williams, Dustin

    2007-11-01

    Diagnosis of anorexia nervosa (AN) and bulimia nervosa (BN), while including such physiological data as weight and the reproductive status of the individual, are primarily based on questionnaires and interviews that rely on self-report of both body-related concerns and eating-related behaviors. While some key components of eating disorders are psychological and thus introspective in nature, reliance on self-report for the assessment of eating-related behaviors and nutritional status lacks the objectivity that a physiologically based measure could provide. The development of a more physiologically informed diagnosis for AN and BN would provide a more objective means of diagnosing these disorders, provide a sound physiological basis for diagnosing subclinical disorders and could also aid in monitoring the effectiveness of treatments for these disorders. Empirically supported, physiologically based methods for diagnosing AN and BN are reviewed herein as well as promising physiological measures that may potentially be used in the diagnosis of AN and BN.

  13. [Anorexia and bulimia: the canton of Vaud's experience of an interdisciplinary approach].

    PubMed

    Gebhard, S; Dorogi, Y; Giusti, V; Stagno, D; Lanz, M; Schmidt, D; Chaubert, C Monney; Laget, J; Michaud, P-A; Stiefel, F

    2011-02-16

    As psychiatric disorders attacking the body, anorexia and bulimia may have severe psychological, physical and social consequences, often requiring a long-standing interdisciplinary, coordinated and individualized approach. Recently the canton of Vaud has initiated and developed an interinstitutional structure--between the University Hospital (CHUV) and the hospitals of the Northern region of the canton (eHnv)--for the care of patients suffering from eating disorders. This structure, allowing the above mentioned approach for the treatment of eating disorders, consists of an outpatient facility located in the CHUV and an inpatient unit in the hospital of Saint Loup of the eHnv. Within this structure, the general practitioner plays a crucial role in the prevention of the chronification of these disorders by means of their early detection and management.

  14. A quantitative study of body-related attitudes in patients with anorexia and bulimia nervosa.

    PubMed

    Ben-Tovim, D I; Walker, M K

    1992-11-01

    The Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) is a psychometrically sound self-report instrument for assessing women's attitudes towards their own bodies. The BAQ responses of a large sample of patients with eating disorders (ED) diagnosed in accordance with DSM-III-R criteria were compared with those from a normative population and from diverse groups of psychiatrically and physically ill patients. The ED group was distinct, and showed extreme responses in the area of weight and shape concerns. But a better discrimination between the ED and other populations was achieved using subscales that related to 'body disparagement' (an intense loathing of the body) and 'attractiveness', rather than to weight and shape concerns. ED patients may have a more pervasive disturbance in body-related attitudes than is currently widely accepted. Patients with anorexia and bulimia nervosa showed very similar attitudes despite the symptomatic differences between the groups. PMID:1488491

  15. Bulimia Nervosa

    MedlinePlus

    ... hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to ... U.S. federal government and is in the public domain. This public information is not copyrighted and may ...

  16. Treating Bulimia.

    ERIC Educational Resources Information Center

    Thornton, Lisa P.; DeBlassie, Richard R.

    1989-01-01

    Identifies and discusses treatment of some irrational cognitions of bulimics concerning food, weight loss, eating, and dieting. Describes use of cognitive, behavioral, and emotional interventions. Notes importance of providing nutrition information and realistic diet practices. Group treatment approach is briefly addressed in dealing with…

  17. Getting better byte by byte: a pilot randomised controlled trial of email therapy for bulimia nervosa and binge eating disorder.

    PubMed

    Robinson, Paul; Serfaty, Marc

    2008-03-01

    One hundred and ten people in an university population responded to emailed eating disorder questionnaires. Ninty-seven fulfilling criteria for eating disorders (bulimia nervosa (BN), binge eating disorder (BED), EDNOS) were randomised to therapist administered email bulimia therapy (eBT), unsupported Self directed writing (SDW) or Waiting list control (WLC). Measures were repeated at 3 months. Diagnosis, Beck depression inventory (BDI) and Bulimia investigatory test (BITE) scores were recorded. Follow-up rate was 63% and results must be interpreted cautiously. However significantly fewer participants who had received eBT or SDW fulfilled criteria for eating disorders at follow up compared to WLC. There was no significant difference between eBT and SDW in the analysis of variance (ANOVA), although in separate analyses, eBT was significantly superior to WLC (p < 0.02) and the difference for SDW approached significance (p = 0.06). BDI and BITE scores showed no significant change. For eBT participants there was a significant positive correlation between words written and improvement in BITE severity score. BN, BED and EDNOS can be treated via email.

  18. Understanding the Relation between Anorexia Nervosa and Bulimia Nervosa in a Swedish National Twin Sample

    PubMed Central

    Bulik, Cynthia M; Thornton, Laura; Root, Tammy L.; Pisetsky, Emily M.; Lichtenstein, Paul; Pedersen, Nancy L.

    2010-01-01

    Background We present a bivariate twin analysis of anorexia nervosa (AN) and bulimia nervosa (BN) to determine the extent to which shared genetic and environmental factors contribute to liability to these disorders. Method Focusing on females from the Swedish Twin study of Adults: Genes and Environment (STAGE) (N=7000), we calculated heritability estimates for narrow and broad AN and BN and estimated their genetic correlation. Results In the full model, the heritability estimate for narrow AN was (a2 = .57; 95% CI: .00, .81) and for narrow BN (a2 = .62; 95% CI: .08, .70) with the remaining variance accounted for by unique environmental factors. Shared environmental factors estimates were (c2 = .00; 95% CI: .00, .67) for AN and (c2 = .00; 95% CI: .00, .40) for BN. Moderate additive genetic (.46) and unique environmental (.42) correlations between AN and BN were observed. Heritability estimates for broad AN were lower (a2 = .29; 95% CI: .04, .43) than for narrow AN, but estimates for broad BN were similar to narrow BN. The genetic correlation for broad AN and BN was .79 and the unique environmental correlation was .44. Conclusions We highlight the contribution of additive genetic factors to both narrow and broad AN and BN and demonstrate a moderate overlap of both genetic and unique environmental factors that influence the two conditions. Common concurrent and sequential comorbidity of AN and BN can in part be accounted for by shared genetic and environmental influences on liability although independent factors also operative. PMID:19828139

  19. Reactivity to 35% carbon dioxide in bulimia nervosa and panic disorder.

    PubMed

    Woznica, Andrea; Vickers, Kristin; Koerner, Naomi; Fracalanza, Katie

    2015-08-30

    The inhalation of 35% carbon dioxide (CO₂) induces panic and anxiety in people with panic disorder (PD) and in people with various other psychiatric disorders. The anxiogenic effect of CO₂ in people with eating disorders has received sparse attention despite the fact that PD and bulimia nervosa (BN) have several common psychological and neurobiological features. This study compared CO₂-reactivity across three groups of participants: females with BN, females with PD, and female controls without known risk factors for enhanced CO₂-reactivity (e.g., social anxiety disorder, first degree relatives with PD). Reactivity was measured by self-reported ratings of panic symptomatology and subjective anxiety, analyzed as both continuous variables (change from room-air to CO₂) and dichotomous variables (positive versus negative responses to CO₂). Analyses of each outcome measure demonstrated that CO₂-reactivity was similar across the BN and PD groups, and reactivity within each of these two groups was significantly stronger than that in the control group. This is the first study to demonstrate CO₂-hyperreactivity in individuals with BN, supporting the hypothesis that reactivity to this biological paradigm is not specific to PD. Further research would benefit from examining transdiagnostic mechanisms in CO₂-hyperreactivity, such as anxiety sensitivity, which may account for this study's results.

  20. Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder in Midlife and Beyond.

    PubMed

    Elran-Barak, Roni; Fitzsimmons-Craft, Ellen E; Benyamini, Yael; Crow, Scott J; Peterson, Carol B; Hill, Laura L; Crosby, Ross D; Mitchell, James E; Le Grange, Daniel

    2015-08-01

    We examined eating disorders in midlife and beyond by comparing frequency of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or eating disorder (OSFED) among midlife eating disorder treatment-seeking individuals and younger controls. We also compared demographic and eating disorder-related characteristics across diagnoses and age groups. Participants included 2,118 treatment-seeking adults who self-reported their eating-related symptoms on the Eating Disorder Questionnaire. Results showed that percent of patients with BN was significantly lower whereas percent of patients with BED and OSFED was significantly higher among midlife relative to younger patients. Percent of patients with AN did not differ between midlife and younger patients. Additionally, midlife and younger patients with BED and OSFED differed on several demographic (e.g., marital status) and eating disorder-related characteristics (e.g., BMI, compulsive exercising). This study suggests that BN is less common whereas BED and OSFED are more common among midlife eating disorder treatment-seeking individuals relative to younger controls. In addition, AN and BN present fairly similarly whereas BED and OSFED present fairly differently among midlife patients relative to younger controls. Attention to these differences and similarities is necessary to understand eating disorders in midlife.

  1. Gender Differences in Risk Factors for Stice's Bulimia in a Non-Clinical Sample.

    PubMed

    Ruisoto, Pablo; Cacho, Raúl; López-Goñi, José J; Real Deus, Eulogio; Vaca, Silvia; Mayoral, Paula

    2015-01-01

    Some females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p .05), a key predictor of body dissatisfaction (r = .33; p .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed. PMID:26388326

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

    PubMed

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

    2015-07-01

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

  3. A behavioral-genetic investigation of bulimia nervosa and its relationship with alcohol use disorder.

    PubMed

    Trace, Sara E; Thornton, Laura M; Baker, Jessica H; Root, Tammy L; Janson, Lauren E; Lichtenstein, Paul; Pedersen, Nancy L; Bulik, Cynthia M

    2013-08-15

    Bulimia nervosa (BN) and alcohol use disorder (AUD) frequently co-occur and may share genetic factors; however, the nature of their association is not fully understood. We assessed the extent to which the same genetic and environmental factors contribute to liability to BN and AUD. A bivariate structural equation model using a Cholesky decomposition was fit to data from 7241 women who participated in the Swedish Twin study of Adults: Genes and Environment. The proportion of variance accounted for by genetic and environmental factors for BN and AUD and the genetic and environmental correlations between these disorders were estimated. In the best-fitting model, the heritability estimates were 0.55 (95% CI: 0.37; 0.70) for BN and 0.62 (95% CI: 0.54; 0.70) for AUD. Unique environmental factors accounted for the remainder of variance for BN. The genetic correlation between BN and AUD was 0.23 (95% CI: 0.01; 0.44), and the correlation between the unique environmental factors for the two disorders was 0.35 (95% CI: 0.08; 0.61), suggesting moderate overlap in these factors. The findings from this investigation provide additional support that some of the same genetic factors may influence liability to both BN and AUD.

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2010-01-01

    Serotonergic dysregulation is thought to underlie much of the pathology in bulimia nervosa (BN). The purpose of this review is to expand the serotonergic model by incorporating specific and nonspecific contributions of estrogens to the development and maintenance of bulimic pathology in order to guide research from molecular genetics to novel therapeutics for BN. Special emphasis is given to the organizing theory of general brain arousal which allows for integration of specific and nonspecific effects of these systems on behavioral endpoints such as binge eating or purging as well as arousal states such as fear, novelty seeking, or sex. Regulation of the serotonergic system by estrogens is explored, and genetic, epigenetic, and environmental estrogen effects on bulimic pathology and risk factors are discussed. Genetic and neuroscientific research support this two-system conceptualization of BN with both contributions to the developmental and maintenance of the disorder. Implications of an estrogenic-serotonergic model of BN are discussed as well as guidelines and suggestions for future research and novel therapeutic targets. PMID:20554102

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

    PubMed

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

    2015-07-01

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

  7. Ecological momentary assessment of stressful events and negative affect in bulimia nervosa

    PubMed Central

    Goldschmidt, Andrea B.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G.; Lavender, Jason M.; Peterson, Carol B.; Crow, Scott J.; Cao, Li; Mitchell, James E.

    2014-01-01

    Objective Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment. Method A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for two weeks. Multi-level structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect. Results Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal, and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating or purging. Conclusions Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment. PMID:24219182

  8. Differential Neural Responses to Food Images in Women with Bulimia versus Anorexia Nervosa

    PubMed Central

    Brooks, Samantha J.; O′Daly, Owen G.; Uher, Rudolf; Friederich, Hans-Christoph; Giampietro, Vincent; Brammer, Michael; Williams, Steven C. R.; Schiöth, Helgi B.; Treasure, Janet; Campbell, Iain C.

    2011-01-01

    Background Previous fMRI studies show that women with eating disorders (ED) have differential neural activation to viewing food images. However, despite clinical differences in their responses to food, differential neural activation to thinking about eating food, between women with anorexia nervosa (AN) and bulimia nervosa (BN) is not known. Methods We compare 50 women (8 with BN, 18 with AN and 24 age-matched healthy controls [HC]) while they view food images during functional Magnetic Resonance Imaging (fMRI). Results In response to food (vs non-food) images, women with BN showed greater neural activation in the visual cortex, right dorsolateral prefrontal cortex, right insular cortex and precentral gyrus, women with AN showed greater activation in the right dorsolateral prefrontal cortex, cerebellum and right precuneus. HC women activated the cerebellum, right insular cortex, right medial temporal lobe and left caudate. Direct comparisons revealed that compared to HC, the BN group showed relative deactivation in the bilateral superior temporal gyrus/insula, and visual cortex, and compared to AN had relative deactivation in the parietal lobe and dorsal posterior cingulate cortex, but greater activation in the caudate, superior temporal gyrus, right insula and supplementary motor area. Conclusions Women with AN and BN activate top-down cognitive control in response to food images, yet women with BN have increased activation in reward and somatosensory regions, which might impinge on cognitive control over food consumption and binge eating. PMID:21799807

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

    PubMed

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

    2016-06-01

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

  10. Hard Exercise, Affect Lability, and Personality Among Individuals with Bulimia Nervosa

    PubMed Central

    Brownstone, Lisa M.; Fitzsimmons-Craft, Ellen E.; Wonderlich, Stephen A.; Joiner, Thomas E.; Le Grange, Daniel; Mitchell, James E.; Crow, Scott J.; Peterson, Carol B.; Crosby, Ross D.; Klein, Marjorie H.; Bardone-Cone, Anna M.

    2013-01-01

    The current study explores the personality traits of compulsivity (e.g., sense of orderliness and duty to perform tasks completely) and restricted expression (e.g., emotion expression difficulties) as potential moderators of the relation between affect lability and frequency of hard exercise episodes in a sample of individuals with bulimic pathology. Participants were 204 adult females recruited in five Midwestern cities who met criteria for threshold or subthreshold bulimia nervosa (BN). Compulsivity was found to significantly moderate the relation between affect lability and number of hard exercise episodes over the past 28 days, such that among those with high compulsivity, level of affect lability was associated with the number of hard exercise episodes; whereas, among those with low compulsivity, affect lability was not associated with the number of hard exercise episodes. The same pattern of findings emerged for restricted expression; however, this finding approached, but did not reach statistical significance. As such, it appears that affect lability is differentially related to hard exercise among individuals with BN depending upon the level of compulsivity and, to a more limited extent, restricted expression. These results suggest that, for individuals with BN with either compulsivity or restricted expression, focusing treatment on increasing flexibility and/or verbal expression of emotions may help them in the context of intense, fluctuating affect. PMID:24183126

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

    PubMed

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

    2016-06-01

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

  12. Gender Differences in Risk Factors for Stice's Bulimia in a Non-Clinical Sample.

    PubMed

    Ruisoto, Pablo; Cacho, Raúl; López-Goñi, José J; Real Deus, Eulogio; Vaca, Silvia; Mayoral, Paula

    2015-09-21

    Some females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p .05), a key predictor of body dissatisfaction (r = .33; p .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed.

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

    PubMed Central

    Tuschen-Caffier, Brunna; Bender, Caroline; Caffier, Detlef; Klenner, Katharina; Braks, Karsten; Svaldi, Jennifer

    2015-01-01

    Objective Cognitive theories suggest that body dissatisfaction results from the activation of maladaptive appearance schemata, which guide mental processes such as selective attention to shape and weight-related information. In line with this, the present study hypothesized that patients with anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by increased visual attention for the most dissatisfying/ugly body part compared to their most satisfying/beautiful body part, while a more balanced viewing pattern was expected for controls without eating disorders (CG). Method Eye movements were recorded in a group of patients with AN (n = 16), BN (n = 16) and a CG (n = 16) in an ecologically valid setting, i.e., during a 3-min mirror exposure. Results Evidence was found that patients with AN and BN display longer and more frequent gazes towards the most dissatisfying relative to the most satisfying and towards their most ugly compared to their most beautiful body parts, whereas the CG showed a more balanced gaze pattern. Discussion The results converge with theoretical models that emphasize the role of information processing in the maintenance of body dissatisfaction. Given the etiological importance of body dissatisfaction in the development of eating disorders, future studies should focus on the modification of the reported patterns. PMID:26714279

  14. Quantitative evidence for distinct cognitive impairment in anorexia nervosa and bulimia nervosa.

    PubMed

    Zakzanis, Konstantine K; Campbell, Zachariah; Polsinelli, Angelina

    2010-03-01

    It is generally agreed that at least some aspects of abnormal eating behaviour is indeed due in part to disordered cognition. The accumulated literature illustrates cognitive impairment in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Yet beyond being inconsistent, these independent studies also do not reveal the magnitude of impairment within and across studies and fail to give due consideration to the magnitude of impairment so as to understand the severity and breadth of impairment and/or differences in cognitive profiles between patients with AN and BN. Hence, the present review on the subject sought to articulate the magnitude of cognitive impairment in patients with AN and BN by quantitatively synthesizing the existing literature using meta-analytic methodology. The results demonstrate modest evidence of cognitive impairment specific to AN and BN that is related to body mass index in AN in terms of its severity, and is differentially impaired between disorders. Together, these results suggest that disturbed cognition is figural in the presentation of eating disorders and may serve to play an integral role in its cause and maintenance. Implications of these findings with respects to future research are discussed.

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

    PubMed

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

    2015-08-01

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

  16. Enhanced ghrelin secretion in the cephalic phase of food ingestion in women with bulimia nervosa.

    PubMed

    Monteleone, Palmiero; Serritella, Cristina; Scognamiglio, Pasquale; Maj, Mario

    2010-02-01

    In humans, the cephalic phase response to food ingestion consists mostly of vagal efferent activation, which promotes the secretion of entero-pancreatic hormones, including ghrelin. Since symptomatic patients with bulimia nervosa (BN) are characterized by increased vagal tone, we hypothesized an enhanced ghrelin secretion in the cephalic phase of vagal stimulation. Therefore, we investigated ghrelin response to modified sham feeding (MSF) in both BN and healthy women. Six drug-free BN women and 7 age-matched healthy females underwent MSF with initially seeing and smelling a meal, and then chewing the food without swallowing it. Blood samples were drawn immediately before and after MSF for hormone assay. Circulating ghrelin increased after MSF in both groups with BN individuals exhibiting a greater ghrelin increase, which positively correlated with the patients' weekly frequency of binge-purging. These results show for the first time an increased ghrelin secretion in the cephalic phase of vagal stimulation in symptomatic BN patients, likely resulting in a potentiation of the peripheral hunger signal, which might contribute to their aberrant binge-purging behavior.

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

    PubMed

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

    2013-03-01

    Binge eating is a core clinical feature of bulimia nervosa (BN). Enhanced reinforcing value of food may play a role in this behavioral disturbance, but a systematic behavioral assessment of objective measures of the rewarding value of binge eating is lacking. The purpose of this study was to quantify the reinforcing value of food in BN patients as compared with normal controls. A progressive ratio (PR) computerized work task was completed under binge and non-binge instruction. The task consisted of 12 trials. The first trial required 50 keyboard taps to earn one portion of yogurt shake, and subsequent trials required progressive work increments of 200 taps for each additional portion. Completion of all 12 trials required 13,800 taps to earn 2100ml of shake. The breakpoint, defined as the largest ratio completed before a participant stopped working, was the measure of reinforcing efficacy. Ten patients and 10 controls completed the experiment. Under binge instruction, patients completed more trials and taps, and had a higher breakpoint than controls. The non-binge instruction yielded opposite findings; compared to controls, patients completed fewer trials and taps, and had a lower breakpoint. These results support the feasibility and potential utility of a PR task to quantify the reinforcing value of food in patients with BN.

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

    PubMed

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

    2015-01-01

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

  19. Does anger mediate between personality and eating symptoms in bulimia nervosa?

    PubMed

    Amianto, Federico; Siccardi, Sara; Abbate-Daga, Giovanni; Marech, Lucrezia; Barosio, Marta; Fassino, Secondo

    2012-12-30

    The goals of the study were to explore anger correlation with bulimic symptoms and to test the mediation power of anger between personality and eating psychopathology. A total of 242 bulimia nervosa (BN) outpatients and 121 healthy controls were recruited. Assessment was performed using Temperament and Character Inventory (TCI); State-Trait Anger Expression Inventory 2 (STAXI-2); Eating Disorder Inventory-2 (EDI-2); Body Shape Questionnaire (BSQ); Binge Eating Scale (BES); and Beck Depression Inventory (BDI). Mediation was tested on the whole BN group, on controls and on two BN subgroups based on a previous history of anorexia nervosa. Self-Directedness and Cooperativeness extensively relate to anger and psychopathology in bulimic group. Bulimic symptoms are related to Trait Reactive Anger. Trait Anger and Anger Expression fully mediate Cooperativeness effects on binge eating and Impulsiveness in the BN subjects. Anger Expression-In partially mediates between Harm Avoidance and Social Insecurity/Interpersonal Distrust in BN subjects. The comparison with controls and the analysis of subgroups underlines that these patterns are specific for BN. Anger mediation between Cooperativeness, and binge eating and impulsive behaviours confirm the relevance of relational dynamics in the expression of these core eating symptoms. Relational skills may represent a relevant target for the treatment of BN.

