The Full Wiki

Eating disorder: Wikis


Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! This article doesn't yet, but we're working on it! See more info or our list of citable articles.

Did you know ...

  • all four stars of Starved, an FX sitcom about eating disorders, struggled with eating disorders themselves, a fact unknown to producers until after casting?

More interesting facts on Eating disorder

Include this on your site/blog:


(Redirected to Eating disorders article)

From Wikipedia, the free encyclopedia

Eating Disorder (EDO)
Classification and external resources
ICD-10 F50.
ICD-9 307.5
MeSH D001068

An eating disorder is characterized by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and emotional health. The causes of eating disorders are complex and not yet fully understood. Eating disorders are estimated to affect 5-10 million females and 1 million males in the United States.[1] Although not yet classified as separate disorder, binge eating disorder[2] is the most common eating disorder in the United States affecting 3.5% of females and 2% of males according to a study by Harvard affiliated McLean Hospital. Bulimia nervosa was the second most common followed by Anorexia nervosa.[3]



  • Eating disorders affect all socioeconomic levels.[4]
  • 40% of 9- and 10-year-old girls are already trying to lose weight.[5]
  • Girls with ADHD are 5.6 times more likely to develop bulimia and 2.7 times more likely to develop anorexia nervosa[6][7]
  • Women who were raised in foster care are 7 times more likely to develop bulimia nervosa.[8]
  • Binge eating is the most common eating disorder in the United States affecting 3.5% of females and 2% of males, followed by bulimia nervosa then anorexia nervosa.[9]
  • Females with anorexia nervosa have a higher suicide rate than those with any other mental health disorder and the general population[10] up to 60 times higher according to one study[11]
  • Anorexia nervosa has the highest mortality rate of any psychiatric disorder.[12]
  • Anorexia nervosa although usually reported in white adolescent females affects all races and ages groups[13][14]
  • The mortality rate for anorexia nervosa is 4.0%, bulimia nervosa is 3.9% and 'eating disorder not otherwise specified' (EDNOS) which includes binge eating disorder is placed at 5.2%[15]
  • Males account for 5%-10% of anorexia nervosa cases[16] and 10%-15% of bulimia nervosa cases.[17]
  • An optimum healthy weight is calculated using the Body Mass Index


It is not known with certainty what causes eating disorders. It can be due to a combination of biological, psychological or environmental causes.


DNA ligase (shown here in color), encircles the double helix to repair a broken strand of human DNA.
  • Genetic: Numerous studies have been undertaken that show a possible genetic predisposition toward eating disorders.[18][19][20]
  • Biochemical:Eating behavior is a complex process controlled by the neuroendocrine system of which the Hypothalamus-pituitary-adrenal-axis (HPA axis) is a major component. Dysregulation of the HPA-axis has been associated with eating disorders,[21][22] such as irregularities in the manufacture, amount or transmission of certain neurotransmitters, hormones[23] or neuropeptides[24].
  • leptin and ghrelin; leptin is a hormone produced primarily by the fat cells in the body it has an inhibitory effect on appetite by inducing a feeling of saiety. Ghrelin is an appetite inducing hormone produced in the stomach and the upper portion of the small intestine. Circulating levels of both hormones are an important factor in weight control. While often associated with obesity both hormones and their respective effects have been implicated in the pathophysiology of anorexia nervosa and bulimia nervosa.[34]
  • immune system:studies have shown that a majority of patients with anorexia and bulimia nervosa have elevated levels of autoantibodies that affect hormones and neuropeptides that regulate appetite control and the stress response. There may be a direct correlation between autoantibody levels and associated psychological traits.[35][36]
Cerebral cortex of the human brain showing the 4 major lobes, below which are the cerebellum, pons, olive, and medulla oblongata
  • infection:PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Children with PANDAS "have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette's Syndrome, and in whom symptoms worsen following infections such as "Strep throat" and Scarlet Fever." (NIMH) There is a possibility that PANDAS may be a precipitating factor in the development of Anorexia nervosa in some cases, (PANDAS AN).[37]
  • lesions:studies have shown that lesions to the right frontal lobe or temporal lobe can cause the pathological symptoms of an eating disorder[38][39][40]
  • tumors:tumors in various regions of the brain have been implicated in the development of abnormal eating patterns.[41][42][43][44][45]
  • brain calcification: a study highlights a case in which prior calcification of the right thalumus may have contributed to development of anorexia nervosa.[46]
  • somatosensory homunculus; is the representation of the body located in the somatosensory cortex, first described by renowned neurosurgeon Wilder Penfield. The illustration was originally termed "Penfield's Homunculus", homunculus meaning little man. "In normal development this representation should adapt as the body goes through its pubertal growth spurt. However, in AN it is hypothesized that there is a lack of plasticity in this area, which may result in impairments of sensory processing and distortion of body image". (Bryan Lask, also proposed by VS Ramachandran)
  • Obstetric complications. There have been studies done which show maternal smoking, obstetric and perinatal complications such as maternal anemia, very pre-term birth (32<wks.), being born small for gestational age, neonatal cardiac problems, preeclampsia, placental infarction and sustaining a cephalhematoma at birth increase the risk factor for developing either anorexia nervosa or bulimia nervosa. Some of this developmental risk as in the case of placental infarction, maternal anemia and cardiac problems may cause intrauterine hypoxia, umbilical cord occlusion or cord prolapse may cause ischemia, resulting in cerebral injury, the prefrontal cortex in the fetus and neonate is highly susceptible to damage as a result of oxygen deprivation this has been shown to contribute to executive dysfunction, ADHD, and may affect personality traits associated with both eating disorders and comorbid disorders such as impulsivity, mental rigidity and obsessionality. The problem of perinatal brain injury, in terms of the costs to society and to the affected individuals and their families, is extraordinary." (Yafeng Dong, PhD) [47][48][49][50][51][52][53][54][55][56][57]


Eating disorders are classified as Axis I[58] disorders in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV). Published by The American Psychiatric Association. There are various other psychological issues that may factor into eating disorders, some fulfill the criteria for a separate Axis I diagnosis or a personality disorder which is coded Axis II and thus are considered comorbid to the diagnosed eating disorder. Axis II disorders are subtyped into 3 "clusters", A, B and C.The causality between personality disorders and eating disorders has yet to be fully established.[59] Some people have a previous disorder which may increase their vulnerability to developing an eating disorder.[60][61][62] Some develop them afterwards.[63] The severity and type of eating disorder symptoms have been shown to affect comorbidity.[64] The DSM-IV should not be used by laypersons to diagnose themselves, even when used by professionals there has been considerable controversy over the diagnostic criteria used for various diagnoses, including eating disorders. There has been controversy over various editions of the DSM including the latest edition DSM-V due in May 2013.[65][66][67][68][69]

Personality traits

There are various childhood personality traits associated with the development of eating disorders.[84] During adolescence these traits may become intensified due to a variety of physiological and cultural influences such as the hormonal changes associated with puberty, stress related to the approaching demands of maturity and socio-cultural influences and perceived expectations, especially in areas that concern body image. Many personality traits have a genetic component and are highly heritable. Maladaptive levels of certain traits may be acquired as a result of anoxic or traumatic brain injury, neurodegenerative diseases such as Parkinson's disease, neurotoxicity such as lead exposure, bacterial infection such as Lyme disease or viral infection such as Toxoplasma gondii as well as hormonal influences. While studies are still continuing via the use of various imaging techniques such as fMRI; these traits have been shown to originate in various regions of the brain[85] such as the amygdala[86][87] and the prefrontal cortex[88] Disorders in the prefrontal cortex and the executive functioning system have have been shown to affect eating behavior.[89][90]


William-Adolphe Bouguereau (1825-1905) - The Difficult Lesson (1884).jpg
Child maltreatment

Child abuse which encompasses physical, psychological and sexual abuse, as well as neglect has been shown by innumerable studies to be a precipitating factor in a wide variety of psychiatric disorders including eating disorders. Children who are subjugated to abuse may develop a disordered eating pattern in an effort to gain some sense of control or for a sense of comfort. Or they may be in an environment where the diet is unhealthful or insufficient.

