Cardiac changes in anorexia nervosa

2016 ◽  
Vol 26 (4) ◽  
pp. 623-628 ◽  
Author(s):  
Michael A. Spaulding-Barclay ◽  
Jessica Stern ◽  
Philip S. Mehler
Keyword(s):  
Weight Loss ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Medical Complications ◽  
Cardiac Complications ◽  
Successful Treatment Outcome ◽  
Comprehensive Literature Review ◽  
Life Threatening ◽  
Weight Restoration

AbstractIntroductionAnorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed.MethodsA comprehensive literature review on cardiac changes in anorexia nervosa was carried out.ResultsThere are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs.ConclusionCardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

scholarly journals Gastrointestinal Complications of Refeeding in Anorexia Nervosa

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Nathalia Marie Trees
Keyword(s):  
Anorexia Nervosa ◽  
Delayed Gastric Emptying ◽  
Medical Complications ◽  
Nutritional Rehabilitation ◽  
Refeeding Syndrome ◽  
Gastrointestinal Complications ◽  
Nutrition Rehabilitation ◽  
Life Threatening ◽  
Weight Restoration ◽  
Eating Disorder Behaviors

Anorexia nervosa (AN) is a complicated and life-threatening mental illness. Restoration of weight and nutrition rehabilitation are key elements for the treatment of AN. However, gastrointestinal (GI) complications often develop due to eating disorder behaviors, concomitant malnutrition, and during the refeeding process. These problems may give rise to significant medical complications and contribute to increased difficulties with refeeding and weight restoration. This review aims to describe common GI complications in AN including delayed gastric emptying, gastric dilatation, superior mesenteric artery (SMA) syndrome, refeeding hepatitis, and refeeding syndrome. Recommendations for clinicians refeeding a patient with AN are provided. Knowledge of these GI manifestations is required for correct management and successful nutritional rehabilitation of patients with AN.

The Medical Complications of Anorexia Nervosa

1993 ◽  
Vol 162 (4) ◽  
pp. 452-462 ◽  
Author(s):  
C. W. Sharp ◽  
C. P. L. Freeman
Keyword(s):  
Weight Loss ◽  
Anorexia Nervosa ◽  
Cardiovascular Complications ◽  
Medical Complications ◽  
Intravenous Hyperalimentation ◽  
Severe Weight Loss ◽  
Life Threatening ◽  
Electrolyte Abnormalities

The physical complications of anorexia nervosa are common and can be life threatening, but psychiatrists and the increasing number of non-medical therapists involved in treatment programmes often overlook these complications. Cardiovascular complications are the most common, and the most likely to result in fatalities, particularly in those patients who vomit, purge or abuse diuretics, because of the electrolyte abnormalities induced. Osteoporosis is an early and perhaps irreversible consequence of severe weight loss. Further, there are dangers in rapid intravenous hyperalimentation.

Anorexia nervosa and attachment

2017 ◽  
Vol 41 (S1) ◽  
pp. S552-S552
Author(s):  
H. De la Red Gallego ◽  
A. Alonso Sánchez ◽  
A. Álvarez Astorga ◽  
S. Gómez Sánchez ◽  
L. Rodríguez Andrés ◽  
...  
Keyword(s):  
Emergency Department ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Clinical Case ◽  
Cognitive Distortions ◽  
Insecure Attachment ◽  
Weight Restoration ◽  
Competing Interest ◽  
The One

