Anorexia Nervosa with a History of Obesity or Overweight

2017 ◽  
pp. 169-188
Author(s):  
Jocelyn Lebow ◽  
Leslie Sim
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Weight Status ◽  
Restrictive Eating ◽  
Prevention Interventions ◽  
History Of ◽  
Weight Restoration ◽  
History Of Obesity ◽  
Fear Of Weight Gain ◽  
The Relationship

The relationship between obesity and restrictive eating disorders is poorly understood and fraught with many misperceptions. Unfortunately, these misperceptions pose challenges for identification and treatment of eating disorders, and may even increase eating disorder risk in higher weight status individuals. Research suggests that restrictive eating disorders are prevalent in individuals with a history of overweight or obesity, and although these individuals may present to treatment at a higher weight, they should not be mistaken to have a subclinical or less malignant illness. In fact, there is mounting evidence that these individuals can have equally as serious or even more severe symptoms, consequences, and comorbidities, and their eating disorder may take significantly longer to be identified than patients with no overweight history. Research is needed to inform treatment adaptations for these individuals, to address realistic fear of weight gain and set appropriate weight restoration goals, as well as to inform prevention interventions.

scholarly journals Comparison of Shoplifting Behaviours in Patients with Eating Disorders, Psychiatric Control Subjects, and Undergraduate Control Subjects

2000 ◽  
Vol 45 (5) ◽  
pp. 471-475 ◽  
Author(s):  
Elliot M Goldner ◽  
Josie Geller ◽  
C Laird Birmingham ◽  
Ronald A Remick
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Self Esteem ◽  
Control Group ◽  
Control Subjects ◽  
The Past ◽  
History Of ◽  
Eating Disorder Symptomatology ◽  
The Relationship

Shoplifting behaviours were examined in an eating disorder group (EDG, n = 48), a psychiatric control group (PCG, n = 46), and an undergraduate control group (UCG, n = 82). They were examined in relation to self-esteem, depression, and eating disorder symptomatology. The 3 groups did not differ in overall history of shoplifting, but EDG women were more likely to have shoplifted in the past 6 months (current shoplifting) and to have shoplifted often than were women from the PCG or UCG. Across all 3 groups, current shoplifting was associated with low self-esteem, elevated depression, and purging behaviours at the time of the assessment. The implications of these findings with regard to the relationship between shoplifting and eating disorder symptomatology will be addressed.

99. In Eating Disorder Recovery: The Relationship Between Malnutrition and Symptoms of Anxiety/Depression in Youth With Restrictive Eating Disorders

2021 ◽  
Vol 68 (2) ◽  
pp. S52-S53
Author(s):  
Jessica A. Lin ◽  
Sara F. Forman ◽  
Carly Milliren ◽  
Julia Vitagliano ◽  
Rebecca Spigel ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Restrictive Eating ◽  
Anxiety Depression ◽  
The Relationship

scholarly journals Higher Caloric Refeeding Is Safe in Hospitalised Adolescent Patients with Restrictive Eating Disorders

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth K. Parker ◽  
Sahrish S. Faruquie ◽  
Gail Anderson ◽  
Linette Gomes ◽  
Andrew Kennedy ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Weight Gain ◽  
Statistical Significance ◽  
Caloric Intake ◽  
Tube Feeding ◽  
Retrospective Chart Review ◽  
Refeeding Syndrome ◽  
Restrictive Eating ◽  
Weight Restoration ◽  
The Mean

Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations.Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review.Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047;p=0.039). No statistical significance was found between electrolytes and calories provided during refeeding.Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome.

Ascertaining an efficient eligibility cut-off for extended Medicare items for eating disorders

2021 ◽  
pp. 103985622110286
Author(s):  
Tracey Wade ◽  
Jamie-Lee Pennesi ◽  
Yuan Zhou
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
False Positive Rate ◽  
Area Under The Curve ◽  
Rate Sensitivity ◽  
True Positive Rate ◽  
Eating Disorder Examination Questionnaire ◽  
Eating Disorder Examination ◽  
Positive Rate ◽  
The Relationship

Objective: Currently eligibility for expanded Medicare items for eating disorders (excluding anorexia nervosa) require a score ⩾ 3 on the 22-item Eating Disorder Examination-Questionnaire (EDE-Q). We compared these EDE-Q “cases” with continuous scores on a validated 7-item version of the EDE-Q (EDE-Q7) to identify an EDE-Q7 cut-off commensurate to 3 on the EDE-Q. Methods: We utilised EDE-Q scores of female university students ( N = 337) at risk of developing an eating disorder. We used a receiver operating characteristic (ROC) curve to assess the relationship between the true-positive rate (sensitivity) and the false-positive rate (1-specificity) of cases ⩾ 3. Results: The area under the curve showed outstanding discrimination of 0.94 (95% CI: .92–.97). We examined two specific cut-off points on the EDE-Q7, which included 100% and 87% of true cases, respectively. Conclusion: Given the EDE-Q cut-off for Medicare is used in conjunction with other criteria, we suggest using the more permissive EDE-Q7 cut-off (⩾2.5) to replace use of the EDE-Q cut-off (⩾3) in eligibility assessments.

scholarly journals The Association of Malnutrition, illness duration, and pre-morbid weight status with anxiety and depression symptoms in adolescents and young adults with restrictive eating disorders: a cross-sectional study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jessica A. Lin ◽  
Grace Jhe ◽  
Julia A. Vitagliano ◽  
Carly E. Milliren ◽  
Rebecca Spigel ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Weight Status ◽  
Severe Disease ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Comprehensive Treatment ◽  
Psychiatric Medication ◽  
Illness Duration ◽  
Restrictive Eating

