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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Addictive eating disorders have been a part of history and have only recently been recognized as psychiatric disorders. Increased publicity has enabled family and friends of eating disordered individuals to recognize the disease and seek help for them from trained medical professionals. Everyone is "at risk," but certain subpopulations have been "coming out of the closet" in epidemic proportions. An ever-increasing number of high school-aged and college-aged females have developed some form of eating disorder, from fad diets to self-induced vomiting. In these individuals, the obsession with thinness takes priority over family, friends, schoolwork, or career. Strangely enough, the eating disordered person's addiction is not to food but to the feeling of numbness her behavior brings. Over time, the need to control is desperately sought and many patients transfer their obsession to other patterns of self-abuse. Nursing intervention should include setting the appropriate example in terms of the professional's relationship with food, while providing much needed emotional support. An innovative method of intervention available to nursing professionals includes the use of creative, visual imagery to repeatedly diffuse fear and anxiety about food until a level of personal autonomy over the disorder and other emotional concerns is achieved. Therefore, a system of recovery can be designed for the anorectic or bulimic patient and the experience of recovery from the eating disorder can be a lifelong process of personal growth.
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PMID:Addictive eating disorders. 264 14

Eating disorders, particularly weight control disorders, appear resistant to long-term modification. While personal values have been shown to influence long-term behavior, their influence on eating patterns has not been studied because of the lack of an instrument to measure those values that are specific to eating. The Eating Values Survey (EVS) was created to measure priorities given to 21 eating-related values, such as sensory qualities of food, the experience of hunger, socializing with others, body appearance, nutritional contribution to health, etc. Responses of 109 male and 99 female university students to the EVS were found stable over a 2-week period and revealed five factors, identified as Gusto, Easy Necessity, Orderliness, Gourmet, and Social Approval. EVS scores also correlated significantly with such self-reported eating disorder variables as being overweight and self-induced vomiting. Sex differences in eating values appeared matters of emphasis rather than of distinction.
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PMID:Measuring personal values that are specific to eating: reliability, factors, and eating pattern correlates. 272 81

Thirteen consecutive referrals of bulimic patients who met DSM-III criteria for bulimia were treated in an open-label, flexible-dose study with trazodone. Three of the 13 dropped out before the fourth week of treatment, the minimum duration of treatment for evaluable subjects, and hence were not included in the analyses. For the 10 evaluable patients, the mean duration of treatment was 6.9 weeks and the mean maximum dose of trazodone was 410 mg (range, 250-600 mg). The number of binge eating and vomiting episodes was significantly decreased (p = 0.05 and 0.06, respectively). These episodes were reduced to zero in four patients and by 55-99% in two patients. Carbohydrate cravings and urges to binge eat were significantly diminished in intensity (p less than 0.02 and 0.008, respectively). The total score (p = not significant) and three subscale scores (p = 0.04, 0.09, and 0.10) of the Eating Disorders Inventory decreased. The mean Hamilton Depression Scale score fell from 10.4 to 3.3 (p = 0.002). Only mild side effects were noted: five subjects complained of morning drowsiness and two of headache. Mean weight was essentially unchanged: pretreatment, 58.5 kg; posttreatment, 57.3 kg. The lack of weight gain represents an advantage of trazodone over other currently prescribed antidepressants, particularly for this group of patients whose fear of becoming fat is a part of their basic pathology.
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PMID:Trazodone treatment of bulimia nervosa. 276 44

This study aims to assess the dental status of anorexics and bulimics by comparison to age-matched controls. One hundred and eight individuals participated, of which 58 had an eating disorder. This group were further subdivided into bulimics who induced vomiting (33), bulimics who did not vomit (7), and anorexics (18). The caries experience (DMFS), plaque levels, gingival inflammation and buffering capacity of saliva were assessed and total vomiting episodes estimated from the product of vomiting frequency and duration. Statistical analysis (one way ANOVA) revealed no significant differences with most of the dental variables between the eating disorder groups and the controls. A linear association (Pearson correlation coefficient) between vomiting frequency, duration or total vomiting episodes and tooth wear was not found, although the frequency of pathological tooth wear is significantly high in the vomiting bulimic group, especially if the total number of vomiting episodes is greater than 1100.
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PMID:The orodental status of anorexics and bulimics. 277 88

Bulimia has been recognized as a distinct eating disorder which is affecting a growing number of young adolescent women. It is characterized by the consumption of huge amounts of food followed by some form of purging, usually vomiting, in order to lose the gained weight. Most bulimics keep their activities secret, which makes diagnosis difficult. The counselor or therapist who is aware of the secretive nature of the disorder will be more alert to the symptoms. Most bulimics experience cognitive distortions relating to food, weight loss, eating, and dieting. The purpose of this paper is to identify and to discuss treatment of some of these irrational cognitions through the use of cognitive, behavioral, and emotional interventions. The importance of providing nutrition information and realistic diet practices is also noted. A group treatment approach is briefly addressed in dealing with the bulimic's problems of isolation, shame, and social acceptance.
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PMID:Treating bulimia. 280 Dec 84

