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Eating Disorder

Dermatophagia


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]
  • Serious organic symptoms and nutritional effects can mimic a systemic illness, particularly in those with atypical presentations. A 15-y-old adolescent male presented with poor growth, low weight, abdominal pain and yellow pigmentation.[ncbi.nlm.nih.gov]
  • Colorectal carcinoma commonly presents with non-specific gastrointestinal symptoms in conjunction with iron deficiency anaemia. Many of these symptoms can mimic eating disorders, which are common in adolescent women.[ncbi.nlm.nih.gov]
  • To date however, the research presents strikingly inconsistent findings, thus complicating our understanding of eating disorder and anxiety co-morbidity.[ncbi.nlm.nih.gov]
  • The clinical presentation may be different, depending on the location of the lesion and age of the patient.[ncbi.nlm.nih.gov]
Anorexia
  • About Anorexia Nervosa Approximately 90-95% of anorexia nervosa sufferers are girls and women. Between 0.5–1% of American women suffer from anorexia nervosa. Anorexia nervosa is one of the most common psychiatric diagnoses in young women.[web.archive.org]
  • Research studies have not found a difference in the medical and psychological impacts of anorexia and atypical anorexia.[nationaleatingdisorders.org]
  • […] and two as typical anorexia nervosa.[doi.org]
  • Neziroglu, The integration of primary anorexia nervosa and obsessive-compulsive disorder, Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 6, 4, (174), (2001).[doi.org]
  • Suicide is a common cause of death in anorexia nervosa and suicide attempts occur often in both anorexia nervosa and bulimia nervosa.[ncbi.nlm.nih.gov]
Weight Loss
  • Abstract The association of weight loss and pediatric brain tumors that affect the diencephalon or brain stem with weight loss is a recognized, but not fully understood phenomenon.[ncbi.nlm.nih.gov]
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.[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: On average, the typical misdiagnosed case was an 18-year-old female with an average weight loss of 16.2 kg.[ncbi.nlm.nih.gov]
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]
  • 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]
  • […] enamel erosion, cavities, and tooth sensitivity Dry skin Dry and brittle nails Swelling around area of salivary glands Fine hair on body (lanugo) Thinning of hair on head, dry and brittle hair Cavities, or discoloration of teeth, from vomiting Muscle weakness[nationaleatingdisorders.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]
  • Fainting, fatigue, and overall weakness. Dry hair and skin; hair loss is common. Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.[web.archive.org]
  • […] rearranging food on a plate) Cooks meals for others without eating Consistently makes excuses to avoid mealtimes or situations involving food Expresses a need to “burn off” calories taken in Maintains an excessive, rigid exercise regimen – despite weather, fatigue[nationaleatingdisorders.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]
Bulimia
  • Both anorexia nervosa and bulimia nervosa are associated with increased mortality. Data on long-term outcome, including mortality, are limited for BED.[ncbi.nlm.nih.gov]
  • For bulimia nervosa, a history of drug use disorder at intake and the use of laxatives during the study significantly predicted suicide attempts. Women with anorexia nervosa or bulimia nervosa are at considerable risk to attempt suicide.[ncbi.nlm.nih.gov]
  • .: Comorbidity of bulimia nervosa and personality disorder. J. Clin. Psychiatry, 50, 57–59, 1989. PubMed Google Scholar 7. Löwenkopf E.I.: Bulimia: Concept and theory. Compr. Psychiatry, 24, 546–554, 1983. Google Scholar 8.[doi.org]
  • There are three main types of eating disorders, anorexia nervosa, bulimia nervosa , and binge eating disorder.[web.archive.org]
Constipation
  • Makes frequent comments about feeling “fat” or overweight despite weight loss Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy Denies feeling hungry Develops food rituals (e.g., eating foods in certain orders[nationaleatingdisorders.org]
  • Chronic irregular bowel movements and constipation as a result of laxative abuse. Peptic ulcers and pancreatitis.[web.archive.org]
  • Menstrual periods cease • Osteopenia or osteoporosis (thinning of the bones) through loss of calcium • Hair/nails become brittle • Skin dries and can take on a yellowish cast • Mild anemia and muscles, including the heart muscle, waste away • Severe constipation[web.archive.org]
  • Withdrawal from 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[my.clevelandclinic.org]
  • […] and the digestion of nutrients, which can lead to: Stomach pain and bloating Nausea and vomiting Blood sugar fluctuations Blocked intestines from solid masses of undigested food Bacterial infections Feeling full after eating only small amounts of food Constipation[nationaleatingdisorders.org]
Hirsutism
  • We found increased occurrence of menstrual disturbances, hirsutism and PCOS in bulimic women, whereas ovarian variables and acne did not differ from controls.[doi.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]