Child abuse and neglect can cause profound changes in both the physiological structure and the neurochemistry of the developing brain. Children who as wards of the state were placed in orphanages or foster homes are especially susceptible to developing a disordered eating pattern. In a study done in New Zealand 25% of the study subjects in foster care exhibited an eating disorder. (Tarren-Sweeney M. 2006) An unstable home environment is detrimental to the emotional well-being of children, even in the absence of blatant abuse or neglect the stress of an unstable home can contribute to the development of an eating disorder.[139][140][141] [142][143][144][145][146][147]

Social isolation

Social isolation has been shown to have a deleterious effect on an individuals' physical and emotional well-being. Those that are socially isolated have a higher mortality rate in general as compared to individuals that have established social relationships. This effect on mortality is markedly increased in those with pre-existing medical or psychiatric conditions, this has been especially noted in cases of coronary heart disease. "The magnitude of risk associated with social isolation is comparable with that of cigarette smoking and other major biomedical and psychosocial risk factors." ( Brummett et al.)

Social isolation can be inherently stressful, depressing and anxiety provoking. In an attempt to ameliorate these distressful feelings an individual may engage in emotional eating in which food serves as a source of comfort. The loneliness of social isolation and the inherent stressors thus associated have been implicated as triggering factors in binge eating as well.[148][149][150][151]

Parental influence

Parental influence has been shown to be an intrinsic component in developing the eating behaviors of children. This influence is manifested and shaped by a variety of diverse factors such as familial genetic predisposition, dietary choices as dictated by cultural or ethnic preferences, the parents' own body shape and eating patterns, the degree of involvement and expectations of their children's eating behavior as well as the interpersonal relationship of parent and child. This is in addition to the general psychosocial climate of the home and the presence or absence of a nurturing stable environment. It has been shown that maladaptive parental behavior has an important role in the development of eating disorders. As to the more subtle aspects of parental influence it has been shown that eating patterns are established in early childhood and that children should be allowed to decide when their appetite is satisfied as early as the age of two. A direct link has been proven between obesity and parental pressure to eat more.

Coercive tactics in regard to diet have not been proven to be efficacious in controlling a child's eating behavior. Affection and attention have been shown to affect the degree of a childs' finickiness and their acceptance of a more varied diet.[152] [153] [154][155][156][157]

Peer pressure

In various studies such as one conducted by The McKnight Investigators, peer pressure was shown to be a significant contributor to body image concerns and attitudes toward eating among subjects in their teens and early twenties.

Eleanor Mackey and co-author, Annette M. La Greca of the University of Miami, studied 236 teen girls from public high schools in southeast Florida. "Teen girls' concerns about their own weight, about how they appear to others and their perceptions that their peers want them to be thin are significantly related to weight-control behavior," says psychologist Eleanor Mackey of the Children's National Medical Center in Washington and lead author of the study. "Those are really important."

Dieting among adolescents was also reported to being influenced by peer behavior. With many of those individuals on a diet reporting that their friends also were dieting. The number of friends dieting and the number of friends who pressured them to diet also played a significant role in their own choices.[158] [159] [160][161]

Cultural pressure

There is a cultural emphasis on thinness which is especially pervasive in western society. There is an unrealistic stereotype of what constitutes beauty and the ideal body type as portrayed by the media, fashion and entertainment industries."The cultural pressure on women to be thin is an important predisposing factor for the development of eating disorders" (Bryan Lask, PhD) [162] [163]

Eating disorders in men

There has been an increasing rate of males suffering from various eating disorders including anorexia nervosa. There is a perceived stigma attached, as eating disorders are generally viewed as primarily affecting women. Among men the rates of eating disorders are higher in the gay and bi-sexual communities (Feldman & Meyer, 2007), yet it also affects heterosexual men. Despite the perceived stigma, some high profile male celebrities have publicised their struggles with eating disorders such as actor Dennis Quaid, who struggled with what he called "manorexia" for which he sought treatment. Quaid said his problems began when he went on a diet to lose forty pounds to play Doc Holliday in the movie "Wyatt Earp" in 1994. Billy Bob Thornton has also struggled with anorexia, once losing 59 lbs.Thomas Holbrook, M.D., is Clinical Director of the Eating Disorders Program at Rogers Memorial Hospital in Oconomowoc, Wisconsin despite being a psychiatrist specializing in eating disorders, he suffered from anorexia nervosa with compulsive exercising. At one time the 6-ft.-tall psychiatrist weighed just 135 lbs. "I was terrified," he says, "of being fat." His story has been chronicled in various publications including USA Today and People Magazine.



Anorexia nervosa (AN) is divided into two subtypes restrictive, which doesn't enage in purging behavior and purging type which does. Bulimia nervosa is divided into two subtypes purging and the less common; non purging. There is a tendency for diagnostic "crossover" in which symptoms change over time between the restricting and binge eating/purging anorexia nervosa subtypes and bulimia nervosa.[164][165] While anorexics are often underweight or below average body weight, bulimics range from a normal weight to even slightly above average weight.

Binge eating

Both bulimics and those with binge eating disorder (BED) engage in binge eating. Those with BED do not engage in any compensatory behavior e.g. they do not purge, use laxatives or engage in compulsive exercise. The binge eating is caused by emotional upset and not by hunger. During these episodes, those affected with BED will consume thousands of calories at once, often in one sitting. Because of the lack of purging, those with BED tend to be overweight or obese, even though persons of normal or average weight can be affected.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder to affect women. Though often associated with obesity it can occur in normal weight individuals. PCOS has been associated with binge eating and bulimic behavior.[168][169][170][171][172][173]

Other eating disorders

Rumination Syndrome

Rumination Syndrome, is characterized by the repeated painless regurgitation of food following a meal which is then either re-chewed, re-swallowed or discarded. It is an under-diagnosed disorder possibly due to the fact that most physicians do not recognize the symptoms of the disorder. While often diagnosed in infants and developmently individuals it also occurs in adults of normal intelligence. An accurate clinical diagnosis is critical in making an accurate diagnosis. The Rome III Consensus Criteria for Rumination Syndrome varies for infants, adolescents and adults. [174][175][176]


Diabulimia; not currently a recognized medical condition, is the deliberate manipulation of insulin including withholding shots, by individuals with Type 1 diabetes in an effort to control their weight.[177] Insulin is an anabolic hormone[178] that is involved in the metabolism of carbohydrates and lipids (fats).[179] It helps the body maintain muscle mass, it also encourages fat retention.[180]

The effects of withholding insulin can lead to severe complications[181] such as diabetic ketoacidosis. The long term effects can lead to the acceleration of diabetes related complications such as diabetic vasculopathy which may lead to limb amputation.[182][183]

Food Maintenance Syndrome

Food Maintenance Syndrome is characterized by a set of aberrant eating behaviors of children in foster care it is "a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity", it resembles "the behavioral correlates of Hyperphagic Short Stature". (Tarren-Sweeney M. 2006)[184] It is hypothesised that this syndrome is triggered by the stress and maltreatment these children are subjected to.

Female Athlete Triad

Female Athlete Triad is a syndrome in which eating disorders/disordered eating behavior, amenorrhoea/oligomenorrhoea and decreased bone mineral density (osteoporosis and osteoenia) are present. Not all patients exhibit all three components of the triad according to recent studies some may have only one or two which increases the difficulty of proper diagnosis and long-term morbidity. The full impact of this disorder may not be realized until menopause when the resultant bone loss is accelerated. The strict criteria for diagnosis have been amended by the American College of Sports Medicine in 2007. The diagnostic criteria are now ascertained on a continuous spectrum instead of the most severe presentation. Disordered eating has been replaced by "optimal energy availability" to "low energy availability with or without an eating disorder". Amenorrhea has been replaced by a spectrum ranging from normal menstruation (eumenorrhea) to "functional hypothalmic amenorrhea", in younger patients delayed primary menstruation may occur. Osteoporosis has been replaced by a spectrum ranging from optimal bone health to osteoporosis.[185][186][187]

Additional eating disorders


Symptoms and complications vary according to the nature and severity of the eating disorder[188]


The initial diagnosis should be made by a competent medical professional."The medical history is the most powerful tool for diagnosing eating disorders"( American Family Physician).[196] There are many medical disorders that mimic eating disorders and comorbid psychiatric disorders. All organic causes should be ruled out prior to a diagnosis of an eating disorder or any other psychiatric disorder is made. According to an in depth study conducted by psychiatrist Richard Hall as published in The Archives of General Psychiatry:

  • Medical illness often presents with psychiatric symptoms.
  • It is difficult to distinguish physical disorders from functional psychiatric disorders on the basis of psychiatric symptoms alone.
  • Detailed physical examination and laboratory screening are indicated as a routine procedure in the initial evaluation of psychiatric patients.
  • Most patients are unaware of the medical illness that is causative of their psychiatric symptoms.
  • The conditions of patients with medically induced symptoms are often initially misdiagnosed as a functional psychosis.[197]


PET scan of the human brain.

