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Treatment – Social/Environmental-Related Malnutrition
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Wendy Phillips, Jennifer Doley
It is important to diagnose and treat BN due to the medical risks associated with the disease, such as electrolyte disturbances and comorbid psychological disorders. Purging by vomiting or laxatives will cause electrolyte depletion that can lead to heart arrhythmias and possibly heart failure and death. Frequent food restriction and/or purging can lead to stomach pain, blood sugar fluctuations, dental decay, and gastroparesis. Laxative abuse can damage nerve endings and weaken the muscles of the intestines, leading to chronic constipation and early satiety. Binge eating can cause the gastrointestinal tract to rupture, which can be immediately life-threatening. Bulimia nervosa with malnutrition can cause pancreatitis, and the loss of muscle mass associated with malnutrition can cause mechanical bowel problems such as severe gastroparesis or intestinal obstruction, alterations in ability to complete activities of daily living, and the inability to fight off infections.56 These side effects can contribute to inadequate intake or impaired digestion, therefore increasing the risk of malnutrition.
Weight and health
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Binge eating disorder means that people are unable to prevent themselves from eating large amounts of food, often in a short time span. Eating feels out of control. Compulsive overeating is a milder form of binge eating. It could include recurrent trips to the cupboard looking for something to eat, constant nibbling or a lack of control around certain foods such as chocolate. Both include eating faster than normal, beyond feeling full; eating when not hungry; eating alone or in secret; feeling guilty or upset after eating; feeling ‘taken over’ and then trying to compensate for the overeating by dieting. Someone with these conditions is likely to be overweight.
Eating Disorders and Treatment
Published in Emily Crews Splane, Neil E. Rowland, Anaya Mitra, Psychology of Eating, 2019
Emily Crews Splane, Neil E. Rowland, Anaya Mitra
Binges usually occur when the individual is alone and are done secretly. The eating is beyond physiological needs, and hunger is not a necessary prerequisite for a binge – psychological factors such as stress, loneliness, or depressed mood can prompt binge eating (Mathes et al., 2009). Foods consumed during binges are normally soft textured and require little or no chewing (e.g., cookie dough, ice cream, breads and sandwiches, milkshakes, juices and sodas, cookies, and cake), are frequently sweet tasting, high in calories and fat (Latner & Wilson, 2000), and are considered “forbidden.” Binges usually contain more than 1,000 calories (often more than 4,000; Kaye et al., 1992). In other words, in a single “sitting” or bout, bulimics may consume more than the recommended caloric intake for an entire day. Bulimics describe their binges as numbing, pleasurable, and even euphoric. However, the “high” is quickly followed by a “low.” After bingeing, bulimics feel guilty, ashamed, worried about weight gain, and often experience self-hatred and depression (Hayaki, Friedman & Brownell, 2002). Bulimics are concerned about their appearance and are fearful of gaining weight. Purging helps alleviate the guilt and discomfort associated with the out-of-control bingeing and eliminates some of the food consumed, but it also causes guilt and shame. Further, because purging empties the stomach, hunger follows and the cycle of binge-eating and purging continues (Figure 11.2).
A closer look at homework compliance in behavior therapy for bulimia nervosa: does homework compliance in between-session period prospectively predict session-by-session change in bulimia symptoms?
Published in Eating Disorders, 2023
Paakhi Srivastava, Megan N. Parker, Emily K. Presseller, Olivia B. Wons, Kelsey E. Clark, Adrienne S. Juarascio
Research has yet to assess whether, during treatment, high HW compliance precedes or follows improvement in BN symptoms which limits understanding of the therapeutic role of HW compliance in promoting reductions in BN symptoms during treatment. HW compliance is expected to have relatively immediate effects on symptom change. For example, individuals who are more compliant with regular eating (a behavioral HW assignment involving eating every 3–4 hours) may be less likely to binge eat due to a decrease in dietary restriction. Alternatively, reductions in BN symptoms may enable a individual to engage in difficult HW assignments. Specifically, an individual experiencing a reduction in binge eating may be better able to regularly eat. Therefore, testing the weekly prospective associations among HW compliance and BN symptoms could clarify whether HW is a driver of change in BN symptoms. Moreover, clarifying whether HW compliance in a given week temporally precedes and predicts symptom improvement in the following week, or vice versa, can guide how the assignment of HW is used to promote, or maintain, specific types of therapeutic change. If greater compliance with behavioral HW is found to precede weekly reductions in behavioral BN symptoms (e.g., binge eating and purging) a therapist may assign specific behavioral assignments to a individual who is struggling to stop self-induced vomiting. Thus, elucidating if compliance with HW temporally precedes changes in BN symptoms and/or if symptom improvements foster greater compliance with HW, could inform treatment planning and implementation.
The interaction between affective lability and eating expectancies predicts binge eating
Published in Eating Disorders, 2022
Anna Marie L. Ortiz, Heather A. Davis, Elizabeth N. Riley, Gregory T. Smith
Binge eating is the consumption of a large amount of food, in a discrete period of time, while experiencing a feeling of loss of control over eating (American Psychiatric Association, 2013). Regular binge eating is included in the diagnostic criteria for DSM-5 bulimia nervosa (BN), binge eating disorder (BED), anorexia nervosa, binge-purge subtype (AN-BP), and certain Other Specified Feeding and Eating Disorders (OSFED; APA, 2013). Importantly, whether part of a diagnosable eating disorder or not, binge eating is associated with distress, including increased depressive symptoms (Puccio et al., 2016), engagement in substance use (Dunn et al., 2002), and heightened social anxiety (Ostrovsky et al., 2013). Further, there is evidence for binge eating impacting one’s ability to meet work, household, and study responsibilities in both men and women (Mond & Hay, 2007).
Addiction to binge eating among women in psychologically abusive relationships: The moderating role of defense mechanisms
Published in Health Care for Women International, 2021
Orly Yona-Drori, Shirley Ben-Shlomo
An additional focus of our study was the correlation between the maturity of defense mechanisms and addictive binge eating. According to the third research hypothesis, women with immature and/or neurotic defense mechanisms were characterized by higher levels of addictive binge eating. This can be explained by the fact that these women find it difficult to cope with both internal and external anxiety in their lives. The levels of anxiety they experience unconsciously lead them to escape a harsh reality by eating uncontrollably, using immature defensive mechanisms that change and/or distort reality, or neurotic defense mechanisms that alleviate the experience. Support for this explanation can be found in clinical studies of binge eating. In one such study (Heatherton & Baumeister, 1991) it was found that binge eating was encouraged by a desire to escape consciousness: eating served to distract attention from life experiences and internal and external stresses. Another study found that overeating could serve as a preservation mechanism to replace the defense mechanism, regulating moods and enabling negative emotions and stressful situations to be dealt with.