  20. Functional and effective connectivity of anterior insula in anorexia nervosa and bulimia nervosa.

    PubMed

    Kim, Kyung Ran; Ku, Jeonghun; Lee, Jung-Hyun; Lee, Hyeongrae; Jung, Young-Chul

    2012-07-19

    The anterior insula has been proposed to play a crucial role in eating disorders. However, it is still poorly understood how the anterior insula is involved in anorexia nervosa (AN) and bulimia nervosa (BN), which are characterized by opposite motivational responses to food. We applied a cue-reactivity paradigm using blood oxygen level-dependent functional magnetic resonance imaging in women with AN (N=18) and BN (N=20) and age-matched healthy controls (N=20). We defined the left anterior insula as a region-of-interest and performed seed-based functional connectivity and effective connectivity MRI analysis. In response to food images compared to non-food images, both the AN group and BN group demonstrated increased activity in the left anterior insula. In the AN group, the left anterior insula demonstrated significant interactions with the right insula and right inferior frontal gyrus. In the BN group, the left anterior insula demonstrated significant interactions with the medial orbitofrontal cortex. The distinct patterns of functional and effective connectivity of the anterior insula may contribute to the different clinical features of AN and BN.

  1. Serotonin alterations in anorexia and bulimia nervosa: new insights from imaging studies.

    PubMed

    Kaye, Walter H; Frank, Guido K; Bailer, Ursula F; Henry, Shannan E; Meltzer, Carolyn C; Price, Julie C; Mathis, Chester A; Wagner, Angela

    2005-05-19

    Anorexia nervosa (AN) and bulimia nervosa (BN) are related disorders with relatively homogenous presentations such as age of onset and gender distribution. In addition, they share symptoms, such as extremes of food consumption, body image distortion, anxiety and obsessions, and ego-syntonic neglect, raises the possibility that these symptoms reflect disturbed brain function that contributes to the pathophysiology of this illness. Recent brain imaging studies have identified altered activity in frontal, cingulate, temporal, and parietal cortical regions in AN and BN. Importantly, such disturbances are present when subjects are ill and persist after recovery, suggesting that these may be traits that are independent of the state of the illness. Emerging data point to a dysregulation of serotonin pathways in cortical and limbic structures that may be related to anxiety, behavioral inhibition, and body image distortions. In specific, recent studies using PET with serotonin specific radioligands implicate alterations of 5-HT1A and 5-HT2A receptors and the 5-HT transporter. Alterations of these circuits may affect mood and impulse control as well as the motivating and hedonic aspects of feeding behavior. Such imaging studies may offer insights into new pharmacology and psychotherapy approaches.

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

    PubMed

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

    2015-12-30

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

  3. Rumination but not distraction increases eating-related symptoms in anorexia and bulimia nervosa.

    PubMed

    Naumann, Eva; Tuschen-Caffier, Brunna; Voderholzer, Ulrich; Caffier, Detlef; Svaldi, Jennifer

    2015-05-01

    Recent models of eating disorders emphasize the importance of ruminative thinking in the occurrence of unhealthy eating behavior. Hence, the aim of the current study was to examine the influence of induced rumination and distraction on the desire to engage in eating-related symptoms in anorexia (AN) and bulimia nervosa (BN). After a sadness induction, either a ruminative or distractive emotion regulation style was encouraged in women with AN (n = 38), BN (n = 37), and non-eating disordered controls (CG; n = 36). At baseline and after the emotion regulation induction feelings of sadness, desire to abstain from eating (DTA) and desire to binge (DTB) were assessed. Main results reveal that rumination led to a significant increase of DTA in the AN group and of DTB in patients with BN. In the CG, DTA significantly decreased after distraction. Although there were significant increases in subjective sadness in the rumination condition, no changes were found in the distraction condition. The results suggest that rumination in response to sadness has a detrimental effect on eating-related symptoms in eating disorders.

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

    PubMed

    Kostopoulou, Myrsini; Varsou, Eleftheria; Stalikas, Anastassios

    2013-09-01

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

  5. Laparoscopic extraction of a swallowed fork in a patient first diagnosed with bulimia nervosa.

    PubMed

    Schenk, C; Mugomba, G; Dabidian, R A; Scheuerecker, H; Glaser, F

    2002-02-01

    Swallowed foreign bodies are relatively common problem. The first reports date back about 3000 years. The first medical report was done by Mestivier in 1759. Several studies show that up to 90% of the foreign bodies (FBs) pass spontaneously and 10% to 20% require an endoscopic removal. Surgical intervention is only indicated in approximately 1% of the cases. Surgical intervention is only necessary, for example, when large or sharp FBs are involved because of the potential risk of perforation and obstruction. The surgical therapy can be carried out by means of laparotomy or laparoscopy; laparoscopy has to be given the first priority whenever possible. The advantages of a laparoscopic procedure are well-known: reduced postoperative pain, better lung function, less postoperative bowel obstruction, shorter hospital stay, and faster reconvalescence. We report an unusual case of an unintentional ingested fork, which required a laparoscopic extraction using three trocars. The 20-year-old female patient was then subsequently diagnosed with bulimia nervosa for the first time during her hospital stay. The patient was discharged home on the fourth postoperative day after an unremarkable course.

  6. The impact of exposure to images of ideally thin models in TV commercials on eating behavior: an experimental study with women diagnosed with bulimia nervosa.

    PubMed

    Rühl, Ilka; Legenbauer, Tanja; Hiller, Wolfgang

    2011-09-01

    This study investigates whether eating behavior in women with diagnosed bulimia nervosa is influenced by prior exposure to images of ideally thin models. Twenty-six participants diagnosed with bulimia nervosa (BN) and 30 normal controls (NC) were exposed to body-related and neutral TV commercials; then food that typically triggers binge eating was provided, and the amount of food eaten was measured. No significant difference for food intake between NC and BN could be found, but food intake for BN was predicted by the degree of thoughts related to eating behaviors during exposure to the thin ideal. No impact of general body image or eating pathology on food intake could be found. The results emphasize the importance of action-relevance of dysfunctional cognitions for the maintenance of eating-disordered behaviors in women with bulimia nervosa, when exposed to eating-disorder-specific triggers. PMID:21855433

  7. The impact of exposure to images of ideally thin models in TV commercials on eating behavior: an experimental study with women diagnosed with bulimia nervosa.

    PubMed

    Rühl, Ilka; Legenbauer, Tanja; Hiller, Wolfgang

    2011-09-01

    This study investigates whether eating behavior in women with diagnosed bulimia nervosa is influenced by prior exposure to images of ideally thin models. Twenty-six participants diagnosed with bulimia nervosa (BN) and 30 normal controls (NC) were exposed to body-related and neutral TV commercials; then food that typically triggers binge eating was provided, and the amount of food eaten was measured. No significant difference for food intake between NC and BN could be found, but food intake for BN was predicted by the degree of thoughts related to eating behaviors during exposure to the thin ideal. No impact of general body image or eating pathology on food intake could be found. The results emphasize the importance of action-relevance of dysfunctional cognitions for the maintenance of eating-disordered behaviors in women with bulimia nervosa, when exposed to eating-disorder-specific triggers.

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

    PubMed

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

    2005-11-01

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

  9. Addicted to Palatable Foods: Comparing the Neurobiology of Bulimia Nervosa to that of Drug Addiction

    PubMed Central

    Hadad, Natalie A.; Knackstedt, Lori A.

    2014-01-01

    Rationale: Bulimia Nervosa (BN) is highly comorbid with substance abuse and shares common phenotypic and genetic predispositions with drug addiction. Although treatments for the two disorders are similar, controversy remains about whether BN should be classified as addiction. Objectives: Here we review the animal and human literature with the goal of assessing whether BN and drug addiction share a common neurobiology. Results: Similar neurobiological features are present following administration of drugs and bingeing on palatable food, especially sugar. Specifically, both disorders involve increases in extracellular dopamine (DA), D1 binding, D3 mRNA, and ΔFosB in the nucleus accumbens (NAc). Animal models of BN reveal increases in ventral tegmental area (VTA) DA and enzymes involved in DA synthesis that resemble changes observed after exposure to addictive drugs. Additionally, alterations in the expression of glutamate receptors and prefrontal cortex activity present in human BN or following sugar bingeing in animals are comparable to the effects of addictive drugs. The two disorders differ in regards to alterations in NAc D2 binding, VTA DAT mRNA expression, and the efficacy of drugs targeting glutamate to treat these disorders. Conclusions: Although additional empirical studies are necessary, the synthesis of the two bodies of research presented here suggests that BN shares many neurobiological features with drug addiction. While few FDA-approved options currently exist for the treatment of drug addiction, pharmacotherapies developed in the future which target the glutamate, DA, and opioid systems may be beneficial for the treatment of both BN and drug addiction. PMID:24500676

  10. Attention Network Dysfunction in Bulimia Nervosa - An fMRI Study

    PubMed Central

    Dahmen, Brigitte; Schulte-Rüther, Martin; Legenbauer, Tanja; Herpertz-Dahlmann, Beate; Konrad, Kerstin

    2016-01-01

    Objective Recent evidence has suggested an increased rate of comorbid ADHD and subclinical attentional impairments in bulimia nervosa (BN) patients. However, little is known regarding the underlying neural mechanisms of attentional functions in BN. Method Twenty BN patients and twenty age- and weight-matched healthy controls (HC) were investigated using a modified version of the Attention Network Task (ANT) in an fMRI study. This design enabled an investigation of the neural mechanisms associated with the three attention networks involved in alerting, reorienting and executive attention. Results The BN patients showed hyperactivation in parieto-occipital regions and reduced deactivation of default-mode-network (DMN) areas during alerting compared with HCs. Posterior cingulate activation during alerting correlated with the severity of eating-disorder symptoms within the patient group. Conversely, BN patients showed hypoactivation during reorienting and executive attention in anterior cingulate regions, the temporo-parietal junction (TPJ) and parahippocampus compared with HCs, which was negatively associated with global ADHD symptoms and impulsivity, respectively. Discussion Our findings demonstrate altered brain mechanisms in BN associated with all three attentional networks. Failure to deactivate the DMN and increased parieto-occipital activation required for alerting might be associated with a constant preoccupation with food or body image-related thoughts. Hypoactivation of executive control networks and TPJ might increase the likelihood of inattentive and impulsive behaviors and poor emotion regulation. Thus, dysfunction in the attentional network in BN goes beyond an altered executive attentional domain and needs to be considered in the diagnosis and treatment of BN. PMID:27607439

  11. Modified sham feeding of sweet solutions in women with and without bulimia nervosa.

    PubMed

    Klein, D A; Schebendach, J E; Brown, A J; Smith, G P; Walsh, B T

    2009-01-01

    Although it is possible that binge eating in humans is due to increased responsiveness of orosensory excitatory controls of eating, there is no direct evidence for this because food ingested during a test meal stimulates both orosensory excitatory and postingestive inhibitory controls. To overcome this problem, we adapted the modified sham feeding technique (MSF) to measure the orosensory excitatory control of intake of a series of sweetened solutions. Previously published data showed the feasibility of a "sip-and-spit" procedure in nine healthy control women using solutions flavored with cherry Kool Aid and sweetened with sucrose (0-20%). The current study extended this technique to measure the intake of artificially sweetened solutions in women with bulimia nervosa (BN) and in women with no history of eating disorders. Ten healthy women and 11 women with BN were randomly presented with cherry Kool Aid solutions sweetened with five concentrations of aspartame (0, 0.01, 0.03, 0.08 and 0.28%) in a closed opaque container fitted with a straw. They were instructed to sip as much as they wanted of the solution during 1-minute trials and to spit the fluid out into another opaque container. Across all subjects, presence of sweetener increased intake (p<0.001). Women with BN sipped 40.5-53.1% more of all solutions than controls (p=0.03 for total intake across all solutions). Self-report ratings of liking, wanting and sweetness of solutions did not differ between groups. These results support the feasibility of a MSF procedure using artificially sweetened solutions, and the hypothesis that the orosensory stimulation of MSF provokes larger intake in women with BN than controls.

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

    PubMed

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

    2014-11-01

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

  13. Brain volumetric abnormalities in patients with anorexia and bulimia nervosa: a voxel-based morphometry study.

    PubMed

    Amianto, Federico; Caroppo, Paola; D'Agata, Federico; Spalatro, Angela; Lavagnino, Luca; Caglio, Marcella; Righi, Dorico; Bergui, Mauro; Abbate-Daga, Giovanni; Rigardetto, Roberto; Mortara, Paolo; Fassino, Secondo

    2013-09-30

    Recent studies focussing on neuroimaging features of eating disorders have observed that anorexia nervosa (AN) is characterized by significant grey matter (GM) atrophy in many brain regions, especially in the cerebellum and anterior cingulate cortex. To date, no studies have found GM atrophy in bulimia nervosa (BN) or have directly compared patients with AN and BN. We used voxel-based morphometry (VBM) to characterize brain abnormalities in AN and BN patients, comparing them with each other and with a control group, and correlating brain volume with clinical features. We recruited 17 AN, 13 BN and 14 healthy controls. All subjects underwent high-resolution magnetic resonance imaging (MRI) with a T1-weighted 3D image. VBM analysis was carried out with the FSL-VBM 4.1 tool. We found no global atrophy, but regional GM reduction in AN with respect to controls and BN in the cerebellum, fusiform area, supplementary motor area, and occipital cortex, and in the caudate in BN compared to AN and controls. Both groups of patients had a volumetric increase bilaterally in somatosensory regions with respect to controls, in areas that are typically involved in the sensory-motor integration of body stimuli and in mental representation of the body image. Our VBM study documented, for the first time in BN patients, the presence of volumetric alterations and replicated previous findings in AN patients. We evidenced morphological differences between AN and BN, demonstrating in the latter atrophy of the caudate nucleus, a region involved in reward mechanisms and processes of self-regulation, perhaps involved in the genesis of the binge-eating behaviors of this disorder.

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    1996-02-01

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

  16. Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders.

    PubMed

    2006-12-01

    It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.

  17. Epistatic interactions implicating dopaminergic genes in bulimia nervosa (BN): relationships to eating- and personality-related psychopathology.

    PubMed

    Thaler, Lea; Groleau, Patricia; Badawi, Guilaine; Sycz, Lindsay; Zeramdini, Nadia; Too, Andrea; Israel, Mimi; Joober, Ridha; Bruce, Kenneth R; Steiger, Howard

    2012-10-01

    We explored the influence of interactions between polymorphisms acting upon postsynaptic receptors (DRD2 TaqA1 rs1800497 and DRD4 7R) and dopamine regulators (COMT rs4680 and DAT1) on the expression of eating symptoms and personality traits in women with bulimia-spectrum eating disorders. We had 269 bulimic women provide blood for genetic assays, and measured eating-disorder symptoms and psychopathological traits using structured interviews and self-report questionnaires. We observed two epistatic interactions on symptom indices: interactions (in predicted directions) of DRD2 by DAT were seen on Body Mass Index (p=.023), and of DRD4 by COMT on self-harming behaviors (p=.014)--with genetic effects that would correspond to reduced dopamine transmission coinciding with more-pathological scores. Our findings suggest that genes acting in the dopamine system interact to influence both eating-related and personality psychopathology, with the result that lower levels of dopamine neuro-transmission correspond to increased psychopathology and body mass in women with bulimia-spectrum disorders. We discuss the implications of our observations.

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

    ERIC Educational Resources Information Center

    Hague, Anne; Kovacich, Joann

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  1. Association between A218C polymorphism of the tryptophan-hydroxylase-1 gene, harm avoidance and binge eating behavior in bulimia nervosa.

    PubMed

    Monteleone, Palmiero; Tortorella, Alfonso; Martiadis, Vassilis; Serino, Ismene; Di Filippo, Carmela; Maj, Mario

    2007-06-21

    Genes involved in serotonin transmission are likely involved in the biological predisposition to bulimia nervosa. We investigated whether the A218C polymorphism of the tryptophan-hydroxylase-1 gene was associated to bulimia nervosa and/or to some phenotypic aspects of the disorder. One hundred eighty Caucasian women (91 patients with bulimia nervosa and 89 healthy controls) were enrolled into the study. They underwent a blood sample collection for A218C polymorphism of the tryptophan-hydroxylase-1 genotyping and a clinical evaluation assessing comorbidity for Axis I and II psychiatric disorders, harm avoidance personality dimension and bulimic symptoms. The distribution of both tryptophan-hydroxylase-1 A218C genotypes and alleles did not significantly differ between patients and controls. Bulimic women with the AA genotype exhibited a more severe binge eating behavior and higher harm avoidance scores than those with CC genotype. These findings support the idea that tryptophan-hydroxylase-1 A218C polymorphism does not play a part in the genetic susceptibility to bulimia nervosa, but it seems to be involved in predisposing bulimic patients to a more disturbed eating behavior and higher harm avoidance.

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

    PubMed

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

    2015-12-01

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

  3. Plamsa leptin response to acute fasting and refeeding in untreated women with bulimia nervosa.

    PubMed

    Monteleone, P; Bortolotti, F; Fabrazzo, M; La Rocca, A; Fuschino, A; Maj, M

    2000-07-01

    Leptin is known to regulate body weight, energy balance, and reproduction. Therefore, investigation of its physiology is of obvious interest in bulimia nervosa (BN), an eating disorder characterized by body weight-related psychopathology, acute changes in the energy balance, and reproductive alterations. To date, the few studies that have assessed leptin production in BN have had several limitations, including the measurement of blood leptin levels in treated patients and the lack of normal weight healthy controls, so that the information they provide is not conclusive. As the investigation of leptin dynamics is likely to be more informative, we decided to assess leptin response to acute fasting and refeeding in both untreated patients with BN and healthy controls. Twelve women meeting the diagnostic criteria for BN of the Diagnostic and Statistical Manual of Mental Disorders, and 10 healthy women of the same age range participated in a 3-day study. At 1800 h on day 1, they received a meal of 1088 Cal, with 53% carbohydrates, 17% protein, and 30% fat. Then, they fasted until 1800 h on day 2, when they received the same meal. On day 3, they received a standard hospital diet of 2600 Cal, divided into 3 meals, with the same percentages of nutrients as described above. Blood samples were collected at different time points for plasma leptin, glucose, and insulin measurements. In bulimic patients, plasma leptin values were significantly lower than in healthy women (P < 0.0001) and were positively related to body weight, expressed as body mass index (r = 0.86; P < 0.0001). The leptin response to the fasting/refeeding paradigm significantly differed between patients and controls (time x group interaction, P < 0.0001). In fact, in healthy subjects, acute fasting induced a 58% decline in the plasma leptin concentration, whereas such a decrease was only 7% in bulimic women (P < 0.001). After acute refeeding, plasma leptin increased in both groups, although in the patients it

  4. Plasma and cerebrospinal fluid measures of arginine vasopressin secretion in patients with bulimia nervosa and in healthy subjects.

    PubMed

    Demitrack, M A; Kalogeras, K T; Altemus, M; Pigott, T A; Listwak, S J; Gold, P W

    1992-06-01

    Bulimia nervosa is a psychiatric syndrome associated with intense hunger, deficient satiety mechanisms, an obsessional preoccupation with the adverse consequences of eating, ritualistic binge eating, and subsequent purging to forestall the effects of the binge. The morbidity of this illness reflects both the psychological suffering associated with a life organized around pathological eating behaviors, as well as medical complications such as fluid and electrolyte imbalances that occur largely as a result of purging and laxative abuse. We report here a study of the osmoregulation of plasma arginine vasopressin secretion and of vasopressin levels in the cerebrospinal fluid. This study was undertaken because vasopressin not only functions as the antidiuretic hormone, and thus as a principal modulator of fluid and electrolyte balance, but also because, in animals, centrally directed vasopressin delays the extinction of behaviors acquired during aversive conditioning. Thirteen normal-weight female patients with bulimia nervosa were studied after at least 1 month of nutritional stabilization and supervised abstinence from binge eating and purging. Plasma vasopressin, plasma sodium, and subjective thirst were measured serially before and during a 2-h infusion of 3% hypertonic saline (0.1 ml/kg min). In addition, cerebrospinal fluid was obtained by lumbar puncture upon admission and at 1 week before hypertonic saline infusion in 11 of these patients and in an additional 11 female patients who did not participate in the hypertonic infusion study. Fifteen healthy normal weight individuals (4 female, 11 male) served as controls for the hypertonic saline infusion and a separate group of 11 healthy normal weight female controls underwent puncture. Compared to controls, bulimic subjects showed a significant reduction in the plasma vasopressin response to hypertonic saline; in 12/13, plasma vasopressin correlated closely with plasma sodium, whereas in one patient vasopressin

  5. Circadian pattern of large neutral amino acids, glucose, insulin, and food intake in anorexia nervosa and bulimia nervosa.