A consultation with a reputable medical professional who specializes in eating disorders is an indispensable part of both the diagnostic process and treatment. A complete medical and psychosocial history should be provided and a rational and formulaic approach to the diagnosis should be used. Neuroimaging using fMRI, MRI, PET and SPECT scans have been used to detect cases in which a lesion, tumor or other organic condition has been either the sole causative or contributory factor in an eating disorder."Right frontal intracerebral lesions with their close relationship to the limbic system could be causative for eating disorders,we therefore recommend performing a cranial MRI in all patients with suspected eating disorders"(Trummer M","intracranial pathology should also be considered however certain is the diagnosis of early-onset anorexia nervosa. Second, neuroimaging plays an important part in diagnosing early-onset anorexia nervosa, both from a clinical and a research prospective".(O'Brien[198][199]

Without visible images of neuropathology, psychiatric disorders have been a fertile ground for stigma and bizarre propositions, as evidenced by etiologic theories involving “schizophrenogenic”[200] and “refrigerator mothers". Neuroimaging will clearly establish psychiatric disorders as being “medical”, thereby bringing these disorders into the mainstream in terms of public attitude and, perhaps more importantly, funding for treating these problems.(Derryck H Smith, MD, Canadian Psychiatric Association) In addition to neuroimaging there are a variety of tests that may be performed to diagnosis and assess the effects of an eating disorder.


After ruling out organic causes and the initial diagnosis of an eating disorder being made by a medical professional a trained mental health professional aids in the assessment and treatment of the underlying psychological components of the eating disorder and any comorbid psychological conditions. The clinician conducts a clinical interview and may employ various psychometric tests. Some are general in nature while others were devised specifically for use in the assessment of eating disorders. Some of the general tests that may be used are the Hamilton Depression Rating Scale[233] and the Beck Depression Inventory.[234] [235]

Differential diagnoses


According to a recent report issued in The Journal of the American Medical Association (JAMA), anywhere from 40,000 to 80,000 deaths in the U.S. are attributable to misdiagnosis in the hospital setting per year. Also in the U.S., deaths due to medical errors are higher than the numbers attributable to the 8th-leading cause of death. More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516).[236]

[237] These figures do not factor in those misdiagnosed outside the hospital setting or for individuals who present with psychiatric symptoms and receive contraindicated i.e. wrong, mental health care predicated upon poor diagnostic procedure. On average, 32,000 Americans commit suicide per year. 77% had seen a physician and 30% had received mental health counseling in the year prior. In England alone independent of the rest of the United Kingdom an average of four psychiatric patients die, many from suicide and another three suffer serious physical harm each day while under the care of the National Health Service.[238][239][240]

  • acute pandysautonomia is one form of an autonomic neuropathy, which are a collection of various syndromes and diseases which affect the autonomic neurons of the autonomic nervous system (ANS). Autonomic neuropathies may be the result of an inherited condition or they may be acquired due to various premorbid conditions such as diabetes and alcoholism, bacterial infection such as Lyme disease or a viral illness. Some of the symptoms of ANS which may be associated with an ED include nausea, dysphagia, constipation, pain in the salivary glands early saiety. It also affects peristalsis in the stomach. ANS may cause emotional instability and has been misdiagnosed as various psychiatric disorders including hysterical neurosis and anorexia nervosa.[241]
  • Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare genetic disorder characterized by gastrointestinal dysmotility, severe cachexia progressive external ophthalmoplegia, post-prandial emesis (vomiting after eating), peripheral neuropathy, and diffuse leukoencephalopathy. Onset is prior to age 20 in 60% of cases. ""Miss A" was a 21-year-old Indian woman diagnosed as having treatment-resistant anorexia nervosa." It was subsequently proven to be MNGIE[242][243][244]
  • achalasia; There have been cases where achalasia, a disorder of the esophagus which affects peristalsis, has been misdiagnosed as various eating disorders including anorexia nervosa, bulimia nervosa, compulsive eating disorder and obesity related problems. It has been reported in cases where there is sub-clinical manifestation of anorexia nervosa and also in cases where the full diagnostic criteria AN has been met.[245]
  • superior mesenteric artery syndrome: (SMA) syndrome; "is a gastrointestinal disorder characterized by the compression of the third or transverse portion of the duodenum against the aorta by the superior mesenteric artery resulting in chronic partial, incomplete, acute or intermittent duodenal obstruction". It may occur as a complication of AN or as a differential diagnosis. There have been reported cases of a tentative diagnosis of AN, where upon treatment for SMA syndrome the patient is asymptomatic.[246][247]
    Borrelia burgdorferi
  • Lyme Disease is known as the "great imitator", as it may present as a variety of psychiatric or neurologic disorders including anorexia nervosa. "A 12 year old boy with confirmed Lyme arthritis treated with oral antibiotics subsequently became depressed and anorectic. After being admitted to a psychiatric hospital with the diagnosis of anorexia nervosa, he was noted to have positive serologic tests for Borrelia burgdorferi. Treatment with a 14 day course of intravenous antibiotics led to a resolution of his depression and anorexia; this improvement was sustained on 3 year follow-up."[248][249] Serologic testing can be helpful but should not be the sole basis for diagnosis. The Centers for Disease Control (CDC) issued a cautionary statement (MMWR 54;125) regarding the use of several commercial tests. Clinical diagnostic criteria has been issued by the CDC (CDC, MMWR 1997; 46: 531-535).
  • Addison's Disease; is a disorder of the adrenal cortex which results in decreased hormonal production. Addison's disease, even in subclinical form may mimic many of the symptoms of anorexia nervosa.[250]
  • Simmond's disease (organic hypopituitarism) – "A 20-year-old Japanese man with a hypothalamic tumor which caused hypopituitarism and diabetes insipidus was mistakenly diagnosed as anorexia nervosa because of anorexia, weight loss, denial of being ill, changes in personality, and abnormal behavior resembling the clinical characteristics of anorexia nervosa"(Hotta, M. 1999)
  • Celiac Disease is an inflammatory disorder triggered by peptides from wheat and similar grains which cause an immune reaction in the small intestine."information on the role of the gastrointestinal system in causing or mimicking eating disorders is scarce."(Leffler DA[251]
  • Gastric adenocarcinoma is one of the most common forms of cancer in the world. Complications due to this condition have been misdiagnosed as an eating disorder.[252]
  • helicobacter pylori is a bacteria which causes stomach ulcers and gastritis and has been shown to be a precipitating factor in the development of gastric carcinomas. It also has an affect on circulating levels of leptin and ghrelin, two hormones which help regulate appetite. Upon successful treatment of helicobacter pylori associated gastritis in pre-pubertal children they showed "significant increase in BMI, lean and fat mass along with a significant decrease in circulating ghrelin levels and an increase in leptin levels" (Pacifico, L)."SUMMARY: H. pylori has an influence on the release of gastric hormones and therefore plays a role in the regulation of body weight, hunger and satiety,"(Weigt J, Malfertheiner P).[253][254]
  • Gall bladder disease which may be caused by inflammation, infection, gallstones, obstruction of the gallbladder or torsion of the gall bladder. Many of the symptoms of gall bladder disease may mimic anorexia nervosa (AN). Laura Daly, a woman from Missouri, suffered from an inherited disorder in which the gall bladder was not properly attached; the resultant complications led to multiple erroneous diagnoses of AN. Upon performance of a CCK test, standard imaging techniques are done with the patient lying prone, in this instance it was done with the patient in an upright position. The gall bladder was shown to be in an abnormal position having flipped over the liver. The gallbladder was removed and the patient has since recovered. The treatment was performed by William P. Smedley, M.D., Pennsylvania.
  • colonic tuberculosis misdiagnosed as anorexia nervosa in a physician at the hospital where she worked. "This patient, who had severe wasting, was misdiagnosed as having anorexia nervosa despite the presence of other symptoms suggestive of an organic disease, namely, fever and diarrhea"(Madani, A 2002).[255]
  • Crohn's Disease: "We report three cases of young 18 to 25 year-old girls, initially treated for anorexia nervosa in a psychiatric department. Diagnosis of Crohn's disease was made within 5 to 13 years."(Blanchet C, Luton JP. 2002)"This disease should be diagnostically excluded before accepting anorexia nervosa as final diagnosis". (Wellmann W et al.)[256][257][258][259]
  • Insulinomas, are (pancreatic tumors) that cause an overproduction of insulin causing hypoglycemia. Various neurological deficits have been ascribed to this condition including misdiagnosis as an eating disorder.[260][261][262][263][264]
  • hypothyroidism, hyperthyroidism, hypoparathyroidism and hyperparathyroidism may mimic some of the symptoms of, can occur concurrently with, be masked by or exacerbate an eating disorder.[265][266][267][268][269][270][271][272]
  • Multiple sclerosis (Encephalomyelitis disseminata) is a progressive autoimmune disorder in which the protective covering (myelin sheath) of nerve cells is damaged as a result of inflammation and resultant attack by the bodies own immune system. In its initial presentation MS has been misdiagnosed as an eating disorder.[273]
  • cestodes (tapeworm) infestations can affect various regions of the human body including the gastrointestinal and neuroendocrine systems. While most of those infected are asymptomatic, infestations can cause psychiatric symptoms, epilepsy, megoblastic anemia, weight gain or loss.
    • Cysticercosis is an infection caused by the larval stage of the pork tapeworm (Taenia solium). The larval stage of T. solium can create cysts in various regions of the body including the brain (neurocysticercosis). Hypothalimic cysticercosis has been associated with obesity. Cysts may form in the bile and pancreatic ducts causing full or partial obstruction some of the symptoms may include weight loss, anorexia, or increased appetite.[274][275]
Differential diagnoses/ Comorbid medical disorders

