Anorexia: Anormal Phobia of Normal Weight

AbstractAnorexia nervosa is a disorder of feeding behavior associated with distortion of body image, mood disturbance and a wide variety of hormonal and metabolic abnormalities. It is supposed that the disease could be the consequence of a combination of cultural-social, psychological and biological factors.Our study confirmed that anorexia mentalis is a serious, life threatening disorder which in our country appears earlier than it was expected and that is strongly related to environmental factors (family, school, fashion, society).We showed that specific personality traits are characteristic for both, young patients and mothers. Sublimation of emotional stress by exceptional performances, accompanied by food restrictive consumption together with hypersensitivity, oppositional behavior and aggression are specific for this disorder. High levels of self-imposed standards increase the risk for psychological distress, especially for eating disorder symptomatology.Both genders could be involved as patients. Boys must be especially followed for possible psychiatric manifestation.We confirmed that the biofeedback as additional therapeutic modality is very useful.

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The Impact of Social, Psychological, and Biological Factors on Adolescent Body Dissatisfaction

PsycEXTRA Dataset ◽

10.1037/e401002005-003 ◽

2005 ◽

Author(s):

D. C. Jones

Keyword(s):

Body Dissatisfaction ◽

Biological Factors ◽

Social Psychological ◽

The Impact

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Overcoming limitations of self-report: an assessment of fear of weight gain in anorexia nervosa and healthy controls using implicit association tests

Journal of Eating Disorders ◽

10.1186/s40337-021-00379-8 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Tiana Borgers ◽

Nathalie Krüger ◽

Silja Vocks ◽

Jennifer J. Thomas ◽

Franziska Plessow ◽

...

Keyword(s):

Anorexia Nervosa ◽

Weight Gain ◽

Normal Weight ◽

Self Report ◽

Healthy Controls ◽

Drive For Thinness ◽

Implicit Association ◽

Association Tests ◽

Implicit Assessment ◽

Fear Of Weight Gain

Abstract Background Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report. Methods We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups. Results Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs. Conclusion The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.

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Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

Acta Médica Portuguesa ◽

10.20344/amp.8963 ◽

2017 ◽

Vol 30 (7-8) ◽

pp. 517

Author(s):

Rodrigo Andrade ◽

Manuel Gonçalves-Pinho ◽

António Roma-Torres ◽

Isabel Brandão

Keyword(s):

Anorexia Nervosa ◽

Dropout Rate ◽

University Hospital ◽

High Rate ◽

Prognostic Features ◽

Illness Duration ◽

Intense Fear ◽

Life Threatening ◽

Fear Of Weight Gain ◽

The Impact

Introduction: Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome.Material and Methods: The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years.Results: From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration groups (p = 0.007).Discussion: There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcome findings was limited by the high rate of dropout and lack of consistent definition criteria.Conclusion: Our results support the idea that illness duration has an important role on the outcome and prognostic features of these patients.

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Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine

Case Reports in Endocrinology ◽

10.1155/2018/8214169 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Kaitlyn Vennard ◽

Matthew P. Gilbert

Keyword(s):

Heart Block ◽

Radioactive Iodine ◽

Radioiodine Therapy ◽

Complete Heart Block ◽

Multiple Organ ◽

Thyroid Storm ◽

Metabolic Abnormalities ◽

Organ Systems ◽

Life Threatening ◽

Life Threatening Complication

Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves’ disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism.

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Setting the scene for eating disorders: childhood care, classification and course of illness

Psychological Medicine ◽

10.1017/s0033291700025447 ◽

1993 ◽

Vol 23 (3) ◽

pp. 663-672 ◽

Cited By ~ 49

Author(s):

Ulrike Schmidt ◽

Jane Tiller ◽

Janet Treasure

Keyword(s):

Anorexia Nervosa ◽

Bulimia Nervosa ◽

Family Environment ◽

Parental Control ◽

Childhood Adversity ◽

Normal Weight ◽

Semistructured Interview ◽

Childhood Experiences ◽

Course Of Illness ◽

Childhood Care

SynopsisThe aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN).There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.