IntroductionAttachment is an innate programming whereby a child seeks for security. There is scientific and empirical evidence that insecure attachment is usual in eating disorder patients [1].ObjectivesTo highlight the relevance of attachment between child and caregivers, as well as its significance in therapeutic approach.MethodsA 17-year-old girl hospitalized after attending to emergency department due to fainting. BMI: 12.89. She reports restrictive behavior since age 11 that her mother regards as “child issues”. Divorced parents, she grew up with her mother, diagnosed of hypochondria, who mentions not understanding why she is not the one who is hospitalized.ResultsDuring hospitalization, she turned 18-years-old. Guardianship of her younger siblings was removed to her mother. She had a secure relationship with her 24-year-old sister, so she decided to move in with her. Later on, she had a positive progress, maintaining the gained weight and mood stability, although cognitive distortions persist.ConclusionsAmong developmental and maintaining factors of eating disorders, impaired attachment is becoming increasingly interesting. Even though the main goal of treatment is weight restoration, exploring attachment patterns can facilitate to achieve that aim. This clinical case emphasizes the importance of attachment in eating disorders among child and young adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Early within-person weight gain and variability during inpatient treatment for anorexia nervosa: Age-dependent effects on treatment outcome

2021 ◽  
Author(s):  
David R. Kolar ◽  
Adrian Meule ◽  
Silke Naab ◽  
Ulrich Voderholzer
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Weight Gain ◽  
Body Dissatisfaction ◽  
Inpatient Treatment ◽  
Average Weight ◽  
Drive For Thinness ◽  
Early Weight Gain ◽  
Age Dependent ◽  
Weight Restoration

Background: Early weight gain during inpatient treatment for anorexia nervosa (AN) is an important predictor of overall treatment outcome. However, weight gain is a dynamic process characterized by within-person variability that may also be age-dependent. Therefore, we examined whether age moderates the effect of within-person weight gain and variability on treatment outcome.Methods: Within-person level estimates of N = 2881 underweight adolescents and adults with AN for daily average weight gain (linear slope) and variability (root mean squared errors) were obtained using random-effects modelling. Linear and logistic regression analyses at the between-person level were calculated to assess their effects on weight, core eating disorder psychopathology and weight restoration. Results: Higher weight gain during the first two weeks of inpatient treatment predicted higher discharge weight, lower drive for thinness and lower body dissatisfaction at discharge, but was not associated with changes in bulimic symptoms. Moreover, higher early weight gain predicted a higher probability of weight restoration at discharge. Moderation analyses revealed that younger age was significantly associated with a stronger effect of early weight gain on weight, drive for thinness and body dissatisfaction at discharge, but was not associated with a higher likelihood of weight restoration. Weight variability was not associated with any treatment outcome. Conclusion: Age moderated the effect of early weight gain on treatment outcome, with larger effects for younger patients. Weight variability did not substantially influence treatment outcome across age and should be of lesser clinical concern during early inpatient treatment when patients gain weight on average.

Physical activity in anorexia nervosa: How relevant is it to therapy response?

2015 ◽  
Vol 30 (8) ◽  
pp. 924-931 ◽  
Author(s):  
S. Sauchelli ◽  
J. Arcelus ◽  
I. Sánchez ◽  
N. Riesco ◽  
S. Jiménez-Murcia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Treatment Program ◽  
Therapy Response ◽  
Hospital Treatment ◽  
Depression Symptoms ◽  
Healthy Weight ◽  
Activity Profile

AbstractObjectiveElevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders.MethodThe sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians.ResultsAlthough AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P = .21), nor daytime physical activity (P = .34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P = .014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology.ConclusionsThere is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process.

scholarly journals Possible role of the gut microbiota in the pathogenesis of anorexia nervosa

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nobuyuki Sudo
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Gain ◽  
Gut Microbiota ◽  
Psychosocial Factors ◽  
Biological Factors ◽  
Fear Of Weight Gain

AbstractAnorexia nervosa (AN), an eating disorder, is characterized by extreme weight loss and fear of weight gain. Psychosocial factors are thought to play important roles in the development and progression of AN; however, biological factors also presumably contribute to eating disorders. Recent evidence has shown that the gut microbiota plays an important role in pathogenesis of neuropsychiatric disorders including AN. In this article, we describe the possible role of the gut microbiota in the development and persistence of AN, based on the latest research works, including those of our group.