    PubMed

    Schreiber, W; Schweiger, U; Werner, D; Brunner, G; Tuschl, R J; Laessle, R G; Krieg, J C; Fichter, M M; Pirke, K M

    1991-05-01

    Insulin, glucose, and large neutral amino acids (LNAA) were studied in 10 patients with anorexia nervosa, 13 patients with bulimia nervosa, and 15 healthy controls. Blood samples were collected at hourly intervals during the day and at two-hour intervals during the night over a 24-hour period. Ad libitum caloric and relative carbohydrate intake was significantly reduced in the anorectic and bulimic patients. Elevated concentrations of beta-hydroxybutyric acid (BHBA) were seen in the bulimic group, and low triiodothyronine (T3) concentrations in the anorectic group. Mean plasma glucose and insulin concentrations were significantly lowered in both groups. The tryptophan (Trp) to LNAA ratio was reduced in anorectic, but not in bulimic patients. These findings suggest that Trp influx into the brain is reduced in anorectic patients, possibly impairing central serotonergic function.

  6. Loneliness mediates the relationship between emotion dysregulation and bulimia nervosa/binge eating disorder psychopathology in a clinical sample.

    PubMed

    Southward, Matthew W; Christensen, Kara A; Fettich, Karla C; Weissman, Jessica; Berona, Johnny; Chen, Eunice Y

    2014-12-01

    Emotion dysregulation has been linked to binge eating disorder (BED) and bulimia nervosa (BN) although the mechanisms by which it affects BN/BED psychopathology are unclear. This study tested loneliness as a mediator between emotion dysregulation and BN/BED psychopathology. A treatment-seeking sample of 107 women with BN or BED was assessed for loneliness (UCLA Loneliness Scale), emotion dysregulation (Difficulties in Emotion Regulation Scale), and BN/BED psychopathology (Eating Disorder Examination) before treatment. Hierarchical linear regressions and bootstrapping mediation models were run. Greater overall emotion dysregulation was associated with greater BN/BED psychopathology, mediated by loneliness (95 % CI 0.03, 0.09). Emotion dysregulation, however, did not mediate between loneliness and BN/BED psychopathology (95 % CI −0.01, 0.01). Targeting loneliness may effectively treat emotional aspects of BN/BED in women.

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

    PubMed

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

    2007-02-01

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

  8. Bilateral necrotizing sialometaplasia of the hard palate in a patient with bulimia: a case report and review of the literature.

    PubMed

    Janner, Simone F M; Suter, Valerie G A; Altermatt, Hans Jörg; Reichart, Peter A; Bornstein, Michael M

    2014-05-01

    Necrotizing sialometaplasia (NS) is a rare and benign lesion that mostly affects the posterior hard palate. Its importance resides in its clinical and microscopic characteristics, which can closely mimic malignant neoplasias, in particular oral squamous cell carcinoma and mucoepidermoid carcinoma. Accurate histopathologic evaluation of an incisional biopsy is considered as the diagnostic gold standard. NS lesions heal spontaneously within weeks, and no further treatment is necessary. We report a case of a bilateral palatal NS in a 22-yearold woman with bulimia, where an incisional biopsy confirmed the clinical diagnosis. The different clinical stages of the lesions from onset to resolution and the possible etiologic factors are described in detail, as well as a discussion of the differential diagnoses of palatal ulcers. When taking a biopsy from suspicious oral lesions, care has to be taken that an appropriate tissue sample is harvested, and the histopathologic analysis is performed by an experienced pathologist to establish a correct diagnosis.

  9. Remote treatment of bulimia nervosa and binge eating disorder: a randomized trial of Internet-assisted cognitive behavioural therapy.

    PubMed

    Ljotsson, B; Lundin, C; Mitsell, K; Carlbring, P; Ramklint, M; Ghaderi, A

    2007-04-01

    The present study investigated the efficacy of self-help based on cognitive behaviour therapy in combination with Internet support in the treatment of bulimia nervosa and binge eating disorder. After confirming the diagnosis with an in-person interview, 73 patients were randomly allocated to treatment or a waiting list control group. Treated individuals showed marked improvement after 12 weeks of self-help compared to the control group on both primary and secondary outcome measures. Intent-to-treat analyses revealed that 37% (46% among completers) had no binge eating or purging at the end of the treatment and a considerable number of patients achieved clinically significant improvement on most of the other measures as well. The results were maintained at the 6-month follow-up, and provide evidence to support the continued use and development of self-help programmes.

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

    PubMed

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

    2014-09-01

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

  11. Art therapy, psychodrama, and verbal therapy. An integrative model of group therapy in the treatment of adolescents with anorexia nervosa and bulimia nervosa.

    PubMed

    Diamond-Raab, Lisa; Orrell-Valente, Joan K

    2002-04-01

    Anorexia nervosa and bulimia nervosa typically afflict individuals in adolescence. Given the intractability of these diseases in combination with the natural recalcitrance of adolescence, treatment with this population presents a daunting challenge. Traditional group therapy that focuses on verbal therapy is often not effective with this population, particularly in the acute stages of the diseases. A group therapy approach that integrates art therapy, psychodrama, and verbal therapy offers an innovative alternative to traditional group therapy.

  12. Age at menarche and digit ratio (2D:4D): relationships with body dissatisfaction, drive for thinness, and bulimia symptoms in women.

    PubMed

    Oinonen, Kirsten A; Bird, Jessica L

    2012-03-01

    This study examined the hypothesis that lower prenatal androgen exposure and earlier puberty are associated with more dysfunctional eating attitudes and behaviors. Relationships between both age at menarche (AAM) and 2D:4D (a marker of prenatal androgen exposure), and EDI-2-Body Dissatisfaction, EDI-2-Drive for Thinness, and EDI-2-Bulimia scores, were examined in women using correlations and regressions. Earlier menarche was associated with higher drive for thinness after controlling for BMI and negative affect, but only in women who were not exclusively heterosexual. Higher 2D:4D was associated with higher Bulimia and Body Dissatisfaction scores, but only in exclusively heterosexual women, and relationships disappeared when covariates were controlled. Later AAM and higher 2D:4D were unique predictors of higher Bulimia scores for exclusive heterosexuals when BMI was controlled. These findings suggest future research should examine sexual orientation as a mediator or moderator of prenatal and postnatal organizational hormonal effects on women's disordered eating attitudes and behaviors.

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2016-06-30

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

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

    PubMed

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

    2016-04-01

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

  17. Endocrine dysfunction in anorexia nervosa and bulimia: comparison with abnormalities in other psychiatric disorders and disturbances due to metabolic factors.

    PubMed

    Hudson, J I; Hudson, M S

    1984-01-01

    The eating disorders of anorexia nervosa and bulimia are associated with marked disturbances in endocrine function. Studies of the hypothalamic-pituitary-adrenal,-thyroid, and -ovarian axes are reviewed, in order to ascertain whether and to what extent alteration in endocrine response is the consequence of abnormal eating, or whether the endocrine abnormalities are primary. Many, if not all, of the disturbances which have been documented can be accounted for the metabolic consequences of disturbed eating behavior, including especially the effects of weight loss. However, it is possible that primary hypothalamic dysfunction may account for or contribute to the following abnormalities: hypercortisolism, blunted TSH response to TRH, and hypogonadism. Given the possibility that primary hypothalamic disturbances are present, the specificity of these disturbances with respect to eating disorders as opposed to other psychiatric disorders, is investigated. It is concluded that, with the possible exception of alterations in the hypothalamic-pituitary-ovarian axis, such disturbances appear not to be specific to eating disorders; rather, they are also present in other psychiatric disorders. In particular, the data reviewed are consistent with the hypothesis that the eating disorders have psychobiological features in common with major affective disorder.

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

    PubMed Central

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

    2014-01-01

    Background Body dissatisfaction is the most relevant body image disturbance in bulimia nervosa (BN). Research has shown that viewing one's own body evokes negative thoughts and emotions in individuals with BN. However, the psychophysiological mechanisms involved in this negative reaction have not yet been clearly established. Our aim was to examine the emotional and attentional processes that are activated when patients with BN view their own bodies. Method We examined the effects of viewing a video of one's own body on the physiological (eye-blink startle, cardiac defense, and skin conductance) and subjective (pleasure, arousal, and control ratings) responses elicited by a burst of 110 dB white noise of 500 ms duration. The participants were 30 women with BN and 30 healthy control women. The experimental task consisted of two consecutive and counterbalanced presentations of the auditory stimulus preceded, alternatively, by a video of the participant's own body versus no such video. Results The results showed that, when viewing their own bodies, women with BN experienced (a) greater inhibition of the startle reflex, (b) greater cardiac acceleration in the first component of the defense reaction, (c) greater skin conductance response, and (d) less subjective pleasure and control combined with greater arousal, compared with the control participants. Conclusion Our findings suggest that, for women with BN, peripheral-physiological responses to self-images are dominated by attentional processes, which provoke an immobility reaction caused by a dysfunctional negative response to their own body. PMID:25036222

  19. Spontaneous imagery in women with bulimia nervosa: an investigation into content, characteristics and links to childhood memories.

    PubMed

    Somerville, Kate; Cooper, Myra; Hackmann, Ann

    2007-12-01

    The study investigated the presence and characteristics of spontaneous imagery in women with bulimia nervosa (BN) and their links to childhood memories. Using a semi-structured interview, data was collected from three groups of female participants: BN participants (N=13), dieting (N=18) and non-dieting controls (N=20). BN participants reported more spontaneous images than non-dieting control participants. Their images were recurrent and significantly more negative and anxiety provoking than those of controls. They involved more sensory modalities than in dieting controls and were more vivid than in non-dieting controls. BN images typically involved the visual, organic and cutaneous modalities. They were linked to a specific childhood memory, similar in emotional tone and sensory modalities. Once depression was controlled, many of the between-group differences became non-significant. The results suggest that imagery may be a significant feature of BN, potentially distinguishing those with BN from controls, although further research into the link between mood, imagery and memory is needed. The findings have clinical implications, particularly for assessment and for the application of imagery rescripting in BN.

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

    PubMed

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

    2016-04-01

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

  1. A history of the identification of the characteristic eating disturbances of Bulimia Nervosa, Binge Eating Disorder and Anorexia Nervosa.

    PubMed

    Heaner, Martica K; Walsh, B Timothy

    2013-06-01

    During the last 25 years, the careful examination of the eating behavior of individuals with eating disorders has provided critical insights into the nature of these disorders. Crucially, studies investigating components of different eating behaviors have documented that Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED) are characterized by objective disturbances in eating patterns that are significantly different than behaviors exhibited by individuals who do not have these eating disorders. The detailed description of the disturbances in eating behavior has helped to identify diagnostic criteria associated with each disorder, and has led to important hypotheses about the underlying pathophysiology. These advances in understanding have provided, and continue to provide, a foundation for translational research and for the development of novel treatment interventions. This review is based on a presentation given by B. Timothy Walsh, M.D. at the 40th anniversary symposium of the Columbia University Appetite talks outlining the evolution of the discovery of the characteristic eating disturbances seen with each disorder.

  2. Clinical Utility of Subtyping Binge Eating Disorder by History of Anorexia or Bulimia Nervosa in a Treatment Sample

    PubMed Central

    Utzinger, Linsey M.; Mitchell, James E.; Cao, Li; Crosby, Ross D.; Crow, Scott J.; Wonderlich, Stephen A.; Peterson, Carol B.

    2016-01-01

    Objective This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Method Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. Results A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. Discussion These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. PMID:25959549

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

    PubMed

    Schnicker, Katja; Hiller, Wolfgang; Legenbauer, Tanja

    2013-10-01

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

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

    PubMed

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

    2016-06-30

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

  5. Dimensions of Emotion Dysregulation in Anorexia Nervosa and Bulimia Nervosa: A Conceptual Review of the Empirical Literature

    PubMed Central

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

    2015-01-01

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

  6. Eating attitudes of anorexia nervosa, bulimia nervosa, binge eating disorder and obesity without eating disorder female patients: differences and similarities.

    PubMed

    Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B

    2014-05-28

    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 (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the "Relationship with food" and "Idea of normal eating." 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.

  7. Dopamine-related deficit in reward learning after catecholamine depletion in unmedicated, remitted subjects with bulimia nervosa.

    PubMed

    Grob, Simona; Pizzagalli, Diego A; Dutra, Sunny J; Stern, Jair; Mörgeli, Hanspeter; Milos, Gabriella; Schnyder, Ulrich; Hasler, Gregor

    2012-07-01

    Disturbances in reward processing have been implicated in bulimia nervosa (BN). Abnormalities in processing reward-related stimuli might be linked to dysfunctions of the catecholaminergic neurotransmitter system, but findings have been inconclusive. A powerful way to investigate the relationship between catecholaminergic function and behavior is to examine behavioral changes in response to experimental catecholamine depletion (CD). The purpose of this study was to uncover putative catecholaminergic dysfunction in remitted subjects with BN who performed a reinforcement-learning task after CD. CD was achieved by oral alpha-methyl-para-tyrosine (AMPT) in 19 unmedicated female subjects with remitted BN (rBN) and 28 demographically matched healthy female controls (HC). Sham depletion administered identical capsules containing diphenhydramine. The study design consisted of a randomized, double-blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were reward learning in a probabilistic reward task analyzed using signal-detection theory. Secondary outcome measures included self-report assessments, including the Eating Disorder Examination-Questionnaire. Relative to healthy controls, rBN subjects were characterized by blunted reward learning in the AMPT--but not in placebo--condition. Highlighting the specificity of these findings, groups did not differ in their ability to perceptually distinguish between stimuli. Increased CD-induced anhedonic (but not eating disorder) symptoms were associated with a reduced response bias toward a more frequently rewarded stimulus. In conclusion, under CD, rBN subjects showed reduced reward learning compared with healthy control subjects. These deficits uncover disturbance of the central reward processing systems in rBN related to altered brain catecholamine levels, which might reflect a trait-like deficit increasing vulnerability to BN.

  8. The Role of Leptin, Melanocortin, and Neurotrophin System Genes on Body Weight in Anorexia Nervosa and Bulimia Nervosa

    PubMed Central

    Yilmaz, Zeynep; Kaplan, Allan S.; Tiwari, Arun K.; Levitan, Robert D.; Piran, Sara; Bergen, Andrew W.; Kaye, Walter H.; Hakonarson, Hakon; Wang, Kai; Berrettini, Wade H.; Brandt, Harry A.; Bulik, Cynthia M.; Crawford, Steve; Crow, Scott; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig L.; Keel, Pamela K.; Klump, Kelly L.; Magistretti, Pierre; Mitchell, James E.; Strober, Michael; Thornton, Laura M.; Treasure, Janet; Woodside, D. Blake; Knight, Joanne; Kennedy, James L.

    2014-01-01

    Objective Although low weight is a key factor contributing to the high mortality in anorexia nervosa (AN), it is unclear how AN patients sustain low weight compared with bulimia nervosa (BN) patients with similar psychopathology. Studies of genes involved in appetite and weight regulation in eating disorders have yielded variable findings in part due to small sample size and clinical heterogeneity. This study: (1) assessed the role of leptin, melanocortin, and neurotrophin genetic variants in conferring risk for AN and BN and (2) explored the involvement of these genes in body mass index (BMI) variations within AN and BN. Method Our sample consisted of 745 individuals with AN without a history of BN, 245 with BN without a history of AN, and 321 controls. We genotyped 20 markers with known or putative function among genes selected from leptin, melanocortin, and neurotrophin systems. Results There were no significant differences in allele frequencies among individuals with AN, BN, and controls. AGRP rs13338499 polymorphism was associated with lowest illness-related BMI in those with AN (p=0.0013), and NTRK2 rs1042571 was associated with highest BMI in those with BN (p=0.0018). Discussion To our knowledge, this is the first study to address the issue of clinical heterogeneity in eating disorder genetics and to explore the role of known or putatively functional markers in genes regulating appetite and weight in individuals with AN and BN. If replicated, our results may serve as an important first step toward gaining a better understanding of weight regulation in eating disorders. PMID:24831852

  9. Dopamine-related deficit in reward learning after catecholamine depletion in unmedicated, remitted subjects with bulimia nervosa.

    PubMed

    Grob, Simona; Pizzagalli, Diego A; Dutra, Sunny J; Stern, Jair; Mörgeli, Hanspeter; Milos, Gabriella; Schnyder, Ulrich; Hasler, Gregor

    2012-07-01

    Disturbances in reward processing have been implicated in bulimia nervosa (BN). Abnormalities in processing reward-related stimuli might be linked to dysfunctions of the catecholaminergic neurotransmitter system, but findings have been inconclusive. A powerful way to investigate the relationship between catecholaminergic function and behavior is to examine behavioral changes in response to experimental catecholamine depletion (CD). The purpose of this study was to uncover putative catecholaminergic dysfunction in remitted subjects with BN who performed a reinforcement-learning task after CD. CD was achieved by oral alpha-methyl-para-tyrosine (AMPT) in 19 unmedicated female subjects with remitted BN (rBN) and 28 demographically matched healthy female controls (HC). Sham depletion administered identical capsules containing diphenhydramine. The study design consisted of a randomized, double-blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were reward learning in a probabilistic reward task analyzed using signal-detection theory. Secondary outcome measures included self-report assessments, including the Eating Disorder Examination-Questionnaire. Relative to healthy controls, rBN subjects were characterized by blunted reward learning in the AMPT--but not in placebo--condition. Highlighting the specificity of these findings, groups did not differ in their ability to perceptually distinguish between stimuli. Increased CD-induced anhedonic (but not eating disorder) symptoms were associated with a reduced response bias toward a more frequently rewarded stimulus. In conclusion, under CD, rBN subjects showed reduced reward learning compared with healthy control subjects. These deficits uncover disturbance of the central reward processing systems in rBN related to altered brain catecholamine levels, which might reflect a trait-like deficit increasing vulnerability to BN. PMID:22491353

  10. Specificity of Affective Instability in Patients With Borderline Personality Disorder Compared to Posttraumatic Stress Disorder, Bulimia Nervosa, and Healthy Controls

    PubMed Central

    Santangelo, Philip; Mussgay, Lutz; Sawitzki, Günther; Trull, Timothy J.; Reinhard, Iris; Steil, Regina; Klein, Christoph; Bohus, Martin; Ebner-Priemer, Ulrich W.

    2014-01-01

    Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses. PMID:24661176

  11. Dopamine-Related Deficit in Reward Learning After Catecholamine Depletion in Unmedicated, Remitted Subjects with Bulimia Nervosa

    PubMed Central

    Grob, Simona; Pizzagalli, Diego A; Dutra, Sunny J; Stern, Jair; Mörgeli, Hanspeter; Milos, Gabriella; Schnyder, Ulrich; Hasler, Gregor

    2012-01-01

    Disturbances in reward processing have been implicated in bulimia nervosa (BN). Abnormalities in processing reward-related stimuli might be linked to dysfunctions of the catecholaminergic neurotransmitter system, but findings have been inconclusive. A powerful way to investigate the relationship between catecholaminergic function and behavior is to examine behavioral changes in response to experimental catecholamine depletion (CD). The purpose of this study was to uncover putative catecholaminergic dysfunction in remitted subjects with BN who performed a reinforcement-learning task after CD. CD was achieved by oral alpha-methyl-para-tyrosine (AMPT) in 19 unmedicated female subjects with remitted BN (rBN) and 28 demographically matched healthy female controls (HC). Sham depletion administered identical capsules containing diphenhydramine. The study design consisted of a randomized, double-blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were reward learning in a probabilistic reward task analyzed using signal-detection theory. Secondary outcome measures included self-report assessments, including the Eating Disorder Examination-Questionnaire. Relative to healthy controls, rBN subjects were characterized by blunted reward learning in the AMPT—but not in placebo—condition. Highlighting the specificity of these findings, groups did not differ in their ability to perceptually distinguish between stimuli. Increased CD-induced anhedonic (but not eating disorder) symptoms were associated with a reduced response bias toward a more frequently rewarded stimulus. In conclusion, under CD, rBN subjects showed reduced reward learning compared with healthy control subjects. These deficits uncover disturbance of the central reward processing systems in rBN related to altered brain catecholamine levels, which might reflect a trait-like deficit increasing vulnerability to BN. PMID:22491353

  12. Resting-state synchrony between anterior cingulate cortex and precuneus relates to body shape concern in anorexia nervosa and bulimia nervosa.

    PubMed

    Lee, Seojung; Ran Kim, Kyung; Ku, Jeonghun; Lee, Jung-Hyun; Namkoong, Kee; Jung, Young-Chul

    2014-01-30

    Cortical areas supporting cognitive control and salience demonstrate different neural responses to visual food cues in patients with eating disorders. This top-down cognitive control, which interacts with bottom-up appetitive responses, is tightly integrated not only in task conditions but also in the resting-state. The dorsal anterior cingulate cortex (dACC) is a key node of a large-scale network that is involved in self-referential processing and cognitive control. We investigated resting-state functional connectivity of the dACC and hypothesized that altered connectivity would be demonstrated in cortical midline structures involved in self-referential processing and cognitive control. Seed-based resting-state functional connectivity was analyzed in women with anorexia nervosa (N=18), women with bulimia nervosa (N=20) and age matched healthy controls (N=20). Between group comparisons revealed that the anorexia nervosa group exhibited stronger synchronous activity between the dACC and retrosplenial cortex, whereas the bulimia nervosa group showed stronger synchronous activity between the dACC and medial orbitofrontal cortex. Both groups demonstrated stronger synchronous activity between the dACC and precuneus, which correlated with higher scores of the Body Shape Questionnaire. The dACC-precuneus resting-state synchrony might be associated with the disorder-specific rumination on eating, weight and body shape in patients with eating disorders. PMID:24300085

  13. Plasma ghrelin in anorexia, bulimia, and binge-eating disorder: relations with eating patterns and circulating concentrations of cortisol and thyroid hormones.