There are multiple medical conditions which may misdiagnosed as a primary psychiatric disorder. These may have have a synergistic effect on conditions which mimic an eating disorder or on a properly diagnosed ED. They also may make it more difficult to diagnose and treat an ED.

  • Lupus: 19 psychiatric conditions have been associated with systemic lupus erythematosus (SLE), including depression and bipolar disorder.[276]
  • Toxoplasma seropositivity even in the absence of symptomatic toxoplasmosis has been linked to changes in human behavior and psychiatric disorders including those comorbid with eating disorders such as depression. In reported case studies the response to antidepressant treatment improved only after adequate treatment for toxoplasma.[277]
  • neurosyphilis;It is estimated that their may be up to one million cases of untreated syphyilis in the U.S. alone. "the disease can present with psychiatric symptoms alone, psychiatric symptoms that can mimic any other psychiatric illness". Many of the manifestations may appear atypical. Up to 1.3% of short term psychiatric admissions may be attributable to neurosyphilis, with a much higher rate in the general psychiatric population. Neurosyphilis like Lyme Disease has been given the appellation the "great imitator" for it may present in various ways such as depression and chronic alcoholism. (Ritchie, M Perdigao J,)[278]
  • dysautonomia a term used to describe a wide variety of autonomic nervous system (ANS) disorders may cause a wide variety of psychiatric symptoms including anxiety, panic attacks and depression. Dysautonomia usually involves failure of sympathetic or parasympathetic components of the ANS system but may also include excessive ANS activity. Dysautonomia can occur in conditions such as diabetes and alcoholism.
Differential diagnoses/Comorbid psychological disorders

There are separate psychological disorders which may be misdiagnosed as an eating disorder.

  • Emetophobia is an anxiety disorder characterized by an intense fear of vomiting. A person so afflicted may develop rigorous standards of food hygiene, such as not touching food with their hands. They may become socially withdrawn to avoid situations which in their perception may make them vomit. Many who suffer from emetophobia are diagnosed with anorexia or self-starvation. In severe cases of emetophobia they may drastically reduce their food intake.[279][280]
  • phagophobia is an anxiety disorder characterized by a fear of eating, it is usually initiated by an adverse experience while eating such as choking or vomiting. persons with this disorder may present with complaints of pain while swallowing.[281]
  • Body dysmorphic disorder (BDD) is listed as a somatoform disorder that affects up to 2% of the population. BDD is characterized by excessive rumination over an actual or perceived physical flaw. BDD has been diagnosed equally among men and women. While BDD has been misdiagnosed as anorexia nervosa, it also occurs comorbidly in 39% of eating disorder cases. BDD is a chronic and debilitating condition which may lead to social isolation, major depression and suicidal ideation and attempts. Neuroimaging studies to measure response to facial recognition have shown activity predominately in the left hemisphere in the left lateral prefrontal cortex, lateral temporal lobe and left parietal lobe showing hemispheric imbalance in information processing. There is a reported case of the development of BDD in a 21 year old male following an inflammatory brain process. Neuroimaging showed the presence of new atrophy in the frontotemporal region.[282][283][284][285][286]


Treatment varies according to type and severity of eating disorder. Usually more than one treatment option is utilized.[287] Some of the treatment methods are:

  • Cognitive Behavioral Therapy(CBT)[288][289][290] is an evidence based approach. The basic premise is that a person's thoughts cause their feelings and behaviors not external stimulus like other people, situations or events in a persons life. The rational is to change how a person thinks and reacts to a situation even if the situation itself does not change. CBT has been shown to be efficacious in the treatment of bulimia nervosa.
  • Family Therapy[292]
    • Maudsley Family Therapy; The Maudsley model of family-based treatment for anorexia nervosa, was developed in the 1980s (Dare, 1985), it utilizes a variety of family therapy models and is designed for use with adolescents 18 and under who are living with their families. It is an evidence based approach designed as an aggressive intervention within three years of the onset of anorexia nervosa and bulimia nervosa.[293][294]
  • Behavioral Therapy; focuses on gaining control and changing unwanted behaviors.[295]
  • Interpersonal Psychotherapy (IPT); "The current treatment of IPT was developed by the late Gerald Klerman and Myrna Weissman in the 1980s as a means of operationalising the interpersonal approach to psychotherapy for a series of treatment studies in depression conducted in the United States. Since that time it has been modified for a variety of other indications including Dysthymia, Bulimia Nervosa, Substance Misuse ,Somatization and depression in a variety of clinical settings. Preliminary studies in Anorexia Nervosa, Bipolar Disorder, PTSD and some anxiety disorders are underway. In each adaptation the fundamentals of the treatment manual are adhered to, however different components are emphasized." (International Society for Interpersonal Psychotherapy)[296]
  • Art Therapy; is the therapeutic use of art. The American Art Therapy Association describes art therapy "as a belief that individuals can resolve conflicts, develop interpersonal skills, and gain self-esteem and insight through the creative process of artistic self-expression".[297]
  • Nutrition counseling[298]
  • Medical Nutrition Therapy; Medical nutrition therapy (MNT) also referred to as Nutrition Therapy is the development and provision of a nutritional treatment or therapy based on a detailed assessment of a person's medical history, psychosocial history, physical examination, and dietary history.[299][300][301]
  • Medication; there are currently medications developed for use in obesity treatment such as Orlistat. To date there are none specifically designed for use in either anorexia or bulimia nervosa although olanzapine has shown promise in various studies for its' propensity to promote weight gain as well as the ability to ameliorate obsessional behaviors concerning weight gain. The Endocrine Research Project has conducted studies with cortisol supplements. Zinc supplements have been shown to be helpful as well.[302][303][304][305][306][307]
  • Self help and guided self help have been shown in various studies to be helpful in varying degrees including cost reduction for treatment in An, BN and BED.[308][309][310][311]
    • Self Help Groups; there are various support and self-help groups for eating disorders which may be helpful and can be used in conjunction with professional treatment. Both Eating Disorders Anonymous and Overeaters Anonymous are based on the traditional 12-step program pioneered in Alcoholics Anonymous. In some instances such as with BED, self help groups alone have been shown to be on par with individual therapy.[312][313]
  • Psychoanalysis is a non evidence based approach. While the psychoanalyst Hilde Bruch, the author of "The Golden Cage" helped bring anorexa nervosa to the public consciousness, the discipline has fallen into disrepute. "Alice Eagly, the chairwoman of the psychology department at Northwestern University, explained why: Psychoanalysis is “not the mainstream anymore” and so “we give it less weight.”".

