Eating Disorders
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Eating Disorders
NIH - Medical Encyclopedia Anorexia nervosa
"Anorexia nervosa is an eating disorder characterized by refusal to stay at even the minimum body weight considered normal for the person's age and height. Other symptoms of the disorder include an intense fear of weight gain and distorted body image. Inadequate eating or excessive exercising results in severe weight loss (see also bulimia and intentional weight loss). The exact cause of anorexia nervosa is not known, but social attitudes towards body appearance, as well as family factors, are believed to play a role in its development. The condition usually occurs in adolescence or young adulthood. It is more common in women, affecting 1-2% of the female population and only 0.1-0.2% of males.
Symptoms
Weight loss of 15% or greater below the expected weight Inappropriate use of laxatives, enemas, or diuretics (water pills) in an effort to lose weight Self-imposed food intake restrictions, often hidden Absence of menstruation Skeletal muscle atrophy Loss of fatty tissue Low blood pressure Dental cavities may be present with self-induced vomiting Blotchy or yellow skin Depression may be present in addition to the eating disorder Most individuals with anorexia nervosa refuse to recognize that they have an eating disorder (denial).
Anorexia nervosa is a serious and potentially deadly medical condition. By some estimates, it leads to death in 10% of cases. Experienced treatment programs have a two-thirds success rate in restoring normal weight, but relapse is common. Women who develop this eating disorder at an early age have a better chance of complete recovery. Most people with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent, however. Weight management may be difficult, and long-term treatment may be necessary to help maintain a healthy body weight. "
Highlighted Article
Outcomes of eating disorders: A systematic review of the literature. (Int J Eat Disord. 2007)
"... reviewed evidence on factors associated with outcomes among individuals with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) RESULTS: At follow up, individuals with AN were more likely than comparisons to be depressed, have Asperger's syndrome and autism spectrum disorders, and suffer from anxiety disorders including obsessive-compulsive disorders. Mortality risk was significantly higher than what would be expected in the population and the risk of suicide was particularly pronounced. The only consistent factor across studies relating to worse BN outcomes was depression."
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Eating Disorders
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Psychological treatments for bulimia nervosa and binging. (Cochrane Database Syst Rev. 2009)
A few months of talk therapy treats bulimia A specific form of talk therapy may help people with binge-type eating disorders stop their unhealthy behaviors with just a few months of treatment, research suggests. A multi-study review of psychological therapies for bulimia nervosa showed that bulimia-specific talk therapy, also called cognitive behavior therapy (CBT), compared with no treatment, led to cessation of binge eating in about 37 percent of those treated, Dr. Phillipa P. J. Hay, at the University of Western Sydney in Australia, and colleagues found. Bulimia-specific CBT "takes around 4 to 5 months," Hay noted in an email to Reuters Health, adding that other psychotherapies take longer -- about a year -- to reach similar levels of efficacy.
Psychological treatments for bulimia nervosa and binging. (Cochrane Database Syst Rev. 2009)
Are Eating Disorder Prevention Programs Effective (J Athl Train. 2009)
Device Therapy
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Drugs
Exercise
General Information
Pain severity in eating disorders predicts longer inpatient hospitalization. (Int J Eat Disord. 2009)
Guidelines
Immunotherapy
Internet Sites
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Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Milkshakes are medicine for anorexic teens in family-based outpatient therapy Getting your teenager to drink a chocolate milkshake isn't something most parents need to worry about. But this is just the approach used in one treatment for anorexia nervosa. Known as Behavioral Family Therapy, or the Maudsley Approach, parents are called up on to supervise the eating habits of their anorexic child, feeding them high-calorie meals like milkshakes and macaroni and cheese until they regain a healthy weight. For the first time, the Maudsley Approach is being compared with a more established treatment known as Family Systems Therapy as part of an ongoing National Institutes of Health (NIH)-funded treatment study at NewYork-Presbyterian Hospital/Westchester Division and five other centers nationally. Both are outpatient therapies for adolescents, aged 12 to 18. "Anorexia is a life-threatening condition. Treating it early is very important since it is during the teenage years that this disorder usually takes hold," says Dr. Katherine Halmi, founder of the Eating Disorders Program at NewYork-Presbyterian Hospital/Westchester Division and professor of psychiatry at Weill Cornell Medical College. "Traditionally, patients with anorexia have been treated in a hospital setting or through one-on-one outpatient therapy. While inpatient treatment is still appropriate in acute cases, we have increasingly seen the value of family-oriented outpatient therapy for adolescents."
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