As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton

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

In mordern society, nutritional and appetite disorders occur in epidemic proportions and are serious health harzards. Obesity and diabetes affect over 30% of American population, while eating disorders, such as anorexia nervosa and bulimia nervosa occur in a growing number of adolescences and young adults. The changes in various sociocultural aspects with the introduction of Westernized culture have had the effect of increasing the risk of same problems in Korea. Disorderd eating patterns are a primary symptom of numerous psychiatric disorders and loss of appetite and cachexia, during illness or in the elderly, preclude proper medical treatment for restoring good health or preserving life. Increased understanding of the systems of the body and brain, related to energy and nutrient balance, may help us to treatment and ultimately prevent these common disorders. In this review, the author highlights the psychobiological mechanisms or factors which are associated with eating behavior, especially in the view of intake psychobiology. This review would be concentrated on 1) the theoretical concepts and theories of eating behavior ; 2) the psychobiological determinants of food intake ; and 3) the psychobiological control of eating behavior.
Aged ; Anorexia Nervosa ; Appetite ; Brain ; Bulimia Nervosa ; Cachexia ; Feeding and Eating Disorders ; Eating* ; Feeding Behavior* ; Humans ; Korea ; Neurosciences* ; Obesity ; Young Adult

OBJECTIVES: This paper aims to understand the emotional-biological pathogenesis of eating disorders, and translate the understanding into new brain directed treatments. METHODS: The first part of the review sets the eating behavior into the context of what is now understood about the central control of appetite and molecular biology. The second part of the review sees how emotion relates to the brain circuit involving eating disorders. RESULTS: In general, patients with anorexia nervosa restricting type were less sensitive to reward, whereas patients with bulimia nervosa and anorexia nervosa binge purging type were more sensitive to it. The emotional life of people with eating disorders centers on food, weight, and shape. The abnormalities in social and emotional functioning both precede and persist outside of eating disorders. CONCLUSIONS: Research into understanding the biological framework of the brain in eating disorders suggests that abnormalities may exist in emotional and information processing. This aspect can be translated into novel brain-directed treatments, particularly in anorexia nervosa.
Anorexia Nervosa ; Appetite ; Automatic Data Processing ; Brain ; Bulimia Nervosa ; Feeding and Eating Disorders* ; Eating* ; Feeding Behavior ; Humans ; Molecular Biology ; Neurobiology ; Reward

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

PURPOSE: The purpose of this study is to investigate the relationship between eating disorders, body image, and self-esteem of female university students. METHODS: A total 123 university female students were recruited in April 2009. Data was collected by using questionnaires. The collected data was analysed by SPSS/WIN using frequency, percentage, mean, standard deviation, ANOVA, & Pearson correlation coefficient. RESULTS: As defined by body mass index (BMI), the obese subjects were rare (8.9%) and the rest (91.1%) was under weight or normal. More than 51.2% of the subjects perceived their weight as overweight, while 8.9% of the women were obese as defined by BMI. Eighty-eight percent of the subjects were not satisfied with their body shape. The total mean score of anorexia nervosa was higher than bulimia nervosa. The scores of eating disorders did not differ significantly by the BMI score. The score of body image was highest in the group of the overweight. There was high positive correlation between self-esteem and body image. CONCLUSION: To ensure resonable body image and weight control behaviors in female university students, education should be reinforsed. Therefore, nursing intervention programs for cognitive changes correcting the understanding about body image need to be developed.
Anorexia Nervosa ; Body Image ; Body Mass Index ; Bulimia Nervosa ; Dietary Sucrose ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Overweight ; Surveys and Questionnaires

