Psychological Disorders
Mohamed Ahmed Abd El-Hay in 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).
Introduction to energy aspects of nutrition
Geoffrey P. Webb in Nutrition, 2019
Bulimia nervosa is characterised by recurrent bouts of binge eating. Periods of restricted eating are interspersed with sometimes huge binges where massive quantities and bizarre mixtures of foods may be consumed in very short periods of time – the voracious eating may continue until abdominal pain, sleep or interruption trigger its end. The binge is followed by self-induced vomiting, purging, fasting and/or excessive exercise. The morbid fear of fatness and distortion of body image seen in anorexia are also seen in this condition. A diagnosis of bulimia would be made if the following features are present in people who are not very underweight. Recurrent bouts of binge eating in which large amounts of food are consumed and in which the person loses control of their eating. Recurrent bouts of inappropriate compensatory behaviour to prevent weight gain after binges e.g. induced vomiting, purging, excessive exercise or fasting. These bouts of bingeing and compensation should occur at an average rate of twice a week for three months to qualify for a diagnosis of bulimia. The person’s self-image is unduly dependent upon their body shape and weight.
Basics of Eating Disorders
Wayne A. Bowers in Civil Commitment in the Treatment of Eating Disorders, 2018
Bulimia nervosa was a rare disorder prior to the 20th century with few references to its existence. Pierre Janet, a French psychologist, described a patient in 1903 with anorexia nervosa who displayed secret compulsive eating behaviors (Gordon, 2000). The behaviors of this patient (episodic overeating, compensatory vomiting, fasting and/or laxative use, and a dread of getting fat) were consistent with the basic diagnostic criteria for bulimia nervosa. Mosche Wulff, a German psychoanalyst, also published a case study in 1932 of a patient using bingeing and purging to remain thin (DiNocola, 1990). In 1945 Ludwig Binswanger, a Swiss psychiatrist, described a case of a female patient who displayed bingeing, purging, and abuse of laxatives to remain thin (DiNocola, 1990). Dr. Marlene Boskind-Lodahl (Boskind-Lodahl, 1976, Boskind-Lodahl & White, 1977, Boskind-Lodahl & White 1978) described her work with a series of 138 women that she treated for an eating disorder. Her publication in 1976 highlighted the problem of eating disorders on college campuses and coined the term “bulimarexia” (Gordon, 2000).
Psychometric validity of the Montgomery and Åsberg Depression Rating Scale for Youths (MADRS-Y)
Published in Nordic Journal of Psychiatry, 2023
Magnus Vestin, Marie Åsberg, Marie Wiberg, Eva Henje, Inga Dennhag
Interestingly, we found that many adolescents reported both decreased and increased sleep and decreased and increased appetite during the last three days. Correlations between decreased and increased sleep were significant and moderate (r = .41 and r = .37), and between decreased and increased appetite significant but small (r = .14 and r = .15). Adolescent sleep is typically more variable compared to children and adults [75] and eating behavior is often more irregular [76]. Clinically, sleeping disorders are common in adolescents and correlated with depressive symptoms [77]. Eating disorders are common in adolescent girls and about 12% may experience some form of bulimia nervosa or binge eating disorder [78]. Importantly, there is a strong association between bulimia nervosa and MDD in adolescent girls [79].
A benchmark study of a combined individual and group anorexia nervosa therapy program
Published in Nordic Journal of Psychiatry, 2023
Bo Skytte Kaa, Johanne Mathilde Nymark Bünemann, Loa Clausen
The need for new and effective treatments for adults with AN is obvious and the inclusion of a group treatment element and thus a higher degree of including others might be relevant. For that reason, we developed a new treatment including elements from group therapy for adults with bulimia nervosa [26] and multifamily therapy for adolescents with anorexia nervosa [27] in combination with traditional multidisciplinary specialized AN treatment in an individual setting. This program is called Combined Individual and Group Anorexia Nervosa Therapy (CIGAN) (contact the author for a copy of the manual). The treatment was delivered in a specialized multidisciplinary approach with a stepped care framework which resulted in inpatient or day care treatment when health was compromised or if outpatient treatment was insufficient to initiate weight gain (see treatment section below).
Comparing illness duration and age as predictors of treatment outcome in female inpatients with anorexia nervosa
Published in Eating Disorders, 2023
Adrian Meule, David R. Kolar, Elisabeth Rauh, Ulrich Voderholzer
The age of onset of the disorder in AN (and bulimia nervosa) is often in adolescence and young adulthood. In fact, it has been estimated that in approximately 80% of cases the onset is before 25 years of age (Solmi et al., 2022). This may explain why age and illness duration are so highly correlated in persons with AN as cases of newly onset AN are rarely found in middle and older adulthood. Thus, the finding that illness duration does not seem to add significant information to patients’ age may be specific to persons with AN and may not translate to other types of eating disorders. For example, average age of onset in persons with binge eating disorder is usually in young adulthood, but new onset cases can also be found across the life span (Hudson et al., 2007). Furthermore, persons with avoidant/restrictive food intake disorder usually have an earlier age of onset than AN (Becker et al., 2019; Cañas et al., 2021), and age seems to be unrelated to illness duration (Duncombe Lowe et al., 2019). Thus, it may well be that age and illness duration are not so strongly related in other eating disorders as they are in AN and, therefore, that illness duration may be a more crucial characteristic to take into account when anticipating treatment outcome or considering different treatment options.
Related Knowledge Centers
- Eating Disorder
- Binge Eating
- Purging Disorder
- Vomiting
- Laxative
- Diuretic
- Stimulant
- Fasting
- Russell'S Sign
- Thyroid Disease