Eating disorders nervosa Obesity

It is commonly supposed that obesity and anorexia are opposite poles of a spectrum of eating disorders that obese people overeat, that anorectics undereat and that "normal people eat "normally, but there is little evidence to support this view. Anorexia nervosa often occurs in girls who were rather obese at puberty, and very rarely occurs in boys at any age. The problem is almost always related to emotional adjustment to sexual maturity in women. 

The BMI can be calculated using a scale, ruler, and pocket calculator. BMl values of 20—25 kg/m are associated with the least health risk. A BMI of 3(1 kg/m is associated with serious risk for premature death due to obesity, BMI values under 16 kg/m suggest an eating disorder such as anorexia nervosa or bulimia. 

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. 

Halmi KA. Eating disorders Anorexia nervosa, buUnua nervosa, and obesity. In Hales RE, Yudofsky SC, eds. Essentials of Qinical Psychiatry, 3d ed. Washington, American Psychiatric Press, 1999 667-685. 

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. 

The psychological and social problems of the obese spill over to people of normal weight as well. There is continual advertising pressure for slimness , and newspapers and magazines are full of propaganda for slimness and diets for weight reduction. This may be one of the factors in the development of major eating disorders such as anorexia nervosa and bulimia (section 8.3.1.1). 

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