Atypical Eating Disorders and Specific Phobia of Vomiting

2017 ◽  
pp. 270-290
Author(s):  
Alexandra Keyes ◽  
David Veale
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Anorexia Nervosa ◽  
Disordered Eating ◽  
Clinical Features ◽  
Food Restriction ◽  
Clinical Case ◽  
Evidence Base ◽  
Specific Phobia ◽  
Case Conceptualization

Some individuals with specific phobia of vomiting (SPOV) (emetophobia) may present with disordered eating, including food restriction and weight loss. Such cases may be misdiagnosed as anorexia nervosa (AN), thus complicating case conceptualization, formulation, and treatment. This chapter outlines the clinical features of SPOV, including those that overlap with AN and other disorders. Treatment approaches and their evidence base are discussed, and a clinical case example of an individual with SPOV and disordered eating is presented. More research is needed to address the overlap between eating disorders and SPOV in order to better distinguish overlaps in presentation and to develop treatments that effectively target the central fears in these cases.

Clinical features in insulin-treated diabetes with comorbid diabulimia, disordered eating behaviors and eating disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S81-S81
Author(s):  
V. Deiana ◽  
E. Diana ◽  
F. Pinna ◽  
M.G. Atzeni ◽  
F. Medda ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Disordered Eating ◽  
Clinical Features ◽  
Eating Behaviors ◽  
Blood Glucose Control ◽  
Diabetic Patients ◽  
Disordered Eating Behaviors ◽  
Dsm 5 ◽  
Combining Data ◽  
Diet Pills

Adherence to self-management and medication regimens is required to achieve blood glucose control in diabetic patients. Therefore, diabulimia, the deliberate insulin restriction/omission to lose weight, and other disordered eating behaviors (DEBs) or eating disorders (EDs), place these patients at risk of complications.We aimed to establish the frequency of diabulimia, DEBs and EDs among patients with type 1 and 2 diabetes (T1DM and T2DM) and their association with other clinical features.A total of 211 insulin-treated diabetic patients (13–55 years old) answered the Diabetes Eating Problem Survey-Revised (DEPS-R), a diabetes-specific screening tool for DEBs, and the Eating Disorders Inventory-3 (EDI-3). SCID-I modified according to DSM-5 criteria was used to diagnose EDs.At the DEPS-R, 20.8% of the sample scored above the cutoff, more frequently females (P = 0.005), patients with T1DM (P = 0.045), with a diagnosis of ED (P < 0.001), positive to the EDI-3 (P ≤ 0.001), with physical comorbidities (P = 0.003), with HbA1c > 7% (P = 0.020). Combining data from the interview with the results at the DEPS-R, 60.2% of the sample presented diabulimia. Dividing the sample by gender, we found that diabulimic females more frequently used diet pills (P = 0.006), had significantly higher HbA1c (P = 0.019) and STAI-Y1 scores (P = 0.004). Other DEBs comprised dietary restraint (51.8% of the sample), binge eating (42.2%), vomiting (6.2%), diet pills (7.1%) or laxatives (1.9%) or diuretics use (4.3%). Overall, 21.8% of the sample, mostly females (P < 0.001) met criteria for at least one DSM-5 diagnosis of ED.Diabetic patients, especially women, should be carefully monitored for the presence of diabulimia, BEDs and EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Managing anorexia from a dietitian's perspective

2009 ◽  
Vol 68 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Annette Cockfield ◽  
Ursula Philpot
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Multidisciplinary Team ◽  
Best Practice ◽  
Tube Feeding ◽  
Evidence Base ◽  
Inpatient Setting ◽  
Team Approach ◽  
Normal Behaviour ◽  
Weight Restoration

Anorexia nervosa has the highest mortality rate of any psychiatric condition and its management is complex and multi-faceted, requiring a multidisciplinary team approach. Dietitians are an important part of the multidisciplinary team, offering objective nutritional advice with the aim of helping the patient to develop an improved relationship with food. Refeeding patients with a low body weight requires careful management; nonetheless, refeeding the low-weight patient with anorexia presents many additional complications, largely of a psychological nature. Treatment plans need to consider psychological, physical, behavioural and psycho-social factors relating to anorexia nervosa. Currently, there is no consistent approach and a paucity of evidence to support best practice for weight restoration in this group of patients. Tube feeding is utilised at varying BMI in anorexia nervosa, mainly in an inpatient setting. However, its use should be seen as a last resort and limited to a life-saving intervention. Weight restoration is best managed by an experienced dietitian within a specialist eating disorders team, using normal foods. This approach is ideal for nutrition rehabilitation, promoting skills for eating and normal behaviour and providing a longer-term solution by challenging unhelpful coping strategies from the onset. Dietitians have a unique mix of skills and knowledge in numerous areas including nutrition, physiology, psychology, sociology and behaviour change, which can be applied to support patients with thoughts and behaviours around food, weight and appetite. Further research is required into the effectiveness of dietetic interventions in eating disorders in order to establish an evidence base for best practice.

