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Query: UMLS:C0028754 (obesity)
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A screening of Bulimia, an eating disorder associated to Obesity and Anorexia Nervosa, has been carried out in the city of Buenos Aires. The data were obtained by means of the questionnaire of Pope & Hudson, administered to young women who attend diet and physical activity programs. Control groups were constituted by female university students and boutique employees. The results indicate that diet and physical fitness searchers are groups at risk of Bulimia. It is concluded that proper preventive measures can be taken by informing and training the personnel, professional or not, in charge of those institutions, and also by promoting the adequate information within the population.
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PMID:[Characterization and detection of bulimia in the city of Buenos Aires]. 325 26

In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important. Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Eating disorders: implications for the 1990's. 331 72

We compared 23 obese subjects meeting DSM-III criteria for bulimia with 47 obese nonbulimic subjects and 47 normal-weight bulimic subjects using structured diagnostic interviews. The obese bulimic subjects were similar to the normal-weight bulimic subjects but different from the nonbulimic obese subjects in exhibiting a high lifetime rate of major affective disorder. However, the obese bulimic subjects were much less likely than the normal-weight bulimic subjects to use self-induced vomiting as a method of purging. These results suggest that obese individuals with bulimic symptoms may constitute a sizable but little-recognized population. Further studies will be required, however, to assess whether the syndrome of bulimia in obesity represents a valid diagnostic entity.
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PMID:Bulimia in obese individuals. Relationship to normal-weight bulimia. 334 87

Obese people as a group have similar mental health as normal weight people, and there are no psychiatric features characteristic of obesity in general. However, small subgroups of obese individuals may have psychiatric abnormalities which are specific for obesity, such as body image disturbance or periodic compulsive overeating (bulimia). Obesity is strongly related to sociocultural factors. In western countries obesity is commoner in lower than in higher social classes. Thus, the development of obesity is influenced by social status. However, also the converse is true: recent observations suggest that obese people lose social status. This is probably due to prejudice and discrimination against obese persons in the modern western society.
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PMID:Psychosocial factors in obesity. 347 94

Because a large percentage of childhood obesity may persist into adulthood and cause a hotbed of so-called seijin-byoh (adult diseases), its treatment should also be considered from the viewpoint of seijin-byoh prophylaxis. Most obese children, however, are awkward in their movements, in spite of binge eating or bulimia, and unable to carry out any severe exercise-diet therapy. For such subjects, we have designed a new practicable procedure, and obtained excellent results for the last five years. The main principle of our procedure is that the control of caloric intake is relaxed as much as possible after due consideration of a child's growth in height: no restriction for mild, 10-15% of the requirement for moderate, and 20-25% for severe obese children, respectively. The ratio of protein/energy is established at a higher level than usual, while that of fat/energy at a lower level. For exercise, walking is the most easy and important exercise and the proper speeds for individuals are converted from the same amount of movement determined at the 1st increase point of serum lactate values, where the proportion of movement-energy originating from body fat reaches the highest percentage at about 75%. Our new procedure is supported also by the fact that the reduction in body weight combines with the improvement in measurement values of fatty metabolites without any change in values of proteins.
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PMID:A new diet-exercise therapy in our obese-child clinic. 361 65

The first 95 patients admitted to an inpatient Eating Disorders Program and diagnosed as having bulimia (binge eating only), bulimarexia (binging and purging), and anorexia nervosa (food restriction only) were evaluated for depression, suicidality, and family history. Major depression was found in 80% of patients; 20% had made suicide attempts in their life; and 40% of those attempting suicide made potentially lethal attempts. Patients with anorexia and bulimarexia tended to be younger, single, and Protestant. Patients with bulimarexia had overeating, oversleeping, more preoccupation with suicide, and more depression in their mothers. Patients with anorexia had more relatives with anorexia and bulimarexia, and patients with bulimia had more relatives with obesity. These findings suggest that eating disorders are unique disorders and not variants of affective disorder or alcoholism.
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PMID:Depression and suicidality in eating disorders. 385 65