The purpose of this study was to investigate the relationship between eating disorders, depression, and body dissatisfaction of middle aged women. Data was collected from June 1 to June 30, 1999 by means of a structured uestionnaire. The subjects for this study were 99 middle aged women between the ages of 35 and 59, recruited from Seoul, Kyungido. The instruments were the BDI(Beck Depression Inventory) developed by Beck(1973), Eating Disorder Inventory(1997) developed by Garner & Garfinkel, Halm, Falk& Schwartz, Shin Mi Young. The instruments were the Body Dissatisfaction(1997) developed by Garner, Olstead & Polivy, Han osoo, yoo hee jung, shin Mi Young. The data was analyzed by the SPSS/PC program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient.The results of this study are as follows 1. The mean body weight and height of the subjects were 57.49kg, 158.62cm.2. Depending upon BMI, the obesity subjects were 18.2% and the rest(81.8%) were under weight or normal. More than 70% of the normal weight subjects(71 subjects) perceived their weight as overweight.3. The total mean scores of anorexia nervosa were higher than bulimia nervosa. The total mean scores of eating disorders was 2.13.4. The total mean scores of depression was 1.50.5. The total mean scores of body dissatisfaction was 3.30. 6. There was a positive correlation between depression and eating disorders(r= .267, p<0.01)and, between body dissatisfaction and eating disorders(r=.273, p<0.01).There was not a significant correlation between depression and body dissatisfaction.According to the present study eating disorders in middle aged women developed because of the tendency to have negative perceptions of their bodies.
Anorexia Nervosa ; Body Weight ; Bulimia Nervosa ; Depression* ; Feeding and Eating Disorders* ; Eating* ; Female ; Gyeonggi-do ; Humans ; Middle Aged* ; Obesity ; Seoul

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

OBJECTIVES: QT interval prolongation and dispersion known as indicators of an increased risk for ventricular arrhythmias and sudden death have been reported to be prolonged in patients with anorexia nervosa. The aims of this study were to compare conduction abnormalities in Korean patients with anorexia nervosa and bulimia nervosa, and to examine its relation with clinical and laboratory factors. METHODS: We retrospectively examined 45 women with anorexia nervosa and 75 women with bulimia nervosa who were assessed by 12-lead electrocardiogram at baseline. QT interval and corrected QT interval, QT dispersion of the difference between the longest and shortest QT intervals, and abnormal U wave were measured for conduction abnormalities. RESULTS: QT interval was significantly longer in patients with anorexia nervosa compared with those with bulimia nervosa. There were no differences in QTc (Corrected QT), QTd (QT dispersion) and abnormal U wave between patients with anorexia nervosa and those with bulimia nervosa. QTd was significantly correlated with the lowest ever lifetime body mass index (kg/m2) as well as the serum amylase level in patients with anorexia nervosa. CONCLUSIONS: These results suggest some conduction abnormalities reported in patients with anorexia nervosa are also found in patients with bulimia nervosa. It appears that severity of weight loss and purging behavior could affect the cardiac arrhythmia in patients with eating disorders. Appropriate attention should be paid to cardiac involvement in patients with eating disorders.
Amylases ; Anorexia ; Anorexia Nervosa ; Arrhythmias, Cardiac ; Body Mass Index ; Bulimia Nervosa ; Death, Sudden ; Eating ; Feeding and Eating Disorders ; Electrocardiography ; Female ; Humans ; Retrospective Studies ; Weight Loss

OBJECTIVE: We examined the association between the tryptophan hydroxylase 1 (TPH1) gene and eating disorders focusing on obsessionality. METHODS: The sample included 62 women with a lifetime diagnosis of anorexia nervosa (AN) as well as 50 women with a lifetime diagnosis of bulimia nervosa (BN) recruited from specialist clinics for eating disorders and 131 healthy women in Korea. Blood samples were collected from all participants for the TPH1 genotyping. The patients were ad ministered the Korean version of the Eating Disorders Examination and obsessionality was conceptualized using measures of persistence, harm avoidance, and obsessive-compulsive symptoms. RESULTS: In the case-control comparisons, the frequency of the A/A genotype was increased in the patients with BN, but this difference was not significant after correcting for multiple testing. We found no effect of the TPH A218C polymorphism on obsessionality in the patients with AN or BN. CONCLUSION: Although the present findings should be regarded as preliminary because of the small size of our sample, they suggest that the TPH1 gene may contribute to the genetic susceptibility to BN and be associated with the other unexplored traits of bulimic case status.
Anorexia Nervosa ; Bulimia Nervosa ; Case-Control Studies ; Eating ; Feeding and Eating Disorders ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Korea ; Obsessive Behavior ; Pilot Projects ; Specialization ; Tryptophan ; Tryptophan Hydroxylase