Extreme bradycardia as presentation of an eating disorder

2021 ◽  
Vol 14 (6) ◽  
pp. e238224
Author(s):  
Elizabeth Anderson ◽  
Julian Gunn
Keyword(s):  
Body Mass Index ◽  
Eating Disorder ◽  
Pericardial Effusion ◽  
Body Mass ◽  
Personal History ◽  
Horner’S Syndrome ◽  
Dietary Advice ◽  
Pleural Effusions ◽  
Horner's Syndrome ◽  
Dietary History

We present a case of extreme bradycardia in an 18-year-old man, accompanied by bilateral pleural effusions, pericardial effusion, endocrine dysregulation and Horner’s syndrome. Despite extensive investigations as an inpatient and multidisciplinary input, it was not until subsequent assessment by an endocrine team that it was revealed that his presentation was attributable to an eating disorder. Following dietary advice, easing of extreme exercise and continued support, the patient improved in all parameters including body mass index and he remains well. This case demonstrates the importance of a thorough personal history incorporating all aspects of social and dietary history.

scholarly journals Restrained eating in Lebanese adolescents: scale validation and correlates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tracy Boulos Nakhoul ◽  
Anthony Mina ◽  
Michel Soufia ◽  
Sahar Obeid ◽  
Souheil Hallit
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Body Dissatisfaction ◽  
Body Mass ◽  
Rating Scale ◽  
Activity Index ◽  
Arab Countries ◽  
Restrained Eating ◽  
Distress Scale

Abstract Background Restrained eating disorder is prevalent worldwide across both ethnic and different cultural groups, and most importantly within the adolescent population. Additionally, comorbidities of restrained eating present a large burden on both physical and mental health of individuals. Moreover, literature is relatively scarce in Arab countries regarding eating disorders, let alone restrained eating, and among adolescent populations; hence, the aim of this study was to (1) validate the Dutch Restrained Eating Scale in a sample of Lebanese adolescents and (2) assess factors correlated with restrained eating (RE), while taking body dissatisfaction as a moderator between body mass index (BMI) and RE. Methods This cross-sectional study, conducted between May and June 2020 during the lockdown period imposed by the Lebanese government, included 614 adolescents aged between 15 and 18 years from all Lebanese governorates (mean age of 16.66 ± 1.01 years). The scales used were: Dutch Restrained Eating Scale, body dissatisfaction subscale of the Eating Disorder Inventory-Second version, Rosenberg Self-Esteem Scale, Beirut Distress Scale (for psychological distress), Hamilton Anxiety Rating Scale and Patient Health Questionnaire (for depression). Results The factor analysis yielded a one-factor solution with Eigen values > 1 (variance explained = 59.65 %; αCronbach = 0.924). Female gender (B = 0.19), higher BMI (B = 0.49), higher physical activity index (B = 0.17), following a diet to lose weight (B = 0.26), starving oneself to lose weight (B = 0.13), more body dissatisfaction (B = 1.09), and higher stress (B = 0.18) were significantly associated with more RE, whereas taking medications to lose weight (B=-0.10) was significantly associated with less RE. The interaction body mass index (BMI) by body dissatisfaction was significantly associated with RE; in the group with low BMI, higher body dissatisfaction was significantly associated with more RE. Conclusions Our study showed that the Dutch Restrained Eating scale is an adapted and validated tool to be used among Lebanese adolescents and revealed factors associated with restrained eating in this population. Since restrained eating has been associated with many clinically-diagnosed eating disorders, the results of this study might serve as a first step towards the development of prevention strategies targeted towards promoting a healthy lifestyle in Lebanese adolescents.

scholarly journals Menstruation disorders in adolescents with eating disorders – target body mass index percentiles for their resolution

2014 ◽  
Vol 12 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Beatriz Vale ◽  
Sara Brito ◽  
Lígia Paulos ◽  
Pascoal Moleiro
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Body Mass ◽  
Female Adolescents ◽  
Secondary Amenorrhea ◽  
Not Otherwise Specified ◽  
Initial Body Mass Index ◽  
The Ideal

Objective To analyse the progression of body mass index in eating disorders and to determine the percentile for establishment and resolution of the disease.Methods A retrospective descriptive cross-sectional study. Review of clinical files of adolescents with eating disorders.Results Of the 62 female adolescents studied with eating disorders, 51 presented with eating disorder not otherwise specified, 10 anorexia nervosa, and 1 bulimia nervosa. Twenty-one of these adolescents had menstrual disorders; in that, 14 secondary amenorrhea and 7 menstrual irregularities (6 eating disorder not otherwise specified, and 1 bulimia nervosa). In average, in anorectic adolescents, the initial body mass index was in 75thpercentile; secondary amenorrhea was established 1 month after onset of the disease; minimum weight was 76.6% of ideal body mass index (at 4th percentile) at 10.2 months of disease; and resolution of amenorrhea occurred at 24 months, with average weight recovery of 93.4% of the ideal. In eating disorder not otherwise specified with menstrual disorder (n=10), the mean initial body mass index was at 85thpercentile; minimal weight was in average 97.7% of the ideal value (minimum body mass index was in 52nd percentile) at 14.9 months of disease; body mass index stabilization occured at 1.6 year of disease; and mean body mass index was in 73rd percentile. Considering eating disorder not otherwise specified with secondary amenorrhea (n=4); secondary amenorrhea occurred at 4 months, with resolution at 12 months of disease (mean 65th percentile body mass index).Conclusion One-third of the eating disorder group had menstrual disorder − two-thirds presented with amenorrhea. This study indicated that for the resolution of their menstrual disturbance the body mass index percentiles to be achieved by female adolescents with eating disorders was 25-50 in anorexia nervosa, and 50-75, in eating disorder not otherwise specified.