    PubMed

    Troisi, Alfonso; Di Lorenzo, Giorgio; Lega, Ilaria; Tesauro, Manfredi; Bertoli, Aldo; Leo, Roberto; Iantorno, Micaela; Pecchioli, Chiara; Rizza, Stefano; Turriziani, Mario; Lauro, Renato; Siracusano, Alberto

    2005-01-01

    The present study was designed to investigate the relations between plasma ghrelin concentrations, eating patterns, and circulating concentrations of cortisol and thyroid hormones in women with anorexia nervosa, bulimia nervosa, and binge-eating disorder. The patterns of disordered eating behavior were assessed using the Eating Attitudes Test (EAT-26) and the Bulimia Test-Revised (BULIT-R). In women with eating disorders, but not in healthy control women, plasma ghrelin concentrations were negatively correlated with body mass index (BMI) and plasma concentrations of thyreotropin (TSH), free T3 and free T4, and positively correlated with plasma concentrations of cortisol. The ghrelin concentrations of women with binge-eating and purging behavior were significantly lower than those of women with anorexia nervosa, restricting type, and there was a negative relation between the frequency and severity of binge-eating and purging behavior, as measured by the BULIT-R total score, and ghrelin concentrations. In a multivariate regression model controlling for the confounding effects of body mass index (BMI) and age, higher ghrelin concentrations were correlated with lower BULIT-R total scores. The results of this study did not confirm the hypothesis advanced in previous studies that ghrelin concentrations are higher in patients with binge-eating/purging forms of eating disorders. Based on these data, we suggest that, in women with eating disorders, ghrelin concentrations best reflect nutritional status rather than specific patterns of disordered eating behavior.

  14. Dysregulation of brain reward systems in eating disorders: neurochemical information from animal models of binge eating, bulimia nervosa, and anorexia nervosa.

    PubMed

    Avena, Nicole M; Bocarsly, Miriam E

    2012-07-01

    Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained through animal models of binge eating, bulimia nervosa, or anorexia nervosa. The findings suggest that alterations in dopamine (DA), acetylcholine (ACh) and opioid systems in reward-related brain areas occur in response to binge eating of palatable foods. Moreover, animal models of bulimia nervosa suggest that while bingeing on palatable food releases DA, purging attenuates the release of ACh that might otherwise signal satiety. Animal models of anorexia nervosa suggest that restricted access to food enhances the reinforcing effects of DA when the animal does eat. The activity-based anorexia model suggests alterations in mesolimbic DA and serotonin occur as a result of restricted eating coupled with excessive wheel running. These findings with animal models complement data obtained through neuroimaging and pharmacotherapy studies of clinical populations. Information on the neurochemical consequences of the behaviors associated with these eating disorders will be useful in understanding these complex disorders and may inform future therapeutic approaches, as discussed here. This article is part of a Special Issue entitled 'Central Control of Food Intake'.

  15. Why and how do women recover from bulimia nervosa? The subjective appraisals of forty women recovered for a year or more.

    PubMed

    Rorty, M; Yager, J; Rossotto, E

    1993-11-01

    As part of a larger study of recovery in bulimia nervosa, 40 women recruited by local advertisement and referral who were recovered from the disorder for a year or more (median recovery = 36 months) participated in semistructured interviews regarding factors they believed to be related to their recovery process. We asked how life experiences and important persons in their lives had helped or hindered their recovery, what aspects of bulimia nervosa they found hardest to change and what they would still like to change, what they felt they gave up by recovering, and their beliefs about the potential for full, lasting recovery. We further inquired about professional and nonprofessional treatments utilized, our subjects' satisfaction with care, and specific helpful and harmful elements in treatment. Spontaneous answers were coded from audiotaped interviews. The women reported diverse experiences, many of which were consistent with clinical and empirical accounts. Almost 90% had received some treatment by a mental health professional, and many also had utilized nonprofessional treatments, particularly Overeaters Anonymous; these treatments were described as helpful by the majority using them. Of note, although parents often provided some practical support for treatment, the majority of subjects reported that their mothers and fathers were more harmful than helpful in the recovery process. PMID:8275061

  16. Resting-state synchrony between anterior cingulate cortex and precuneus relates to body shape concern in anorexia nervosa and bulimia nervosa.

    PubMed

    Lee, Seojung; Ran Kim, Kyung; Ku, Jeonghun; Lee, Jung-Hyun; Namkoong, Kee; Jung, Young-Chul

    2014-01-30

    Cortical areas supporting cognitive control and salience demonstrate different neural responses to visual food cues in patients with eating disorders. This top-down cognitive control, which interacts with bottom-up appetitive responses, is tightly integrated not only in task conditions but also in the resting-state. The dorsal anterior cingulate cortex (dACC) is a key node of a large-scale network that is involved in self-referential processing and cognitive control. We investigated resting-state functional connectivity of the dACC and hypothesized that altered connectivity would be demonstrated in cortical midline structures involved in self-referential processing and cognitive control. Seed-based resting-state functional connectivity was analyzed in women with anorexia nervosa (N=18), women with bulimia nervosa (N=20) and age matched healthy controls (N=20). Between group comparisons revealed that the anorexia nervosa group exhibited stronger synchronous activity between the dACC and retrosplenial cortex, whereas the bulimia nervosa group showed stronger synchronous activity between the dACC and medial orbitofrontal cortex. Both groups demonstrated stronger synchronous activity between the dACC and precuneus, which correlated with higher scores of the Body Shape Questionnaire. The dACC-precuneus resting-state synchrony might be associated with the disorder-specific rumination on eating, weight and body shape in patients with eating disorders.

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

    PubMed Central

    2011-01-01

    Fibroblast growth factor (FGF) 23, a circulating 26-kDa peptide produced by osteogenic cells, is a novel phosphaturic factor. In our previous study, binge-eating/purging type anorexia nervosa (AN-BP) patients had elevated plasma intact FGF23 (iFGF23) levels, while restricting type (AN-R) patients had plasma iFGF23 levels similar to healthy controls. Although bulimia nervosa (BN) patients as well as some patients with AN-BP regularly engage in binge eating, there have been no studies regarding plasma iFGF23 levels in BN patients. Therefore, this study was performed to determine plasma iFGF23 concentrations in BN patients and healthy controls. The study population consisted of 13 female BN patients and 11 healthy female controls. Blood samples were collected from all subjects after overnight fasting. Plasma iFGF23 was measured using an ELISA kit in a cross-sectional manner. The two-tailed Mann-Whitney U-test was used to assess differences between BN patients and healthy controls. In addition, BN patients were divided into two groups based on questionnaire-reported binge eating frequency immediately prior to participation in this study: high frequency of binge eating (once a week or more; HF group; n = 8) and low frequency of binge eating (less than once a week; LF group; n = 5). Two-tailed Mann-Whitney U-test with Bonferroni's correction was performed after the Kruskal-Wallis test to assess differences between HF group, LF group, and healthy controls. Median (quartiles) plasma iFGF23 levels were greater in BN patients (35.5 [14.8-65.0] pg/ml) than in controls (3.8 [not detected-5.3] pg/ml; p = 0.002). In addition, median (quartiles) plasma iFGF23 levels were greater in the HF group (62.3 [44.4-73.4] pg/ml) than in controls (p < 0.001) and in the LF group (12.9 [not detected-30.3] pg/ml; p = 0.011), while there were no differences between the LF group and controls (p = 0.441). This is the first study to show that BN patients have elevated plasma iFGF23 levels

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

    PubMed

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

    2014-03-01

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

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

    PubMed

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

    2014-07-01

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

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

    PubMed

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

    2014-07-01

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

  1. [Effects of inpatient treatment on eating disorder symptoms, health-related quality of life and personal resources in anorexia and bulimia nervosa].

    PubMed

    Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang

    2011-07-01

    The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources.

  2. Family relations and eating disorders. The effectiveness of an integrated approach in the treatment of anorexia and bulimia in teenagers: results of a case-control systemic research.

    PubMed

    Onnis, L; Barbara, E; Bernardini, M; Caggese, A; Di Giacomo, S; Giambartolomei, A; Leonelli, A; Mule', A M; Nicoletti, P G; Vietri, A

    2012-03-01

    This article presents the results of a broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of Psychotherapy (Unità Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Età Evolutiva), both at the "La Sapienza" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a single kind of treatment, which is the usual medical- nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14 patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This improvement was not present or not of the same degree in the control

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

    PubMed

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

    2016-01-01

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

  4. Blood levels of the endocannabinoid anandamide are increased in anorexia nervosa and in binge-eating disorder, but not in bulimia nervosa.

    PubMed

    Monteleone, Palmiero; Matias, Isabelle; Martiadis, Vassilis; De Petrocellis, Luciano; Maj, Mario; Di Marzo, Vincenzo

    2005-06-01

    The endocannabinoid system, consisting of two cannabinoid receptors (CB1 and CB2) and the endogenous ligands anandamide (arachidonoylethanolamide (AEA)) and 2-arachidonoylglycerol (2-AG), has been shown to control food intake in both animals and humans, modulating either rewarding or quantitative aspects of the eating behavior. Moreover, hypothalamic endocannabinoids seem to be part of neural circuitry involved in the modulating effects of leptin on energy homeostasis. Therefore, alterations of the endocannabinoid system could be involved in the pathophysiology of eating disorders, where a deranged leptin signalling has been also reported. In order to verify this hypothesis, we measured plasma levels of AEA, 2-AG, and leptin in 15 women with anorexia nervosa (AN), 12 women with bulimia nervosa (BN), 11 women with binge-eating disorder (BED), and 15 healthy women. Plasma levels of AEA resulted significantly enhanced in both anorexic and BED women, but not in bulimic patients. No significant change occurred in the plasma levels of 2-AG in all the patients' groups. Moreover, circulating AEA levels were significantly and inversely correlated with plasma leptin concentrations in both healthy controls and anorexic women. These findings show for the first time a derangement in the production of the endogenous cannabinoid AEA in drug-free symptomatic women with AN or with BED. Although the pathophysiological significance of this alteration awaits further studies to be clarified, it suggests a possible involvement of AEA in the mediation of the rewarding aspects of the aberrant eating behaviors occurring in AN and BED.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2013-01-01

    Is starvation in anorexia nervosa (AN) or overeating in bulimia nervosa (BN) a form of addiction? Alternatively, why are individuals with BN more vulnerable and AN protected from substance abuse? Such questions have been generated by recent studies that suggest that there are overlapping neural circuits for foods and drugs of abuse. In order to determine whether a shared neurobiology contributes to eating disorders (EDs) and substance abuse, this review focused on imaging studies that investigated response to tastes of food and tasks designed to characterize reward and behavioral inhibition in AN and BN. BN and those with substance abuse disorders may share dopamine D2 receptor related vulnerabilities, and opposite findings may contribute to “protection” from substance abuse in AN. Moreover, imaging studies provide insights into executive cortico-striatal processes related to extraordinary inhibition and self-control in AN and diminished inhibitory self-control in BN that may influence the rewarding aspect of palatable foods and likely other consummatory behaviors. AN and BN tend to have premorbid traits, such as perfectionism and anxiety that make them vulnerable to employing extremes of food ingestion which serve to reduce negative mood states. Dysregulation within and/or between limbic and executive cortio-striatal circuits contributes to such symptoms. Limited data support the hypothesis that reward and inhibitory processes may contribute to symptoms in ED and addictive disorders, but little is known about the molecular biology of such mechanisms in terms of shared or independent processes. PMID:23380716

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

    PubMed Central

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

    2015-01-01

    Background: Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. Design: Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an “A-B-A-C-A” single case experimental design. Impulsivity levels were assessed with the Conner’s Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. Results: After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. Discussion: This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN. PMID:26236261

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2013-05-01

    Is starvation in anorexia nervosa (AN) or overeating in bulimia nervosa (BN) a form of addiction? Alternatively, why are individuals with BN more vulnerable and individuals with AN protected from substance abuse? Such questions have been generated by recent studies suggesting that there are overlapping neural circuits for foods and drugs of abuse. To determine whether a shared neurobiology contributes to eating disorders and substance abuse, this review focused on imaging studies that investigated response to tastes of food and tasks designed to characterize reward and behavioral inhibition in AN and BN. BN and those with substance abuse disorders may share dopamine D2 receptor-related vulnerabilities, and opposite findings may contribute to "protection" from substance abuse in AN. Moreover, imaging studies provide insights into executive corticostriatal processes related to extraordinary inhibition and self-control in AN and diminished inhibitory self-control in BN that may influence the rewarding aspect of palatable foods and likely other consummatory behaviors. AN and BN tend to have premorbid traits, such as perfectionism and anxiety that make them vulnerable to using extremes of food ingestion, which serve to reduce negative mood states. Dysregulation within and/or between limbic and executive corticostriatal circuits contributes to such symptoms. Limited data support the hypothesis that reward and inhibitory processes may contribute to symptoms in eating disorders and addictive disorders, but little is known about the molecular biology of such mechanisms in terms of shared or independent processes.

  10. The Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa: A Systematic Review and Recommendations for Future Research

    PubMed Central

    Bürger, Carolina; Schmidt, Luise; Herbst, Nirmal; Voderholzer, Ulrich

    2015-01-01

    Background Previous studies have shown an unmet need in the treatment of eating disorders. In the last decade, interest in technology-based interventions (TBIs) (including computer- and Internet-based interventions [CBIs] or mobile interventions) for providing evidence-based therapies to individuals with different mental disorders has increased. Objective The aim of this review was to systematically evaluate the potential of TBIs in the field of eating disorders, namely for anorexia nervosa (AN) and bulimia nervosa (BN), for both prevention and treatment, and also for carers of eating disorder patients. Methods A systematic literature search was conducted using Medline and PsycINFO. Bibliographies of retrieved articles were also reviewed without date or study type restrictions. Results Forty studies resulting in 45 publications reporting outcomes fulfilled the inclusion criteria: 22 randomized controlled trials, 2 controlled studies, and 16 uncontrolled studies. In total, 3646 patients were included. Overall, the studies provided evidence for the efficacy of guided CBIs, especially for BN patients and for compliant patients. Furthermore, videoconferencing also appeared to be a promising approach. Evaluation results of Internet-based prevention of eating disorders and Internet-based programs for carers of eating disorder patients were also encouraging. Finally, there was preliminary evidence for the efficacy of mobile interventions. Conclusions TBIs may be an additional way of delivering evidence-based treatments to eating disorder patients and their use is likely to increase in the near future. TBIs may also be considered for the prevention of eating disorders and to support carers of eating disorder patients. Areas of future research and important issues such as guidance, therapeutic alliance, and dissemination are discussed. PMID:25840591

  11. Interaction between serotonin transporter and dopamine D2/D3 receptor radioligand measures is associated with harm avoidant symptoms in anorexia and bulimia nervosa.

    PubMed

    Bailer, Ursula F; Frank, Guido K; Price, Julie C; Meltzer, Carolyn C; Becker, Carl; Mathis, Chester A; Wagner, Angela; Barbarich-Marsteller, Nicole C; Bloss, Cinnamon S; Putnam, Karen; Schork, Nicholas J; Gamst, Anthony; Kaye, Walter H

    2013-02-28

    Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) have alterations of measures of serotonin (5-HT) and dopamine (DA) function, which persist after long-term recovery and are associated with elevated harm avoidance (HA), a measure of anxiety and behavioral inhibition. Based on theories that 5-HT is an aversive motivational system that may oppose a DA-related appetitive system, we explored interactions of positron emission tomography (PET) radioligand measures that reflect portions of these systems. Twenty-seven individuals recovered (REC) from eating disorders (EDs) (7 AN-BN, 11 AN, 9 BN) and nine control women (CW) were analyzed for correlations between [(11)C]McN5652 and [(11)C]raclopride binding. There was a significant positive correlation between [(11)C]McN5652 binding potential (BP(non displaceable(ND))) and [(11)C]Raclopride BP(ND) for the dorsal caudate, antero-ventral striatum (AVS), middle caudate, and ventral and dorsal putamen. No significant correlations were found in CW. [(11)C]Raclopride BP(ND), but not [(11)C]McN5652 BP(ND), was significantly related to HA in REC EDs. A linear regression analysis showed that the interaction between [(11)C]McN5652 BP(ND) and [(11)C]raclopride BP(ND) in the dorsal putamen significantly predicted HA. This is the first study using PET and the radioligands [(11)C]McN5652 and [(11)C]raclopride to show a direct relationship between 5-HT transporter and striatal DA D2/D3 receptor binding in humans, supporting the possibility that 5-HT and DA interactions contribute to HA behaviors in EDs.

  12. Risk for self-reported anorexia or bulimia nervosa based on drive for thinness and negative affect clusters/dimensions during adolescence: A three-year prospective study of the TChAD cohort

    PubMed Central

    Peñas-Lledó, Eva; Bulik, Cynthia M.; Lichtenstein, Paul; Larsson, Henrik; Baker, Jessica H.

    2015-01-01

    Objective The present study explored the cross-sectional and predictive effect of drive for thinness and/or negative affect scores on the development of self-reported anorexia nervosa (AN) and bulimia nervosa (BN). Method K-means were used to cluster the Eating Disorder Inventory-Drive for Thinness (DT) and Child Behavior Checklist Anxious/Depressed (A/D) scores from 615 unrelated female twins at age 16–17. Logistic regressions were used to assess the effect of these clusters on self-reported eating disorder diagnosis at ages 16–17 (n=565) and 19–20 (n=451). Results DT and A/D scores were grouped into four clusters: Mild (scores lower than 90th percentile on both scales), DT (higher scores only on DT), A/D (higher scores only on A/D), and DT-A/D (higher scores on both the DT and A/D scales). DT and DT-A/D clusters at age 16–17 were associated cross-sectionally with AN and both cross-sectionally and longitudinally with BN. The DT-A/D cluster had the highest prevalence of AN at follow-up compared with all other clusters. Similarly, an interaction was observed between DT and A/D that predicted risk for AN. Discussion Having elevated DT and A/D scores may increase risk for eating disorder symptomatology above and beyond a high score on either alone. Findings suggest that cluster modeling based on DT and A/D may be useful to inform novel and useful intervention strategies for AN and BN in adolescents. PMID:26013185

  13. Counseling Concerns for the Individual with Bulimia.

    ERIC Educational Resources Information Center

    Leclair, Norma J; Berkowitz, Belinda

    1983-01-01

    Presents characteristics, medical concerns, treatment alternatives, and family issues for counselors working with nonhospitalized clients. Emphasis is placed on attending the interaction of the behavioral, cognitive, and affective domains in the client. Counselors should use interventions based on theory and research. (Author/JAC)

  14. Earliest recollections in anorexia and bulimia.

    PubMed

    Fassino, S; Abbate Daga, G; Garzaro, L; Rovera, G G

    1998-06-01

    Earliest Recollections (ER) are very useful as they reveal information about a person's main aims and lifestyle, according to the Individual Psychology assumption of the inner coherence of the personality. This paper looks at the utility of analyzing ER in psychopathological research, diagnosis and therapy. Its purpose is to compare particular ER in a group of anorectic outpatients, a group of bulimic outpatients and in a control group. The results provide further evidence that ER are a useful instrument to identify various aspects of family dynamics, particular pathological nuclei which are often of the borderline type. They can also help to overcome the initial hostility towards any therapy that is often present in anorectic and assist the therapist early on in drawing a mental picture of the premises for understanding the lifestyle of the subject both as a child, and now as a patient.

  15. Bulimia Nervosa: A Review of Family Characteristics.

    ERIC Educational Resources Information Center

    Lau, DeeAnne Karyl

    The purpose of this literature review was to demonstrate that a family systems conceptualization of family dysfunction could be applied to bulimic families. In general, self-report and observational family characteristics studies support the hypothesis that bulimic families, like anorectic families, have significant systemic dysfunction in…

  16. Dialectical behaviour therapy and an added cognitive behavioural treatment module for eating disorders in women with borderline personality disorder and anorexia nervosa or bulimia nervosa who failed to respond to previous treatments. An open trial with a 15-month follow-up.

    PubMed

    Kröger, Christoph; Schweiger, Ulrich; Sipos, Valerija; Kliem, Sören; Arnold, Ruediger; Schunert, Tanja; Reinecker, Hans

    2010-12-01

    There is evidence from case studies suggesting that adapted dialectical behavior therapy (DBT) for borderline personality disorder (BPD) and eating disorders (ED) might improve disorder related complaints. Twenty-four women with BPD (9 with comorbid anorexia nervosa [AN] and 15 with bulimia nervosa [BN]), who already had failed to respond to previous eating-disorder related inpatient treatments were consecutively admitted to an adapted inpatient DBT program. Assessment points were at pre-treatment, post-treatment, and 15-month follow-up. At follow-up, the remission rate was 54% for BN, and 33% for AN. Yet 44% of women with AN crossed over to BN and one woman additionally met the criteria of AN. For women with AN, the mean weight was not significantly increased at post-treatment, but had improved at follow-up. For women with BN, the frequency of binge-eating episodes was reduced at post-treatment as well as at follow-up. Self-rated eating-related complaints and general psychopathology, as well as ratings on global psychosocial functioning, were significantly improved at post-treatment and at follow-up. Although these findings support the assumption that the adapted DBT inpatient program is a potentially efficacious treatment for those who failed to respond to previous eating-disorder related inpatient treatments, remission rates and maintained eating-related psychopathology also suggest that this treatment needs further improvement.

