Pattern of birth in restrictive and bulimic eating disorders

Objective: To determine whether different eating disorders are associated with being born at different points in the year. Based on previous research, it was hypothesised that being born during warm months (June–August) is likely to be associated with restrictive anorexia, rather than bulimic disorders (bulimia nervosa, binge-purge anorexia). Method: Case notes from 105 eating-disordered women were used to yield dates of birth and diagnosis. Associations were calculated between diagnostic group and birth period (month, quarter of year, high-risk quarter). Results: Restrictive anorexics were significantly more likely than the bulimics (42.6% vs. 24.1%) to be born during the warmest quarter (June–August) than during the remainder of the year. Conclusions: This preliminary study suggests that being born during warmer periods may form a small risk factor for the development of a restrictive eating disorder. Further research is suggested to test and extend the hypothesis.     

成都市区1486名女性大、中学生进食障碍的 现况调查

目的 探讨女性大、中学生进食障碍的患病率及其相关因素.方法 采用最优分配分层整群随机抽样法从成都市区抽取大学6所、普通高中1所、普通中专1所、成人中专2所、职业高中1所、初中3所,共1486名女性大、中学生,采用进食障碍问卷、体像障碍量表、抑郁自评量表、贝克焦虑自评量表、自编调查问卷进行现场调查.采用t检验和logistic回归分析数据.结果 成都市女性大、中学生进食障碍估计患病率3.32%;各年龄组中17岁组估计患病率最高(7.16%);各学龄阶段中高中组最高(5.21%).进食障碍倾向组在认识偏差(P=0.009)、期望偏差(P=0.000)方面均比非进食障碍倾向组得分高.关注减肥相关媒体宣传、童年时父母关系紧张、童年时受虐待、进食障碍问卷的不满体型因子、内感受意识因子及焦虑是进食障碍倾向的相关危险因素.结论 进食障碍在女性大、中学生中估计患病率较高,应积极干预.     

Plasma homocysteine levels in female patients with eating disorders

OBJECTIVE: To examine plasma homocysteine, vitamin B(12), and folate levels in females with restricting and bingeing/purging eating disorders (EDs). METHOD: Adolescent and adult female patients were compared to appropriate control groups with regard to plasma homocysteine levels. RESULTS: The plasma homocysteine level of the adult ED patients was higher than that of controls for all age groups examined. In adolescents, no significant difference was found comparing ED patients younger than 16 years of age to control data, whereas in the 16-20 year age group, the plasma homocysteine level was significantly higher among the ED group, regardless of the type of ED. Vitamin B(12) and folate levels were within normal limits in all ED groups. CONCLUSION: Elevated plasma homocysteine levels were found in adult and older adolescent female ED patients (but not in younger adolescents) compared to controls. This finding is not related to deficiencies in vitamin B(12) or folate.     

The Role of Ghrelin,Salivary Secretions,and Dental Care in Eating Disorders

Eating disorders, including anorexia and bulimia nervosa, are potentially life-threatening syndromes characterized by severe disturbances in eating behavior. An effective treatment strategy for these conditions remains to be established, as patients with eating disorders tend to suffer from multiple relapses. Because ghrelin was originally discovered in the stomach mucosa, it has been widely studied over the past decade in an effort to uncover its potential roles; these studies have shed light on the mechanism by which ghrelin regulates food intake. Thus, studying ghrelin in the context of eating disorders could improve our understanding of the pathogenesis of eating disorders, possibly resulting in a promising new pharmacological treatment strategy for these patients. In addition, early detection and treatment of eating disorders are critical for ensuring recovery of young patients. Oral symptoms, including mucosal, dental, and saliva abnormalities, are typically observed in the early stages of eating disorders. Although oral care is not directly related to the treatment of eating disorders, knowledge of the oral manifestations of eating disorder patients may aid in early detection, resulting in earlier treatment; thus, oral care might contribute to overall patient management and prognosis. Moreover, ghrelin has also been found in saliva, which may be responsible for oral hygiene and digestion-related functions. This review discusses the pharmacological potential of ghrelin in regulating food-intake and the role of saliva and oral care in young patients with eating disorders.     

Excessive exercise in anorexia nervosa and bulimia nervosa: relation to eating characteristics and general psychopathology

OBJECTIVE: Excessive exercise is a well-known phenomenon in anorexia nervosa, but less is known about its role in bulimia nervosa. In addition, there is little evidence regarding the psychopathological processes that might act as predisposing, triggering, or maintaining factors for such exercise. The present study examined the presence of excessive exercise in different women with eating disorders, and its psychopathological correlates. METHODS: Case notes from 63 anorexia nervosa and 61 bulimia nervosa patients were examined. Two-way multivariate analyses of variance (diagnosis x use of excessive exercise) were used to determine the impact of the two factors upon eating characteristics (EAT-40 and BITE) and psychopathological symptoms (SCL-90-R). RESULTS: While high levels of depression were more likely among all patients who used excessive exercise, levels of anxiety and somatization were particularly high only among those anorexics who exercised excessively. DISCUSSION: Possible explanatory models are advanced to account for this pattern of findings, focusing on the possible use of exercise as an affect regulation strategy among anorexia nervosa patients. Further research is suggested to test and develop this model, and possible clinical implications are outlined.     

Eating Disorder in a Hemodialysis Patient: Case Report

Renal replacement therapy may encourage eating disorders in some patients. Hemodialysis requires patients to attend dialysis sessions three times per week, during which time they are weighed pre- and posttreatment, so the importance of limiting "fluid weight" gains to prevent fluid overload and elevated blood pressure are constantly reinforced by the dialysis team. Patients must also follow rigorous therapeutic dietary modifications to prevent the buildup of urea and harmful waste products between treatments. This is a case report of a 30-year-old man receiving renal replacement therapy who had anorexia nervosa of the bulimic subtype.