The linkage “Body Mass Index-Insomnia Levels-Eating Disorder Flexibility” in Italian nurses during the Covid-19 outbreak: a psychoendocrinological employment disease.

2021 ◽  
Vol 21 ◽  
Author(s):  
Elsa Vitale ◽  
Vito Galatola ◽  
Rocco Mea ◽  
Francesca Di Dio ◽  
Anna Canonico
Keyword(s):  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Eating Disorder ◽  
Incidence Rate ◽  
Body Mass ◽  
Working Condition ◽  
Behavioral Flexibility ◽  
Nursing Profession ◽  
Online Questionnaire ◽  
Socio Demographic Factors

Aim: To evaluate differences between insomnia condition and flexibility attitude to eating in Italian nurses directly involved in the care of patients affected by Covid-19 according to sex, Body Mass Index, shift working condition and incidence of new Covid-19 cases in the region of participants. Moreover, any correlations between the insomnia condition and the flexible attitude to eat have been investigated. Methods: An online questionnaire was administered in October 2020, including the socio-demographic section, the insomnia condition assessment, and the behavioral flexibility evaluation to develop an eating disorder. Results: 341 Italian nurses answered the questionnaire. Regarding the insomnia condition levels, nurses belonging to regions with a higher incidence rate of the Covid-19 pandemic recorded higher levels of insomnia than others (p=.004). Females and nurses belonging to areas with lower Covid-19 incidence rate recorded a significantly higher total eating flexibility attitude (p=.003; p<.001), also, in the Food and Exercise flexibility (p=.007; p<.001). As regards the flexible attitude for weight and shape, significant differences were recorded among nurses according to their BMI values (p<.001) and to their incidence rate of the belonging region (p<.001). The insomnia condition levels significantly correlated with the eat flexibility attitude both in its total score (p=.010), in the general score (p=.010), and the weight and shape score (p<.001). All correlations between the insomnia conditions and the flexibility to eat were significantly inverse except for the food and exercise dimension. All the eat flexibility sub-dimensions significantly correlated among them (p<.001). Conclusion: There was a direct correlation among socio-demographic factors, BMI values, insomnia, and behavioral flexibility scores in Italian nurses. So, it could be assumed that the nursing profession is at risk of developing a metabolic syndrome condition. Therefore, it could be considered a psychoendocrinological employment disease during the Covid-19 outbreak.

scholarly journals Childhood body mass index and development of eating disorder traits across adolescence

2018 ◽  
Vol 26 (5) ◽  
pp. 462-471 ◽  
Author(s):  
Camilla A. Wiklund ◽  
Ralf Kuja-Halkola ◽  
Laura M. Thornton ◽  
Katarina Bälter ◽  
Elisabeth Welch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Eating Disorder ◽  
Body Mass ◽  
Childhood Body Mass Index

Possible role of adipocytokines in systemic sclerosis–associated small pericardial effusion

2018 ◽  
Vol 3 (2) ◽  
pp. 153-158
Author(s):  
Angela Chialà ◽  
Cinzia Rotondo ◽  
Emanuela Praino ◽  
Dorotea Natuzzi ◽  
Fabio Cacciapaglia ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Systemic Sclerosis ◽  
Pericardial Effusion ◽  
Body Mass ◽  
Serum Levels ◽  
Interferon Γ ◽  
Interquartile Range ◽  
Pulmonary Arterial ◽  
Factor Α

Introduction: Pericardial effusion is a common manifestation of systemic sclerosis, but its pathogenesis has been poorly investigated. Adipokines and interleukins may play a role in the pathophysiology of pericardial effusion. This study aimed at evaluating serum levels of adipokines and interleukins in systemic sclerosis patients with and without pericardial effusion. Methods: A total of 87 systemic sclerosis patients (age 52.6 ± 14 years; disease duration 8.2 ± 6.7 years) were recruited in this study. Demographics, body mass index, and clinical characteristics were recorded in each patient. Pericardial effusion was considered pathologic when ≥50 mL was detected by echocardiography. Serum levels of adiponectin, leptin, resistin, visfatin, tumor necrosis factor-α, interferon-γ, interlueukin-2, interlueukin-10, and interlueukin-17 were measured using Multiplex Immunoassay (Bioplex 200 System). Results: In all, 11 (13%) systemic sclerosis patients had pericardial effusion. Systemic sclerosis patients with and without pericardial effusion did not differ in age, sex, and body mass index. Systemic sclerosis patients with pericardial effusion had significantly higher levels of visfatin (median/interquartile range: 1546 pg/mL (interquartile range: 8590) vs 388 pg/mL (interquartile range: 103), p = 0.03) and interlueukin-17 (1.33 pg/mL (interquartile range: 3.5) vs 0.05 pg/mL (interquartile range: 0.56), p = 0.04), but lower levels of adiponectin (2,845,000 pg/mL (interquartile range: 4,132,900) vs 5,272,100 pg/mL (interquartile range 8,243,600), p = 0.02) than patients without pericardial effusion. Interstitial lung disease, pulmonary arterial hypertension, and “limited” or “diffuse” cutaneous subset did not correlate to adipokines or interleukin levels. Conclusion: Visfatin and adiponectin may play an important role in the pathogenesis of systemic sclerosis–related pericardial effusion. Further longitudinal studies are needed to unravel a possible role of these molecules as biomarkers of pericardial effusion in systemic sclerosis patients.

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