  17. The role of "mixed" orexigenic and anorexigenic signals and autoantibodies reacting with appetite-regulating neuropeptides and peptides of the adipose tissue-gut-brain axis: relevance to food intake and nutritional status in patients with anorexia nervosa and bulimia nervosa.

    PubMed

    Smitka, Kvido; Papezova, Hana; Vondra, Karel; Hill, Martin; Hainer, Vojtech; Nedvidkova, Jara

    2013-01-01

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

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

    PubMed Central

    Papezova, Hana; Vondra, Karel; Hill, Martin; Hainer, Vojtech; Nedvidkova, Jara

    2013-01-01

    Eating disorders such as anorexia (AN) and bulimia nervosa (BN) are characterized by abnormal eating behavior. The essential aspect of AN is that the individual refuses to maintain a minimal normal body weight. The main features of BN are binge eating and inappropriate compensatory methods to prevent weight gain. The gut-brain-adipose tissue (AT) peptides and neutralizing autoantibodies play an important role in the regulation of eating behavior and growth hormone release. The mechanisms for controlling food intake involve an interplay between gut, brain, and AT. Parasympathetic, sympathetic, and serotoninergic systems are required for communication between brain satiety centre, gut, and AT. These neuronal circuits include neuropeptides ghrelin, neuropeptide Y (NPY), peptide YY (PYY), cholecystokinin (CCK), leptin, putative anorexigen obestatin, monoamines dopamine, norepinephrine (NE), serotonin, and neutralizing autoantibodies. This extensive and detailed report reviews data that demonstrate that hunger-satiety signals play an important role in the pathogenesis of eating disorders. Neuroendocrine dysregulations of the AT-gut-brain axis peptides and neutralizing autoantibodies may result in AN and BN. The circulating autoantibodies can be purified and used as pharmacological tools in AN and BN. Further research is required to investigate the orexigenic/anorexigenic synthetic analogs and monoclonal antibodies for potential treatment of eating disorders in clinical practice. PMID:24106499

  19. Anorexia Nervosa and Bulimia: A Self-Help Group.

    ERIC Educational Resources Information Center

    Franko, Debra L.

    1987-01-01

    Implemented weekly self-help group for female anorexics and bulimics. Eighteen women who had consistently attended sessions evaluated group six months after it had begun. Found that self-help group benefited most members. Discusses findings in relation to curative factors of such groups. Offers suggestions for professionals interested in…

  20. REM and delta sleep in anorexia nervosa and bulimia.

    PubMed

    Levy, A B; Dixon, K N; Schmidt, H

    1987-03-01

    Several recent investigations have suggested that neurobiological similarities may exist between patients with eating disorders and those with depression. We performed polysomnograms for two consecutive nights on nine bulimic and six anorectic patients who had no concomitant diagnosis of endogenous depression. The rapid eye movement (REM) latency, REM density, and delta sleep of these subjects on night 2 were compared to those of 10 healthy controls of similar ages. Contrary to reports of shortened REM latency and increased REM density in depressed patients, we did not find significant REM differences between eating disorder patients without endogenous depression and healthy control subjects. Low weight anorectics did appear to have less delta sleep than did controls. These findings do not support the contention that eating disorders are variants of affective disorders.

  1. Anorexia, bulimia, and the athletic triad: evaluation and management.

    PubMed

    Fenichel, Rebecca M; Warren, Michelle P

    2007-12-01

    Caloric restriction caused by undernutrition or over-exercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin on bone. Identifying patients at risk for low bone mineral density and fracture is important, as is screening with dual energy radiograph absorptiometry. Treatment has focused on oral contraceptive use, yet improved bone mineral density is marked by nutritional recovery and anovulation reversal. Therefore, resolving the nutrition deficiency should be the cornerstone of treatment. Cognitive-behavioral therapy aims for weight recovery, which can lead to reversal of amenorrhea and improvement in other associated metabolic abnormalities. During treatment, estradiol levels can be followed to assess hypothalamic-pituitary-ovarian recovery because estradiol secretion may increase well before ovulation occurs. In patients failing the above interventions, hormone replacement should be considered, but bone mineral density should be followed because patients may continue to lose bone despite treatment with oral contraceptives if nutrition is not improved.

  2. Anorexia, bulimia, and the female athlete triad: evaluation and management.

    PubMed

    Mendelsohn, Felicia A; Warren, Michelle P

    2010-03-01

    The female athlete triad is an increasingly prevalent condition involving disordered eating, amenorrhea, and osteoporosis. An athlete can suffer from all 3 components of the triad, or just 1 or 2 of the individual conditions. The main element underlying all the aspects of the triad is an adaptation to a negative caloric balance. Screening for these disorders should be an important component of an athlete's care. Prevention and treatment should involve a team approach, including a physician, a nutritionist, and a mental health provider.

  3. [Role of leptin in human reproduction (anorexia, bulimia)].

    PubMed

    Pilka, L; Rumpík, D; Pilka, R

    2012-12-01

    Leptin may act as the critical link between adipose tissue and the reproductive system, indicating whether adequate energy reserves are presenting for normal reproductive functions. Future interventional studies involving leptin administration are excepted to further clarify this role of leptin and may provide new therapeutic options for the reproductive dysfunctions associated with states of relative leptin deficiency or resistance.

  4. Outcome Evaluation of an Intensive Residential Treatment Program for Bulimia

    PubMed Central

    WOOLEY, ORLAND W.; WOOLEY, SUSAN C.; DEDDENS, JAMES A.

    1993-01-01

    A 1-month intensive treatment program for bulimic women (ITP) was evaluated. Patients followed up after 1 year had reduced the frequency of purging by 86%, and 38% were symptom free. Patients reported improvements in important relationships and in progress toward life goals. They rated the program highly. Results from the Eating Disorders Inventory, Symptom Checklist 90-R, Eating Attitudes Test, Zung Depression and Anxiety, Body-Cathexis, MMPI, and Color-A-Person Body Dissatisfaction measures indicated highly significant improvement. Patients not followed up had improved similarly but were more impaired. Dropout rate was 1.5%. Results compare well with those of other established eating disorder programs and suggest that the ITP is an effective alternative to hospitalization. PMID:22700149

  5. Resisting Anorexia/Bulimia: Foucauldian Perspectives in Narrative Therapy

    ERIC Educational Resources Information Center

    Lock, Andrew; Epston, David; Maisel, Richard; de Faria, Natasha

    2005-01-01

    Foucault's analysis of unseen power as it operates in discourses that construct "practices of discipline" and "technologies of the self" has been a central conceptual resource in the development of narrative therapy. Narrative therapists take the view that ?unseen aspects of power work to construct both how a person understands their situation,…

  6. The Counselor's Role in the Treatment of Anorexia Nervosa and Bulimia.

    ERIC Educational Resources Information Center

    Frey, Diane

    1984-01-01

    Reviews the psychological, physiological, and behavioral characteristics of anorexic and bulimic clients. Describes at risk clients and discusses developmental, preventive, and remedial intervention strategies. (LLL)

  7. [Sleep in anorexia nervosa, bulimia nervosa and depressive diseases: a polysomnographic comparative study].

    PubMed

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

    1989-10-01

    All-night EEG sleep in 20 anorexics, 10 bulimics, 10 endogenous depressives, and in 10 healthy subjects (all age matched) was compared. In addition, the REM sleep-induction-test was performed in 12 patients with an eating disorder, 7 depressives, and 12 controls by application of the cholinergic agent RS 86. During baseline night, EEG-sleep parameters, especially REM latency, did not differ between the patients and the controls, except for the phasic components of REM sleep (REM density) that were increased in the depressive patients. The frequency of shortened REM latencies, however, was significantly higher in the depressed patients. These observations indicate that in some of the young depressives the disturbance of the REM sleep regulating transmitter system is already present to a similar degree as it is assumed in elderly depressives. After the application of RS 86, REM latency was shortened in all groups under investigation. However, the REM sleep inducing effect of RS 86 was significantly more pronounced in the depressives when compared with both the eating disorder patients and the controls. In the latter two samples, the shortening of REM latency was similar. Furthermore, the eating disorder patients with a concomitant major depression reacted similar to RS 86 as the non-depressed eating disorder patients and the control subjects. Whereas baseline EEG-sleep did not differ significantly among eating disorder patients, young depressives, and healthy subjects, the REM sleep inducing effect of the cholinergic agent RS 86 clearly distinguished between the depressives and both the patients suffering from eating disorders and the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. A Treatment for College Women at Risk for Bulimia: A Controlled Evaluation.

    ERIC Educational Resources Information Center

    Kaminski, Patricia L.; McNamara, Kathleen

    1996-01-01

    College women (n=29) evidencing low body esteem, repeated dieting efforts, and other dysfunctional eating behaviors or attitudes were randomly assigned to group treatment or control. Participants who received the intervention reported significantly improved levels of self-esteem and body satisfaction, reductions in reliance on potentially…

  9. Explicit and implicit emotional expression in bulimia nervosa in the acute state and after recovery.

    PubMed

    Tárrega, Salomé; Fagundo, Ana B; Jiménez-Murcia, Susana; Granero, Roser; Giner-Bartolomé, Cristina; Forcano, Laura; Sánchez, Isabel; Santamaría, Juan José; Ben-Moussa, Maher; Magnenat-Thalmann, Nadia; Konstantas, Dimitri; Lucas, Mikkel; Nielsen, Jeppe; Bults, Richard G A; Lam, Tony; Kostoulas, Theodoros; Fakotakis, Nikos; Riesco, Nadine; Wolz, Ines; Comín-Colet, Josep; Cardi, Valentina; Treasure, Janet; Fernández-Formoso, José Antonio; Menchón, José Manuel; Fernández-Aranda, Fernando

    2014-01-01

    Expression of emotional state is considered to be a core facet of an individual's emotional competence. Emotional processing in BN has not been often studied and has not been considered from a broad perspective. This study aimed at examining the implicit and explicit emotional expression in BN patients, in the acute state and after recovery. Sixty-three female participants were included: 22 BN, 22 recovered BN (R-BN), and 19 healthy controls (HC). The clinical cases were drawn from consecutive admissions and diagnosed according to DSM-IV-TR diagnostic criteria. Self reported (explicit) emotional expression was measured with State-Trait Anger Expression Inventory-2, State-Trait Anxiety Inventory, and Symptom Check List-90 items-Revised. Emotional facial expression (implicit) was recorded by means of an integrated camera (by detecting Facial Feature Tracking), during a 20 minutes therapeutic video game. In the acute illness explicit emotional expression [anxiety (p<0.001) and anger (p<0.05)] was increased. In the recovered group this was decreased to an intermediate level between the acute illness and healthy controls [anxiety (p<0.001) and anger (p<0.05)]. In the implicit measurement of emotional expression patients with acute BN expressed more joy (p<0.001) and less anger (p<0.001) than both healthy controls and those in the recovered group. These findings suggest that there are differences in the implicit and explicit emotional processing in BN, which is significantly reduced after recovery, suggesting an improvement in emotional regulation.

  10. Treatment of childhood sexual abuse in anorexia nervosa and bulimia nervosa: a feminist psychodynamic approach.

    PubMed

    Kearney-Cooke, A; Striegel-Moore, R H

    1994-05-01

    In this article a parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by clients with eating disorders. In particular, we describe how sexual abuse has a significant and lasting effect on body image, identity, self-regulation, and interpersonal functioning. Treatment issues are outlined including the nature of the healing relationship, assessment of abuse, development of capacity for self-soothing, techniques for assisting in memory recall, sculpting of images, description and reenactment of abuse, dealing with shame, and ending the cycle of repeated victimization.

  11. Examining the role of self-discrepancy and self-directed style in bulimia nervosa.

    PubMed

    Mason, Tyler B; Pearson, Carolyn M; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Erickson, Ann L; Mitchell, James E; Crow, Scott J; Smith, Tracey L; Klein, Marjorie H; Peterson, Carol B

    2016-10-30

    Two of the primary components within Integrative Cognitive Affective Therapy (ICAT) are self-discrepancy and self-directed style. Self-discrepancy includes both actual:ideal (discrepancy between oneself and who one wishes they were) and actual:ought (discrepancy between oneself and who one believes they ought to be). Self-directed style in ICAT refers to a variety of behaviors emitted by a person toward the self including self-blaming and self-affirming. This study explored main effects and interactions between self-discrepancy and self-directed style in relation to global eating disorder (ED) psychopathology, depressive symptoms, and anxiety. Eighty treatment-seeking adults from the Midwest with BN or subthreshold BN completed interviews and self-report measures. Self-affirm and self-blame were associated with ED psychopathology, depressive symptoms, and anxiety. Actual:ideal discrepancy was related to anxiety and actual:ought discrepancy was related to anxiety and depressive symptoms. Interactions were found between self-affirm and actual:ought discrepancy as well as self-blame and actual:ought discrepancy for depressive symptoms. High actual:ought was related to increased depressive symptoms regardless of levels of self-affirm or self-blame. Effect sizes for models were medium-to-large with anxiety models demonstrating the largest effects. This study provides further evidence supporting the ICAT model and treatment, which targets self-discrepancies, self-directed styles, and related emotional states. PMID:27512918

  12. Chemical and physical oral findings in a case of anorexia nervosa and bulimia.

    PubMed

    Jensen, O E; Featherstone, J D; Stege, P

    1987-09-01

    The deleterious effect on enamel of continual acid challenge from regurgitation of gastric contents in bulimic subjects is well documented. No previous reports, however, have been published on chemical and physical measurements of teeth from such subjects, or on the importance of fluoride in maintaining their dentition. Teeth were obtained from a deceased anorexic and bulimic patient. Shortly before death this patient had saliva analyses and in vivo enamel biopsies at our clinic, before and after a 3-week regimen of daily rinsing with 0.05% NaF. After 4 years of daily regurgitation there was an almost normal thickness of the enamel surfaces typically "at risk", i.e. the palatal surfaces of the maxillary anterior teeth, with normal hardness measurements 10 micron away from the outer surface. SEM micrographs showed an irregular topography, with crystalline deposits rich in calcium, phosphate and fluoride. These surfaces were more reactive to uptake of additional fluoride when given as a daily rinse, than the more protected, and therefore, presumed unaffected surfaces. Our findings suggest that frequent and meticulous oral hygiene measures can substantially minimize the erosive effect on tooth enamel of gastric contents in bulimic patients, especially if fluoride products are used regularly.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  14. Prevalence of Eating Disorders Such as Anorexia and Bulimia Nervosa among the College Population.

    ERIC Educational Resources Information Center

    Martin, M. Elizabeth

    1993-01-01

    Reviews results of studies concerning prevalence of eating disorders among high school and college student populations. Compares results of related studies and offers recommendations to student affairs professionals on how they might provide supportive services for students struggling with eating disorders. (Author/NB)

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

    PubMed Central

    Salvini, Alessandro; Faccio, Elena; Mininni, Giuseppe; Romaioli, Diego; Cipolletta, Sabrina; Castelnuovo, Gianluca

    2012-01-01

    Starting from the critical review of various motivational frameworks of change that have been applied to the study of eating disorders, the present paper provides an alternative conceptualization of the change in psychotherapy presenting a single-case study. We analyzed six psychotherapeutic conversations with a bulimic patient and found out narratives “for” and “against” change. We read them in terms of tension between dominance and exchange in I-positions, as described by Hermans. These results indicate that the dialogical analysis of clinical discourse may be a useful method to investigate change from the beginning to the end of therapy. PMID:23233845

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  17. The Relationship between Substance Use and Clinical Characteristics among Adolescent Girls with Anorexia Nervosa or Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Wiederman, Michael W.; Pryor, Tamara

    1997-01-01

    Explores clinical characteristics associated with adolescent girls (N=110) diagnosed with an eating disorder and increased exposure to illicit drugs. Results indicate substance use was unrelated to scores on several scales of eating disorder symptomatology. One scale, though, predicted substance use regardless of age or eating disorder diagnosis.…

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

    ERIC Educational Resources Information Center

    Scott, Ronald L.; Baroffio, James R.

    1986-01-01

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

  19. CAD/CAM monolithic restorations and full-mouth adhesive rehabilitation to restore a patient with a past history of bulimia: the modified three-step technique.

    PubMed

    Vailati, Francesca; Carciofo, Sylvain

    2016-01-01

    Due to an increasing awareness about dental erosion, many clinicians would like to propose treatments even at the initial stages of the disease. However, when the loss of tooth structure is visible only to the professional eye, and it has not affected the esthetics of the smile, affected patients do not usually accept a full-mouth rehabilitation. Reducing the cost of the therapy, simplifying the clinical steps, and proposing noninvasive adhesive techniques may promote patient acceptance. In this article, the treatment of an ex-bulimic patient is illustrated. A modified approach of the three-step technique was followed. The patient completed the therapy in five short visits, including the initial one. No tooth preparation was required, no anesthesia was delivered, and the overall (clinical and laboratory) costs were kept low. At the end of the treatment, the patient was very satisfied from a biologic and functional point of view. PMID:26835523

  20. At the core of eating disorders: Overvaluation, social rank, self-criticism and shame in anorexia, bulimia and binge eating disorder.

    PubMed

    Duarte, Cristiana; Ferreira, Cláudia; Pinto-Gouveia, José

    2016-04-01

    This study examined the similarities and differences in eating psychopathology symptoms, overvaluation of body shape, weight and eating, general psychopathology, social comparison, self-criticism and shame, between AN, BN and BED patients. Also, the mediator effect of self-criticism and social comparison on the association between overvaluation and shame, was tested. Participants were 119 patients (34 AN, 34 BN and 51 BED) diagnosed through the Eating Disorder Examination. Results indicated that BED patients are older and present higher BMI. The groups differed regarding eating disorders' symptomatology, but no significant differences were observed in overvaluation, self-criticism, shame and overall psychopathology symptoms. The path model confirmed that overvaluation has a significant indirect association with shame, which is mediated by severe self-criticism and negative social comparisons. The model was fond to be invariant between the clinical groups. These findings contribute for the understanding of the common processes that feed the perpetual cycle of eating psychopathology. Thus, these data have potential implications for transdiagnostic approaches to treatment. PMID:26995245

  1. At the core of eating disorders: Overvaluation, social rank, self-criticism and shame in anorexia, bulimia and binge eating disorder.

    PubMed

    Duarte, Cristiana; Ferreira, Cláudia; Pinto-Gouveia, José

    2016-04-01

    This study examined the similarities and differences in eating psychopathology symptoms, overvaluation of body shape, weight and eating, general psychopathology, social comparison, self-criticism and shame, between AN, BN and BED patients. Also, the mediator effect of self-criticism and social comparison on the association between overvaluation and shame, was tested. Participants were 119 patients (34 AN, 34 BN and 51 BED) diagnosed through the Eating Disorder Examination. Results indicated that BED patients are older and present higher BMI. The groups differed regarding eating disorders' symptomatology, but no significant differences were observed in overvaluation, self-criticism, shame and overall psychopathology symptoms. The path model confirmed that overvaluation has a significant indirect association with shame, which is mediated by severe self-criticism and negative social comparisons. The model was fond to be invariant between the clinical groups. These findings contribute for the understanding of the common processes that feed the perpetual cycle of eating psychopathology. Thus, these data have potential implications for transdiagnostic approaches to treatment.

  2. CAD/CAM monolithic restorations and full-mouth adhesive rehabilitation to restore a patient with a past history of bulimia: the modified three-step technique.

    PubMed

    Vailati, Francesca; Carciofo, Sylvain

    2016-01-01

    Due to an increasing awareness about dental erosion, many clinicians would like to propose treatments even at the initial stages of the disease. However, when the loss of tooth structure is visible only to the professional eye, and it has not affected the esthetics of the smile, affected patients do not usually accept a full-mouth rehabilitation. Reducing the cost of the therapy, simplifying the clinical steps, and proposing noninvasive adhesive techniques may promote patient acceptance. In this article, the treatment of an ex-bulimic patient is illustrated. A modified approach of the three-step technique was followed. The patient completed the therapy in five short visits, including the initial one. No tooth preparation was required, no anesthesia was delivered, and the overall (clinical and laboratory) costs were kept low. At the end of the treatment, the patient was very satisfied from a biologic and functional point of view.

  3. Body Image

    MedlinePlus

    ... spider veins Body dysmorphic disorder (BDD) Eating disorders Anorexia nervosa Binge eating disorder Bulimia nervosa Over-exercising ... conditions? Visit our Mental health section. Fact sheets Anorexia nervosa Binge eating disorder Bulimia nervosa Cosmetics and ...

  4. Resources

    MedlinePlus

    ... Breastfeeding - resources Bulimia - resources Burns - resources Cancer - resources Cerebral palsy - resources Celiac disease - resources Child abuse - resources Chronic fatigue syndrome - resources Chronic pain - ...

