OBJECTIVES: To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. METHODS: One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. RESULTS: In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. CONCLUSIONS: Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.
Age of Onset ; Anorexia Nervosa* ; Bulimia ; Bulimia Nervosa* ; Eating ; Eating Disorders ; Female ; Humans ; Mothers ; Parents*

Many therapeutic approaches for treafment of binge eating problem including cognitive-behavioral therapy, behavior therapy, focal psychotherapy. psychoanalysis, nutritional counseling, family intervention, psychoeducation, and medication have value. Nevertheless, current research suggest that the most important approant approach to date is a specific form of cognilive-behavioral therapy designed ariginally for patients with bulimia nervosa and recently adapfed for those with binge eating disorder and anorexia nervosa. But it is also important to stress that cognitive-behavioral therapy is not panacea, some patients fail to benefit and others made only limited gains. So there is a need for clinician not only to carefully assess the patient status before freatment start but also to become familiar with and be able to introduce other therapeutic approach.
Anorexia Nervosa ; Behavior Therapy ; Binge-Eating Disorder ; Bulimia Nervosa ; Bulimia* ; Counseling ; Humans ; Psychoanalysis ; Psychotherapy

OBJECTIVES: This study compared cognitive-behavioral traits related to eating behaviors, obsessive-compulsive traits, and depression levels in bulimic subjects with and without a history of anorexia nervosa according to the perspective that there are common diagnostic transitions over time in subgroups of eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). METHODS: We compared EDI-2, MOCI, and BDI scores between the bulimic group with a history of anorexia (n=98), the bulimic group without a history of anorexia (n=99), and the non-clinic group (n=100) by ANOVA. RESULTS: The bulimic group with a history of anorexia showed significantly higher scores on four of the EDI-2 subscales (Ineffectiveness, Interoceptive Awareness, Impulse Regulation and Social Insecurity) than the other two groups. They also indicated significantly higher scores on both the MOCI subscale 'rumination' and BDI than both the other groups. CONCLUSION: These findings suggest that it is important to consider a prior history of anorexia nervosa in order to understand symptom severity in patients with bulimia. Psychological variables such as ineffectiveness, impulse regulation, social insecurity, rumination, and depression are crucial to consider while treating bulimics with a history of anorexia.
Anorexia ; Anorexia Nervosa ; Bulimia ; Bulimia Nervosa ; Depression ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Humans

Dental erosion is defined as tooth structure loss by acidic chemical substance. It is caused by extrinsic factors such as acidic foods, drugs, and working environments, and also intrinsic factors such as gastric acid regurgitation in gastro-esophageal disorder or intensive vomiting in bulimia nervosa. These lesions can be treated with direct resin filling, laminate or full contour crown depending on the intensity of clinical problem. This is a case report about treatment of rare clinical case: labial erosion of anterior tooth caused by frequent intake of acidic fruit and palatal erosion of anterior tooth caused by intensive vomiting in bulimia nervosa.
Bulimia Nervosa ; Crowns ; Fruit ; Gastric Acid ; Intrinsic Factor ; Tooth ; Vomiting

Human ; Female ; Young Adult ; Bulimia Nervosa ; Depression ; Eating ; Euphoria

OBJECTIVE: Over the last few years there has been growing concern about bulimia nervosa in Korea, but there was only a few clinical study, especially about outcome and predictors. CBT combined with pharmacotherapy has been recognized as the most effective short-term treatment modality, but there was nonresponders. The purpose of this paper is to examine the factors that influence treatment response and outcome in patients with bulimia nervosa. The identification of prognostic factors in bulimia nervosa will help clinicians to deliver the most appropriate type of initial treatment to patients. METHOD: The subjects were 62 patients from the outpatients of Mind & Mind psychiatric clinic, who had been previously evaluated by EDI-2 and MMPI. The sociodemographic data, disease progress, past history, family history, BMI, EDI-2 and MMPI were variables assessed. All patients received a 12-week course of CBT combined with pharmacotherapy (fluoxetine 20-60mg/d). Responders and non-responders group ware compared with each variables. Responders were defined as patients who had maximum symptom frequencies of three or less during the last 4 weeks of treatment. RESULT: Among 62 patients, responders were 32 and non-responders were 30. There was no difference in sociodemographic variables such as age, education level, job, marriage. As a result of comparing the two groups, non-responders were differentiated by their higher frequency of binge eating vomiting, history of suicide attempt, family history of psychiatric illness and use of laxatives or diuretics. And among the subscale of EDI-2, there were significant high scores in bulimia, ineffectiveness, interoceptive awareness. CONCLUSION: The findings suggest that frequency of binge eating, vomiting, history of suicide attempt, family history of psychiatric illness, and use of laxatives or diuretics could be prognostic factors in patients with bulimia nervosa.
Bulimia Nervosa* ; Bulimia* ; Diuretics ; Drug Therapy ; Education ; Humans ; Korea ; Laxatives ; Marriage ; MMPI ; Outpatients ; Suicide ; Vomiting

