scholarly journals Eating disorders, especially anorexia nervosa, are associated with an increased risk of attempted suicide in young women

2005 ◽  
Vol 8 (1) ◽  
pp. 20-20 ◽  
Author(s):  
M. Pompili ◽  
R. Tatarelli
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Young Women ◽  
Attempted Suicide ◽  
Increased Risk

Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

2021 ◽  
Author(s):  
Ashley E. Tate ◽  
Shengxin Liu ◽  
Ruyue Zhang ◽  
Zeynep Yilmaz ◽  
Janne T. Larsen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Diagnosis ◽  
Disordered Eating Behaviors ◽  
Increased Risk ◽  
Clinical Diagnoses

OBJECTIVE <p>To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. </p> <p>RESEARCH DESIGN AND METHODS</p> <p>Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. </p> <p>RESULTS</p> <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> <p>CONCLUSION</p> <p>Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes. </p>

Attempted Suicide in Patients With Eating Disorders

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 378-387 ◽  
Author(s):  
Gwendolyn Portzky ◽  
Kees van Heeringen ◽  
Myriam Vervaet
Keyword(s):  
Eating Disorders ◽  
Personality Traits ◽  
Suicidal Behavior ◽  
Attempted Suicide ◽  
University Hospital ◽  
Clinical Population ◽  
State Dependent ◽  
Increased Risk ◽  
History Of ◽  
Social Insecurity

Background: Suicide is a major cause of mortality for patients with eating disorders (ED), especially for patients with anorexia nervosa. Attempted suicide is also relatively common in patients with anorexia or bulimia nervosa. Aims: This study aimed at examining associations between attempted suicide and trait- and state-dependent characteristics in a large clinical population of ED patients. Method: The sample consisted of 1,436 in- and outpatients of the Centre for Eating Disorders of the Ghent University Hospital. Measures of ED symptoms, psychopathology, and personality traits were compared between ED patients with and ED patients without a history of attempted suicide. Results: A history of attempted suicide was found in 11.8% of the ED patients and lifetime suicidal ideation was reported by 43.3%. Multivariate analyses showed that a history of attempted suicide was associated with higher scores on depression, purging symptomatology, early-developed cognitive schemes (impaired autonomy and increased inhibition), and social insecurity. Conclusion: These findings support the increased risk of suicidal behavior in ED. The presence of particular personality traits, of cognitive schemes, and of purging and depressive symptoms should increase vigilance for suicidal behavior.

scholarly journals Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

2021 ◽  
Author(s):  
Ashley E. Tate ◽  
Shengxin Liu ◽  
Ruyue Zhang ◽  
Zeynep Yilmaz ◽  
Janne T. Larsen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Diagnosis ◽  
Disordered Eating Behaviors ◽  
Increased Risk ◽  
Clinical Diagnoses

OBJECTIVE <p>To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. </p> <p>RESEARCH DESIGN AND METHODS</p> <p>Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. </p> <p>RESULTS</p> <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> <p>CONCLUSION</p> <p>Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes. </p>

Endocrinology of eating disorders

2011 ◽  
pp. 280-287
Author(s):  
Gerasimos E. Krassas ◽  
Luigi Bartalena
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Young Women ◽  
Binge Eating Disorder ◽  
Strong Association ◽  
Excessive Weight ◽  
The Usa

Eating disorders affect about five million Americans every year. There are three different eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders are complex conditions deriving from a complex interplay of long-standing behavioural, emotional, psychological, interpersonal, and social factors. The neuronal circuits that control the ingestion of food are mainly related to catecholaminergic, serotoninergic, and peptidergic systems. In this respect, while serotonin, dopamine and prostaglandin promote the ingestion of food, by contrast, neuropeptide Y, noradrenaline, γ‎-aminobutyric acid (GABA), and opioid peptides inhibit food ingestion, thus causing the development of eating disorders (1). Eating disorders typically occur in adolescent girls or young women, although 5–15% of cases of anorexia nervosa and bulimia nervosa and 40% of cases of binge eating disorder occur in boys and men. Approximately 3% of young women are affected with these disorders, and probably twice that number has clinically important variants. Although early disorders mostly develop in adolescence or young adulthood, they can occur after the age of 40 years and are increasingly seen in young children (2). Eating disorders are more prevalent in industrialized societies than in nonindustrialized societies, and occur in all socioeconomic classes and major ethnic groups in the USA. About half of those who have anorexia nervosa or bulimia nervosa fully recover, approximately 30% have a partial recovery, and 20% have no substantial improvement in symptoms (2). The aim of this chapter is to give an overview of the endocrinology of eating disorders leading to excessive weight gain or excessive weight loss in humans. It is of note that despite the strong association between obesity and eating disorders, the increase in obesity is not followed by an increase in eating disorders (3).