Although the literature supports the existence of psychogenic vomiting as a distinct psychiatric disorder, the DSM III-R does not include it as a diagnostic category. Of the numerous articles in the literature which describe this disorder, few discuss treatment. The purposes of this paper are to review the existing literature, to describe the family dynamics which are thought to precipitate the evolution of psychogenic vomiting in the identified patient, and to describe a treatment protocol which has been successfully employed in an outpatient setting. The illness is characterized as an eating disorder in terms of etiology, symptomatology, and treatment. A treatment strategy is described which includes insight-oriented psychotherapy with cognitive/behavioral interventions and family therapy. Two case studies are included which illustrate that a combined therapy approach is efficacious in treating psychogenic vomiting.
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PMID:A treatment strategy for psychogenic vomiting. 281 32

A double-blind, placebo-controlled trial of d-fenfluramine in bulimia nervosa was undertaken in order to assess its efficacy in controlling bulimic behavior and relieving more general symptoms. A high proportion of the patients evaluated were reluctant to enter the drug trial in spite of the offer of additional supportive psychotherapy and counselling on dietary control. Moreover, 17 out of the 42 enrolled patients withdrew halfway through the 12 week trial. Were it not for this high rate of defaulting, there might be clearer support for the efficacy of d-fenfluramine in reducing the frequency of overeating and self-induced vomiting in these bulimic patients. An unexpected finding was that among the noncompleters, those on d-fenfluramine had experienced relief of their bulimic symptoms. The persistence of depressive symptoms and features of the eating disorder probably contributed to the noncompleters leaving the trial. Reassuring findings were the absence of weight loss and serious unwanted effects from d-fenfluramine. By itself, d-fenfluramine did not benefit some of the patients with severe bulimia nervosa, but it may yet prove a useful adjunct to psychological treatments.
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PMID:A controlled trial of d-fenfluramine in bulimia nervosa. 305 13

Desipramine and fenfluramine were administered to bulimic patients in a 15-week study of double-blind, placebo-controlled, crossover design. The 22 patients in the study met DSM-III criteria for bulimia and were of normal weight. Twelve subjects were randomly allocated to the fenfluramine group, and 10 subjects received desipramine. Half the subjects in each group received the active drug in the first 6 weeks and half received placebo. There was a 3-week washout period, after which subjects were crossed over for the remaining 6 weeks. The Eating Disorder Inventory, profile of Mood States, bulimia symptom checklists, and Hopkins Symptom Checklist were administered at weeks 0, 2, 4, 6, 9, 11, 13, and 15. Subjects maintained a daily record of bingeing, vomiting, and laxative/diuretic abuse. Results indicated that both drugs had beneficial effects on bingeing and vomiting frequency, although a greater proportion of patients were identified who responded to fenfluramine than to desipramine. Fenfluramine and desipramine were also effective in reducing the psychological symptoms of bulimia, such as the urge to binge, and feelings of depression. Results suggest that direct alteration of central food intake regulatory centers can effectively control bulimia.
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PMID:Treatment of bulimia with fenfluramine and desipramine. 306 43

The increased prevalence of bulimia has received great publicity by the news media. Such publicity predisposes individuals to self-diagnosis. A 57-year-old man with a 10-year history of food regurgitation presented to an eating disorder clinic complaining of bulimia, which he had heard discussed on a television talk show. He proved not to have bulimia but a large pharyngoesophageal (Zenker's) diverticulum. The diagnosis of bulimia may be misattributed to various symptoms by patients. The differential diagnosis of chronic regurgitation and vomiting must be considered in such patients.
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PMID:Non-bulimia: food regurgitation in a patient with self-diagnosed bulimia. 308 93

We report the biochemical results in 90 women presenting to an eating disorders clinic: 61 who had bulimia, 22 with anorexia nervosa and seven unclassified. The results were compared with 30 control women. The group of women with an eating disorder had significantly higher concentrations of total CO2, calcium, AST, ALT, ALP, albumin and cholesterol and significantly lower concentrations of potassium, chloride and phosphate in the plasma. The elevated calcium could be accounted for in part by an increase in total CO2 and an increase in albumin. Hypokalaemia was strongly associated with self-induced vomiting and laxative abuse. Biochemical abnormalities occurred in both forms of eating disorders; however, hypercholesterolaemia was more common in anorexia nervosa and abnormal liver enzymes were more common in bulimia.
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PMID:Biochemical abnormalities in anorexia nervosa and bulimia. 310 18


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