    Psychoanalysis has been accused of having iatrogenic, i.e. harmful tendencies."Psychoanalysis is a great idea in personality, just as long as one is a male, who grew up in a two parent house, who had either a sister or female playmate at a very young age, with a great memory, and who has lots of money and no specific time frame in which one would like one's psychological problems cured." (Popkin, Nathan. NWU)."Psychoanalysis is a spurious, ineffective pseudoscience, Freud's legacy continues to inform a "therapeutic" tradition that destroys people's lives." (Frederick Crews).[314] In 2004 The French Institute of Health and Medical Research (INSERM) issued an official government funded report on three separate therapeutic approaches. The report was highly critical of the efficacy of psychoanalysis.[315][316]

Paying for treatment

Unfortunately getting the proper diagnosis and treatment for an eating disorder is expensive.[317][318] There are few studies on cost effectiveness of various treatment modalities and none on how a patients socioeconomic status affects treatment.[319] Patients with anorexia nervosa are often discharged early while still underweight due to limitations in health care coverage, which results in relapse and rehospitalization.[320]

  • In the United Kingdom there are about two dozen NHS eating disorders clinics. But quality and access to care depend upon the region the patient lives in. They are also subject to the NICE:guidelines There are several private clinics in the U.K., the average cost is £300 to £500 per day. Occasionally the NHS will cover this cost. The best source of information is the non-profit organization beat.[321][322]
  • In the United States the cost of in treatment is not always fully covered by private insurance. The National Eating Disorders Association provides information on how deal with insurance companies more effectively. Medicaid and Medicare do cover the cost of eating disorder treatment and they are accepted at various hospitals and some private clinics. Quality and accessibility to services vary by state. Some organizations such as The Manna Fund also offer private "scholarships" to help defray the cost.
  • In Canada the national health insurance program, often referred to as "Medicare", is composed of 13 provincial and territorial health insurance plans they share certain common features but not all, access and quality of care may be better in certain provinces and not all services are covered. The National Eating Disorder Information Centre (NEDIC) is a non-profit entity that provides information on resources.


Monarch Butterfly Pink Zinnia 1800px.jpg

There are varying estimates as to the prognosis of individual eating disorders as the criteria used to arrive at the respective conclusions vary. With increasing knowledge as to the causes of individual eating disorders and which treatment options prove to be the most efficacious, the remission rates and ultimately full recovery rates rise.

  • anorexia nervosa (AN);for AN the remission rate has been placed between 75%-83%, with varying estimates as to the full recovery rate. Dr. Walter Vandereycken a noted expert in the field chooses to be optimistic in his prognostic assessment and places the potential recovery rate at 70%.[323]
  • bulimia nervosa (BN); for BN the remission rate has been placed as high as 75%[324] In a 7.5 year follow-up study done by Herzog et al. at the Harvard Medical School the full recovery rate for BN was 74%, 99% of those with BN achieved at least partial recovery.[325]
  • binge eating disorder (BED); the outcomes of studies on BED treatment were predicated on the absence of binge eating episodes at 6mo. and 12mo. followup, the rate in this study was 51.7%. The reduction of binge eating episodes was 88.3%.[326]


  • Anorexia Misdiagnosed Publisher:Laura A. Daly; 1st edition (December 15, 2006) Language:English ISBN 0938279076 ISBN 978-0938279075
  • Wasted: A Memoir of Anorexia and Bulimia Marya Hornbacher. Publisher: Harper Perennial; 1 edition (January 15, 1999) Language: English ISBN 0060930934 ISBN 978-0060930936
  • Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence By Bryan Lask, Rachel Bryant-Waugh Publisher: Psychology Press; 2 edition (October 12, 2000) ISBN 0863778046 ISBN 978-0863778049
  • Too Fat or Too Thin?: A Reference Guide to Eating Disorders; Cynthia R. Kalodner. Publisher: Greenwood Press; 1 edition (August 30, 2003) Language: English ISBN 0313315817 ISBN 978-0313315817
  • Overcoming Binge Eating; Christopher Fairburn. Publisher: The Guilford Press; Reissue edition (March 10, 1995) Language:English ISBN 0898621798 ISBN 978-0898621792
  • The Great Starvation Experiment: Ancel Keys and the Men Who Starved for Science. By Todd Tucker. (Minneapolis: University of Minnesota Press, 2006. ISBN 9780816651610.)
  • The Golden Cage: The Enigma of Anorexia Nervosa: Hilde Bruch. Publisher: Vintage (March 12, 1979) Language: English ISBN 039472688X ISBN 978-0394726885
  • Phantoms in the Brain : Probing the Mysteries of the Human Mind, VS Ramachandran, Sandra Blakeslee, Publisher: Harper Perennial (August 18, 1999) Language:English ISBN 0688172172 ISBN 978-0688172176
  • Psychiatric Aspects of ImpulsivityF. Gerard Moeller, M.D., Ernest S. Barratt, Ph.D., Donald M. Dougherty Am J Psychiatry 158:1783-1793, November © 2001 American Psychiatric Association
  • Blascovich, J., & Tomaka, J. (1991). Measures of self-esteem. In J. P. Robinson, P. R. Shaver, & L. S. Wrightsman (Eds.) Measures of personality and social psychological attitudes, Volume I. San Diego, CA: Academic Press.
  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Abstract
  • The many faces of perfectionism, The need for perfection comes in different flavors, each associated with its own set of problems, researchers say. By ETIENNE BENSON. Monitor Staff, November 2003, Vol 34, No. 10 Print version: page 18Article
  • Psychiatric Times. July 1, 2000 Vol. 17 No. 7 When a Patient Has No Story To Tell: Alexithymia Rený J. Muller, Ph.D. Article
  • A test of behavioral rigidity. Schaie, K. Warner The Journal of Abnormal and Social Psychology. Vol 51(3), Nov 1955, 604-610.Article
  • Stewin, L (September 1983). "The concept of rigidity: An enigma". Advancement of Counselling 6 (3): 227–232. doi:10.1007B/F00124273. 
  • Waniek C; Prohovnik I; Kaufman MA; Dwork AJ Rapidly progressive frontal-type dementia associated with Lyme disease. New York State Psychiatric Institute, NY 10032, USA.J Neuropsychiatry Clin Neurosci 1995 Summer;7(3):345-7 Abstract
  • William Sheehan, Steven Thurber. Anorexia Nervosa: A Suggestion for an Altruistic Paradigm from an Evolutionary Perspective. Article
  • Forman-Hoffman VL, Cunningham CL Geographical clustering of eating disordered behaviors in U.S. high school students Int J Eat Disord. 2008 Apr;41(3):209-14.PMID 18027858 U.S. Govt. Funded
  • Decline and Fall of the Freudian Empire by Hans Eyesneck Publisher:Transaction Publishers; Revised edition (August 13, 2004) Language: English ISBN 0765809451 ISBN 978-0765809452
  • The lengthening hour: Time and the demise of psychoanalysis as therapy. Social Science & Medicine, Volume 20, Issue 9, 1985, Pages 939-943 Kenneth P. Starkey
  • Madness on the couch: blaming the victim in the heyday of psychoanalysis By Edward Dolnick Publisher: Simon & Schuster; 1 edition (October 7, 1998) Language: English ISBN 0684824973 ISBN 978-0684824970