Cultural Expectations of Thinness in Women

1980 ◽  
Vol 47 (2) ◽  
pp. 483-491 ◽  
Author(s):  
David M. Garner ◽  
Paul E. Garfinkel ◽  
Donald Schwartz ◽  
Michael Thompson
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Young Women ◽  
Women's Magazines ◽  
Significant Trend ◽  
Cultural Expectations ◽  
Recent Increase ◽  
Miss America ◽  
Cultural Pressures ◽  
Population Weight

The cultural pressures on women to be thin and diet have been linked to the expression of serious eating disorders such as anorexia nervosa. The current study attempts to document and quantify the shift toward a thinner ideal shape for females in our culture over the last 20 years. Data from Playboy centerfolds and Miss America Pageant contestants indicated a significant trend toward a thinner standard. Over the same period there was a significant increase in diet articles in six popular women's magazines. These changes occurred within the context of increasing population weight norms for young women. Biosocial implications including the apparent recent increase in anorexia nervosa are discussed.

scholarly journals A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses

2019 ◽  
Vol 216 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Moritz Herle ◽  
Bianca De Stavola ◽  
Christopher Hübel ◽  
Mohamed Abdulkadir ◽  
Diana Santos Ferreira ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Longitudinal Study ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Latent Class ◽  
Risk Difference ◽  
Eating Behaviours ◽  
Increased Risk

BackgroundEating behaviours in childhood are considered as risk factors for eating disorder behaviours and diagnoses in adolescence. However, few longitudinal studies have examined this association.AimsWe investigated associations between childhood eating behaviours during the first ten years of life and eating disorder behaviours (binge eating, purging, fasting and excessive exercise) and diagnoses (anorexia nervosa, binge eating disorder, purging disorder and bulimia nervosa) at 16 years.MethodData on 4760 participants from the Avon Longitudinal Study of Parents and Children were included. Longitudinal trajectories of parent-rated childhood eating behaviours (8 time points, 1.3–9 years) were derived by latent class growth analyses. Eating disorder diagnoses were derived from self-reported, parent-reported and objectively measured anthropometric data at age 16 years. We estimated associations between childhood eating behaviours and eating disorder behaviours and diagnoses, using multivariable logistic regression models.ResultsChildhood overeating was associated with increased risk of adolescent binge eating (risk difference, 7%; 95% CI 2 to 12) and binge eating disorder (risk difference, 1%; 95% CI 0.2 to 3). Persistent undereating was associated with higher anorexia nervosa risk in adolescent girls only (risk difference, 6%; 95% CI, 0 to 12). Persistent fussy eating was associated with greater anorexia nervosa risk (risk difference, 2%; 95% CI 0 to 4).ConclusionsOur results suggest continuities of eating behaviours into eating disorders from early life to adolescence. It remains to be determined whether childhood eating behaviours are an early manifestation of a specific phenotype or whether the mechanisms underlying this continuity are more complex. Findings have the potential to inform preventative strategies for eating disorders.

Personality trait risk factors for attempted suicide among young women with eating disorders

2004 ◽  
Vol 19 (3) ◽  
pp. 131-139 ◽  
Author(s):  
G. Youssef ◽  
B. Plancherel ◽  
J. Laget ◽  
M. Corcos ◽  
M.F. Flament ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Young Women ◽  
Suicidal Behaviour ◽  
Minnesota Multiphasic Personality Inventory ◽  
Suicide Attempts ◽  
Risk Indicators ◽  
Control Group ◽  
Clinical Group

AbstractObjectiveClinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders.MethodThe clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory—second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts.ResultsSuicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for ‘Depression’ and ‘Antisocial practices’ represented significant suicidal risk, for women with AN-P the scales for ‘Hysteria’, ‘Psychopathic deviate’, ‘Shyness/Self-consciousness’, ‘Antisocial Practices’, ‘Obsessiveness’ and ‘Low self-esteem’ were risk indicators and for women with BN-P the ‘Psychasthenia’, ‘Anger’ and ‘Fears’ scales were risk indicators.ConclusionThis study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a) have AN-R with a tendency to self-punishment and antisocial conduct, (b) have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c) if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

scholarly journals Emotional abuse interacts with borderline personality in adolescent inpatients with binge-purging eating disorders

2021 ◽  
Author(s):  
J. Spiegel ◽  
S. Arnold ◽  
H. Salbach ◽  
E. G. Gotti ◽  
E. Pfeiffer ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Emotional Abuse ◽  
Borderline Personality ◽  
Female Adolescent ◽  
Personality Style ◽  
Personality Styles ◽  
Increased Risk ◽  
Main Effect ◽  
Adolescent Inpatients

