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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The compulsion to maintain a lean body shape while living in a society obsessed with food may encourage the use of dieting, binge eating and purging behaviors in young women. The body of literature on bulimia nervosa (Boskind-Lodahl and Sirlin 1977; Fairburn and Cooper 1984; Katzman and Wolchik 1984; Scott 1988) clearly establishes its relationship to the current American fashion for thinness and the value placed on physical attractiveness for self-esteem. This notion promotes a multitude of weight control strategies ranging from self-starvation (Humphrey 1983; Brownell and Foreyth 1986) to cigarette smoking (Klesges and Klesges 1988), many of which may have a profound influence on maintenance of good health. Similar to weight control, exercise behavior could be viewed as falling on a continuum from reasonable efforts to maintain physical fitness to a preoccupation with exercise that is far out of proportion to the expected benefits of a 30-minute, three to five day a week routine. Characteristics of obligatory exercise have been described by several researchers and include maintaining a rigid schedule of intense exercise; resisting temptation to lapse into nonexercising; feelings of guilt and anxiety when the exercise schedule is violated; compensatory increase in exercise to make up for lapses; pushing oneself even when tired, ill, or injured; mental preoccupation with exercise; and detailed recordkeeping on exercise (Yates et al. 1983; Blumenthal et al. 1984; Nudelman et al. 1988). In a competitive society, obsessive exercise behaviors may be linked to the development of rigid dietary guidelines while one strives toward the "optimal" lean-fat ratio of body composition.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychological and behavioral differences among females classified as bulimic, obligatory exerciser and normal control. 160 74

The basic criterion for the diagnosis of anorexia (AN - anorexia nervosa) by ICD-10 (International Classification of Diseases, version 10) is the body weight less than 15% of the expected normal body weight. According to DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, version IV) the basic feature of AN is a refusal to maintain body weight equal or greater than the minimal normal weight. The prevalence of anorexia nervosa is 0.3-0.5% or even 1.3-3.7% if include pre-anorexic states (eg. the phenomenon of pro-ana). The main feature of anorexia is a reduction of caloric intake. According to the recommendations of the American Psychiatric Association (APA) for nutritional treatment of patients with AN the main goals in therapy of AN are: restoration of body weight, normalization of eating patterns, achievement a normal feeling of hunger and satiety and correction of the consequences of improper nutrition. APA suggests that achievable weight gain is about 0.9-1.4 kg per week in the case of hospitalized patients and approximately 0.23-0.45 kg per week in the case of outpatients. During the nutritional treatment of AN numerous side effects including anxiety, phobia, occurrence of obsessive thoughts and compulsive behavior, suicidal thoughts and intentions may occur. According to National Institute for Clinical Excellence (NICE) the most important goal of AN therapy is weight gain in the range of 0.5-1 kg per week in hospitalized patients and 0.5 kg per week for outpatients. A person suffering from anorexia in the initial period of nutritional treatment spends twice more energy to maintain elevated body temperature, which significantly increases during the night rest. This phenomenon is called nocturnal hyperthermia and has a negative effect on the healing process. "Refeeding syndrome" is an adverse effect of nutritional treatment in anorexia. It is caused by too rapid nutrition in a patient suffering from chronic starvation. It can endanger the patient's life.
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PMID:[Contemporary criteria of the diagnosis and current recommendations for nutritional therapy in anorexia nervosa]. 2496 16

The compulsive nature of weight loss behaviors central to anorexia nervosa (AN), such as relentless self-starvation and over-exercise, has led to the suggestion of parallels between AN and other compulsive disorders such as obsessive-compulsive disorder (OCD) and addictions. There is a huge unmet need for effective treatments in AN, which has high rates of morbidity and the highest mortality rate of any psychiatric disorder, yet a grave paucity of effective treatments. Viewing compulsivity as a transdiagnostic concept, seen in various manifestations across disorders, may help delineate the mechanisms responsible for the persistence of AN, and aid treatment development. We explore models of compulsivity that suggest dysfunction in cortico-striatal circuitry underpins compulsive behavior, and consider evidence of aberrancies in this circuitry across disorders. Excessive habit formation is considered as a mechanism by which initially rewarding weight loss behavior in AN may become compulsive over time, and the complex balance between positive and negative reinforcement in this process is considered. The physiological effects of starvation in promoting compulsivity, positive reinforcement, and habit formation are also discussed. Further research in AN may benefit from a focus on processes potentially underlying the development of compulsivity, such as aberrant reward processing and habit formation. We discuss the implications of a transdiagnostic perspective on compulsivity, and how it may contribute to the development of novel treatments for AN.
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PMID:Compulsivity in anorexia nervosa: a transdiagnostic concept. 2510 Oct 36

The characteristic relentless self-starvation behavior seen in Anorexia Nervosa (AN) has been described as evidence of compulsivity, with increasing suggestion of parallels with addictive behavior. This study used a thematic qualitative analysis to investigate the parallels between compulsive behavior in AN and Substance Use Disorders (SUD). Forty individuals currently suffering from AN completed an online questionnaire reflecting on their experience of compulsive behavior in AN. Eight main themes emerged from thematic qualitative analysis; compulsivity as central to AN, impaired control, escalating compulsions, emotional triggers, negative reactions, detrimental continuation of behavior, functional impairment, and role in recovery. These results suggested that individuals with AN view the compulsive nature of their behavior as central to the maintenance of their disorder, and as a significant barrier to recovery. The themes that emerged also showed parallels with the DSM-V criteria for SUDs, mapping onto the four groups of criteria (impaired control, social impairment, risky use of substance, pharmacological criteria). These results emphasize the need for further research to explore the possible parallels in behavioral and neural underpinnings of compulsivity in AN and SUDs, which may inform novel treatment avenues for AN.
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PMID:Does compulsive behavior in Anorexia Nervosa resemble an addiction? A qualitative investigation. 2653 48

Research in computational psychiatry has sought to understand the basis of compulsive behavior by relating it to basic psychological and neural mechanisms: specifically, goal-directed versus habitual control. These psychological categories have been further identified with formal computational algorithms, model-based and model-free learning, which helps to provide quantitative tools to distinguish them. Computational psychiatry may be particularly useful for examining phenomena in individuals with anorexia nervosa (AN), whose self-starvation appears both excessively goal directed and habitual. However, these laboratory-based studies have not aimed to examine complex behavior, as seen outside the laboratory, in contexts that extend beyond monetary rewards. We therefore assessed (1) whether behavior in AN was characterized by enhanced or diminished model-based behavior, (2) the domain specificity of any abnormalities by comparing learning in a food-specific (i.e., illness-relevant) context as well as in a monetary context, and (3) whether impairments were secondary to starvation by comparing learning before and after initial treatment. Across all conditions, individuals with AN, relative to healthy controls, showed an impairment in model-based, but not model-free, learning, suggesting a general and persistent contribution of habitual over goal-directed control, across domains and time points. Thus, eating behavior in individuals with AN that appears very goal-directed may be under more habitual than goal-directed control, and this is not remediated by achieving weight restoration.
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PMID:Deficient Goal-Directed Control in a Population Characterized by Extreme Goal Pursuit. 3328 76