Abstract Background Restrictive eating disorders (EDs) are often comorbid with anxiety and depression symptoms, placing patients at risk for more severe disease, worse treatment outcomes, and higher rates of mortality. To identify risks for developing such co-morbidities, we assessed the association of malnutrition, ED illness duration, and pre-morbid weight status with symptoms of anxiety and depression in adolescents/young adults (AYAs) with EDs. Methods 145 participants with restrictive EDs (anorexia nervosa [AN], other specified feeding and eating disorders [OSFED], avoidant restrictive food intake disorder [ARFID]) were included from the RECOVERY study, a longitudinal web-based registry of AYAs with EDs. We measured malnutrition as percent of expected body mass index (%eBMI), based on participants’ pre-morbid growth trajectory. Outcomes were anxiety and depression scores from the Generalized Anxiety Disorder 7-item (GAD-7) and Center for Epidemiologic Studies Depression (CES-D) scales. We used multiple linear regression to examine the association of malnutrition, ED duration, and pre-morbid weight status with symptoms of anxiety and depression. Results Mean (SD) age was 16.4(3.0) years; 87% were female; 89% white; 85% had AN, 6% OSFED, 10% ARFID. Of these, 2/3 had ED symptoms ≥1 year, 1/3 had previous higher level of ED care (HLOC), and half were taking psychiatric medications. Mean %eBMI was 90% (range 57–112%). Mean GAD-7 was 9.4(5.9) and CES-D was 24(13.8), indicating most participants had clinically significant anxiety and/or depression. Degree of malnutrition was not significantly associated with anxiety or depression adjusting for age, sex, sexual orientation, ED diagnosis, and use of psychiatric medication. Those with longer duration of ED symptoms had higher depression scores after adjusting for malnutrition, HLOC, length of ED symptoms, and time in our care (p = 0.038). Patients with pre-morbid BMIs ≥75th percentile had lower depression scores than those with pre-morbid BMIs <75th percentile (p = 0.014). Conclusions We find high degree of clinically relevant anxiety and depression symptoms in a population of AYAs with EDs. Our findings suggest that factors beyond malnutrition play a role in the co-morbid mood and anxiety disorders in this population. Overall, rapid ED diagnosis and comprehensive treatment for patients with EDs across the weight spectrum—and especially those with psychiatric co-morbidities—will likely aid in recovery.

The Welsh Eating Disorder Service Review 2018, Scottish Eating Disorder Service Review 2021 and recommendations of best practice in comorbid eating disorders and diabetes

2021 ◽  
pp. 135910452110138
Author(s):  
Jacinta Tan ◽  
Gemma Johns
Keyword(s):  
Eating Disorders ◽  
United Kingdom ◽  
Eating Disorder ◽  
High Mortality ◽  
Best Practice ◽  
Service Development ◽  
The United Kingdom ◽  
Scottish Government ◽  
The Relationship ◽  
Service Change

Background: Diabetes and eating disorders are frequently comorbid. This particular comorbidity is not only often poorly recognised, but is difficult to treat and has a high mortality. Method: In this article, we will briefly review the relationship between diabetes and eating disorders. We will review the current NICE and other guidance and reports concerning both diabetes and eating disorders in the United Kingdom. We will then describe the recommendations of the 2018 Welsh Government Eating Disorder Service Review and the 2021 the Scottish Government Eating Disorder Service Review regarding diabetes and eating disorders, which will lead to service change. Conclusions: We conclude that this is a relatively underdeveloped but important area where there needs to be further service development and more collaboration between diabetes and eating disorder services.

Anorexia Nervosa and Depression in a Woman Blind since the Age of Nine Months

1993 ◽  
Vol 38 (7) ◽  
pp. 469-471 ◽  
Author(s):  
Clifford W. Sharp
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Major Depression ◽  
Food Intake ◽  
Older Women ◽  
The Body ◽  
Atypical Presentation ◽  
History Of

A woman aged 58 who has been blind since the age of nine months presented with major depression and a 40 year history of an eating disorder characterized by a restriction of food intake and body disparagement. The case is additional evidence that a specifically visual body image is not essential for the development of anorexia nervosa and supports the view that the concept of body image is unnecessary and unproductive in eating disorders. Greater emphasis should be placed on attitudes and feelings toward the body, and the possibility of an eating disorder should be considered in cases of older women with an atypical presentation.

Clinical Handbook of Complex and Atypical Eating Disorders

2017 ◽  
Keyword(s):  
Eating Disorders ◽  
Diagnostic Category ◽  
Ethnically Diverse ◽  
Autism Spectrum ◽  
Treatment Approaches ◽  
Eating Disorder Treatment ◽  
Controlled Treatment ◽  
History Of ◽  
Complicating Factors ◽  
History Of Obesity

The aim of this book is to collate what is known about an array of complicating factors for patients with eating disorders, serving as an accessible introduction to each of the comorbidities and symptom presentations highlighted in the volume. The Handbook of Complex and Atypical Eating Disorders presents the available data about atypical and complex ED, in addition to what is known about treatment approaches. The first section contains chapters on the treatment of eating disorders with various psychiatric comorbidities, including trauma, borderline personality disorder, substance use, suicidality, anxiety disorders, and autism spectrum disorders, which may greatly complicate the application of standard treatment approaches. The second section contains chapters exploring treatment of eating disorders with atypical symptom presentations which (i) are not located as a specific diagnostic category in diagnostic criteria for ED’s, (ii) centrally feature ED pathology, and (iii) have emerging data suggesting the distinct nature of the syndrome, including purging disorder, muscle dysmorphia, night eating syndrome, and anorexia with a history of obesity. The final section has chapters which focus on how to adapt eating disorder treatment for atypical populations typically neglected in controlled treatment trials: LGBT, pediatric, male, ethnically diverse, and older adults.

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