Abstract Purpose Childhood abuse is associated with an increased risk of developing eating disorders (EDs) as well as personality disorders (PDs). However, their interaction is still uncertain, particularly in adolescents. This study investigates the correlations between childhood emotional neglect (CEN), childhood emotional abuse (CEA), and obsessive-compulsive and borderline personality styles in female adolescent inpatients with eating disorders (EDs). Methods One hundred and twenty-eight inpatients (ages 14-18) were assessed, 54 were diagnosed with restricting-type anorexia nervosa (AN-R) and 33 with a binge-purging ED [BP-ED; comprising patients with binge-purging type anorexia nervosa (AN-BP), n = 15, and bulimia nervosa (BN), n = 18]. Fifty healthy participants made up the control group (CG). CEN and CEA were assessed with the Childhood Trauma Questionnaire, while the Personality Style and Disorder Inventory was implemented to determine personality styles. Results A MANOVA revealed a significant main effect of CEA on spontaneous-borderline personality style [F(8,119) = 17.1, p < 0.001, η2 = 0.126], as well as a main effect of ED group on spontaneous-borderline [F(2,119) = 3.1, p = 0.048, η2 = 0.050]. A significant interaction between ED group, CEA, and spontaneous-borderline was found [F(2,119) = 3.5, p = 0.034, η2 = 0.055] with BP-ED showing significantly higher scores in CEA (9.3 ± 4.0) and in spontaneous-borderline (14.2 ± 6.2). Conclusions Considering CEA and borderline personality style in adolescent inpatients with BN or AN-BP may help improve the understanding of the etiology and maintenance of BP-ED and provide more effective treatment targets. Level of evidence Level III, case–control analytic study.

scholarly journals Incidence and outcomes of eating disorders during the COVID-19 pandemic

2021 ◽  
pp. 1-3
Author(s):  
Maxime Taquet ◽  
John R. Geddes ◽  
Sierra Luciano ◽  
Paul J. Harrison
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Relative Risk ◽  
Suicidal Ideation ◽  
Electronic Health Records ◽  
Attempted Suicide ◽  
Hazard Ratio ◽  
Health Records ◽  
The Usa ◽  
Electronic Health

Summary There are concerns that eating disorders have become commoner during the coronavirus disease 2019 (COVID-19) pandemic. Using the electronic health records of 5.2 million people aged under 30, mostly in the USA, we show that the diagnostic incidence was 15.3% higher in 2020 overall compared with previous years (relative risk 1.15, 95% CI 1.12−1.19). The relative risk increased steadily from March 2020 onwards, exceeding 1.5 by the end of the year. The increase occurred solely in females, and primarily related to teenagers and anorexia nervosa. A higher proportion of patients with eating disorders in 2020 had suicidal ideation (hazard ratio HR = 1.30, 1.16−1.47) or attempted suicide (HR = 1.69, 1.21−2.35).

scholarly journals Avaliação da procura pelos serviços de saúde e tratamento farmacológico de pacientes com anorexia e bulimia nervosa

2019 ◽  
Vol 8 (5) ◽  
Author(s):  
Fernando Yamamoto Chiba ◽  
Suzely Adas Saliba Moimaz ◽  
Artênio José Ísper Garbin ◽  
Cléa Adas Saliba Garbin
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
World Health Organization ◽  
Young Women ◽  
American Psychiatric Association ◽  
World Health ◽  
Health Organization ◽  
The Impact