See also


  1. ^ Patrick L.Eating disorders: a review of the literature with emphasis on medical complications and clinical nutrition. Alternative Medicine review, 2002 Jun;7(3)184-202 PMID 12126461
  2. ^ Streigel-Moore RH Franko DL Should binge eating disorder be included in the DSM-V? A critical review of the state of the evidence. Annual Review of Clinical Psychology 2008;4:305-24. PMID 18370619
  3. ^ Hudson et al.The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication.[Biological Psychiatry.2007 Feb 1;61(3)348-58 PMID 16815322]
  4. ^ Gard MC, Freeman CP. The dismantling of a myth: a review of eating disorders and socioeconomic status. International Journal of Eating Disorders July 20(1);1-12 PMID 8807347
  5. ^ Schreiber GB modification efforts reported by black and white preadolescent girls: National Heart, Lung, and Blood Institute Growth and Health Study. Pediatrics. 1996 Jul;98(1):63-70.PMID 8668414
  6. ^ Biederman J.Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study. Dev Behav Pediatr. 2007 Aug;28(4):302-7.PMID 17700082
  7. ^ Girls With ADHD Are at Increased Risk for Eating Disorders and Depression Medline Article
  8. ^ Northwest Foster Care Alumni Study[1]
  9. ^ Sullivan PF. Mortality in anorexia nervosa. Biological Psychiatry 2007 Feb 1;61(3)348-58:1073-1074 PMID 7793446
  10. ^ Hudson JI et al.The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry.2007 Feb 1;61(3)348-58 PMID 16815322
  11. ^ Keel PK et al. Predictors of mortality in eating disorders Arch Gen Psychiatry 2003;Feb.60(2):179-83 PMID 12578435
  12. ^ Sullivan PF Mortality in anorexia nervosa. Am J Psychiatry 1995;152:1073-1074 PMID 7793446
  13. ^ Available at National Institute of Mental Health National Comorbidity Survey(NCS) and NCS-Revised (NCSR)
  14. ^ Robinson P, Andersen A. Anorexia nervosa in American blacks J Psychiatr Res. 1985;19(2-3):183-8.PMID 4045739
  15. ^ American Journal of Psychiatry 2009 Dec;166(12):1342-6. PMID 19833789
  16. ^ Lucas, Beard,Kurland 50 year trends in the incidence of anorexia in Rochester, Minnesota; a population based study, American Journal of Psychiatry Jul;1991 148 (7);917-922 PMID 2053633
  17. ^ Caralat DJ,Carmago CA Jr Review of bulimia nervosa in men American Journal of Psychiatry 1991Jul;148(7)831-834 PMID 2053621
  18. ^ The evolving genetics of eating disorders Psychiatric Clinics of North America 2001 Jun;24 (2):215-225 PMID 11416922
  19. ^ Genetics in eating disorders:state of the science CNS Spectrum.2004 Jul;9(7):215-225 PMID 11416922
  20. ^ Environmental and genetic factors for eating disorders: what the clinician needs to know Child and Adolescent Psychiatric Clinics of North America Jan;18(1):67-82 PMID 19014858
  21. ^ Gross MJ Corticotropin-releasing factor and anorexia nervosa: reactions of the hypothalamus-pituitary-adrenal axis to neurotropic stressAnn Endocrinol (Paris). 1994;55(6):221-8. PMID 7864577
  22. ^ Licinio J, Wong ML,The hypothalamic-pituitary-adrenal axis in anorexia nervosa. Gold PW.Psychiatry Res. 1996 Apr 16;62(1):75-83.PMID 8739117
  23. ^ Chaudhri O, Small C, Bloom S. Gastrointestinal hormones regulating appetite. Philos Trans R Soc Lond B Biol Sci. 2006 Jul 29;361(1471):1187-209. PMID 16815798
  24. ^ Gendall KA.Leptin, neuropeptide Y, and peptide YY in long-term recovered eating disorder patients. Biol Psychiatry. 1999 Jul 15;46(2):292-9. PMID 10418705
  25. ^ Jimerson DC,,Eating disorders and depression: is there a serotonin connection? Biol Psychiatry. 1990 Sep 1;28(5):443-54. PMID 2207221
  26. ^ Leibowitz, The role of serotonin in eating disorders. Drugs 1990;39Suppl 3:33-44 PMID 2197074
  27. ^ Blundell et al.serotonin, eating behavior, fat intake Obes Res 1995 Nov;3 Suppl4:471s-476s PMID 8697045
  28. ^ Kaye WH, Anorexia, obsessional behavior and serotonin, Psycopharmacology Bulletin 1997;33(3)335-44 PMID 9550876
  29. ^ Bailer UF et al.Altered 5-HT(2A) receptor binding after recovery from bulimia-type anorexia nervosa: relationships to harm avoidance and drive for thinness. Neuropsychopharmacology. 2004 Jun;29(6):1143-55. PMID 15054474
  30. ^ Hainer V et al.,Serotonin and norepinephrine reuptake inhibition and eating behavior. Annals of The New York Academy of Sciences 2006 Nov;1083:252-69 PMID 17148744
  31. ^ Altered norepinephrine in bulimia: effects of pharmacological challenge with isoproternol Psychiatric Residency 1990 Jul;33 (1):1PMID 2171006
  32. ^ Wang et, al. Brain dopamine and obesity Lancet 2001 Feb. 3;357(9253):354-357 PMID 11210998
  33. ^ Volknow et al. Brain dopamine is associated with eating behavior in humans International Journal of Eating Disorder 2003 Mar:33 (2)136-42 PMID 1216579
  34. ^ Frederich R, Hu S, Raymond N, Pomeroy C. Leptin in anorexia nervosa and bulimia nervosa: importance of assay technique and method of interpretation. PMID 11919545
  35. ^ Fetissov SO et al.Autoantibodies against neuropeptides are associated with psychological traits in eating disorders. Proc Natl Acad Sci U S A. 2005 Oct 11;102(41):14865-70. Epub 2005 Sep 29.PMID 16195379
  36. ^ Sinno al. Regulation of feeding and anxiety by alpha-MSH reactive autoantibodies. Psychoneuroendocrinology. 2009 Jan;34(1):140-9. Epub 2008 Oct 8.PMID 18842346
  37. ^ Sokol MS. Child Adolesc Psychopharmacol. 2000 Summer;10(2):133-45.Infection-triggered anorexia nervosa in children: clinical description of four cases. PMID 10933123
  38. ^ Uher R, Treasure J. Brain lesions and eating disorders. J Neurol Neurosurg Psychiatry. 2005 Jun;76(6):852-7. PMID 15897510
  39. ^ Houy E et al.Anorexia nervosa associated with right frontal brain lesion. Int J Eat Disord. 2007 Dec;40(8):758-61. PMID 17683096
  40. ^ Trummer M et al.,Right hemispheric frontal lesions as a cause for anorexia nervosa report of three cases Acta Neurochir (Wien). 2002 Aug;144(8):797-801; discussion 801. PMID 12181689
  41. ^ Winston AP Pineal germinoma presenting as anorexia nervosa: Case report and review of the literature. Int J Eat Disord. 2006 Nov;39(7):606-8. PMID 17041920
  42. ^ Chipkevitch E, Fernandes AC. Hypothalamic tumor associated with atypical forms of anorexia nervosa and diencephalic syndrome. Arq Neuropsiquiatr. 1993 Jun;51(2):270-4. PMID 8274094
  43. ^ Rohrer TR et al.Craniopharyngioma in a female adolescent presenting with symptoms of anorexia nervosa. Klin Padiatr. 2006 Mar-Apr;218(2):67-71. PMID 16506105
  44. ^ Chipkevitch E. Brain tumors and anorexia nervosa syndrome. Brain Dev. 1994 May-Jun;16(3):175-9, discussion 180-2.PMID 7943600
  45. ^ Lin L et al. Brain tumor presenting as anorexia nervosa in a 19-year-old man. J Formos Med Assoc. 2003 Oct;102(10):737-40. PMID 14691602
  46. ^ Conrad R et al. Nature against nurture, calcification in the right thalamus in a young man with anorexia nervosa and obsessive compulsive personality-disorder CNS Spectrum 2008 Oct;13(10)906-10 PMID 18955946
  47. ^ Burke CJ, Tannenberg AE, Payton DJ Ischaemic cerebral injury, intrauterine growth retardation, and placental infarction. Dev Med Child Neurol. 1997 Nov;39(11):726-30.PMID 9393885
  48. ^ Cnattinghuis S Very pre-term birth, birth trauma and the risk of anorexia nervosa among girls. Arch Gen Psychiatry 1999 Jul;56(7):634-8PMID 10401509
