Presentation
The authors present a case exhibiting transient eating disorder in early childhood, alongside discussion of some considerations relevant to this age group. The subject was a boy aged 5 years 6 months at first presentation. [ncbi.nlm.nih.gov]
Dunkel, Psychiatric manifestations as initial presentation for pediatric CNS germ cell tumors, a case series, Child's Nervous System, 32, 8, (1359), (2016). [doi.org]
Entire Body System
- Weight Loss
Frequent comments about feeling “fat” or overweight despite weight loss. Anxiety about gaining weight or being “fat.” Denial of hunger. [web.archive.org]
The patient's upper gastrointestinal symptoms and weight loss were found to be secondary to gastric outlet obstruction from a gastric adenocarcinoma. [ncbi.nlm.nih.gov]
WARNING SIGNS & SYMPTOMS OF ANOREXIA NERVOSA Emotional and behavioral Dramatic weight loss Dresses in layers to hide weight loss or stay warm Is preoccupied with weight, food, calories, fat grams, and dieting Refuses to eat certain foods, progressing [nationaleatingdisorders.org]
Results: The patient's upper gastrointestinal symptoms and weight loss were found to be secondary to gastric outlet obstruction from a gastric adenocarcinoma. [doi.org]
- Weight Gain
Results: A 42‐year‐old woman with a 27‐year history of AN had involuntary weight gain when she became hyperthyroid, but lost weight after treatment of the hyperthyroidism. [doi.org]
Using cognitive-behavioural therapy, clomipramine and enteral nutrition, weight gain and disappearance of restrictive and obsessive-compulsive behaviours were obtained. [ncbi.nlm.nih.gov]
If NS-RED occurs often enough, a person can experience weight gain and increase their risk of developing type 2 diabetes. [webmd.com]
- Weakness
Muscle loss and weakness. Severe dehydration, which can result in kidney failure. Fainting, fatigue, and overall weakness. Dry hair and skin; hair loss is common. [web.archive.org]
Anorexia can lead to health problems caused by undernutrition and low body weight, such as: low blood pressure slow or irregular heartbeats feeling tired, weak, dizzy, or faint constipation and bloating irregular periods weak bones delayed puberty and [kidshealth.org]
Low heart rate and blood pressure, which can change the heart muscle, risking heart failure Inadequate nutrition Loss of bone density Muscle loss Dry hair and skin; hair loss Severe dehydration which can lead to kidney problems Fainting and overall weakness [my.clevelandclinic.org]
- Anemia
Haematological disorders (anemia, thrombocytopenia, leukopenia) found on admission seem related to bone marrow hypoplasia and to gelatinous marrow transformation described in severe state of malnutrition. [ncbi.nlm.nih.gov]
However, “in more serious cases, a child may exhibit symptoms of hemolytic anemia.” [smartparenting.com.ph]
Hemolytic anemia induced by dapsone transmitted through breast milk. Annals of Internal Medicine. Apr 1982;96(4):465-466. 4. Youngster I, Arcavi L, Schechmaster R, et al. [infantrisk.com]
Other symptoms may develop over time: thinning of the bones brittle hair and nails dry and yellowish skin growth of fine hair over body mild anemia and muscle weakness and loss severe constipation low blood pressure, slowed breathing and pulse drop in [adaa.org]
- Fatigue
We report a case of ventricular fibrillation in a patient presenting with fatigue and a recent history of vomiting. [ncbi.nlm.nih.gov]
Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in. Withdrawal from usual friends and activities. [web.archive.org]
Levocarnitine administration in elderly subjects with rapid muscle fatigue: Effect on body composition, lipid profile and fatigue. Drugs Aging 2003 ; 20: 761 – 767. Google Scholar | Crossref | Medline | ISI [doi.org]
Resists or is unable to maintain a body weight appropriate for their age, height, and build Maintains an excessive, rigid exercise regime – despite weather, fatigue, illness, or injury Learn more about anorexia nervosa > BULIMIA NERVOSA Evidence of binge [nationaleatingdisorders.org]
Gastrointestinal
- Diarrhea
[…] friends, family, and daily activities Constant trips to the bathroom after eating Health consequences of bulimia include: Electrolyte imbalance which can lead to irregular heartbeat Tooth decay and staining from acid of vomit Frequent constipation or diarrhea [my.clevelandclinic.org]
Of course, some of these foods are quite healthy – once diarrhea has resolved, be sure to include them regularly. Another organ-specific side effect is kidney disease. [vasculitisfoundation.org]
[…] amounts of mouthwash, breath mints, or perfume to disguise the smell of vomiting Taking laxatives, diuretics, or enemas Periods of fasting or compulsive, intense exercising, especially after eating Frequent complaints of sore throat, upset stomach, diarrhea [helpguide.org]
Celiac disease patients may present with gastrointestinal symptoms such as diarrhea, steatorrhea, weight loss, vomiting, abdominal pain, anorexia, constipation, bloating, and distension due to malabsorption. [en.wikipedia.org]
[…] patients had an increased number of general practice consultations compared with controls in the five years prior to diagnosis and in particular, three clinical features were independently associated with subsequent diagnosis: depression and/or anxiety, diarrhea [doi.org]
