Cases of repeated acute gastric dilatations after binge eating in one patient are rarely reported. We report here a case of repeated acute gastric dilatations in a 22-year-old woman with bulimia nervosa. Her repeated acute gastric dilatations seem to have been related to superior mesenteric artery syndrome. On her last visit due to acute gastric dilatation, she underwent emergency gastric decompression surgery because of abdominal compartment syndrome; however, she eventually died because of ischemia reperfusion injury. Emergency physicians should be aware of the need to manage acute gastric dilatation in patients with eating disorder and should pay attention to the signs and distinctive clinical features of abdominal compartment syndrome.
Bulimia Nervosa* ; Bulimia* ; Decompression ; Dilatation* ; Eating ; Emergencies ; Female ; Gastric Dilatation ; Humans ; Intra-Abdominal Hypertension* ; Reperfusion Injury ; Superior Mesenteric Artery Syndrome ; Young Adult

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

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

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*

A 21-year-old female with a history of bulimia nervosa came to the emergency room due to severe abdominal pain after excessive eating five hours previously. On arrival at the emergency room, extreme abdominal distension was detected and the patient's legs changed color. Computed tomography suggested severe gastric dilatation, so abdominal compartment syndrome was suspected and an emergent laparotomy was supposed to be conducted. Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started. In spite of active resuscitation for 29 min, the patient did not recover and expired. As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.
Abdominal Pain ; Anesthesia ; Bulimia ; Bulimia Nervosa ; Eating ; Feeding and Eating Disorders* ; Emergency Service, Hospital ; Fatal Outcome* ; Female ; Gastric Dilatation* ; Hemodynamics ; Humans ; Incidence ; Intra-Abdominal Hypertension ; Laparotomy ; Leg ; Resuscitation ; Young Adult

OBJECTIVES: Medical complications are common and often serious in patients with eating disorders, however, little is known about complications in patients with bulimia nervosa. METHODS: We conducted a retrospectively investigation of clinical characteristics and hematologic, biochemical, hormonal, and bone density evaluations in 90 Korean women with bulimia nervosa together with 100 healthy Korean women of comparable ages. RESULTS: In patients with bulimia nervosa, 20% were anemic, 3.3% were hypokalemic, 14.4% had increased alanine aminotransferase, 24.4% were lower in serum protein, 8.8% were hypercholesterolemia, and 77.8% were hyperamylasemia. Osteopenia at any one site was identified in 26.7% of patients and the lowest-ever body mass index was the main determinant of bone mineral density in patients with bulimia nervosa. CONCLUSION: In this study, many features of medical findings reported in anorexia nervosa were found in bulimia nervosa, however, the findings in bulimia nervosa were milder form than in anorexia nervosa. Management of any physical abnormalities in bulimia nervosa should focus on correction of the eating disorder.
Alanine Transaminase ; Anorexia Nervosa ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Bulimia Nervosa* ; Bulimia* ; Feeding and Eating Disorders ; Female ; Humans ; Hyperamylasemia ; Hypercholesterolemia ; Retrospective Studies

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

Eating disorders impact on both physical and mental health with a profound disruption in the quality of life of adolescent. The prevalence of these disorders has been increasing in East Asia and over 10% of young people have some eating disorder related traits. Cultural changes such as the internalisation of the thin ideal predispose to eating disorders. The core features of eating disorders are the pursuit of weight loss and the resultant low body weight or compensatory behavior. The nutritional compromise of eating disorders, particularly anorexia nervosa, results in disruption in menstrual cycle, increased medical risks, and an eventual increase in mortality. The mortality rate of anorexia nervosa is 12 times the rate of healthy age-matched women. The underlying medical causes of the increased mortality rate were cardiovascular, endocrine, hematopoietic, autoimmune, respiratory, and urogenital in nature. High frequencies of medical complications in eating disorders emphasizes the importance of recognizing eating disorders as a medical risk in adolescent in Korea. Successful approaches to prevention against eating disorders have already been developed for adolescent in Europe. Public health interventions targeted at schools responsible for the care of adolescent (parents, teachers, college tutors) would be useful in Korea.
Adolescent ; Anorexia Nervosa ; Body Weight ; Bulimia Nervosa ; Eating ; Feeding and Eating Disorders ; Europe ; Far East ; Female ; Humans ; Korea ; Menstrual Cycle ; Mental Health ; Prevalence ; Public Health ; Quality of Life ; Weight Loss

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