Epidemiology and Course of Eating Disorders

Author(s):  
Pamela Keel

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.

Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.


2020 ◽  
Vol 112 (4) ◽  
pp. 941-947 ◽  
Author(s):  
Eric Stice ◽  
Paul Rohde ◽  
Heather Shaw ◽  
Chris Desjardins

ABSTRACT Background Eating disorders affect 13% of females and contribute to functional impairment and mortality, but few studies have identified risk factors that prospectively correlate with future onset of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Identifying risk factors specific to each eating disorder is critical for advancing etiologic knowledge and designing effective prevention programs. Objectives This study examined whether weight suppression (the difference between a person's highest past weight at their adult height and their current weight) correlates with future onset of AN, BN, BED, and PD. Methods Data from 1165 young women with body image concerns (mean ± SD age: 21.9 ± 6.4 y) who completed annual diagnostic interviews over a 3-y follow-up period were examined. Logistic regression models evaluated the relation of baseline weight suppression to onset risk of each eating disorder controlling for age, dietary restraint, and intervention condition. Results Elevated weight suppression predicted future onset of AN (OR: 1.36; 95% CI: 1.03, 1.80), BN (OR: 1.34; 95% CI: 1.11, 1.62), PD (OR: 1.46; 95% CI: 1.23, 1.74), and any eating disorder (OR: 1.32; 95% CI: 1.12, 1.56), but not BED (OR: 1.10; 95% CI: 0.89, 1.37). Highest past weight correlated with future onset of BN and PD but not onset of AN, BED, or any eating disorder, and baseline current weight was inversely related to future AN onset only, implying that women with the largest difference between their highest past weight and current weight are at greatest risk of eating disorders. Conclusions The results provide novel evidence that weight suppression correlates with future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviors and suggest weight-suppressed women constitute an important risk group to target with selective prevention programs. These trials were registered at clinicaltrials.gov as NCT01126918 and NCT01949649.


2009 ◽  
Vol 15 (2) ◽  
pp. 129-136 ◽  
Author(s):  
Zafra Cooper ◽  
Christopher G. Fairburn

SummaryBinge eating occurs across the entire range of eating disorders. It is required for a diagnosis of bulimia nervosa but it is also seen in some cases of anorexia nervosa and in many cases of eating disorder not otherwise specified (usually referred to as eating disorder NOS or atypical eating disorder). This article focuses on the management of those eating disorders in which binge eating is a prominent feature.


2011 ◽  
Vol 26 (S2) ◽  
pp. 2176-2176
Author(s):  
J. Treasure

The DSM V will probably include four categories of eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified. The lifetime prevalence is about 5%. Cultural, social and interpersonal elements can trigger the onset and changes in neural networks can sustain the illness. Brain based explanatory models have been developed which include an imbalance between top down control and hedonic and homeostatic elements. The longer the duration of untreated illness the harder it is to reverse the illness as a variety of maintaining factors develop. CBT remains the treatment of choice for bulimia nervosa but there is more uncertainty about treatment for anorexia nervosa although treatment with a focus on the interpersonal elements is of value


1991 ◽  
Vol 159 (4) ◽  
pp. 562-565 ◽  
Author(s):  
Phillipa J. Hay ◽  
Anne Hall

Of 107 recently admitted psychiatric patients screened for eating-disorder symptoms by questionnaire, 17% met DSM–III–R criteria for eating disorders. Eight patients (one male) had bulimia nervosa. Ten patients had eating disorder not otherwise specified: seven (three male) bulimic type, and three (one male) anorexia nervosa type. The most common concurrent diagnoses were mood and personality disorders. As eating-disorder symptoms are relevant to the diagnosis and management of other psychiatric disorders they should be assessed routinely in all psychiatric patients.


2010 ◽  
Vol 40 (10) ◽  
pp. 1735-1744 ◽  
Author(s):  
K. T. Eddy ◽  
S. A. Swanson ◽  
R. D. Crosby ◽  
D. L. Franko ◽  
S. Engel ◽  
...  

ObjectiveAnorexia nervosa (AN) and bulimia nervosa (BN) are marked by longitudinal symptom fluctuations. DSM-IV-TR does not address how to classify eating disorder (ED) presentations in individuals who no longer meet full criteria for these disorders. To consider this issue, we examined subthreshold presentations in women with initial diagnoses of AN and BN.MethodA total of 246 women with AN or BN were followed for a median of 9 years; weekly symptom data were collected at frequent intervals using the Longitudinal Interval Follow-up Evaluation of Eating Disorders (LIFE-EAT-II). Outcomes were ED presentations that were subthreshold for ⩾3 months, including those narrowly missing full criteria for AN or BN, along with binge eating disorder (BED) and purging disorder.ResultsDuring follow-up, most women (77.6%) experienced a subthreshold presentation. Subthreshold presentation was related to intake diagnosis (Wald χ2=8.065, df=2, p=0.018). Individuals with AN most often developed subthreshold presentations resembling AN; those with BN were more likely to develop subthreshold BN. Purging disorder was experienced by half of those with BN and one-quarter of those with AN binge/purge type (ANBP); BED occurred in 20% with BN. Transition from AN or BN to most subthreshold types was associated with improved psychosocial functioning (p<0.001).ConclusionsSubthreshold presentations in women with lifetime AN and BN were common, resembled the initial diagnosis, and were associated with modest improvements in psychosocial functioning. For most with lifetime AN and BN, subthreshold presentations seem to represent part of the course of illness and to fit within the original AN or BN diagnosis.


Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


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