scholarly journals Skeletal effects and refeeding syndrome in anorexia nervosa

2020 ◽  
pp. 585-587
Author(s):  
Naomi VĂDUVA ◽  
Lehel PUSKAS ◽  
Andreea-Liana RĂCHIȘAN ◽  
Anamaria Magdalena TOMȘA ◽  
Andreea Alexandra ALDEA ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Therapeutic Approach ◽  
Nutritional Support ◽  
Nutritional Rehabilitation ◽  
Key Factors ◽  
Refeeding Syndrome ◽  
Laboratory Findings ◽  
Life Threatening ◽  
Weight Restoration ◽  
Skeletal Effects

Purpose Anorexia nervosa (AN) is a psychiatric disorder which can lead to numerous medical complications. In the clinical practice, during weight restoration, it is relatively common to observe potentially fatal complications, such as refeeding syndrome (RS). The objective of this case report is to highlight some key factors regarding nutritional support and the therapeutic approach in AN to avoid life-threatening complications, for example severe hypophosphatemia. Methods We present the case of a 14-year-old girl suffering from AN, who was admitted to our hospital with lethargy, emaciation with bitemporal wasting, hirsutism and pitting lower extremity edema. Results Based on the laboratory findings, the concerning condition of the patient was attributed to hypophosphatemia (1,64 mg/dl) caused by RS. Conclusions Refeeding syndrome is a potentially lethal condition in the case of AN patients. Hypophosphatemia, which is a result of the refeeding syndrome, is a relatively common complication of overly aggressive nutritional rehabilitation. Physicians who are involved in treating this condition, should be aware of this potentially life-threatening syndrome, and assess their therapeutic approach accordingly Keywords: anorexia nervosa, hypophosphatemia, refeeding syndrome, nutritional support,

Defining Eating Disorders

2017 ◽  
pp. 289-314
Author(s):  
Evelyn Attia ◽  
Anne E. Becker ◽  
Cynthia M. Bulik ◽  
Alison E. Field ◽  
Neville H. Golden ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
General Population ◽  
Bulimia Nervosa ◽  
Binge Eating Disorder ◽  
Medical Complications ◽  
Dsm 5 ◽  
Psychological Comorbidities

This chapter describes the diagnostic criteria used in clinical and research settings to define eating disorders and highlights important changes in the criteria introduced by DSM-5 in 2013. Emerging evidence suggests that the DSM-5 categories usefully capture a range of eating problems in need of clinical attention that were not well described in previous DSM editions. The chapter also reviews the characteristics of adolescents and young adults with eating disorders, their frequency in the general population, and their psychological comorbidities. Important medical complications associated with the disorders, especially among adolescents, are summarized, as well as approaches to their treatment. The chapter covers in greatest detail anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Eating disorders

2020 ◽  
pp. 6509-6513
Author(s):  
Christopher G. Fairburn
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Dietary Restriction ◽  
Eating Behaviour ◽  
Medical Attention ◽  
Medical Complications ◽  
Electrolyte Disturbance ◽  
Medical Unit ◽  
Life Threatening

The eating disorders are a group of conditions, central to which is a disturbance of eating behaviour. The main diagnoses are anorexia nervosa and bulimia nervosa, in both of which there is an extreme concern with weight and shape. In anorexia nervosa, persistent dietary restriction leads to weight loss, which may be severe. In bulimia nervosa, the dietary restriction is interrupted by repeated episodes of binge eating (typically followed by self-induced vomiting) and weight is usually unremarkable. Both disorders may be accompanied by medical complications that present to physicians. Anorexia nervosa has the potential to be life-threatening because of the consequences of starvation. Patients may require medical attention for the correction of electrolyte disturbance and sometimes admission to a medical unit for refeeding. The main treatment of eating disorders is psychological. The prognosis of bulimia nervosa is generally good but is less positive for anorexia nervosa.

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