Eating Disorders

2018 ◽  
pp. 541-562
Author(s):  
Robyn Sysko ◽  
Sara Alavi
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Monitoring And Evaluation ◽  
Treatment Monitoring ◽  
Assessment Instruments ◽  
Psychiatric Diagnoses ◽  
Case Conceptualization ◽  
Significant Morbidity ◽  
Scientific Support

In comparison to other psychiatric diagnoses, eating disorders are relatively rare among the population, but are associated with significant morbidity and mortality. This chapter focuses on the assessment of eating disorders in adults and youth, including individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder. It begins with a review of the nature of the disorders, which is followed by a review of clinical assessment instruments designed for the assessment purposes of (a) diagnosis, (b) case conceptualization and treatment planning, and (c) treatment monitoring and evaluation. Recommendations are included for instruments with the greatest scientific support and for assessing eating disorders in a clinically sensitive manner.

The Unified Protocol for Eating Disorders

2017 ◽  
pp. 150-163
Author(s):  
Christina L. Boisseau ◽  
James F. Boswell
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Case Examples ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Outpatient Settings

This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, and other specified feeding or eating disorders. We focus on the five core treatment modules, highlighting aspects of each one that are particularly relevant to eating disorders and discuss the evidence supporting their use. Next, using clinical case examples from both residential and outpatient settings, we illustrate how each of these core modules can be applied to the treatment of eating disorders. Finally, we provide recommendations for future applications of the UP in this population.

The eating disorders

2020 ◽  
pp. 1045-1047
Author(s):  
Chris Fairburn ◽  
Rebecca Murphy
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Clinical Features ◽  
Binge Eating Disorder ◽  
Over Time

This chapter describes the three main eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder), together with other similar related states. It explains how they are classified and describes their clinical features, development, and course. It is noted that the eating disorders have many features in common and that people move between them over time. These two observations support adopting a transdiagnostic perspective on these conditions.

Anorexia Nervosa in Patients of Afro-Caribbean Extraction

1985 ◽  
Vol 146 (6) ◽  
pp. 653-656 ◽  
Author(s):  
Joseph P. Thomas ◽  
George I. Szmukler
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Clinical Features

SummaryRecently there has been an increase in the number of reports of anorexia nervosa in non-Caucasian subjects. This paper describes three patients of Afro-Caribbean extraction with anorexia nervosa and/or bulimia nervosa seen at a specialist eating disorders clinic at the Maudsley Hospital between 1981 and 1983. No cases had been seen prior to this. The key clinical features were found to be, in the main, typical.

scholarly journals Outpatient CBT for Underweight Patients with Eating Disorders: Effectiveness Within a National Health Service (NHS) Eating Disorders Service

2018 ◽  
Vol 47 (2) ◽  
pp. 217-229
Author(s):  
Paul E. Jenkins ◽  
Ceri Morgan ◽  
Catherine Houlihan
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Real World ◽  
Evidence Base ◽  
Behaviour Therapy ◽  
Psychosocial Impairment ◽  
Cognitive Behaviour

Background: Underweight eating disorders (EDs) are notoriously difficult to treat, although a growing evidence base suggests that outpatient cognitive behaviour therapy for EDs (CBT-ED) can be effective for a large proportion of individuals. Aims: To investigate the effectiveness of CBT-ED for underweight EDs in a ‘real-world’ settings. Method: Sixty-three adults with underweight EDs (anorexia nervosa or atypical anorexia nervosa) began outpatient CBT-ED in a National Health Service setting. Results: Fifty-four per cent completed treatment, for whom significant changes were observed on measures of ED symptoms, psychological distress and psychosocial impairment. There was also a large effect on body weight at end-of-treatment. Conclusions: The results suggest that good outcomes can be achieved by the majority of those who complete treatment, although treatment non-completion remains a significant barrier to recovery. Future studies should focus on improving treatment retention, as evidence suggests that CBT-ED in ‘real-world’ settings is effective.

Anorexia Nervosa and Related Conditions in Schoolchildren

1987 ◽  
Vol 4 (4) ◽  
pp. 217-225 ◽  
Author(s):  
Paula H. Salmons
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Clinical Features ◽  
Biological Factors

The clinical features of anorexia nervosa and the prevalence of the eating orders in different societies is described. The role of physiological, cultural and biological factors in the aetiology of eating are reviewed. Finally ways of preventing eating disorders are considered.

Diagnostic Issues in Primary Anorexia Nervosa

1982 ◽  
Vol 11 (3) ◽  
pp. 235-244 ◽  
Author(s):  
Larry Kirstein
Keyword(s):  
Weight Loss ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Literature Review ◽  
Clinical Case ◽  
Eating Patterns ◽  
Case Presentation ◽  
Body Image Disturbances

A literature review and clinical case presentation approach are employed to highlight unresolved diagnostic issues in Primary Anorexia Nervosa. The material is examined and discussed along a multidimensional list of variables considered important for the diagnosis, including definitions of weight loss, associated biological symptoms, eating patterns and body image disturbances.

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.

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