  5. The Evolution of "Enhanced" Cognitive Behavior Therapy for Eating Disorders: Learning from Treatment Nonresponse

    ERIC Educational Resources Information Center

    Cooper, Zafra; Fairburn, Christopher G.

    2011-01-01

    In recent years there has been widespread acceptance that cognitive behavior therapy (CBT) is the treatment of choice for bulimia nervosa. The cognitive behavioral treatment of bulimia nervosa (CBT-BN) was first described in 1981. Over the past decades the theory and treatment have evolved in response to a variety of challenges. The treatment has…

  6. Child Sexual Abuse and Bulimic Behaviors: An Exploratory Investigation of the Frequency and Nature of a Relationship.

    ERIC Educational Resources Information Center

    Korte, Kelli L.; Horton, Connie Burrows; Graybill, Daniel

    1998-01-01

    The co-occurrence of child sexual abuse and the development of bulimia was studied in a nonclinical sample (N=391). Results are discussed, including consideration of possible linkage between the experience of sexual abuse and bulimia. ANOVA analysis is presented briefly. The hypothesis of dissociation as a link was not supported. (EMK)

  7. Evaluation of An Eating Disorder Lesson Plan.

    ERIC Educational Resources Information Center

    Moriarty, Dick; And Others

    This document reports on the quantitative and qualitative evaluation of "A Preventive Curriculum for Anorexia Nervosa and Bulimia" (Carney and Veilleux, 1986) which was published by the Bulimia Anorexia Nervosa Association-Canadian/American (BANA-Can/Am), an organization which was formed in 1983 by parents, professionals, and patients in…

  8. Attachment to God/Higher Power and Bulimic Symptoms among College Women

    ERIC Educational Resources Information Center

    Buser, Juleen K.; Gibson, Sandy

    2016-01-01

    The authors examined the relationship between avoidant and anxious attachment to God/Higher Power and bulimia symptoms among 599 female college student participants. After controlling for body mass index, the authors found a positive association between both attachment variables and bulimia. When entered together in a regression, anxious…

  9. Similarities between Restrained Eaters and Bulimics.

    ERIC Educational Resources Information Center

    Ruderman, Audrey J.

    Little is known about the etiology of bulimia. However Polivy and Herman have hypothesized that dieting causes bulimia and that differences between dieters and bulimics are quantitative rather than qualitative. The purpose of this study was to examine these hypotheses and further examine the parallels between bulimics and dieters. Female college…

  10. Predicting Eating Disorder Group Membership: An Examination and Extension of the Sociocultural Model

    ERIC Educational Resources Information Center

    Engler, Patricia A.; Crowther, Janis H.; Dalton, Ginnie; Sanftner, Jennifer L.

    2006-01-01

    The purpose of this research was to examine and extend portions of the sociocultural model of bulimia nervosa (Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. "Clinical Psychology Review," 14, 633-661; Stice, E., & Agras, W. S. (1998). Predicting onset and…

  11. Psychopathology of EDNOS Patients: To Whom Do They Compare?

    ERIC Educational Resources Information Center

    Moor, Sasha; Vartanian, Lenny R.; Touyz, Stephen W.; Beumont, P. J. V.

    2004-01-01

    Do the levels of psychopathology displayed by patients with an eating disorder not otherwise specified (EDNOS) more closely resemble those displayed by full-criteria anorexia and bulimia nervosa patients than they do those of non-eating-disorder controls? Three groups of eating disorder patients (anorexia nervosa, n = 27; bulimia nervosa, n = 23;…

  12. Slaying the Food Monster: Help for Bulimics.

    ERIC Educational Resources Information Center

    Snyder, Francine; Levy, Karen Gorbitz

    1984-01-01

    Bulimia is an eating disorder often referred to as the binge-purge syndrome. The bulimic usually functions well at work and often holds a top-level position. Reasons for bulimia include feelings of inadequacy, societal pressures to be thin, and high parental expectations. Low self-esteem is a common characteristic of the bulimic. (RM)

  13. Family Structure and Eating Disorders: The Family Environment Scale and Bulimic-Like Symptoms.

    ERIC Educational Resources Information Center

    Bailey, Carol A.

    1991-01-01

    Family variables derived from the Family Environment Scale are examined using data from 174 college women at a Pacific Northwest university and 2 universities in Houston (Texas) with varying degrees of bulimia. Subjects' self-reports indicate family dysfunctions, but the study illustrates the complexity of the family's role in bulimia. (SLD)

  14. Familiarizing Students with the Empirically Supported Treatment Approaches for Eating Disorders.

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Urban, Greg; Zanotti, Mary; Chambliss, Catherine

    In recent years, bulimia nervosa has plagued young women and become a major issue in mental health care. Strategies for training counseling students so as to acquaint them with clinical research on treatments for bulimia are presented in this report. It reviews empirically supported treatments (ESTs) concerning eating disorders in order to…

  15. Correlates of Eating Disorders in College Students.

    ERIC Educational Resources Information Center

    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…

  16. Motivations for dieting: Drive for Thinness is different from Drive for Objective Thinness.

    PubMed

    Chernyak, Yelena; Lowe, Michael R

    2010-05-01

    Drive for thinness is a cardinal feature of bulimia nervosa. However, the widely used Drive for Thinness (DFT) subscale of the Eating Disorder Inventory (Garner, 2004; Garner, Olmstead, & Polivy, 1983) appears to measure a desire to be thinner, not a desire to be objectively thin. We developed the Drive for Objective Thinness (DFOT) Scale and compared unrestrained and restrained eaters and those with bulimia nervosa on the DFT subscale, Goldfarb's Fear of Fat Scale (GFFS; Goldfarb, Dykens, & Gerrard, 1983), and the DFOT Scale. Restrained eaters had higher scores than unrestrained eaters on the DFT subscale and the GFFS, but both groups had low scores on the DFOT Scale. Only the group with bulimia nervosa showed elevated scores on the DFOT Scale. We conclude that restrained eaters diet mostly to avoid weight gain, that individuals with bulimia nervosa diet to achieve thinness and avoid fatness, and that the drive for objective thinness is a unique feature of bulimia nervosa.

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

    ERIC Educational Resources Information Center

    Oldis, Katherine O.

    1986-01-01

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

  18. Eating Disorders: Counseling Issues. In Brief: An Information Digest from ERIC/CAPS.

    ERIC Educational Resources Information Center

    Herbert, Deborah, Comp.

    This digest describes the characteristics and extent of anorexia and bulimia, and provides psychosocial and family profiles of the victims. The role of counseling programs in treating these disorders is discussed. (BH)

  19. Appetite - increased

    MedlinePlus

    ... drugs (such as corticosteroids, cyproheptadine, and tricyclic antidepressants) Bulimia (most common in women 18 to 30 years ... Becker AE, Baker CW. Eating disorders. In: Feldman M, Friedman LS, ... and Liver Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; ...

  20. Laxative overdose

    MedlinePlus

    ... JL, Bravender T, Rund DA. Anorexia nervosa and bulimia nervosa. In: Tintinalli JE, Stapczynski JS, Ma OJ, ... McGraw-Hill; 2011:chap 286. Tanofsky-Kraff M. Eating disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  1. Eating Disorders: About More Than Food

    MedlinePlus

    ... disorders? Where can I find more information? Share Eating Disorders: About More Than Food Download PDF Download ePub Order a free hardcopy What are eating disorders? The eating disorders anorexia nervosa, bulimia nervosa, and ...

  2. Nonlinear analysis of heart rate variability in patients with eating disorders.

    PubMed

    Vigo, Daniel E; Castro, Mariana N; Dörpinghaus, Andrea; Weidema, Hylke; Cardinali, Daniel P; Siri, Leonardo Nicola; Rovira, Bernardo; Fahrer, Rodolfo D; Nogués, Martín; Leiguarda, Ramón C; Guinjoan, Salvador M

    2008-01-01

    Patients with anorexia nervosa or bulimia nervosa often have signs of autonomic dysfunction potentially deleterious to the heart. The aim of this study was to ascertain the nonlinear properties of heart rate variability in patients with eating disorders. A group of 33 women with eating disorders (14 anorexia, 19 bulimia) and 19 healthy controls were included in the study. Conventional time- and frequency-domain heart rate variability measurements, along with nonlinear heart rate variability measurements including the short-term fractal scaling exponent alpha and approximate entropy (ApEn) were calculated. Anorexia nervosa patients exhibited decreased values of alpha, while bulimia nervosa patients had decreased values of ApEn. Low-frequency heart rate variability was decreased in patients with anorexia. In conclusion, these results are compatible with the view that a more severe alteration of cardiac autonomic function is present in anorexia than in bulimia.

  3. What causes bone loss?

    MedlinePlus

    ... weight-loss surgery) Cystic fibrosis Other conditions that prevent the small intestine from absorbing nutrients well People with eating disorders, such as anorexia nervosa or bulimia , are also at higher risk ...

  4. Who Is at Risk for Long QT Syndrome?

    MedlinePlus

    ... excessive vomiting or diarrhea or other conditions that cause low blood levels of potassium or sodium. These conditions include the eating disorders anorexia nervosa and bulimia, as well as some ...

  5. When Teens' Eating Habits Become Unhealthy.

    ERIC Educational Resources Information Center

    Lucas, Alexander R.

    1984-01-01

    Eating disorders than may beset teenagers and seriously affect their health are discussed. Facts about causes, symptoms, and treatments for anorexia nervosa and bulimia, a disorder which involves overeating, followed by self-induced vomiting or purging, are presented. (PP)

  6. Helping Athletes Avoid Hazardous Weight Control Behavior.

    ERIC Educational Resources Information Center

    Janz, Kathleen

    1988-01-01

    This article addresses dangerous dieting techniques used by athletes and provides coaches and teachers specific strategies to aid in preventing eating-related disorders among athletes. Symptoms of anorexia and of bulimia are described. (JL)

  7. Personality Correlates of College Age Bulimics.

    ERIC Educational Resources Information Center

    Holleran, Paula R.; And Others

    1988-01-01

    Examined relationships between bulimia and the personality characteristics of assertiveness, masculinity, femininity, masculinity-femininity, and externality in 205 female college students, 15 of whom were classified as bulimic. Found low but statistically significant negative relationships between assertiveness, masculinity, and…

  8. Gastroparesis

    MedlinePlus

    ... nervosa or bulimia may also develop delayed gastric emptying. Gastric emptying may resume and symptoms improve when food ... intestine reattached to the remaining stomach to improve emptying of stomach contents. Rarely the stomach is completely removed. Electrical ...

  9. Are You Getting Too Much Exercise?

    MedlinePlus

    ... periods (women). Compulsive exercise may be associated with eating disorders, such as anorexia and bulimia . It can cause ... see a counselor who treats compulsive exercise or eating disorders. Your provider or counselor may use one or ...

  10. [Bulimic and depressive symptomatology in Puerto Rican adolescents].

    PubMed

    Cruz-Bermúdez, Nelson D; Rosselló, Jeannette

    2003-01-01

    Bulimia nervosa and depression have been identified as frequent mental health problems among adolescents. Bulimia nervosa, an eating disorder has been associated with depression especially among female population. The literature has established a high comorbidity between these disorders. Although depression was initially conceptualized as an adult disorder, recent research evidenced this disorder among adolescents. For this study, it was hypothesized that participants who presented bulimic symptomatology were going to present a higher depressive symptomatology than those who had no bulimic symptoms. The Bulimia Test (Bulit) and the Children's Depression Inventory (CDI) were administered to 309 students from a private high school in San Juan, Puerto Rico. Correlation analyses and group comparisons were performed to investigate the relationship between bulimia nervosa and depression among participants. As hypothesized, a significant correlation (p < .01) was found between depression and bulimia nervosa symptomatology. Females showed a higher average of bulimic symptomatology than males. Early identification for treatments with bulimia and depression would be helpful in preventing future problems in later adulthood. Implications of this study are discussed.

  11. Exploring the Relationship Between Social Anxiety and Bulimic Symptoms: Mediational Effects of Perfectionism Among Females

    PubMed Central

    Menatti, Andrew R.; Weeks, Justin W.; Levinson, Cheri A.; McGowan, Maggie M.

    2013-01-01

    Previous findings indicate that social anxiety and bulimia co-occur at high rates; one mechanism that has been proposed to link these symptom clusters is perfectionism. We tested meditational models among 167 female undergraduates in which maladaptive evaluative perfectionism concerns (MEPC; i.e., critical self-evaluative perfectionism) mediated the relationship between social anxiety and bulimic symptoms. Results from a first model indicated that MEPC mediated the relationship between fear of public scrutiny and bulimia symptoms. This indirect effect was significant above and beyond the indirect effects of maladaptive body-image cognitions and perfectionism specific to pure personal standards. A second model was tested with MEPC mediating the relationship between social interaction anxiety and bulimia symptoms. Similar results were obtained; however, in this model, a significant direct effect remained after partialing out the indirect effect of the mediators. Theoretical implications are discussed. PMID:24932054

  12. Barriers to access and utilization of eating disorder treatment among women.

    PubMed

    Thompson, Carly; Park, Sinyoung

    2016-10-01

    Anorexia, bulimia, and other specified feeding or eating disorders (OSFED) are psychiatric disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). One difference of eating disorders compared to other psychiatric disorders is the physical effects of the disease. Although anorexia is easier to physically detect than bulimia and OSFED, many women remain undiagnosed and untreated. Even if an eating disorder is recognized by the individual, barriers to clinical diagnosis and treatment persist. This study examines the barriers to treatment among women with anorexia, bulimia, and OSFED using Andersen's Behavioral Model. The physical, psychological, and personality trait differences among the eating disorder subgroups may affect treatment utilization and access. PMID:26971265

  13. Exploring the Relationship Between Social Anxiety and Bulimic Symptoms: Mediational Effects of Perfectionism Among Females.

    PubMed

    Menatti, Andrew R; Weeks, Justin W; Levinson, Cheri A; McGowan, Maggie M

    2013-10-01

    Previous findings indicate that social anxiety and bulimia co-occur at high rates; one mechanism that has been proposed to link these symptom clusters is perfectionism. We tested meditational models among 167 female undergraduates in which maladaptive evaluative perfectionism concerns (MEPC; i.e., critical self-evaluative perfectionism) mediated the relationship between social anxiety and bulimic symptoms. Results from a first model indicated that MEPC mediated the relationship between fear of public scrutiny and bulimia symptoms. This indirect effect was significant above and beyond the indirect effects of maladaptive body-image cognitions and perfectionism specific to pure personal standards. A second model was tested with MEPC mediating the relationship between social interaction anxiety and bulimia symptoms. Similar results were obtained; however, in this model, a significant direct effect remained after partialing out the indirect effect of the mediators. Theoretical implications are discussed. PMID:24932054

  14. Ecological Momentary Assessment of Affect, Stress, and Binge-Purge Behaviors: Day of Week and Time of Day Effects in the Natural Environment

    PubMed Central

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

    2010-01-01

    Objective The present study examined ecological momentary assessments of binge/vomit behavior, mood, and type and severity of stressors in a sample of 133 women with bulimia nervosa. Method Participants completed an ecological momentary assessment protocol for a period of 2 weeks. Results Mixed-effects and multilevel logistic models revealed significant variation across time of day and day of the week in the occurrence of binging, vomiting, positive and negative affect, and the severity and types of stressful events. Discussion These findings explicate how momentary and daily experiences vary in the natural environments of women with bulimia nervosa, and document critical time periods for intervention. PMID:19115371

  15. [Eating disorders--transient nuisance or perpetual problem?].

    PubMed

    Keski-Rahkonen, Anna

    2010-01-01

    Approximately 7% of Finnish women develop an eating disorder before the age of 30. While at least 70% of anorectic women will recover from their illness, normalization of body weight and hormone function usually takes years. Some of the anorexia cases become chronic. Bulimia nervosa has been considered a milder disease than anorexia, but the disease picture of bulimia may fluctuate, often exhibiting highly prolonged symptoms. Psychotherapeutic treatment and medication produce good responses to bulimic symptoms, whereas evidence of the efficacy of anorectic therapies remains less certain.

  16. Eating disorders should be considered in the differential diagnosis of patients presenting with acute kidney injury and electrolyte derangement

    PubMed Central

    Talbot, Ben Edward Michael; Lawman, Sarah H A

    2014-01-01

    We present a case of a 40-year-old woman with a history of ongoing anorexia nervosa and bulimia nervosa who has required multiple admissions to hospital for management of acute kidney injury (AKI) and electrolyte derangement. This case is of interest as recent studies have highlighted the significant prevalence of disordered eating and the major public health implications this may have. We discuss the unusual finding of hypercalcaemia in this case and address the investigation and management of AKI and electrolyte disturbance in a patient with anorexia and bulimia. PMID:24654247

  17. [Significance of brief interventions in the healthcare supply chain of eating disorders: a narrative review].

    PubMed

    Rossi, Maddalena Elisa; Neubauer, Karolin; Weigel, Angelika; Wendt, Hanna; von Rad, Kathrin; Romer, Georg; Löwe, Bernd; Gumz, Antje

    2015-02-01

    So far there is no comprehensive overview on brief outpatient interventions in eating disorders. The specific relevance of psychotherapeutic brief interventions for Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder is presented against the background of current healthcare supply chains. This review is based on a literature search that evaluated relevant publications in applicable literature databases. The articles were excerpted and are presented in a narrative overview. In summary, the literature shows a marginal expansion of healthcare provision towards personnel-efficient and cost economic therapeutic solutions for Bulimia Nervosa and Binge Eating Disorder, while the treatment of Anorexia Nervosa is currently determined by more in- and extensive approaches. PMID:24838437

  18. Eating Disorders: Facts about Eating Disorders and the Search for Solutions.

    ERIC Educational Resources Information Center

    Spearing, Melissa

    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…

  19. Conceptual Complexity and Obsessionality in Bulimic College Women.

    ERIC Educational Resources Information Center

    Johnson, Nancy S.; Holloway, Elizabeth L.

    1988-01-01

    Examined relationship between bulimia, conceptual complexity, obsessional symptoms, and obsessional traits in 54 college women classified as bulimic-anorexic vomiters, normal-weight bulimic vomiters, clinical controls, and normal controls. Found both bulimic groups exhibited significantly lower levels of conceptual functioning, significantly…

  20. Evidence-Based Practices in Outpatient Treatment for Eating Disorders

    ERIC Educational Resources Information Center

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

    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…

  1. Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

    ERIC Educational Resources Information Center

    Fursland, Anthea; Byrne, Sharon; Watson, Hunna; La Puma, Michelle; Allen, Karina; Byrne, Susan

    2012-01-01

    Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no…

  2. Psychological Treatment of Eating Disorders

    ERIC Educational Resources Information Center

    Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.

    2007-01-01

    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…

  3. Real vs. Ideal Self Discrepancy in Bulimics.

    ERIC Educational Resources Information Center

    Kosak, Karen

    Bulimia is an eating disorder prevalent among young women, characterized by binge eating episodes followed by purging with subsequent depressive moods and self-deprecating thoughts. To determine whether bulimic women exhibit a greater discrepancy between their perceived and ideal selves than do nonbulimics, three samples of women were assessed.…

  4. A Mediational Model of Autonomy, Self-Esteem, and Eating Disordered Attitudes and Behaviors.

    ERIC Educational Resources Information Center

    Frederick, Christina M.; Grow, Virginia M.

    1996-01-01

    Findings from a study of the relationships among autonomy deficits, low self-esteem, and eating disorders of 71 college women supported a mediational model in which lack of autonomy was related to decreased global self-esteem, which in turn was associated with bulimia and body dissatisfaction. (SLD)

  5. Eating Disorders of White American, Racial and Ethnic Minority American, and International Women.

    ERIC Educational Resources Information Center

    Osvold, Lise Leigh; Sodowsky, Gargi Roysircar

    1993-01-01

    Considers eating attitudes and behaviors related to anorexia nervosa, bulimia, and obesity of white American, African-American, Native American, and some international women from the point of view of cultural influences such as sex role, the media, socioeconomic class, and acculturation to Western society. (Author/NB)

  6. An Application of Expectancy Theory to Eating Disorders: Development and Validation of Measures of Eating and Dieting Expectancies.

    ERIC Educational Resources Information Center

    Hohlstein, Leigh Anne; Smith, Gregory T.; Atlas, Jana G.

    1998-01-01

    Five eating reinforcement expectancies and one dieting--thinness reinforcement expectancy were identified and their factor structure replicated on an independent sample of 557 women. Expectancies for negative reinforcement from eating characterized bulimia but not anorexia and were correlated with indexes of restraint plus disinhibition in a…

  7. Whoever Said "You Can Never Be Too Thin?" What to Do When Your Child Has an Eating Disorder.

    ERIC Educational Resources Information Center

    Santucci, Patricia

    1991-01-01

    Offers advice to parents of children with eating disorders, focusing on the warning signs of anorexia nervosa and bulimia nervosa. Suggestions for parents who think their children have eating disorders are provided. Parents are encouraged to be positive role models and be sensitive to stress. (SM)

  8. Mom and Dad Return to a Commuter Campus: A Program for Re-Parenting of Eating Disordered Females.

    ERIC Educational Resources Information Center

    Engebretson, Darold; Hollander, Barbara

    This paper concerns the high incidence of eating disorders, anorexia nervosa and bulimia, among the female population in colleges. It identifies several major issues in attempting to provide counseling services for eating disordered students (limited resources, a large estimated patient pool, length of treatment involved, and policy changes to…

  9. A Health Connection. Helping Physical Educators Address Eating Disorders.

    ERIC Educational Resources Information Center

    Lindsey, Billie J.; Janz, Kathleen F.