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]
  • The diagnostic workup typically includes complete medical and psychosocial history and follows a rational and formulaic approach to the diagnosis.[en.wikipedia.org]
  • […] 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]

Treatment

  • Family treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa.[ncbi.nlm.nih.gov]
  • PURPOSE: To investigate whether recovery from an eating disorder is related to pre-treatment attachment and mentalization and/or to improvement of attachment and mentalization during treatment.[ncbi.nlm.nih.gov]
  • Studies comparing PSH with GSH found no significant differences between treatment groups at end of treatment or follow-up.[ncbi.nlm.nih.gov]
  • […] other eating disorders during assessment and treatment across the continuum of care.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract Eating disorders are potentially life threatening and have not lost their relatively poor prognosis in the last decades.[ncbi.nlm.nih.gov]
  • Abstract Colorectal carcinoma in the population aged less than 20 years of age is rare but associated with poor prognosis, which is attributable to advanced disease at presentation and higher incidence of the unfavourable mucinous histology.[ncbi.nlm.nih.gov]
  • These distinctions may be relevant to etiology, prognosis, and treatment.[ncbi.nlm.nih.gov]
  • The analysis of leptin values may be a useful index of assessing the adipose tissue stores in the clinical setting, but will be of no help for diagnosis nor prognosis of severe eating disorders.[ncbi.nlm.nih.gov]
  • 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]

Etiology

  • These distinctions may be relevant to etiology, prognosis, and treatment.[ncbi.nlm.nih.gov]
  • Diagnosis and etiology of the condition are discussed and a comprehensive list of treatment options is evaluated.[ncbi.nlm.nih.gov]
  • Alterations of these peptides are unlikely to be trait-related disturbances that contribute to the etiology of eating disorders.[ncbi.nlm.nih.gov]
  • Despite the fact that a huge body of research has carefully examined the possible risk factors associated with the eating disorders, they have failed not only to uncover the exact etiology of eating disorders, but also to understand the interaction between[ncbi.nlm.nih.gov]
  • In this case report, we describe an uncommon etiology of hypokalemia in a patient with disordered eating. Copyright  2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]

Epidemiology

  • 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]
  • 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]
  • To review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).[ncbi.nlm.nih.gov]
  • Psychiatry. 26(6):543–548, NOV 2013 DOI: 10.1097/YCO.0b013e328365a24f, PMID: 24060914 Issn Print: 0951-7367 Publication Date: 2013/11/01 Checking for direct PDF access through Ovid Abstract Purpose of review To review the recent literature about the epidemiology[doi.org]
  • Mitchell, Alex Keywords: Bulimia Anorexia Meta-analysis Ballet Eating disorders Epidemiology Review Dance EDNOS Issue Date: 2014 Publisher: John Wiley and Sons Ltd and Eating Disorders Association Citation: ARCELUS, J., WITCOMB, G.L. and MITCHELL, A.,[dspace.lboro.ac.uk]
Sex distribution
Age distribution

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]
  • This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.[ncbi.nlm.nih.gov]
  • These findings add further evidence to the hypothesis that homocysteine might be involved in the pathophysiology of anorexia and bulimia nervosa.[ncbi.nlm.nih.gov]
  • […] spectrum of depressive disorders from no depression to severe depression, with somewhat higher rates of depression in bulimic anorectic and bulimia nervosa patients than in restricting anorexia nervosa patients, but the model would admit a specific pathophysiology[ncbi.nlm.nih.gov]
  • The signs, symptoms and pathophysiological mechanisms of CHS are reviewed in light of clinical presentations that mimic eating disorder phenomenology complicated by addiction.[ncbi.nlm.nih.gov]

Prevention

  • RESULTS: Improvements of treatment utilization and the reach of prevention programs would have the largest effects on the population's disease burden. Improving the efficacy of treatment, prevention, and aftercare show only limited effects.[ncbi.nlm.nih.gov]
  • […] high-risk groups and prevention (n 21).[ncbi.nlm.nih.gov]
  • Patients must also follow rigorous therapeutic dietary modifications to prevent the buildup of urea and harmful waste products between treatments.[ncbi.nlm.nih.gov]
  • Abstract Eating disorder prevention programs have been assessed up to 3 years post-implementation; however, their impact on long-term resilience is unclear.[ncbi.nlm.nih.gov]
  • OBJECTIVE: Examine the impact of age on baseline eating disorder symptoms/risk factors and on the effects of completing three variants of an eating disorder prevention program.[ncbi.nlm.nih.gov]

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