- Failure to Thrive
“Failure to thrive” due to pontine glioma. Arch Neurol 1977 ; 34 : 295 –7. ↵ Rohmer A, Ebtinger R, Bronstein MJ. Fausse anorexie nerveux. Vrai tumeur du IV ventricle. Rev Neuropsychiatr Infant 1975 ; 23 : 191 –3. ↵ Levine R, Lipson S, Devinsky O. [doi.org]
Cardiovascular
- Acrocyanosis
These manifestations include xerosis, lanugo-like body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrheic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, generalized pruritus [ncbi.nlm.nih.gov]
- Palpitations
They also have palpitations, high body temperature and a tendency to get tired easily. On the other hand, hypothyroidism happens when the thyroid gland does not actively produce thyroid hormones to keep the body running normally. [pna.gov.ph]
[…] while it is reversible with treatment and refeeding, it is possible that it may cause permanent, microscopic changes to the heart muscle that increase the risk of sudden cardiac death.[127] Individuals with anorexia nervosa may experience chest pain or palpitations [en.wikipedia.org]
- Orthostatic Hypotension
Hypotension (low blood pressure) is common, and symptoms include fatigue and weakness. Orthostatic hypotension, a marked decrease in blood pressure when standing from a supine position, may also occur. [en.wikipedia.org]
- Hypotension
Hypotension (low blood pressure) is common, and symptoms include fatigue and weakness. Orthostatic hypotension, a marked decrease in blood pressure when standing from a supine position, may also occur. [en.wikipedia.org]
Musculoskeletal
- Osteoporosis
Osteoporosis has been reported in anorexia nervosa (AN), but not in other eating disorders. [ncbi.nlm.nih.gov]
Reduction of bone density (osteoporosis), which results in dry, brittle bones. Muscle loss and weakness. Severe dehydration, which can result in kidney failure. Fainting, fatigue, and overall weakness. Dry hair and skin; hair loss is common. [web.archive.org]
Skin
- Alopecia
PDDPC includes the psychophysiologic disorders such as atopic eczema, psoriasis, vitiligo, and alopecia areata. [link.springer.com]
- Hypertrichosis
Localized acquired hypertrichosis. AMA Arch Derm Syphilol 1952; 65 (4): 458–63 PubMed CrossRef Google Scholar 34. Tanaka OM, Vitral RW, Tanaka GY, et al. Nailbiting, or onychophagia: a special habit. [link.springer.com]
Psychiatrical
- Fear
KEYWORDS: Anorexia nervosa; Anxiety; Eating disorders; Fear of food [ncbi.nlm.nih.gov]
[…] of choking or vomiting No body image disturbance or fear of weight gain Learn more about ARFID > PICA The persistent eating, over a period of at least one month, of substances that are not food and do not provide nutritional value Typical substances [nationaleatingdisorders.org]
- Denial
Denial of hunger. Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate). Consistent excuses to avoid mealtimes or situations involving food. [web.archive.org]
Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. [nationaleatingdisorders.org]
This case was further complicated by the well-defined history of anorexia nervosa (binge-purge type), major depressive disorder, obsessive-compulsive disorder, migraine headache, and the initial denial of cannabis use. [ncbi.nlm.nih.gov]
- Anger
Other behaviors which occurred more specifically in bulimic women dealt with a projection of repressed anger toward male authority figures. [ncbi.nlm.nih.gov]
Craig Oolup, Jason Brown, Elizabeth Nowicki and Danielle Aziz, The Emotional Experience and Expression of Anger: Children’s Perspectives, Child and Adolescent Social Work Journal, 33, 3, (279), (2016). Sharon L. [doi.org]
[…] combines tools from CBT and acceptance commitment therapy (ACT) to help deal with feelings of depression, anger, stress, and anxiety. [healthline.com]
“If I had seen where it leads, that no matter what you’re going through and however you’re externalising your anger and your sadness, ultimately it becomes a question of ‘how do you want to live?’ [independent.co.uk]
- Behavior Disorder
Girls with eating disorders had significantly higher rates of major depression, anxiety disorders, and disruptive behavior disorder compared to ADHD girls without eating disorders. [ncbi.nlm.nih.gov]
- Abnormal Behavior
Most victims of an eating disorder do not recognize that they have a problem and they will refuse eating disorders treatment and attempt to hide their abnormal behavior from others. [healthyplace.com]
This explained the tense situation the patient had under certain circumstances, although, he had an abnormal behavior and mental state. [omicsonline.org]
Dohan FC, Levitt DR, Kushnir LD: Abnormal behavior after intracerebral injection of polypeptides from wheat gliadin: Possible relevance to schizophrenia. Pavlovian Journal of Biological Science 13:73–82, 1978 PubMed CrossRef Google Scholar 57. [doi.org]
Neurologic
- Hyperactivity
Childhood impulsivity, as opposed to hyperactivity or inattention, best predicted adolescent BN symptoms, particularly for girls. Among youth with ADHD, treatment received during the follow‐up period was not associated with BN pathology. [doi.org]