    1985-01-01

    In response to concern about the prevalence of anorexia and bulimia, several departments of the University of Iowa collaborated to design and implement an inservice training program for dance and physical educators, coaches and athletic trainers. The rationale, planning, program content, and implications of the eating disorders project are…

  10. The Relationship of Gender and Family Environment to Eating Disorder Risk in Adolescents.

    ERIC Educational Resources Information Center

    Felker, Kenneth R.; Stivers, Cathie

    1994-01-01

    Surveys measured components of family environment and adolescents' risk of developing anorexia nervosa or bulimia. Females displayed a greater risk than males for developing eating disorders. Lower cohesion, expressiveness, independence, and organization in the family implied a higher eating disorder risk, as did greater conflict and control. (RJM)

  11. Group Treatment of Eating Disorders in a University Counseling Center.

    ERIC Educational Resources Information Center

    Snodgrass, Gregory; And Others

    Sociocultural pressures to pursue an unrealistic ideal of thinness have contributed to an increasing number of students seeking help at a university counseling center for the eating disorders of anorexia nervosa and bulimia. To help these students, a group treatment technique was developed using a cognitive-behavioral approach. Treatment…

  12. Development and Validation of a Multifactorial Treatment Outcome Measure for Eating Disorders.

    ERIC Educational Resources Information Center

    Anderson, Drew A.; Williamson, Donald A.; Duchmann, Erich G.; Gleaves, David H.; Barbin, Jane M.

    1999-01-01

    Developed a brief self-report inventory to evaluate treatment outcome for anorexia and bulimia nervosa, the Multifactorial Assessment of Eating Disorders, and evaluated the instrument in a series of studies involving 1,054 women. Results support a stable factor structure and satisfactory reliability and validity, and establish normative data. (SLD)

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

    ERIC Educational Resources Information Center

    Katzman, Melanie A.; Wolchik, Sharlene A.

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

  14. Treatment and Counseling Approaches for Eating Disorders.

    ERIC Educational Resources Information Center

    Hamilton, Kristin L.

    Maladaptive eating behaviors are a growing phenomenon which has captured the interest of not only health and psychology professionals, but also the general public. This paper examines the various types of treatment and counseling approaches for treating anorexia nervosa and bulimia nervosa. Definitions for both disorders are provided, followed by…

  15. Personality Features and Expressed Concerns of Adolescents with Eating Disorders.

    ERIC Educational Resources Information Center

    Pryor, Tamara; Wiederman, Michael W.

    1998-01-01

    Investigates differences between adolescent females diagnosed with either anorexia nervosa (n=26) or bulimia nervosa (n=30) using the Millon Adolescent Personality Inventory. About half of the participants displayed an inhibited personality style. Anorexics scored higher on the Respectful personality scale. Expressed concerns over self-concept,…

  16. Self-Reported Eating Disorders of Black, Low-Income Adolescents: Behavior, Body Weight Perceptions, and Methods of Dieting.

    ERIC Educational Resources Information Center

    Balentine, Margaret; And Others

    1991-01-01

    Study identified African-American low-income adolescents who thought they had bulimia or anorexia nervosa, identified common behaviors, and compared actual and perceived body weight and dieting methods. About 12 percent suspected an eating disorder and perceived themselves as heavier more often than their peers. Fasting was the most common dieting…

  17. Separation-Individuation Difficulties and Cognitive-Behavioral Indicators of Eating Disorders among College Women.

    ERIC Educational Resources Information Center

    Friedlander, Myrna L.; Siegel, Sheri M.

    1990-01-01

    Tested theoretical link between difficulties with separation-individuation and cognitive-behavioral indicators characteristic of anorexia nervosa and bulimia. Assessed 124 college women using three self-report measures. Results suggest strong relation between 2 sets of variables and support theoretical assertions about factors that contribute to…

  18. Scope and Significance of Eating Disorders.

    ERIC Educational Resources Information Center

    Mitchell, James E.; Eckert, Elke D.

    1987-01-01

    Describes the increasing prevalence of anorexia nervosa and bulimia in many industrialized societies, and their association with significant morbidity and mortality. Discusses the genetic risks for the development of anorexia nervosa, and treatment strategies. Of these, pharmacotherapy and psychotherapy, particularly those incorporating…

  19. Sex Roles and Eating Disorders: Evidence for Two Independent Relationships.

    ERIC Educational Resources Information Center

    Perdue, Lauren

    Because such eating disorders as anorexia and bulimia have been found to be more common in women than in men, much recent research on these disorders has examined their relationship to gender roles. Some evidence exists supporting the existence of two types of eating disorders; one associated with stereotypically feminine concerns, the other…

  20. Famine at the Feast: A Therapist's Guide to Working with the Eating Disordered.

    ERIC Educational Resources Information Center

    Doane, H. Mitzi

    This guide, written for therapists and counselors working with eating disordered individuals, focuses on both bulimia and anorexia. A brief historical perspective and comments on epidemiology and etiology are provided. Definitions and clinical characteristics of both disorders are presented as well as psychodevelopmental profiles of male and…

  1. Evaluation of an Eating Disorder Curriculum.

    ERIC Educational Resources Information Center

    Moriarty, Dick; And Others

    1990-01-01

    A qualitative and quantitative evaluation of "A Preventive Curriculum for Anorexia Nervosa and Bulimia" is reported. The evaluation, which included teachers, researchers, health professionals, and students, included development of the curriculum as well as pilot testing activities. The curriculum development and evaluation consisted of three…

  2. Perplexities and Provocations of Eating Disorders

    ERIC Educational Resources Information Center

    Halmi, Katherine A.

    2009-01-01

    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,…

  3. Eating Disorders and Sports.

    ERIC Educational Resources Information Center

    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…

  4. Bulimic Beliefs: Food for Thought.

    ERIC Educational Resources Information Center

    Bauer, Barbara G.; Anderson, Wayne P.

    1989-01-01

    Contends that individuals suffering from bulimia nervosa share characteristic pattern of thinking which must be understood if effective treatment is to take place. Presents these beliefs, gathered by clinical experience and literature review, in format describing each belief, discussing common causes for its development, and suggesting therapeutic…

  5. Self-Mutilation and Eating Disorders.

    ERIC Educational Resources Information Center

    Favazza, Armando R.; And Others

    1989-01-01

    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…

  6. Binge-Eating and Vomiting: A Survey of a High School Population.

    ERIC Educational Resources Information Center

    Carter, Jo A.; Duncan, Pamela A.

    1984-01-01

    Surveyed 421 high school females to determine the prevalence of bulimia. Teenage vomiters were found to have higher levels of somatic symptoms, anxiety, social dysfunction, depression, and disturbed attitudes toward food, eating, and dieting. The findings provided information useful to school personnel who work with adolescents. (JAC)

  7. The Encultured Body: Policy Implications for Healthy Body Image and Disordered Eating Behaviours.

    ERIC Educational Resources Information Center

    Gaskill, Deanne, Ed.; Sanders, Fran, Ed.

    The purpose of this publication is to provide discussion of some of the most difficult and controversial issues surrounding body image and eating disorders, specifically, anorexia nervosa and bulimia nervosa. It includes contributions from a number of nationally and internationally recognized clinicians and researchers in the field. It also…

  8. Behavioral and Emotional Antecedents and Consequences of Binge Eating in Bulimic and Binge Eating College Women.

    ERIC Educational Resources Information Center

    Katzman, Melanie A.; Wolchik, Sharlene A.

    Recent studies have indicated that bulimia, characterized by binge eating followed by depressed mood and purging, is increasing. To investigate the behavioral and emotional antecedents and consequences of binge eating in women, 22 female college students (14 diagnosed bulimics, 8 binge eaters) completed self-monitoring forms for four binges.…

  9. Incidence and Correlates of Bulimic Behavior in a Female High School Population.

    ERIC Educational Resources Information Center

    Johnson, C.; And Others

    1984-01-01

    This investigation surveyed 1268 high school females to identify and compare students for bulimic behavior. Approximately five percent of the students met rigorous criteria for the diagnosis of bulimia. Between-group comparisons indicated that body dissatifaction, drive for thinness, and chronicity of dieting differentiated the two groups.…

  10. Incidence, prevalence, and risk of eating disorder behaviors in military academy cadets.

    PubMed

    Beekley, Matthew D; Byrne, Robert; Yavorek, Trudy; Kidd, Kelli; Wolff, Janet; Johnson, Michael

    2009-06-01

    Eating disorders are a particular problem for college students, as well as college athletes and military personnel. We examined the incidence, prevalence, and risk of eating disorders at the United States Military Academy (USMA) over a 7-year period (total population 12,731 cadets). The incidence per year for females was 0.02% for anorexia, 0.17% for bulimia, and 0.17% for eating disorders not otherwise specified (EDNOS) and for males was 0.0% for anorexia, 0.003% for bulimia, and 0.02% for eating disorders not otherwise specified. The total prevalence of diagnosed eating disorders for females was 5% and for males was 0.1%. For females over the 7-year period, we found a prevalence of 0.2% for anorexia, 1.2% for bulimia, 1.2% for eating disorders not otherwise specified, and for males we found a prevalence of 0.0% for anorexia, 0.02% for bulimia, and 0.03% for eating disorders not otherwise specified. Nineteen percent of females and 2% of males scored a 20 or higher on the Eating Attitudes Test (EAT)-26 survey indicating they were at risk for developing an eating disorder. We conclude that the prevalence of eating disorders at USMA is comparable to civilian colleges. PMID:19585779

  11. Psychometric Properties of the Eating Attitudes Test

    ERIC Educational Resources Information Center

    Ocker, Liette B.; Lam, Eddie T. C.; Jensen, Barbara E.; Zhang, James J.

    2007-01-01

    The study was designed to examine the construct validity and internal consistency reliability of the Eating Attitudes Test (EAT) using a confirmatory factor analysis (CFA). Two widely adopted EAT models were tested: three-factor (Dieting, Bulimia and Food Preoccupation, and Oral Control) with 26 items (Garner, Olmsted, Bohr, & Garfinkel, 1982),…

  12. Post-traumatic stress disorder and the lost memory syndrome.

    PubMed

    Berman, L H

    1995-03-01

    A number of different symptoms may result as the reaction to severe stress. It is unjustified to assume that specific disorders, such as bulimia, multiple personality, borderline personality, etc., are caused by specific early childhood trauma. Fadism is harmful to the patient and the medical profession.

  13. Internalization of the Thin Ideal as a Predictor of Body Dissatisfaction and Disordered Eating in African, African-American, and Afro-Caribbean Female College Students

    ERIC Educational Resources Information Center

    Gilbert, Stefanie C.; Crump, Stacey; Madhere, Serge; Schutz, William

    2009-01-01

    This study, conducted at a historically Black university, evaluated the impact of awareness and internalization of the Western thin ideal of beauty on body dissatisfaction, drive for thinness, and bulimia in African-American, African, and Caribbean women. The relationship between internalization of the thin ideal and disordered eating was…

  14. Reconstructing the Ideal Body Image in Teen Fashion Magazines

    ERIC Educational Resources Information Center

    Malachowski, Colleen C.; Myers, Scott A.

    2013-01-01

    According to the National Eating Disorders Association (NEDA, 2005), 10 million women and one million men struggle with eating disorders, including anorexia and bulimia. Disordered eating is most common in adolescent girls ages 15-19 and is prevalent in a diverse range of populations (NEDA, 2005). For example, African-American girls aged 11-14…

  15. The Relationship between Eating Disorder Not Otherwise Specified (EDNOS) and Officially Recognized Eating Disorders: Meta-Analysis and Implications for DSM

    ERIC Educational Resources Information Center

    Thomas, Jennifer J.; Vartanian, Lenny R.; Brownell, Kelly D.

    2009-01-01

    Eating disorder not otherwise specified (EDNOS) is the most prevalent eating disorder (ED) diagnosis. In this meta-analysis, the authors aimed to inform Diagnostic and Statistical Manual of Mental Disorders revisions by comparing the psychopathology of EDNOS with that of the officially recognized EDs: anorexia nervosa (AN), bulimia nervosa (BN),…

  16. Binge Eating Disorder: A Review of a New "DSM" Diagnosis

    ERIC Educational Resources Information Center

    Myers, Laura L.; Wiman, Allison M.

    2014-01-01

    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…

  17. EATING DISORDERS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Anorexia nervosa (AN) and bulimia nervosa (BN) are complex disorders that are often perplexing to therapists and difficult to manage. The purpose of this chapter is to review the history, nature, etiology, and treatment of these disorders, as well as to provide a brief introduction to the proposed d...

  18. Teaching Students with Emotional Disorders and/or Mental Illnesses.

    ERIC Educational Resources Information Center

    Alberta Learning, Edmonton.

    This resource manual is designed to assist Alberta teachers in the identification and education of students with emotional disorders and/or mental illnesses. It takes a comprehensive look at six emotional disorders. The first section focuses on eating disorders. It describes the characteristics and symptoms of anorexia nervosa, bulimia nervosa,…

  19. Disordered Eating in Southwestern Pueblo Indians and Hispanics.

    ERIC Educational Resources Information Center

    Snow, Janeanne T.; Harris, Mary B.

    1989-01-01

    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…

  20. Brief Report: Young People at Risk for Eating Disorders in Southeast Brazil

    ERIC Educational Resources Information Center

    Moya, Tatiana; Fleitlich-Bilyk, Bacy; Goodman, Robert

    2006-01-01

    A representative sample of 7-14-year-old young people in southeast Brazil (N=1251) was assessed using standardized parent and youth interviews, thereby identifying an "at-risk" group of young people who met one or more DSM-IV criteria for anorexia and/or bulimia nervosa. These young people were compared with an age and gender matched comparison…

  1. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    ERIC Educational Resources Information Center

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  2. Protective Factors, Physical Abuse, and Purging from Community-Wide Surveys of Female Adolescents.

    ERIC Educational Resources Information Center

    Perkins, Daniel F.; Luster, Tom; Jank, Wolfgang

    2002-01-01

    Examined relationship between physical abuse and purging through a survey of 100,236 females ages 12 to 18. Investigated other influences on resiliency such as age, ethnicity, family structure and support, parental education, school climate, sexual abuse, religiosity, and other adult support. Found statistical correlations between bulimia and…

  3. The Experience of Bulimic College Students Who Use "Pro-Ana/Pro-Mia" Web Sites: A Two-Phase Mixed-Method Study

    ERIC Educational Resources Information Center

    Davis, Blair J.

    2010-01-01

    Eating disorders (EDs) are a serious problem in the U.S. due to their rise in prevalence during the 20th century and high morbidity and mortality rates. A relatively new, controversial phenomenon, "pro-Ana" (pro-anorexia) and "pro-Mia" (pro-bulimia) Web sites, came to the public's attention around 2000. These sites are created by and for people…

  4. Sociocultural Experiences of Bulimic and Non-Bulimic Adolescents in a School-Based Chinese Sample

    ERIC Educational Resources Information Center

    Jackson, Todd; Chen, Hong

    2010-01-01

    From a large school-based sample (N = 3,084), 49 Mainland Chinese adolescents (31 girls, 18 boys) who endorsed all DSM-IV criteria for bulimia nervosa (BN) or sub-threshold BN and 49 matched controls (31 girls, 18 boys) completed measures of demographics and sociocultural experiences related to body image. Compared to less symptomatic peers, those…

  5. Childhood Risk Factors for Thin Body Preoccupation and Social Pressure to Be Thin

    ERIC Educational Resources Information Center

    Agras, W. Stewart; Bryson, Susan; Hammer, Lawrence D.; Kraemer, Helena C.

    2007-01-01

    Objective: Thin body preoccupation and social pressure to be thin (TBPSP) in adolescence are risk factors for the development of full and partial bulimia nervosa and binge eating disorder. This study examined precursors of these potent risk factors. Method: A prospective study followed 134 children from birth to 11.0 years and their parents.…

  6. Gender-Related Self-Discrepancies and Bulimic Eating Behavior.

    ERIC Educational Resources Information Center

    Klingenspor, Barbara

    2002-01-01

    Explored the link between development of bulimic eating behavior and suppression of masculine traits in adolescence. German high school students completed a sex role inventory. Among girls, higher risk of developing bulimia appeared to be caused by increasing discrepancies between actual and ideal self-concept on masculine-typed personality…

  7. Evaluation of Extinction as a Functional Treatment for Binge Eating

    ERIC Educational Resources Information Center

    Bosch, Amanda; Miltenberger, Raymond G.; Gross, Amy; Knudson, Peter; Breitwieser, Carrie Brower

    2008-01-01

    Binge eating is a serious behavior problem exhibited by individuals diagnosed with binge eating disorder and bulimia nervosa. Binge eating is thought to be maintained by automatic negative reinforcement in the form of relief from negative emotional responding. Current treatments produce only moderate abstinence, perhaps because they do not attempt…

  8. Eating Disorders in the Adolescent Population: An Overview.

    ERIC Educational Resources Information Center

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

    2003-01-01

    Selectively reviews the literature on the diagnostic criteria for eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder) as described in "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) and "International Classification of Diseases" (10th ed.). Discusses the prevalence and course of eating disorders,…

  9. Marital and Parent-Child Relationships in Families with Daughters Who Have Eating Disorders

    ERIC Educational Resources Information Center

    Latzer, Yael; Lavee, Yoav; Gal, Sharon

    2009-01-01

    This study assesses and compares the relationship between parents' marital quality, parent-child relationship, and severity of eating-related psychopathology in families with and without eating disorders. Data are collected from the mother, father, and daughter of 30 families with a daughter diagnosed with anorexia or bulimia and from 30 matched…

  10. Muscle Dysmorphia: A New Form of Eating Disorder?

    ERIC Educational Resources Information Center

    Goodale, Kimberly R.; Watkins, Patti Lou; Cardinal, Bradley J.

    2001-01-01

    Examined symptoms of muscle dysmorphia (MD), a variation of the eating disorders anorexia nervosa and bulimia, among college students. Surveys indicated that MD symptomatology appears in the general population and among both sexes. MD significantly related to eating disorder pathology and depression, and to some degree to impaired social support.…

  11. Beyond Bulimic Learning: Improving Teaching in Further Education

    ERIC Educational Resources Information Center

    Coffield, Frank; Costa, Cristina; Müller, Walter; Webber, John

    2014-01-01

    Students are bingeing on large amounts of information and then, in government induced bouts of vomiting otherwise known as national tests, they spew it all out. This is how Frank Coffield introduces the term Bulimia Academica, which he treats every bit as seriously as its medical counterpart. Students resort to bulimic learning to cope with a…

  12. Eating Disorder Diagnostic Scale: Additional Evidence of Reliability and Validity

    ERIC Educational Resources Information Center

    Stice, Eric; Fisher, Melissa; Martinez, Erin

    2004-01-01

    The authors conducted 4 studies investigating the reliability and validity of the Eating Disorder Diagnostic Scale (HDDS; E. Stice, C. F. Telch, & S. L. Rizvi, 2000), a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa, and binge eating disorder. Study 1 found that the HDDS showed criterion validity with interview-based…

  13. Logical Functional Analysis in the Assessment and Treatment of Eating Disorders

    ERIC Educational Resources Information Center

    Ghaderi, Ata

    2007-01-01

    Cognitive behaviour therapy (CBT) is now suggested to be the treatment of choice for bulimia nervosa. However, it is also known than no more than approximately 50% of patients recover after receiving CBT. When the first-line manual-based treatment fails, the therapist should use other empirically supported treatments, and if they do not work or…

  14. Prevalence of Bulimic Behaviors and Trends in Eating Attitudes among Turkish Late Adolescents

    ERIC Educational Resources Information Center

    Kiziltan, Gul; Karabudak, Efsun; Unver, Sibel; Sezgin, Emine; Unal, Ayse

    2006-01-01

    The eating attitudes and the prevalence of bulimic behaviors in a group of 300 late adolescents were investigated using the key questions from the Bulimia Investigatory Test, Edinburgh (BITE), and additional questions. Only four subjects (1.3%) scored above the cut-off point on the BITE, and prevalence rates of males and females were the same.…

  15. Coming to Terms With Risk Factors for Eating Disorders: Application of Risk Terminology and Suggestions for a General Taxonomy

    ERIC Educational Resources Information Center

    Jacobi, Corinna; Hayward, Chris; de Zwaan, Martina; Kraemer, Helena C.; Agras, W. Steward

    2004-01-01

    The aims of the present review are to apply a recent risk factor approach (H. C. Kraemer et al., 1997) to putative risk factors for eating disorders, to order these along a timeline, and to deduce general taxonomic questions. Putative risk factors were classified according to risk factor type, outcome (anorexia nervosa, bulimia nervosa,…

  16. A Prospective Study of Extreme Weight Change Behaviors among Adolescent Boys and Girls

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Ricciardelli, Lina A.

    2006-01-01

    This study examined changes in extreme weight change attitudes and behaviors (exercise dependence, food supplements, drive for thinness, bulimia) among adolescent boys and girls over a 16 month period. It also investigated the impact of body mass index, puberty, body image, depression and positive affect on these attitudes and behaviors 16 months…

  17. The Continuum Versus Categorical Debate on Eating Disorders: Implications for Counselors

    ERIC Educational Resources Information Center

    Perosa, Linda M.; Perosa, Sandra L.