Since Russell described bulimia nervosa as an independent and distinctive eating problem, it has been regarded as one of the rapidly increasing problems during the past two decades in Western society. However, in the past few years, the number of reports concerning eating disorders have increased in developing countries including Korea with the rapid introduction of the Western culture accompanied by economic development. Most individuals suffering from bulimia nervosa can be treated as outpatients. Patients with uncomplicated bulimia nervosa rarely require hospitalization and may achieve clinical improvement with nutritional management or counseling, individual or group cognitive-behavioral therapy(CBT), behavioral techniques, and interpersonally oriented or psychodynamically oriented psychotherapies. However, in clinical practice, CBT with nutritional counseling or inter-personal psychotherapy is a usual method chosen for the treatment of such patients in combination with pharmacotherapy. This review aimed at giving a compact and systemized account of the clinical guidelines that we consider essential in the management of patients with bulimia nervosa. The author also introduced treatment experience with bulimic patients at Seoul Paik Hospital.
Bulimia Nervosa* ; Bulimia* ; Counseling ; Developing Countries ; Drug Therapy ; Eating ; Feeding and Eating Disorders ; Economic Development ; Hospitalization ; Humans ; Korea ; Outpatients ; Psychotherapy ; Seoul

Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. Males in bulimia account for 10-15% of all bulimic patients. There are many methods of treatment, including drug therapy, or psychotherapy. Among them cognitive behavior therapy is reported to be the most effective method of improving the binge eating behavior and the cognitive distortion about body weight and body image. In this case, a male bulimic patient, who was hospitalized in the closed ward involuntarily, was treated with modified Fairburn's cognitive behavior therapy model. After 6 weeks of treatment, binge eating and self-induced vomiting behaviors were controlled and weight gain was nearly successful.
Body Image ; Body Weight ; Bulimia Nervosa* ; Bulimia* ; Cognitive Therapy* ; Drug Therapy ; Female ; Humans ; Male* ; Psychotherapy ; Vomiting ; Weight Gain

OBJECTIVE: Although it is thought that eating disorders result from the interplay of personal and sociocultural factors, a comprehensive model of eating disorders remains to be established. The aim of this study was to determine the extent to which the childhood factors and deficit in visuoperceptual ability contribute to eating disorders. METHODS: A total of 76 participants - 22 women with anorexia nervosa (AN), 28 women with bulimia nervosa (BN), and 26 healthy women of comparable age, IQ, and years of education - were examined. Neuropsychological tasks were applied to measure the visuoperceptual deficits, viz. the Rey-Osterrieth complex figure test and the group embedded figures test (GEFT). A questionnaire designed to obtain retrospective assessments of the childhood risk factors was administered to the participants. RESULTS: The women with both AN and BN were less likely to report having supportive figures in their childhood and poor copy accuracy in the Rey-Osterrieth test. The women with AN were more likely to report premorbid anxiety, childhood emotional undereating and showed poor performances in the GEFT. In the final model, the factors independently contributing to the case status were less social support in childhood as a common factor for both AN and BN, and childhood emotional undereating and poor ability in the low-level visuospatial processing for AN. CONCLUSION: Our results suggest the disturbance in the food-emotion relationship and the deficit in low-level visuospatial processing in people with AN. Lower social support appears to contribute to an increase in vulnerability to both AN and BN.
Anorexia ; Anorexia Nervosa ; Anxiety ; Bulimia ; Bulimia Nervosa ; Coat Protein Complex I ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Risk Factors

The aim of this literature review was to evaluate the hedonic aspect of eating-related disorders. Addiction research has implications for the study of eating disorders and obesity and therefore, we collated and summarized recent clinical and neuroscience findings in regard to the "wanting" or "liking" aspect of eating disorders and obesity. The addictive personality is prone to substance dependence and these personality types are also known to be susceptible to binge eating. The biological framework underpinning the hedonic aspect of abnormal eating behavior has two components: 1) the incentive component of "wanting" or, in its extreme, craving feeling involving the dopaminergic system, and 2) the pleasure or "liking" network involving the opioid and cannabinoid systems. The hedonic system is not merely related to food, but is part of a global organizational unit governing behavioral choices. In general, patients with anorexia nervosa (restricting) were less sensitive to reward, whereas patients with bulimia nervosa (binge/purge) were more sensitive to reward. People with obesity tended to be more sensitive to food as a reward, a function which involves the dopamine system. While recognizing the addictive aspect of abnormal eating behaviors, we have provided treatment recommendations with respect to these disorders and obesity.
Anorexia Nervosa ; Bulimia ; Bulimia Nervosa ; Dopamine ; Eating ; Feeding and Eating Disorders ; Feeding Behavior ; Humans ; Motivation ; Neurosciences ; Obesity ; Pleasure ; Reward ; Substance-Related Disorders