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The Social Psychology of the Epileptic Child, by Christopher Bagley. Coral Gables, Florida: The University of Miami Press, 1971, 307 pp., $12.00

PEDIATRICS ◽

10.1542/peds.50.4.676 ◽

1972 ◽

Vol 50 (4) ◽

pp. 676-676

Author(s):

Sheila J. Wallace

Keyword(s):

Social Psychology ◽

Empirical Study ◽

Behavior Disorder ◽

Biological Factors ◽

Social Psychological ◽

Epileptic Child ◽

The Social ◽

Epileptic Children ◽

University Of Miami ◽

The University

The author, a sociologist, describes his monograph as an "empirical study of the interaction of social, psychological and biological factors leading to behavior disorder in epileptic children." The first part of the book consists of a brief introduction to the problems it was felt relevant to investigate and to the sources of patients and of information received about them. A second section is devoted to an examination of the literature. This is comprehensive and well-argued.

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Anorexia nervosa and the gastrointestinal tract

Frontline Gastroenterology ◽

10.1136/flgastro-2021-101857 ◽

2021 ◽

pp. flgastro-2021-101857

Author(s):

Wisam Jafar ◽

James Morgan

Keyword(s):

Anorexia Nervosa ◽

Healthcare Professionals ◽

Signs And Symptoms ◽

Nutritional Therapy ◽

Nutrition Support ◽

Multidisciplinary Teams ◽

High Morbidity ◽

Support Teams ◽

Life Threatening ◽

Acute Admissions

Anorexia nervosa (AN) is a complex eating disorder associated with a high morbidity and mortality, however, there is a lack of dedicated training for healthcare professionals outside of mental health specialities. There has been a reported increase in acute admissions of patients with AN, which may have been precipitated by the isolation and loss of support networks created by the COVID-19 pandemic. The purpose of this review is to highlight that AN can present with a wide variety of signs and symptoms relating to both the hollow and solid organs of the gastrointestinal (GI) tract some of which may even be life threatening. The overlap of symptoms with several other functional and organic GI diseases makes diagnosis challenging. Gastroenterologists and allied healthcare professionals need to be aware of the wide array of possible GI manifestations not only to help rationalise investigations but to also facilitate early involvement of the relevant multidisciplinary teams. Many of the GI manifestations of AN can be reversed with careful nutritional therapy under the guidance of nutrition support teams.

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Abstract 096: Association of Body Mass Index With Bleeding in Patients Taking Warfarin for Atrial Fibrillation or Venous Thromboembolism

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.096 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Kyle Stahlbaum ◽

Eva Kline-Rogers ◽

Xiaowen Kong ◽

Geoffrey D Barnes ◽

Brian Haymart ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Quality Improvement ◽

Venous Thromboembolism ◽

Body Mass ◽

Normal Weight ◽

Risk Scores ◽

Quality Improvement Initiative ◽

Minor Bleeding ◽

Life Threatening

Background: Most patients taking warfarin for atrial fibrillation (AF) and venous thromboembolism (VTE) have a target International Normalized Ratio (INR) between 2-3 to reduce risk of bleeding and thromboembolic events. Body Mass Index (BMI) is not included in traditional bleed risk scores, but may be an indicator of bleeding risk in warfarin patients. Methods: Using data from the multi-site Michigan Anticoagulation Quality Improvement Initiative (MAQI 2 ) Registry, we identified all AF/VTE patients , separated them into three cohorts: BMI < 20 (underweight), BMI 20-25 (normal weight) and BMI >25 (overweight). Bleeding events in these cohorts were identified and stratified into severity according to International Society of Thrombosis and Hemostasis criteria. Results: Of 6,054 patients, 4,766 (78.7%) had a BMI of > 25. These patients were generally younger, with higher prevalence of hypertension. The HAS-BLED scores were slightly lower in overweight AF patients (2.6 vs 2.8; p=0.04); otherwise no difference between groups. The overall minor, major, and life threatening bleeding rates were 22.8/27.7; 4.3/3.7; and 1.2/0.7 (per 100 patient years) in AF and VTE patients, respectively. A higher proportion of females were underweight for both indications, and AF patients were older. More underweight and normal weight AF and VTE patients had a bleeding history compared to overweight patients. Bleeding outcomes are listed in Table. Comparisons were made with Poisson regression analysis. Conclusion: In a large, unselected cohort of warfarin treated patient from a multi-site registry, minor bleeding was more common in underweight and normal weight AF patients; major and life-threatening bleeding was more common in underweight and normal weight VTE patients. Since the majority of patients were overweight, further studies are needed to determine if reasons for bleeding differ between patients based on BMI in order to guide quality improvement efforts.

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