  49. ^ Favoro A et al. Perinatal factors and the risk of developing anorexia nervosa and bulimia nervosa Arch Gen Psychiatry 2006 Jan;63(1)82-8. PMID 16389201
  50. ^ Favoro A The relationship between obstetric complications and temperament in eating disorders:a mediation hypothesis Psychosom Med 2008 Apr.70(3):372-7 PMID 18256341
  51. ^ Decker MJ et al.Episodic neonatal hypoxia evokes executive dysfunction and regionally specific alterations in markers of dopamine signaling. Neuroscience. 2003;117(2):417-25. PMID 12614682
  52. ^ Decker MJ, Rye DB.Neonatal intermittent hypoxia impairs dopamine signaling and executive functioning. Sleep Breath. 2002 Dec;6(4):205-10. PMID 12524574
  53. ^ Scher MS.Fetal and neonatal neurologic case histories: assessment of brain disorders in the context of fetal-maternal-placental disease. Part 1: Fetal neurologic consultations in the context of antepartum events and prenatal brain development. J Child Neurol. 2003 Feb;18(2):85-92. PMID 12693773
  54. ^ Scher MS, Wiznitzer M, Bangert BA.Cerebral infarctions in the fetus and neonate: maternal-placental-fetal considerations. Clin Perinatol. 2002 Dec;29(4):693-724, vi-vii. PMID 12516742
  55. ^ Burke CJ, Tannenberg AEDev Med Child Neurol. 1995 Jun;37(6):555-62. Prenatal brain damage and placental infarction--an autopsy study. PMID 7789664
  56. ^ Squier M, Keeling JW.The incidence of prenatal brain injury. Neuropathol Appl Neurobiol. 1991 Feb;17(1):29-38. PMID 2057048
  57. ^ Al Mamun A Does maternal smoking during pregnancy have a direct effect on future offspring obesity? Evidence from a prospective birth cohort study. Am J Epidemiol. 2006 Aug 15;164(4):317-25. PMID 16775040
  58. ^ Westen D, Harnden-Fischer J. Personality profiles in eating disorders: rethinking the distinction between axis I and axis II. Am J Psychiatry. 2001 Apr;158(4):547-62. PMID 11282688
  59. ^ Rosenvinge et al. The comorbidity of eating disorders and personality disorders: a metanalytic review of studies between 1983 and 1998 Eating and Weight Disorders 2000 June;5(2):52-61 PMID 10941603
  60. ^ Kaye WH Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American journal of Psychiatry 2004 Dec;161(12)2215-21 PMID 15569892
  61. ^ Thornton C, Russell J.Obsessive compulsive comorbidity in the dieting disorders Int J Eat Disord. 1997 Jan;21(1):83-7. PMID 8986521
  62. ^ Vitousek K, Manke F. Personality variables and disorders in anorexia nervosa and bulimia nervosa. J Abnorm Psychol. 1994 Feb;103(1):137-47. PMID 8040475
  63. ^ Braun Dl Psychiatric comorbidity in patients with eating disorders. Psychological Medicine 1994;24:854-67 PMID 7892354
  64. ^ Spindler A, Milos G. Eat Behav. 2007 Aug;8(3):364-73. Links between eating disorder symptom severity and psychiatric comorbidity. PMID 17606234
  65. ^ Collier R. DSM revision surrounded by controversy. Media has become part of the cause for disorders such as anorexia and bulimia. Psychologists say since the media plays such a powerful role in US culture that it's escalating impressions on youth, beauty and weight have started to have negative effects on women that watch TV and are more exposed to the media. There is no direct evidence given that this is a new study, however, it has increasingly become part of popular media debate. CMAJ. 2009 Nov 17. PMID 19920166
  66. ^ Kutchins H, Kirk SA.DSM-III-R: the conflict over new psychiatric diagnosesHealth Soc Work. 1989 May;14(2):91-101.PMID 2714710
  67. ^ DSM-IV Diagnostic Criteria for Eating Disorders May Be Too Stringent Marlene Busko/ Article
  68. ^ The Politics of Disease Definition: A Summer of DSM-V Controversy in Review. Stanford Center for Law and the BiosciencesArticle
  69. ^ Psychiatry manual's secrecy criticized. Los Angeles Times Article
  70. ^ RC Casper Depression and Anxiety 1998;Suppl 1;96-104 PMID 9809221
  71. ^ Serpell L, Livingstone A, Neiderman M, Lask B.Anorexia nervosa: obsessive-compulsive disorder, obsessive-compulsive personality disorder, or neither? Clin Psychol Rev. 2002 Jun;22(5):647-69. PMID: 12113200
  72. ^ Bulik Et. Al.Alcohol use disorder comorbidity in eating disorders: a multicenter study. Journal of Clinical Psychiatry 2004 July;65(7):1000-6 PMID 15291691
  73. ^ Larsson JO,Hellzen MPatterns of personality disorders in women with chronic eating disorders; Eating and Weight Disorders 2004 Sep;9(3):200-5 PMID 15656014
  74. ^ JN Swinburne Touz Sm The co-morbidity of eating disorders and anxiety: a review Eur Eat Disord Rev 2007 Jul;15(4):253-74 PMID 17676696
  75. ^ Ronningstam E.Pathological narcissism and narcissistic personality disorder in Axis I disorders. Harv Rev Psychiatry. 1996 Mar-Apr;3(6):326-40. PMID 9384963
  76. ^ Anderlich MB American Journal of Psychiatry 2003 Feb;160(2)242-7 PMID 12562569
  77. ^ Pinto A, Mancebo MC, Eisen JL, Pagano ME, Rasmussen SA. The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake. Clin Psychiatry. 2006 May;67(5):703-11.PMID 16841619
  78. ^ Lucka I, Cebella A. Characteristics of the forming personality in children suffering from anorexia nervosa Psychiatr Pol. 2004 Nov-Dec;38(6):1011-8.PMID 15779665
  79. ^ Bulimia nervosa and attention deficit hyperactivity disorder: a possible role for stimulant medication. Dukarm CP. J Women's Health (Larchmt). 2005 May;14(4):345-50. PMID 15916509
  80. ^ Mikami AY et, el.Bulimia nervosa symptoms in the Multimodal Treatment Study of Children with ADHD. Int J Eat Disord. 2009 Apr 17 PMID 19378318
  81. ^ Biederman J. et al.Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study. J Dev Behav Pediatr. 2007 Aug;28(4):302-7. PMID 17700082
  82. ^ Cortese S. et al.Attention-deficit/hyperactivity disorder (ADHD) and binge eating Nutr Rev. 2007 Sep;65(9):404-11. Nutr Rev. 2008 Jun;66(6):357. PMID 17958207
  83. ^ Bruce KR et, al.Bulimia nervosa with co-morbid avoidant personality disorder: behavioural characteristics and serotonergic function. Psychol Med. 2004 Jan;34(1):113-24.PMID 14971632
  84. ^ Podar I, Hannus A, and affectivity characteristics associated with eating disorders: a comparison of eating disordered, weight-preoccupied, and normal samples .J Pers Assess. 1999 Aug;73(1):133-47.PMID 10497805
  85. ^ Gardini S et al.Individual differences in personality traits reflect structural variance in specific brain regions. Brain Res Bull. 2009 Jun 30;79(5):265-70. Epub 2009 Mar 28. PMID 19480986
  86. ^ Marsh AA et al. Reduced amygdala response to fearful expressions in children and adolescents with callous-unemotional traits and disruptive behavior disorders. Am J Psychiatry. 2008 Jun;165(6):712-20. Epub 2008 Feb 15. PMID 18281412
  87. ^ Iidaka T et al. Volume of left amygdala subregion predicted temperamental trait of harm avoidance in female young subjects. A voxel-based morphometry study. Brain Res. 2006 Dec 13;1125(1):85-93. Epub 2006 Nov 17. PMID 17113049
  88. ^ Rubino V et al.Activity in medial prefrontal cortex during cognitive evaluation of threatening stimuli as a function of personality style.
  89. ^ Spinella M, Lyke J. Executive personality traits and eating behavior. Int J Neurosci. 2004 Jan;114(1):83-93. PMID 14660070
  90. ^ Sinai C. hormones and personality traits in attempted suicide. Psychoneuroendocrinology. 2009 Nov;34(10):1526-32. Epub 2009 Jun 13.PMID 19525070