Behavioural difficulties including shyness, hyperactivity and emotional instability are present in almost 80% of the described patients with Lujan-Fryns syndrome but eating disorders have not been previously reported in this condition. [ncbi.nlm.nih.gov]
- Seizure
We therefore recommend performing a cranial MRI in all patients with suspected eating disorders, especially if they occur in combination with focal seizures. [doi.org]
A cavernoma, located on the frontal side of the right sylvian, was discovered by chance after a seizure. Surgical treatment of the lesion resulted in complete remission of the eating disorder at two years follow-up. [ncbi.nlm.nih.gov]
Severe dehydration and electrolyte imbalances can lead to seizures and muscle cramps. If the brain and blood vessels can’t push enough blood to the brain, it can cause fainting or dizziness, especially upon standing. [nationaleatingdisorders.org]
- Peripheral Neuropathy
Lower extremity pain secondary to tabes is described as shooting, in contrast to pain secondary to pain due to diabetic and other peripheral neuropathies, which is often described as burning (Swartz, 1990). [web.archive.org]
Urogenital
- Amenorrhea
CASE: a 20-year-old Caucasian woman presented with obsessive-compulsive disorder followed by altered eating habits with major weight loss and amenorrhea. The medical workup, treatment and outcome are described. [ncbi.nlm.nih.gov]
For women, the clearest sign that an eating disorder has grown severe is usually amenorrhea —a warning that a lack of fat has caused the body to stop producing estrogen. [outsideonline.com]
Most of patients with eating disorder NOS had subthreshold levels of anorexia, bulimia, or binge eating; they failed to meet the sustained amenorrhea criteria for anorexia or the frequency/duration criteria for bulimia or binge eating. [web.archive.org]
- Kidney Failure
Severe dehydration, which can result in kidney failure. Fainting, fatigue, and overall weakness. Dry hair and skin; hair loss is common. [web.archive.org]
[…] might not have kidney failure — many other things can cause them. [kidshealth.org]
Some of the major health risks resulting from eating disorders include: heart failure osteoporosis infertility kidney failure depressed immune system pneumonia liver disease exercise-related injuries such as stress fractures death We need to be aware [uhs.berkeley.edu]
Severe, prolonged dehydration can lead to kidney failure. Inadequate nutrition can decrease the number of certain types of blood cells. Anemia develops when there are too few red blood cells or too little iron in the diet. [nationaleatingdisorders.org]
Workup
The medical workup, treatment and outcome are described. Using cognitive-behavioural therapy, clomipramine and enteral nutrition, weight gain and disappearance of restrictive and obsessive-compulsive behaviours were obtained. [ncbi.nlm.nih.gov]
[…] reported in individuals with depression. 88, 89 Fatigue There is now good evidence to show not only that fatigue can be a symptom of CD, but also that it is a common clinical presentation. 90 – 93 Serological screening for CD is now recommended in the workup [doi.org]
The diagnostic workup typically includes complete medical and psychosocial history and follows a rational and formulaic approach to the diagnosis. [en.wikipedia.org]
Treatment
Treatment for binge eating Experts agree that binge eating treatment must tackle the obesity that comes with binge eating and the psychological problems that underlie the disorder. But they’re still debating which aspect to treat first. [apa.org]
Self‐help treatments can be used as a "stand‐alone" treatment or in conjunction with other treatments (both psychological and pharmacological). [doi.org]
Family treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa. [ncbi.nlm.nih.gov]
Treatments and Therapies Adequate nutrition, reducing excessive exercise, and stopping purging behaviors are the foundations of treatment. [nimh.nih.gov]
Prognosis
On the other hand, a prognosis concerning human problems may influence the further course considerably. A pessimistic prognosis for a line of business may start a negative trend.” [doi.org]
Abstract Eating disorders are potentially life threatening and have not lost their relatively poor prognosis in the last decades. [ncbi.nlm.nih.gov]
Etiology
These distinctions may be relevant to etiology, prognosis, and treatment. [ncbi.nlm.nih.gov]
Epidemiology
To explore how genetic epidemiology has informed the identification of endophenotypes and how endophenotypes may inform future classification of eating disorders. Literature review and synthesis. [ncbi.nlm.nih.gov]
The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 1627 – 1637. Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C. & Eaves, L. J. ( 1992 ). [doi.org]
Pathophysiology
Further studies are necessary to provide more insight into the epigenetic dysregulation of the dopaminergic neurotransmission in the pathophysiology of eating disorders. [ncbi.nlm.nih.gov]
Prevention
[…] of high-risk groups and prevention (n = 21). [ncbi.nlm.nih.gov]
In the present study exposure plus response prevention was used in the context of a 6-wk., 12-session behavioral group. [doi.org]