    2004-01-01

    The authors summarize a study by D. A. Williamson et al. (2002) in which clinical groups with anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, and binge eating disorder were contrasted with nonclinical groups of participants (i.e., obese and normal weight). The eating disorder groups were qualitatively different. Also,…

  18. Feast or Famine.

    ERIC Educational Resources Information Center

    Scholzman, Steven C.

    2002-01-01

    Describes anorexia and bulimia, two eating disorders that affect adolescent females more frequently than males. Discusses causes, effects, and treatments of these two eating disorders. Describes what teachers can do to identify students with these disorders and help those who suffer from them. (PKP)

  19. Eating Disorders in Adolescent Males

    ERIC Educational Resources Information Center

    Ray, Shannon L.

    2004-01-01

    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…

  20. Untreated Recovery from Eating Disorders

    ERIC Educational Resources Information Center

    Woods, Susan

    2004-01-01

    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…

  1. Conflicting Gender Role Prescriptions and Disordered Eating in Single-Sex and Coeducational School Environments.

    ERIC Educational Resources Information Center

    Mensinger, Janell

    2001-01-01

    Examined the hypothesis that adolescent girls attending single-sex schools would exhibit greater body dissatisfaction and disordered eating than their coeducational counterparts, reanalyzing data from relevant subscales of an eating disorder inventory (drive for thinness, bulimia, and body dissatisfaction) and a figure rating scale from an earlier…

  2. Binge Eating Disorder: A Review of a New "DSM" Diagnosis

    ERIC Educational Resources Information Center

    Myers, Laura L.; Wiman, Allison M.

    2014-01-01

    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…

  3. Eating Disorders: The School Counselor's Role.

    ERIC Educational Resources Information Center

    Omizo, Sharon A.; Omizo, Michael M.

    1992-01-01

    Discusses role of school counselor in providing assistance to students who may be at risk for developing anorexia nervosa and bulimia and students who already display behaviors and physical symptoms of either of these illnesses. Addresses specific concerns regarding intervention strategies used by the school counselor in the student's recovery…

  4. Primary Prevention of Eating Disorders.

    ERIC Educational Resources Information Center

    Shisslak, Catherine M.; And Others

    1987-01-01

    Summarizes current understanding of anorexia nervosa and bulimia (clinical symptoms and outcome, prevalence and risk factors), offering suggestions for the primary prevention of these disorders at the individual, family, and community levels, and emphasizing prevention in the schools. (Author/KS)

  5. Eating Patterns and Disorders in a College Population: Are College Women's Eating Problems a New Phenomenon?

    ERIC Educational Resources Information Center

    Hesse-Biber, Sharlene

    1989-01-01

    Analysis of questionnaires returned by 395 sophomores reveals that the eating difficulties of college women may be a problem that only partially resembles clinical eating disorders. They displayed the behavioral symptoms but not the psychological traits associated with anorexia and bulimia. Diagnosis and treatment issues, and sociocultural…

  6. Sociocultural Influences in Eating Disorders: Shape, Super Woman and Sport.

    ERIC Educational Resources Information Center

    Moriarty, Dick; Moriarty, Mary

    Through a review of the literature, this presentation provides information on eating disorders as they relate to sport and fitness and examines the role of all physical and health education teachers, coaches, administrators, and guidance counsellors in either precipitating or preventing anorexia nervosa or bulimia. These professionals are in a…

  7. Eating Disorders in Young Athletes. A Round Table.

    ERIC Educational Resources Information Center

    Physician and Sportsmedicine, 1985

    1985-01-01

    A round table discussion by a physician, a psychiatrist, a dietitian, and 3 college coaches reviewed the problem of anorexia nervosa and bulimia in young athletes who are compulsive overachievers. Coaches need to know the symptoms and potential consequences of these illnesses in order to detect them and to counsel athletes properly. (MT)

  8. School Counselors' Knowledge of Eating Disorders.

    ERIC Educational Resources Information Center

    Price, Joy A.; And Others

    1990-01-01

    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…

  9. Related Addictive Disorders.

    ERIC Educational Resources Information Center

    Buck, Tina; Sales, Amos

    This paper provides an overview of addiction related to substance abuse. It provides basic information, prevalence, diagnostic criteria, assessment tools, and treatment issues for eating disorders, compulsive gambling, sex addictions, and work addictions. Eating disorders such as anorexia nervosa and bulimia nervosa, especially affect adolescents.…

  10. Eating Disorders of the Adolescent: Current Issues in Etiology, Assessment, and Treatment.

    ERIC Educational Resources Information Center

    Phelps, LeAdelle; Bajorek, Ellen

    1991-01-01

    Literature on the prevalence, symptomatology, and etiology of anorexia nervosa and bulimia in adolescents is reviewed. The school psychologist is in an essential position to help the adolescent and family. Assessment, consultation, and intervention strategies are discussed for the school psychologist, and psychological and pharmacological…

  11. Facts for Families from the American Academy of Child and Adolescent Psychiatry [1991].

    ERIC Educational Resources Information Center

    American Academy of Child and Adolescent Psychiatry, Washington, DC.

    Nine fact sheets relevant to children's emotional well-being are presented in this document. The first fact sheet, "Teenagers with Eating Disorders" focuses on anorexia nervosa and bulimia. The second fact sheet, "Children and Grief" describes age-related responses to death, and ways of coping with a death in a family that includes children. The…

  12. The Relationship between Attachment and Eating Disorders: A Review of the Literature.

    ERIC Educational Resources Information Center

    Lewis, Robin Marie

    A review was conducted of literature published over the past 15 years pertaining to attachment factors associated with the formation of anorexia and bulimia nervosa. This review first aims to shed light on the connections between disruption in attachment and psychological disturbances underlying eating disorders. The second purpose is to encourage…

  13. Predisposing, Precipitating, Perpetuating, Professional Help, and Prevention Factors of Eating Disorders.

    ERIC Educational Resources Information Center

    Moriarty, Dick; Chanko, Cathy

    This report describes an eating disorder as a multi-dimensional physiological, psychological, social, and cultural illness. A chart describing the typical anorexic and bulimic is included which has on its horizontal axis the predisposing, precipitating, perpetuating, professional help, and prevention factors of anorexia nervosa and bulimia. On its…

  14. Disordered Eating in College Students: Links with Childhood Abuse and Maternal Eating Behavior.

    ERIC Educational Resources Information Center

    Feilke, Kim; Chambliss, Catherine

    The prevalence of sexual conflicts in many patients with eating disorders has been well documented. A parallel has been found between psychological problems experienced by victims of childhood sexual abuse and patients with anorexia nervosa and/or bulimia. Past studies have used inpatient clinical samples; however, this study extended this area of…

  15. Relationship among Family, Peer Networks and Bulimic Symptomatology in College Women.

    ERIC Educational Resources Information Center

    Pauls, Brian Scott; Daniels, Thomas

    2000-01-01

    Tests explanatory power of a sociocultural model in predicting bulimic symptomatology in a sample of college women (N=141). High scores on the Bulimia Test were negatively correlated with scores on the cohesion subscale of the Family Adaptability and Cohesion Evaluation Scale. Pressures to diet from family and friends were also found to be…

  16. Eating Problems and Their Risk Factors: A 7-Year Longitudinal Study of a Population Sample of Norwegian Adolescent Girls

    ERIC Educational Resources Information Center

    Kansi, Juliska; Wichstrom, Lars; Bergman, Lars R.

    2005-01-01

    The longitudinal stability of eating problems and their relationships to risk factors were investigated in a representative population sample of 623 Norwegian girls aged 13-14 followed over 7 years (3 time points). Three eating problem symptoms were measured: Restriction, Bulimia-food preoccupation, and Diet, all taken from the 12-item Eating…

  17. The Eating Disorders Inventory among Asian American College Women.

    ERIC Educational Resources Information Center

    Tsai, Grace; Gray, James

    2000-01-01

    Assesses the prevalence rate of bulimic disorders among 257 female Asian Americans from 18 to 30 years old. Finds that only two of the 257 women met the classification for bulimia nervosa. Contends that the findings illustrate the need for future research among culturally different populations. (CMK)

  18. Tailoring Cognitive Behavioral Treatment for Binge Eating in Adolescent Girls

    ERIC Educational Resources Information Center

    Yarborough, Bobbi Jo; DeBar, Lynn L.; Firemark, Alison; Leung, Sue; Clarke, Gregory N.; Wilson, G. Terence

    2013-01-01

    Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with…

  19. Eating Disorders as Sequelae of Sexual Abuse: A Review of the Literature.

    ERIC Educational Resources Information Center

    White, Jama Leigh

    The literature regarding the relationship between sexual abuse and eating disorders was reviewed. Overall, women with anorexia and bulimia seem to have similar to slightly higher incidences of childhood sexual abuse than has the general population. At the same times, rates of abuse among eating disordered women, including those who experienced…

  20. Group Cognitive-Behavioral Therapy and Group Interpersonal Psychotherapy for the Nonpurging Bulimic Individual: A Controlled Comparison.

    ERIC Educational Resources Information Center

    Wilfrey, Denise E.; And Others

    1993-01-01

    Evaluated effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating among 56 women with nonpurging bulimia. At posttreatment, both CBT and IPT conditions showed significant improvement in reducing binge eating, compared to waiting-list condition. Binge eating remained significantly…

  1. Boys with Eating Disorders

    ERIC Educational Resources Information Center

    Hatmaker, Grace

    2005-01-01

    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…

  2. Disordered Eating in Girls with Type 1 Diabetes: Examining Directions for Prevention

    ERIC Educational Resources Information Center

    Starkey, Karina; Wade, Tracey

    2010-01-01

    Girls with Type 1 diabetes (insulin-dependent diabetes mellitus [IDDM]) have been identified to be at an increased risk for developing bulimia nervosa (BN) and subthreshold eating disorders. The co-occurrence of these conditions can severely compromise the physical health of these individuals and can even accelerate mortality. The use of a unique…

  3. Self-Destructive Behavior in Women.

    ERIC Educational Resources Information Center

    Kessel, Greer; Chrisler, Joan C.

    Trichotillomania (hair-pulling) and delicate self-cutting are self-destructive behaviors which utilize the body as a vehicle for self-expression. Like anorexia and bulimia, these behaviors occur primarily in young women. This study compared groups of women college students who engage in these self-destructive behaviors with those who do not. It…

  4. Appetite-Focused Cognitive-Behavioral Therapy in the Treatment of Binge Eating with Purging

    ERIC Educational Resources Information Center

    Dicker, Stacy L.; Craighead, Linda Wilcoxon

    2004-01-01

    The first-line treatment for bulimia nervosa (BN), cognitive-behavioral therapy (CBT), uses food-based self-monitoring. Six young women presenting with BN or significant purging behavior were treated with a modification, Appetite-Focused CBT (CBT-AF), in which self-monitoring is based on appetite cues and food monitoring is proscribed. This change…

  5. Children and Adolescents with Eating Disorders: Strategies for Teachers and School Counselors.

    ERIC Educational Resources Information Center

    Manley, Ronald S.; Rickson, Heidi; Standeven, Bill

    2000-01-01

    this article provides an overview of anorexia nervosa and bulimia in children and adolescents, including ages of onset, prevalence, and clinical characteristics. Behavior, cognitive, and affective characteristics are outlined. Strategies are provided for teachers and counselors who are concerned about students who have or may have eating…

  6. Weight Loss Emphasis in Popular Magazines: A Twenty Year Analysis.

    ERIC Educational Resources Information Center

    Shealy, Lucinda; And Others

    Cultural pressure for thinness has been cited as a contributing factor in the apparent increase in the eating disorders of anorexia and bulimia. Previous research has examined popular periodicals as an indicator of cultural pressure for thinness. This study assessed changes over the past 20 years in numbers of popular magazine articles focusing on…

  7. [Involvement of eating disorders in metabolic syndrome].

    PubMed

    Suzuki, Mari Hotta

    2015-04-01

    This article gives an outline about involvement of eating disorders in metabolic syndrome. Anorexia nervosa and bulimia nervosa become common diseases in woman in Japan. Binge-eating disorder and night eating syndrome are observed in men as well as women. Binge eating is characteristic of bulimia nervosa, binge-eating disorder and night eating syndrome. It should be noted that high energy availability observed in these diseases results in obesity and exacerbate metabolic syndrome. Cognitive-behavioral therapy and medication with selective serotonin reuptake inhibitors(SSRIs) can make patients to control symptoms and improve their QOL. Osteoporosis is one of chief complications and sequelae of anorexia nervosa. Low-birth weight babies born from emaciated patients with eating disorders are subject to metabolic syndrome in the future.

  8. Eating disorder and schizophrenia.

    PubMed

    Shiraishi, H; Koizumi, J; Suzuki, T; Yamaguchi, N; Mizukami, K; Hori, M; Tanaka, Y

    1992-12-01

    Five cases with eating disorders (one case with anorexia nervosa alone, 4 cases with anorexia nervosa and bulimia nervosa) complicated with schizophrenia and 3 cases of bulimia nervosa complicated with schizophrenia were reported. The eating disorders and schizophrenia were diagnosed according to the diagnostic criteria of DSM-III-R. As to the type of schizophrenia, 4 patients were of an undifferentiated type and 4 cases were of a disorganized type. Regarding the prepsychotic personality, 6 of the 8 cases showed schizothyme personality traits. All the patients showed depressive symptoms which are relatively common in eating disorders. In all the patients, significant social or school life difficulties persisted and a resumption of premorbid functioning was not seen. The possibility of an affinity between anorexia nervosa and schizophrenia was discussed.

  9. Preventative measures for bulimic patients with dental erosion.

    PubMed

    Sundaram, G; Bartlett, D

    2001-03-01

    The preventative techniques suggested to bulimic patients are frequently undervalued and ignored in favour of restorative treatment, possibly because the dentist may not be aware of the eating disorder. Educating bulimic patients about fluoride application, the use of brushing techniques, antacids, cheese, xylitol chewing gum and the possible use of mouth guards may minimise the effect of acids. Together with attempts at improving patient compliance they can be a valuable adjunct to treatment of bulimic patients with dental problems. Monitoring the wear on teeth by comparing study casts is a good way to maintain control but there are circumstances when restorations are indicated, perhaps when further delay may result in the prognosis of the teeth being compromised. Following a brief introduction to causes of bulimia and the consequences to the dentition, this paper, based on a literature review, considers patient-orientated techniques for prevention and provisional management of erosion of dental hard tissues for patients with bulimia nervosa.

  10. Disordered eating and alcohol use among college women: associations with race and big five traits.

    PubMed

    Martin, Jessica L; Groth, Gabrielle; Longo, Laura; Rocha, Tracey L; Martens, Matthew P

    2015-04-01

    Excessive alcohol use and disordered eating are considerable health-related problems among college women. The purpose of the present study was to examine how specific patterns of disordered eating (i.e., anorexia, bulimia, binge eating) are related to alcohol use and related problems and the influence of racial group membership and Big Five personality traits on the co-occurrence of these behaviors. Participants were 153 undergraduate women. Results indicated that White women reported more binge drinking, alcohol-related problems, disordered eating, anorexia nervosa symptoms, and bulimia nervosa symptoms than non-White women. Women with higher levels of openness and who engage in extreme exercise, dieting, fasting, or purging were more at risk for heavy and problematic alcohol use. Implications for the treatment of co-occurring disorders among college students and further research are discussed. PMID:25734858

  11. Disordered eating and alcohol use among college women: associations with race and big five traits.

    PubMed

    Martin, Jessica L; Groth, Gabrielle; Longo, Laura; Rocha, Tracey L; Martens, Matthew P

    2015-04-01

    Excessive alcohol use and disordered eating are considerable health-related problems among college women. The purpose of the present study was to examine how specific patterns of disordered eating (i.e., anorexia, bulimia, binge eating) are related to alcohol use and related problems and the influence of racial group membership and Big Five personality traits on the co-occurrence of these behaviors. Participants were 153 undergraduate women. Results indicated that White women reported more binge drinking, alcohol-related problems, disordered eating, anorexia nervosa symptoms, and bulimia nervosa symptoms than non-White women. Women with higher levels of openness and who engage in extreme exercise, dieting, fasting, or purging were more at risk for heavy and problematic alcohol use. Implications for the treatment of co-occurring disorders among college students and further research are discussed.

  12. Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries

    PubMed Central

    Makino, Maria; Tsuboi, Koji; Dennerstein, Lorraine

    2004-01-01

    Objective To compare the prevalence of eating disorders between Western and non-Western countries. Method Potential references were identified through an English-language literature search using Medline and Medscape articles. Results Prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects in Western countries. Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing. Conclusion The prevalence of eating disorders in non-Western countries is lower than that of the Western countries but appears to be increasing. PMID:15520673

  13. What contributes to excessive diet soda intake in eating disorders: appetitive drive, weight concerns, or both?

    PubMed

    Brown, Tiffany A; Keel, Pamela K

    2013-01-01

    Excessive diet soda intake is common in eating disorders. The present study examined factors contributing to excessive intake in a sample of individuals with lifetime eating disorders based on proposed DSM-5 criteria (n = 240) and non-eating disorder controls (n = 157). Individuals with eating disorders, particularly bulimia nervosa, consumed more diet soda than controls. Eating disorder symptoms that reflect increased appetitive drive or increased weight concerns were associated with increased diet soda intake. Increased weight concerns were associated with increased diet soda intake when levels of appetitive drive were high, but not when they were low. Results highlight the importance of monitoring diet soda intake in individuals with eating disorders and may have implications for the maintenance of dysregulated taste reward processing in bulimia nervosa.

  14. Appropriate care for children with eating disorders and obesity.

    PubMed

    El-Radhi, A Sahib

    Eating disorders are essentially psychological diseases that are characterised by abnormal eating habits. Anorexia nervosa and bulimia are the most common forms of eating disorders. There is an increased recognition of eating disorders among both men and women, and growing numbers of children and teenagers seeking help for eating disorders. Fear of body-weight gain is central to both anorexia nervosa and bulimia. Before the diagnosis of an eating disorder is made, it is essential to exclude organic diseases that may present with similar symptoms to eating disorders. Management initially should focus on correcting the nutritional deficiencies and dehydration at a paediatric or paediatric gastroenterology department, followed by a multidisciplinary approach. At the other extreme, the prevalence of obesity in children is increasing at an alarming rate, and presents a serious public health challenge.

  15. [Early risk factors of eating disorders--do events of prenatal and perinatal periods bear significance?].

    PubMed

    Raevuori, Anu; Niemelä, Solja; Keski-Rahkonen, Anna; Sourander, Andre

    2009-01-01

    Evidence of the relation of complications occurring in the pregnancy, delivery and neonatal periods to the risk of contracting a subsequent eating disorder has been obtained during recent years. Factors associated with parturition and neonatal period seem to predict both anorexia and bulimia, whereas disorders during pregnancy are more clearly associated with the descendant's anorexia. This difference may play an important role in the pathogenesis of the disorders.

  16. Pilot study employing heart rate variability biofeedback training to decrease anxiety in patients with eating disorders

    PubMed Central

    2014-01-01

    Heart rate variability (HRV) biofeedback, a technique which encourages slow meditative breathing, was offered to 25 in-patients with various eating disorder diagnoses-anorexia nervosa, bulimia nervosa and binge eating disorder. We found that this modality had no serious side effects, and was subjectively useful to most participants. An enhanced ability to generate highly coherent HRV patterns in patients with recent onset anorexia nervosa was observed. PMID:24917934

  17. Eating Disorders

    PubMed Central

    Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E

    2004-01-01

    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 self-concept disturbances, are more prevalent among women than men. Women with eating disorders are also at risk for long-term psychological and social problems, including depression, anxiety, substance abuse and suicide. For instance, in 2000, the prevalence of depression among women who were hospitalized with a diagnosis of anorexia (11.5%) or bulimia (15.4 %) was more than twice the rate of depression (5.7 %) among the general population of Canadian women. The highest incidence of depression was found in women aged 25 to 39 years for both anorexia and bulimia. Data Gaps and Recommendations Hospitalization data are the most recent and accessible information available. However, this data captures only the more severe cases. It does not include the individuals with eating disorders who may visit clinics or family doctors, or use hospital outpatient services or no services at all. Currently, there is no process for collecting this information systematically across Canada; consequently, the number of cases obtained from hospitalization data is underestimated. Other limitations noted during the literature review include the overuse of clinical samples, lack of longitudinal data, appropriate comparison groups, large samples, and ethnic group analysis. PMID:15345084

  18. Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

    PubMed

    Cartwright, Martina M

    2004-12-01

    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. PMID:15571940

  19. Eating disorders today--not just a girl thing.

    PubMed

    Hepworth, Kimberly

    2010-01-01

    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. PMID:20632480

  20. [Nutritional education at school].

    PubMed

    Gavidia, Valentín; Talavera, Marta; Asensi, Alejandro

    2004-02-01

    Children and youths who are well-educated run a lower risk of developing eating disorders; therefore teaching these topics in schools is very important. Nonetheless, disorders such as obesity, anorexia and bulimia occur more frequently all the time among children and youths. What is happening? If students are offered a correct nutritional basis, why do these disorders not decrease? What can be done in schools about these disorders? PMID:15067845