This study compared (1) purging bulimics (those who terminate binging with self-induced vomiting and/or excessive use of laxatives), N = 26; (2) non-purging bulimics, N = 24; and (3) control subjects (in whom no eating problems were apparent), N = 24. These groups were examined empirically on several personality and demographic variables. Additionally, procedures were taken to control for the effects that being overweight may have had on the personality characteristics, which surprisingly has not been undertaken in previous research on bulimia. The comparison of the bulimics (purging and non-purging bulimics grouped together) with the controls empirically confirmed former clinical observations that have linked bulimics with low self-esteem, high anxiety, external locus of control, and a high incidence of maternal and family obesity. With regard to the comparison between the purging and non-purging bulimics, no significant differences between them appeared on any of the dimensions examined here.
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PMID:A pilot comparison of purging and non-purging bulimics. 385 73

The present study was conducted to determine the prevalence and severity of binge eating among 432 women seeking behavioral treatment for obesity and to assess the relationship between binge eating and dietary restraint. Subjects completed standardized self-report questionnaires which assessed the severity of binge eating and habitual dietary restraint. Binge eating was extremely prevalent, with 46% of subjects reporting serious problems. Serious binge eating was more common in younger and heavier subjects. Further, binge eating severity was significantly related to overall dietary restraint. The current findings indicate that the treatments of binge eating may need to be considered in planning behavioral programs for the obese.
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PMID:Binge eating and dietary restraint in obese patients. 385 90

Anorexia and bulimia are eating disorders affecting a significant number of adolescent and young adult women. The core symptoms of both disorders are similar and include a fear of obesity, body image disturbance, erratic eating patterns, and purging. These symptoms produce significant physical and psychologic complications. Both anorexia and bulimia appear to have a common origin in a fear of obesity and dieting. Anorectics, being "successful" dieters, lose a significant amount of weight; whereas bulimics alternate between binges and purges. Treatment for the eating disorders is gradually evolving as clinical research experience accumulates. For anorexia, hospitalization is indicated when weight falls below 15% of ideal, and most investigators agree that therapy for the core symptoms cannot be undertaken until weight is restored. During the impatient stay, a behavior modification program can effectively organize medical, nutritional, and psychologic support, and offers the quickest and most direct route to weight restoration. The nasogastric tube and total parenteral nutrition are used primarily for those who are severely emaciated or who actively resist standard modes of therapy. Inpatient treatment is most effectively and efficiently rendered in a specialized eating disorder unit. Once weight restoration is progressing, behavior therapy for core symptoms is commenced and continued on an outpatient basis. A variety of behavioral techniques are employed, and they are designed primarily to influence anorectic assumptions and beliefs. Although there may be a brief inpatient stay for initiation of treatment, the bulk of therapy for bulimia occurs on an outpatient basis. The available literature indicates that behavioral techniques and antidepressant medication are effective for the symptoms of bulimia. Early identification of core symptoms of both disorders can lead to an initiation of treatment before the core symptoms become ingrained. A potentially more effective intervention lies in efforts to influence the media. As noted, standards for feminine beauty as portrayed in the media have changed significantly over the past 20 years. An attempt at the primary prevention of eating disorders would include efforts to convince the media to change their standards of femininity from cosmetic slimness to a focus on health and physical fitness. These efforts could stem from professional and lay organizations who have the interest and capability to influence policy.
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PMID:Eating disorders: assessment and treatment. 386 31

Since the discovery of the satiety effect of CCK in 1973, progress has been made and problems have been encountered. The progress has included the accumulation of strong, indirect evidence that exogenous CCK acts in the abdomen to activate vagal afferent fibers and that exogenous CCK may be useful in the treatment of bulimia and obesity in humans. The most pressing problem is the current lack of evidence for the hypothesis that the satiety effect of exogenous CCK reveals a physiological function of endogenous CCK released by food entering the small intestine during a meal. Since clarification of this problem and exploitation of the current progress seem possible with current ideas and techniques, the satiety effect of CCK should continue to receive considerable experimental attention.
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PMID:The satiety effect of cholecystokinin. Recent progress and current problems. 389 96


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