Eating disorders Anorexia nervosa Bulimia

Bupropion has also been used to treat the eating disorders anorexia nervosa and bulimia nervosa. Unfortunately, their electrolyte abnormalities leave patients with eating disorders especially vulnerable to seizures therefore, bupropion is no longer used to treat them. 

There are several types of disorders that, although they are encountered less often in clinical practice, we have chosen to discuss in this chapter. Compared to disorders discussed in earlier chapters, their biological basis is less well understood at this time, and the role of medications may be less clear. These disorders are Touiette s syndrome, eating disorders (anorexia and bulimia nervosa), attention deficit disorder (ADD), self-mutilation, sleep disorders, obesity, aggression, and chronic pain. 

Millions of people in the United States are affected by eating disorders. More than 90% of those afflicted are adolescents or young adult women. Although all eating disorders share some common manifestations, anorexia nervosa, bulimia nervosa, and binge eating each have distinctive symptoms and risks. 

Characteristic Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder... 

Ferron, E, Considine, R.V., Peino, R., Lado, I.E., Dieguez, C., and Casanueva, F.R (1997). Serum leptin concentrations in patients with anorexia nervosa, bulimia nervosa and non-specific eating disorders correlate with body mass index but are independent of the respective disease. Clin Endocrinol 46 289-293. 

Three types of eating disorders are included in the ICD-10 anorexia nervosa, bulimia nervosa, and overeating. 

Health, N. C. C. f. M. (2003). Eating Disorders Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. London, UK, British Psychological Society. 

Flier JS, Foster DW. Eating disorders Obesity, anorexia nervosa, bulimia nervosa. In Wilson JD, Foster DW, Kronenberg HM, Larsen PR, eds. Williams Textbook of Endocrinology. Philadelphia, WB Saunders, 1998 1061-1097. 

Serotonin is found in various cells within the central ner- yjl vous system, where it inhibits feeding. Serotonin has been implicated in human eating disorders such as anorexia nervosa, bulimia, and the carbohydrate craving associated with seasonal affective disorder (SAD). SAD is a clinical depression triggered... 

Weilbutrin (Bupropino hydrochloride) A medication that has been successfully used to treat depression in adults. One type of this medication Zyban (bupropion hydrochloride) has been used for smoking cessation. Both of these medications contain bupropin and should not be used together. This medication is not recommended for eating disorders such as bulimia or anorexia nervosa because of the potential for the incidence of seizures. 

The DSM-IV includes two primary eating disorder diagnoses Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The DSM also includes a... 

Figure 13.32 The female triad disordered eating, osteoporosis and menstrual cycle disturbance. A low energy intake and high energy expenditure can Lead to endocrine changes that result in osteoporosis and disturbance in the menstrual cycle. A low energy intake in female runners, rowers or gymnasts in order to maintain a low body weight can lead to other disturbances in eating such as bulimia or anorexia nervosa. Stress may contribute to energy imbalance and may have additional effects on the hypothalamus.

Miller, K.B., Klump, K.L., Keel, P.K., McGue, M., and lacono, W.G. (1998) A population-based twin study of anorexia and bulimia nervosa heritability and shared transmission with anxiety disorders. Presented at the Eating Disorder Research Society Meeting, Boston, MA. 

B. (1999) Metabolic changes in the brain of patients with anorexia and bulimia nervosa as detected by proton magnetic resonance spectroscopy. Int Eat Disord 26 119-136. 

Garner, D.M., Olmsted, M.P., and Polivy, J. (1983) Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int/ Eat Disord 2 15-34. 

H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of stuttering, trembling in Parkinson s disease, or exhibiting abnormal eating behavior in anorexia nervosa or bulimia nervosa. 

Although these disorders are more common in adolescent girls or young women, 5% to 15% of anorexia nervosa and bulimia nervosa and approximately 40% of binge-eating disorders occur in boys and men (498). 

The role of medication in the treatment of bulimia nervosa seems better established than its role in the treatment of anorexia nervosa. The American Psychiatric Association Practice Guideline for Eating Disorders ( 510) suggests that antidepressants may be useful in bulimia nervosa with or without depression. They may be particularly helpful, however, in those with depression, anxiety, obsessions, or who have failed psychosocial therapies. 

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