Implantable cardioverter‐defibrillator therapy in a 34‐year‐old patient with eating disorders and after the third sudden cardiac arrest

Eating disorders (ED) such as anorexia nervosa and bulimia are psychiatric diseases associated with the highest mortality rate of any other psychiatric disorders. More recently, long‐term outcome studies with follow‐up of over 20 years report a mortality of between 15% and 18% (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). The sudden death secondary to arrhythmias is often the cause of death in these patients (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). A case of life‐threatening ventricular arrhythmia (VA) in a patient with ED is presented. Clinical records (cardiologic, psychiatric), electrocardiograms, echocardiogram, coronary angiogram, cardiac magnetic resonance, and endocrine diagnostics were performed. Finally a cardioverter‐defibrillator (ICD) was implanted in the patient after her third cardiac arrest. An optimal approach to antiarrhythmic therapy in such patients is a real challenge for a cardiologist. © 2014 Wiley Periodicals, Inc. Int J Eat Disord 2015; 48:253–257     

Prevalence of eating disorders in middle‐aged women

Objective: Little is known about the prevalence and correlates of eating disorders (ED) in middle‐aged women. Method: We mailed anonymous questionnaires to 1,500 Austrian women aged 40–60 years, assessing ED (defined by DSM‐IV), subthreshold ED, body image, and quality of life. We broadly defined “subthreshold ED” by the presence of either (1) binge eating with loss of control or (2) purging behavior, without requiring any of the other usual DSM‐IV criteria for frequency or severity of these symptoms. Results: Of the 715 (48%) responders, 33 [4.6%; 95% confidence interval (CI): 3.3–6.4%] reported symptoms meeting full DSM‐IV criteria for an ED [bulimia nervosa = 10; binge eating disorder = 11; eating disorder not otherwise specified (EDNOS) = 12]. None displayed anorexia nervosa. Another 34 women (4.8%; CI: 3.4–6.6%) displayed subthreshold ED. These women showed levels of associated psychopathology virtually equal to the women with full‐syndrome diagnoses. Discussion: ED appear common in middle‐aged women, with a preponderance of binge eating disorder and EDNOS diagnoses as compared to the “classical” diagnoses of anorexia and bulimia nervosa. Interestingly, middle‐aged women with even very broadly defined subthreshold ED showed distress and impairment comparable to women with full‐scale ED. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:320–324)     

Estrogenic suppression of binge‐like eating elicited by cyclic food restriction and frustrative‐nonreward stress in female rats

Because binge eating and emotional eating vary through the menstrual cycle in human females, we investigated cyclic changes in binge‐like eating in female rats and their control by estrogens. Binge‐like eating was elicited by three cycles of 4 days of food restriction and 4 days of free feeding followed by a single frustrative nonreward‐stress episode (15 min visual and olfactory exposure to a familiar palatable food) immediately before presentation of the palatable food. Intact rats showed binge‐like eating during the diestrous and proestrous phases of the ovarian cycle, but not during the estrous (periovulatory) phase. Ovariectomized (OVX) rats not treated with estradiol (E2) displayed binge‐like eating, whereas E2‐treated OVX rats did not. The procedure did not increase signs of anxiety in an open‐field test. OVX rats not treated with E2 that were subjected to food restriction and sacrificed immediately after frustrative nonreward had increased numbers of cells expressing phosphorylated extracellular signal‐regulated kinases (ERK) in the central nucleus of the amygdala (CeA), paraventricular nucleus of hypothalamus (PVN), and dorsal and ventral bed nuclei of the stria terminalis (BNST) compared with nonrestricted or E2‐treated rats. These data suggest that this female rat model is appropriate for mechanistic studies of some aspects of menstrual‐cycle effects on emotional and binge eating in human females, that anxiety is not a sufficient cause of binge‐like eating, and that the PVN, CeA, and BNST may contribute to information processing underlying binge‐like eating.     

Yoga and pilates: Associations with body image and disordered‐eating behaviors in a population‐based sample of young adults

Objective

To examine associations between participating in mind‐body activities (yoga/Pilates) and body dissatisfaction and disordered eating (unhealthy and extreme weight control practices and binge eating) in a population‐based sample of young adults.

Method

The sample included 1,030 young men and 1,257 young women (mean age: 25.3 years, SD = 1.7) who participated in Project EAT‐III (Eating and Activity in Teens and Young Adults).

Results

Among women, disordered eating was prevalent in yoga/Pilates participants and nonparticipants, with no differences between the groups. Men participating in yoga/Pilates were more likely to use extreme weight control behaviors (18.6% vs. 6.8%, p = .006) and binge eating (11.6% vs. 4.2%, p = .023), and marginally more likely to use unhealthy weight control behaviors (49.1% vs. 34.5%; p = .053), than nonparticipants after adjusting for sociodemographics, weight status, and overall physical activity.

Discussion

Findings suggest the importance of helping yoga/Pilates instructors recognize that their students may be at risk for disordered eating. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010