Introdução: Os transtornos alimentares são caracterizados como distúrbios do comportamento alimentar, associados ao desequilíbrio nos pensamentos, ações e atitudes dos indivíduos resultando em prejuízos à saúde do indivíduo. Estas condições são cada vez mais comuns na sociedade atual e têm ganhado crescente atenção da comunidade científica. Objetivo: Analisar a procura pelo atendimento e farmacoterapia em mulheres com anorexia e bulimia nervosa atendidas em uma faculdade de medicina em 2018. Material e método: Realizou-se análise documental dos prontuários médicos. A procura pelo atendimento foi considerada não-espontânea quando a paciente foi encaminhada pela unidade de urgência/emergência ou compareceu acompanhada por responsável legal sem admitir necessidade de tratamento. Resultados: Identificou-se 14 pacientes, com idade média de 31,21 anos. 43% apresentaram procura não-espontânea pelo atendimento, sendo 83% destas encaminhadas por unidades de urgência/emergência. Foram prescritos 21 medicamentos diferentes, sendo a maioria antidepressivos. 52% dos fármacos prescritos não são disponibilizados pelo Sistema Único de Saúde. 29% dos pacientes apresentavam polifarmácia, 43% automedicação e 57% pensamento de morte. Houve associação entre o pensamento de morte e uso de 4 ou mais medicamentos. Conclusão: Uma parcela considerável das pacientes teve procura não-espontânea pelo atendimento. Os fármacos prescritos foram principalmente antidepressivos e a maioria não é disponibilizado no Sistema Único de Saúde, evidenciando a onerosidade econômica e social do tratamento.Descritores: Transtornos da Alimentação e da Ingestão de Alimentos; Anorexia; Bulimia; Tratamento Farmacológico.ReferênciasLe LK, Barendregt JJ, Hay P, Mihalopoulos C. Prevention of eating disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2017;53:46-58.Herpertz-Dahlmann B. Adolescent eating disorders: definitions, symptomatology, epidemiology and comorbidity. Child Adolesc Psychiatr Clin N Am. 2009;18(1):31-47.Zabala MJ, Macdonald P, Treasure J. Appraisal of caregiving burden, expressed emotion and psychological distress in families of people with eating disorders: a systematic review. Eur Eat Disord Rev. 2009;17(5):338-49.Sharan P, Sundar AS. Eating disorders in women. Indian J Psychiatry. 2015; 57(Suppl 2): S286–S295.Brandys MK, de Kovel CG, Kas MJ, van Elburg AA, Adan RA. Overview of genetic research in anorexia nervosa: The past, the present and the future. Int J Eat Disord. 2015;48(7):814-25.Mitchison D, Hay PJ. The epidemiology of eating disorders: genetic, environmental, and societal factors. Clin Epidemiol. 2014;6:89-97.American Psychiatric Association; 2013. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington.Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14(4):406-14.Geneva: World Health Organization; 1992. World Health Organization. The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines.Stewart TM, Williamson DA. Multidisciplinary treatment of eating disorders--Part 1: Structure and costs of treatment. Behav Modif. 2004;28(6):812-30.Donaldson AA, Hall A, Neukirch J, Kasper V, Simones S, Gagnon S, et al. Multidisciplinary care considerations for gender nonconforming adolescents with eating disorders: A case series. Int J Eat Disord. 2018;51(5):475-479.Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Política Nacional de Alimentação e Nutrição/Ministério da Saúde, Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Brasília: Ministério da Saúde, 2013. 84 p.Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. departamento de assistência farmacêutica e insumos estratégicos. Relação nacional de medicamentos essenciais: RENAME 2017. Brasília: Ministério da Saúde, 2017. 210 p.Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. J Abnorm Psychol. 2013;122(2):445-57.Lewinsohn PM, Striegel-Moore RH, Seeley JR. Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry. 2000;39(10):1284-92.van Son GE, van Hoeken D, Bartelds AI, van Furth EF, Hoek HW. Time trends in the incidence of eating disorders: a primary care study in the Netherlands. Int J Eat Disord. 2006;39(7):565-9.Hoek HW, van Hoeken D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord. 2003;34(4):383–96.Brand-Gothelf A, Leor S, Apter A, Fennig S. The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls. J Nerv Ment Dis. 2014;202(10):759-62.Bühren K, Schwarte R, Fluck F, Timmesfeld N, Krei M, Egberts K, et al. Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa. Eur Eat Disord Rev. 2014;22(1):39-44.Mizusaki K, Gih D, LaRosa C, Richmond R, Rienecke RD. Psychotropic usage by patients presenting to an academic eating disorders program. Eat Weight Disord. 2018 Jun 7. doi: 10.1007/s40519-018-0520-3. [Epub ahead of print]Fazeli PK, Calder GL, Miller KK, Misra M, Lawson EA, Meenaghan E, et al. Psychotropic medication use in anorexia nervosa between 1997 and 2009. Int J Eat Disord. 2012;45(8):970-6.Nascimento RCRM, Álvares J, Guerra Junior AA, Gomes IC, Costa EA, Leite SN et al. Availability of essential medicines in primary health care of the Brazilian Unified Health System. Rev. Saúde Pública. 2017;51(Suppl 2):10s.Fassino S, Abbate-Daga G. Resistance to treatment in eating disorders: a critical challenge. BMC Psychiatry. 2013;13:282.Becker AE, Fay KE, Agnew-Blais J, Khan AN, Striegel-Moore RH, Gilman SE. Social network media exposure and adolescent eating pathology in Fiji. Br J Psychiatry. 2011;198(1):43-50.Groesz LM, Levine MP, Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: a meta-analytic review. Int J Eat Disord. 2002;31(1):1-16.

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