Showing posts with label Nervosa. Show all posts
Showing posts with label Nervosa. Show all posts

Bulimia Nervosa

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What is ?Statistics on Risk Factors for Progression of How is Diagnosed?Prognosis of How is Treated? ReferencesDrugs/Products Associated with What is ?

is a psychological disease. is characterised by the episodic, uncontrolled and impulsive binge eating followed by self-induced vomiting or consumption of laxatives or purgatives to avoid the weight gain associated with such behaviour.

Statistics on

is more common in women than in men. Bulimia generally starts at about 16 to 18 years of age. Any given woman has a 1-4% chance of developing this condition throughout her lifetime.

Bulimia is often found in association with other eating disorders such as anorexia nervosa.

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Risk Factors for

There are few predisposing factors for the development of this eating disorder. The main risk factor of bulimia is a family history of psychiatric illness or a co-existing psychiatric problem. If another close family member has suffered from depression or eating disorder in the past, the risk of developing bulimia is increased.

If the patient has suffered or is suffering from depression, they are also more likely to develop an eating disorder. Whether this trend represents a genetic or environmental link is not entirely known.

Progression of

Excessive dieting by bulimia patients commonly have a history which progresses to bulimia-type behaviour (induced vomiting) with repeating diet failure. The patient will regularly engage in eating binges followed by the bulimia behaviours of vomiting and use of purgatives/laxatives to avoid the calorie content of the food.

Excessive vomiting and laxative induced diarrhoea may result in an electrolyte imbalance which could be potentially life-threatening if left untreated. Binge eating disorder is bulimia without the vomiting and other weight-reducing strategies.

How is Diagnosed?

Without the occurrence of complications, investigations such as blood tests are not warranted for this bulimia.

Unless sufferers come forward with their condition it can be hard for even the closest of friends and family to see any signs completely out of the ordinary.

Prognosis of

Prognosis for is better than for anorexia nervosa. With treatment for bulimia, approximately 60% of patients will recover.

How is Treated?

There is usually no requirement for hospital admission for bulimia illness sufferers, unless the patient is suffering from an electrolyte disturbance that can be induced by long-term vomiting and diarrhoea. It must be stressed that the electrolyte complications of bulimia can be life-threatening.

Bulimia treatment tends to focus on breaking the binge-purge cycles.

Patients will benefit most from psychotherapy in a number of settings. Individual and group psychotherapy have been proven to imporve the outcome of patients with . The use of anti-depressants such as fluoxetine, in combination with psychotherapy increases the overall outcome of this eating disorder.


More information

Nutrition For more information on nutrition, including information on types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition. 

Psychology and psychotherapy For more information on psychology and psychotherapy, including different types of therapy, see Psychology and Psychotherapy.

References

American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th ed. American Psychiatric Press, Inc; 1994. eMedicineKumar P, Clark M. Clinical Medicine. Fourth Ed. WB Saunders, 2002. Sadock BJ., Sadock VA. Kaplan and Sadock's Pocket Handbook of Clinical Psychiatry 3rd Edition. Lippincott Williams and Wilkins 1996.

Symptoms of This Disease:ImpulsivityTreatments Used in This Disease:Individual TherapyParent Training / Parent TherapyDrugs/Products Used in the Treatment of This Disease:Fluoxetine-BC (Fluoxetine hydrochloride)Nardil (Phenelzine sulfate)Prozac (Fluoxetine hydrochloride)Tofranil (Imipramine hydrochloride)
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Anorexia Nervosa (Self-Starvation, Malnutrition, Severe Weight Loss, Extreme Weight Loss)

">Anorexia Nervosa (Self-Starvation, Malnutriti...
What is Anorexia Nervosa?Statistics on Anorexia NervosaRisk Factors for Anorexia NervosaProgression of Anorexia NervosaHow is Anorexia Nervosa Diagnosed?Prognosis of Anorexia NervosaHow is Anorexia Nervosa Treated?Anorexia Nervosa ReferencesWhat is Anorexia Nervosa?

Anorexia nervosaAnorexia nervosa is a psychological disease.

This condition is hallmarked by an extreme reluctance to consume food as a result of a psychological disturbed body image. This may lead to extreme malnutrition and weight loss. Anorexia nervosa is potentially life-threatening.

Statistics on Anorexia Nervosa

The incidence of anorexia nervosa is 1-10 per 100,000 females aged between 15 and 34 years. There is a prevalence rate of 1-2% among schoolgirls and university students. Anorexia nervosa is much less common among men with a 1:10 ratio of boys:girls.

The onset of anorexia nervosa disease usually occurs between the ages of 10 and 30 years, initiated by a stressful life event. Anorexia nervosa occurs mostly in those individuals striving for success in industries that demand a slim body image such as modelling and dancing. There is also a higher prevalence of anorexia nervosa in higher social classes.

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Risk Factors for Anorexia Nervosa

Several theories have been put forward to explain the origin of anorexia nervosa, but none have stood the test of time.

The following are important important associations of anorexia nervosa:

Stressful life events: The condition most commonly follows a stressful situation or event in the patient's life. Genetic: There is a higher rate of anorexia nervosa in those with a family history of this anorexia. An increased occurrence has beenshown to exist in full-blood sisters.Turbulent family relationships: Overprotective parents, and a pattern of conflict avoidance is shown to increase the risk of developing anorexia in children. Children are thought to use anorexia nervosa as a kind of hunger strike. The child then gains power in the family dynamic for it is the child who recieves the attention and decides the outcome of a family dilemma.

