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Adolescent Medicine
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Perry B. Dinardo, Jennifer Hyland, Ellen S. Rome
Bulimia nervosa (BN) is characterized by repeated episodes of binge eating, defined as eating an amount of food that is larger than most individuals would consume during a similar period of time, as well as a sense of being “out of control” and unable to limit the overeating during the episode. BN also involves associated inappropriate compensatory behaviors such as self-induced vomiting, fasting, or excessive exercise to prevent weight gain. Misuse of laxatives, diuretics, or other medications and hyperexercise for the purpose of weight loss or preventing weight gain due to binge eating also constitutes purging behavior. Additionally, for the diagnosis of BN to be applied, the individual’s self-image must also be overly influenced by body weight and shape. The binge eating and associated inappropriate compensatory behaviors typically occur at least once a week for 3 months. Subthreshold BN involves a similar presentation as described above, except the behaviors are occurring less frequently than once a week for at least 3 months.
Restricted eating disorders
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Cardiac screening may also be considered, as cardiac changes often occur in severe eating disorders. Purging can lead to electrolyte abnormalities and cardiac dysfunction2,16, and these may be long-lasting, and may impact on the pregnancy. Women with eating disorders may well have anaemia and hypertension or pre-eclampsia which have been suggested to be more common29. Increased routine screening, as well as increased fetal surveillance, may therefore be necessary. Women with anorexia may also have a higher risk of antepartum haemorrhage (APH)9. Underweight women have been shown to have an 8% increased risk for admission during pregnancy30 for a variety of reasons.
Psychological Disorders
Published in Mohamed Ahmed Abd El-Hay, Understanding Psychology for Medicine and Nursing, 2019
People with bulimia nervosa fear gaining weight and are intensely preoccupied and dissatisfied with their bodies. However, people with bulimia stay within a normal weight range or may even be slightly overweight. After bingeing, a patient compensates by purging herself of the excessive food, by self-induced vomiting or by misuse of laxatives or enemas. Once she purges, she often feels psychologically relieved. Some people with bulimia do not purge themselves of the excess food. Rather, they use fasting and excessive exercise to keep their body weight within the normal range (American Psychiatric Association, 2000). Like anorexia nervosa, bulimia nervosa can have a serious physical impact on the body. Repeated purging disrupts the body’s electrolyte balance, leading to muscle cramps, irregular heartbeats, and other potentially fatal cardiac problems. Self-induced vomiting erodes tooth enamel by the acidic vomitus, causing tooth decay and gum disease. Frequent vomiting, especially when practiced for long periods of time, can damage the gastrointestinal tract as well as the teeth (Forney, Buchman-Schmitt, Keel, & Frank, 2016).
Male eating disorders in midlife—possible links between excessive sports and hormones
Published in The Aging Male, 2023
Kai K. Kummer, Barbara Mangweth-Matzek
As we have briefly discussed, diagnostic criteria as well as assessment tools for EDs have so far mainly been based on clinical presentations and validations in female groups, leading to a gender-biased view of ED symptomatology. While in females the control of eating behavior is mainly influenced by a socially and media conveyed image of thinness, the ideal body image is different for males. For them it is directed toward a muscular Adonis-like physique, that requires a combination of losing weight in the sense of reducing fat content and gaining weight due to increasing muscle tissue [26]. This combination of leanness and muscularity is characterized by a “bulking and cutting” dietary practice, where “bulking” is a phase of excessive protein replenishment and “cutting” restrictive eating behavior, thereby closely resembling bulimic binges [26,34,35]. In addition, classical purging methods, like vomiting or laxative use are applied after binges.
Psychoform and somatoform dissociation among individuals with eating disorders
Published in Nordic Journal of Psychiatry, 2020
Doris Nilsson, Annika Lejonclou, Rolf Holmqvist
Eating Disorder Examination Questionnaire, version 6.0 (EDE-Q) was administered to assess the extent of eating disorder. The EDE-Q v.6.0 is a self-report questionnaire [36] derived from the Eating disorder examination [37] that uses a 7-point Likert type scale assessing the frequencies of eating problems over the past 28 days from no days = 0 to everyday = 6. This 36-item instrument examines the attitudinal, emotional and behavioral symptoms of disordered eating and assesses the symptoms of purging and binge eating over the same period. The symptoms of purging include vomiting, laxative use, use of diuretics and hard exercising. The EDE-Q consists of four subscales: restraint, eating concern, shape concern and weight concern as well as a global score which is the average of the four subscales. The instrument has good psychometric properties [38] concerning internal consistency [39] and temporal stability [40]. Convergent validity with the EDE interview supports the use of the instrument as a screening tool for eating disorder psychopathology [41]. Normative data for EDE-Q have been published in e.g. in England [42] in the USA [43] and in Sweden [44]. In a recent Norwegian study cutoff was suggested at 2.5, based on data across different levels of BMI and age and different diagnostic groups [45]. This cutoff is used in the present study.
Compensatory behaviors among racial and ethnic minority undergraduate women
Published in Eating Disorders, 2019
Amanda B. Bruening, Marisol Perez
Compensatory behaviors are of particular importance when investigating the progression of disordered eating symptoms to eating disorders. These behaviors are clinically significant and include excessive exercise, fasting, self-induced vomiting as well as misuse of use of laxatives and diuretics. Recent research has suggested they may be more common than previously estimated. More than a third (38.7%) of college women engage in excessive exercise, and 10.4% report engaging in self-induced vomiting or use of laxatives or diuretics (Schaumberg, Anderson, Reilly, & Anderson, 2014). Engagement in any such behavior has been associated with greater body image disturbance, disordered eating, and general psychopathology among community and clinical samples (Stice, Ziemba, Margolis, & Flick, 1996) as well as poorer treatment outcomes (Olmsted, Kaplan, & Rockert, 1994). In addition, research suggests that those who engage in purging behaviors (e.g., self-induced vomiting and use of laxatives, diuretics, and emetics) are at greatest risk for the development of an eating disorder (Schaumberg et al., 2014; Stiles-Shields, Labuschagne, Goldschmidt, Doyle, & Le Grange, 2011).