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Eating disorders are characterized by eating and appetite disorders, which develop on a mental basis. Currently, there is a rapid increase in the frequency of these disorders, especially among children and adolescents. Eating disorders include anorexia nervosa, bulimia nervosa and EDNOS, which include a dozen or so disorders, but this group is still expanding. Eating disorders are characterized by the highest mortality rate among all mental illnesses. They mainly affect adolescents and young adults as well as the female sex, however, there are more and more cases among men and people from other age groups. Anorexia nervosa is the conscious reduction of food intake in order to reduce body weight. In this disorder there is abnormal body image, underweight and fear of weight gain. According to the American Psychiatric Association, there are two types of anorexia nervosa - restrictive (limiting) and bulimic (laxative). Bulimia nervosa is characterized by abnormal food intake (overeating) and co-occurrence of compensatory methods aimed at limiting the absorption of consumed food. These methods include: provoking vomiting, excessive physical effort, taking diuretics and laxatives. Among the eating disorders we also distinguish eating disorders not defined otherwise (EDNOS). This is a group of diseases in which pathological eating behaviour occurs, but they do not meet the diagnostic criteria of anorexia or bulimia. The diagnosis of eating disorders is difficult not only because of the lack of specialists dealing with this subject, but also because of the lack of public awareness of these diseases. That is why it is so important to educate both medical staff and the general public about eating disorders.
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PMID:[Eating disorders - diagnosis and characteristics]. 3235 48

Emotional deprivation can lead to growth faltering of infants and children. The mechanism(s) involved differ in that for infants, the major metabolic problem is inadequate energy intake for growth. In young children, it is likely that the emotional deprivation causes a syndrome not only of growth faltering, but with bizarre behaviors, especially with regard to food: hoarding, gorging and vomiting, hyperphagia, drinking from the toilet, and eating from garbage pails. Other disturbed behaviors include, poor sleep, night wanderings, and pain agnosia. The pathophysiology appears to be reversible hypopituitarism, at least for the growth hormone and hypothalamic-pituitary- adrenal axes. The review begins with an historical perspective concerning stress, children and growth and then moves to the issue of hospitalism, where young infants failed to thrive (and died) due to inadequate stimulation and energy intake. Refeeding programs at the end of World Wars I and II noted that some children did not thrive despite an adequate energy intake. It appeared that in addition taking care of their emotional needs permitted super-physiologic (catch-up) growth. Next came the first notions from clinical investigation that hypopituitarism might be the mechanism of growth faltering. Studies that address this mechanism from a number of observational and clinical research studies are reviewed in depth to show that the hypopituitarism was relieved upon removal from the deprivational environment and occurred much too quickly to be due to adequate energy alone. These findings are then compared to those from malnourished children and adoptees from emerging countries, especially those from orphanages where their psychosocial needs were unmet despite adequate caloric intake. Together, these various conditions define one aspect of the field of psychoneuroendocrinology.
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PMID:Emotional Deprivation in Children: Growth Faltering and Reversible Hypopituitarism. 3311 95


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