Progression of Anorexia Nervosa

The age of onset of anorexia in women is usually between 10 and 30 years of age, seldom occurring after the age of 30 years.

The onset of anorexia nervosa usually goes unnoticed until a significant amount of weight has been lost. Weight loss is achieve with severe diet restriction and excessive amounts of exercise. Weight loss may be also occur with self-stimulation of vomiting and excessive use of laxatives. With further weight loss, a woman's period may cease, and the patient may develop low blood pressure, slow heart rate, and become very sensitive to the cold. Throughout any stage of the disease, the patient may exhibit psychological symptoms of depression and anxiety, related to their distorted body image of being "fat."

How is Anorexia Nervosa Diagnosed?

Fecal occult blood may be indicative of esophagitis, gastritis, or repetitive colonic trauma from laxative abuse as well as a bleeding disorder or severe protein malnutrition.

Prognosis of Anorexia Nervosa

Anorexia nervosaAnorexia nervosa runs a fluctuating course, with exacerbations and partial remissions. Long-term follow up suggests that about two-thirds of patients maintain normal weight and that the remaining one-third are split between those who are moderately underweight and those who are seriously underweight.

Indicators of a poor anorexia nervosa outcome include:

A long initial illness; Severe weight loss; Older age at onset; Bulimia, vomiting or purging; Personality difficulties; and Difficulties in relationships.


Suicide has been reported in 2-5% of patients with chronic anorexia nervosa. The mortality rate per year is 0.5% from all causes. More than one-third have recurrent affective illness, and various family, genetic and endocrine studies have found associations between eating disorders and depression.

50% of patients make a full recovery, 30% a partial recovery and 20% none.

How is Anorexia Nervosa Treated?

Anorexia nervosaAnorexia nervosa treatment can be conducted on an outpatient basis unless the weight loss is severe and accompanied by marked physical symptoms such as dizziness, weakness and/or electrolyte and vitamin disturbances. Hospital admission may then be unavoidable and may need to be on a medical ward initially. Rarely the patient's weight loss may be so severe as to be life-threatening. If the patient cannot be persuaded to enter hospital, compulsary admission may have to be used.

Inpatient treatment goals include:

Establishing a good relationship with the patient; Restoring the weight to a level between the ideal bodyweight and the patient's ideal weight; The provision of a balanced diet, building up to 12.6MJ (3000 calories) in 3 to 4 meals per day; The elimination of purgaitve and/or laxative use and vomiting.


Outpatient treatment can be conducted on either or both of cognitive behavioural psychotherapeutic lines or dynamic psychotherapeutive lines. It is vital to set up a therapeutic alliance. Individual psychotherapy is better than family therapy if the patient has left home and vice versa.

Motivational enhancement techniques have been used with some success.

Drug treatment has met with limited success, except to symptomatically treat insomnia and depressive illness.


Article kindly reviewed by:

The DAA WA Oncology Interest Group
and
Food4Health (Helen Baker Dietitian-APD)


More informationNutrition
For more information on nutrition, including information on types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition. Psychology and psychotherapy 
For more information on psychology and psychotherapy, including different types of therapy, see Psychology and Psychotherapy.

 

Anorexia Nervosa References

Bochereau D, Clervoy P, Corcos M, Girardon N. Eating disorders: Anorexia nervosa in adolescents [in French]. Presse Med. 1999;28(2):89-99. [Abstract]Deep AL, Nagy LM, Weltzin TE, et al. Premorbid onset of psychopathology in long-term recovered anorexia nervosa. Int J Eat Disord. 1995;17(3):291-7. [Abstract]Kumar P, Clark M (eds). Clinical Medicine (5th edition). Edinburgh: WB Saunders Company; 2002. [Book]Cushing TA, Waldrop RD. Anorexia nervosa [online]. Omaha, NE: eMedicine; 2003 [cited 8 July 2003]. Available from: URL link

Symptoms of This Disease:ImpulsivityTreatments Used in This Disease:Individual TherapyParent Training / Parent Therapy
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Article Dates: calendar icon Modified: 17/2/2011calendar icon Reviewed: 4/12/2006 calendar icon Created: 8/7/2003 List Diseases by Medical Area All Diseases Men's Health Diseases Women's Health Diseases Children's Health Diseases Allergy Diseases Blood Diseases Bone Diseases Brain Diseases Cancer Diseases Dental Diseases Eye Diseases Fitness Diseases Gastro Diseases Heart Diseases Hormone Diseases Infection Diseases Joints Diseases Kidney Diseases Lungs Diseases Mental Health Diseases Pain Diseases Pregnancy Diseases Skin Diseases Weight Loss Diseases Medical advertising
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Resend Activation Email -Forgot your Password?Today's medical surveyTrauma

Have you ever suffered second-hand trauma, for example after watching a disaster on TV/internet/or a loved one going through it?

  Yes, I sought help from a counsellor/other professional

  Yes, I talked through it with loved ones

  Yes, but I was too embarrassed to talk about it

  No

  Other (please comment)

Comment:

What is 2 + 2 =

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if you want advice please see your treating physician.

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