  91. ^ Thompson RL, Brossart DF, Carlozzi AF, Miville ML. Five-factor model (Big Five) personality traits and universal-diverse orientation in counselor trainees. J Psychol. 2002 Sep;136(5):561-72.PMID 12431039
  92. ^ DeYoung CG, Peterson JB, Higgins DM.J Pers. Sources of openness/intellect: cognitive and neuropsychological correlates of the fifth factor of personality.2005 Aug;73(4):825-58.PMID 15958136
  93. ^ MacLaren VV, Best LA.Female students' disordered eating and the big five personality facets. Eat Behav. 2009 Aug;10(3):192-5. Epub 2009 Apr 17.PMID 19665103
  94. ^ Heaven PC, Mulligan K, Merrilees R, Woods T, Fairooz Y. Neuroticism and conscientiousness as predictors of emotional, external, and restrained eating behaviors. Int J Eat Disord. 2001 Sep;30(2):161-6.PMID 11449449
  95. ^ Casper RC, Hedeker D, McClough JF. Personality dimensions in eating disorders and their relevance for subtyping. J Am Acad Child Adolesc Psychiatry. 1992 Sep;31(5):830-40.PMID 1400113
  96. ^ Luo X, Kranzler HR, Zuo L, Wang S, Gelernter J. Personality Traits of Agreeableness and Extraversion are Associated with ADH4 VariationBiol Psychiatry. 2007 Mar 1;61(5):599-608. Epub 2006 Oct 25.PMID 17069770
  97. ^ Wright CI. et. al.Neuroanatomical correlates of extraversion and neuroticism. Cereb Cortex. 2006 Dec;16(12):1809-19. Epub 2006 Jan 18.PMID 16421327
  98. ^ Mendez MF, Chen AK, Shapira JS, Lu PH, Miller BL.Acquired extroversion associated with bitemporal variant of frontotemporal dementia. J Neuropsychiatry Clin Neurosci. 2006 Winter;18(1):100-7.PMID 16525077
  99. ^ Rankin KP. and left medial orbitofrontal volumes show an opposite relationship to agreeableness in FTD. Dement Geriatr Cogn Disord. 2004;17(4):328-32.PMID 15178947
  100. ^ Graziano WG, Tobin RM.Agreeableness: dimension of personality or social desirability artifact? Bergeman CS Genetic and environmental effects on openness to experience, agreeableness, and conscientiousness: an adoption/twin study. J Pers. 1993 Jun;61(2):159-79.PMID 8345444
  101. ^ J Pers. 2002 Oct;70(5):695-727. PMID 12322857
  102. ^ Miller JL and introversion: a risky combination for disordered eating among a non-clinical sample of undergraduate women. Eat Behav. 2006 Jan;7(1):69-78. Epub 2005 Aug 1. PMID 16360625
  103. ^ Takano A, Relationship between neuroticism personality trait and serotonin transporter binding. Biol Psychiatry. 2007 Sep 15;62(6):588-92. Epub 2007 Mar 6. PMID 17336939
  104. ^ Deckersbach T, 'et al..Regional cerebral brain metabolism correlates of neuroticism and extraversion. Depress Anxiety. 2006;23(3):133-8. PMID 16470804
  105. ^ Button EJ Self esteem, eating problems and psychological wellbeing in a cohort of school age 15-16: question and interview PMID 8986516Int J Eat Disord 1997 Jan;21(1):39-41
  106. ^ Strober M.,Personality factors in anorexia nervosa.,Pediatrician. 1983-1985;12(2-3):134-8. PMID 6400211
  107. ^ Eiber R et al..Self-esteem: a comparison study between eating disorders and social phobia. Encephale. 2003 Jan-Feb;29(1):35-41. PMID 12640325
  108. ^ Favaro A, Tenconi E, Santonastaso P.The relationship between obstetric complications and temperament in eating disorders: a mediation hypothesis. Psychosom Med. 2008 Apr;70(3):372-7. Epub 2008 Feb 6.PMID 18256341
  109. ^ Iidaka T. Volume of left amygdala subregion predicted temperamental trait of harm avoidance in female young subjects. A voxel-based morphometry study. Brain Res. 2006 Dec 13;1125(1):85-93. Epub 2006 Nov 17.PMID 17113049
  110. ^ Peterson CB.Personality dimensions in bulimia nervosa, binge eating disorder, and obesity. Compr Psychiatry. 2010 Jan-Feb;51(1):31-6. Epub 2009 May 2. PMID 19932823
  111. ^ Gardini S, Cloninger CR, Venneri A.Individual differences in personality traits reflect structural variance in specific brain regions. Brain Res Bull. 2009 Jun 30;79(5):265-70. Epub 2009 Mar 28.PMID 19480986
  112. ^ Halmi KA et al.Perfectionism in anorexia nervosa: variation by clinical subtype, obsessionality, and pathological eating behavior. Am J Psychiatry. 2000 Nov;157(11):1799-805. PMID 11058477
  113. ^ Ruggiero GM al.Stress situation reveals an association between perfectionism and drive for thinness. Int J Eat Disord. 2003 Sep;34(2):220-6. PMID 12898558
  114. ^ Hewitt PL"The impact of perfectionistic self-presentation on the cognitive, affective, and physiological experience of a clinical interview Psychiatry. 2008 Summer;71(2):93-122. PMID 18573033
  115. ^ Frewen PA, Pain C, Dozois DJ, Lanius RA. Alexithymia in PTSD: psychometric and FMRI studies. Ann N Y Acad Sci. 2006 Jul;1071:397-400.PMID 16891585
  116. ^ O Guilbaud et, al. Alexithymia and depression in eating disorders Encephale. 2000 Sep-Oct(5);1-6 PMID 11192799
  117. ^ Smith, al.Alexithymia in patients with eating disorders: an investigation using a new projective technique. Percept Mot Skills. 1997 Aug;85(1):247-56. PMID 9293583
  118. ^ Peskine A, Picq C, Pradat-Diehl P.Brain Inj. Cerebral anoxia and disability. 2004 Dec;18(12):1243-54.PMID 15666568
  119. ^ Ho AK, Robbins AO, Barker RAHuntington's disease patients have selective problems with insightMov Disord. 2006 Mar;21(3):385-9. PMID 16211608
  120. ^ Tchanturia K et al.Perceptual illusions in eating disorders: rigid and fluctuating styles Behav Ther Exp Psychiatry. 2001 Sep;32(3):107-15. PMID 11934124
  121. ^ Cserjési R.Affect, cognition, awareness and behavior in eating disorders. Comparison between obesity and anorexia nervosa. Orv Hetil. 2009 Jun 1;150(24):1135-43. PMID 19482720
  122. ^ Bechara A, Damasio AR, Damasio H, Anderson SW. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994 Apr-Jun;50(1-3):7-15.PMID 8039375
  123. ^ Eysenck SB, Eysenck HJ.The place of impulsiveness in a dimensional system of personality description Br J Soc Clin Psychol. 1977 Feb;16(1):57-68. PMID 843784
  124. ^ Welch SL, Fairburn CG. Impulsivity or comorbidity in bulimia nervosa. A controlled study of deliberate self-harm and alcohol and drug misuse in a community sample. Br J Psychiatry. 1996 Oct;169(4):451-8. PMID 8894196
  125. ^ Corstorphine E et al. Trauma and multi-impulsivity in the eating disorders. Eat Behav. 2007 Jan;8(1):23-30. Epub 2004 Sep 22. PMID 17174848
  126. ^ Patton JH, Stanford MS, Barratt ES. J Clin Psychol. 1995 Nov;51(6):768-74. Factor structure of the Barratt impulsiveness scale. PMID 8778124
  127. ^ Chamberlain SR, Sahakian BJ. The neuropsychiatry of impulsivity Curr Opin Psychiatry. 2007 May;20(3):255-61. PMID 17415079
  128. ^ Smith CF.Association of dietary restraint and disinhibition with eating behavior, body mass, and hunger. Eat Weight Disord. 1998 Mar;3(1):7-15.PMID 11234257
  129. ^ Bryant EJ, King NA, Blundell JE. Disinhibition: its effects on appetite and weight regulation. Obes Rev. 2008 Sep;9(5):409-19. Epub 2007 Dec 26.PMID 18179615
  130. ^ Personality and substance dependence symptoms: modeling substance-specific traits. Grekin ER, Sher KJ, Wood PK. Psychol Addict Behav. 2006 Dec;20(4):415-24.PMID 17176176
  131. ^ Young SE et. al.Genetic and environmental influences on behavioral disinhibition Am J Med Genet. 2000 Oct 9;96(5):684-95.PMID 11054778
  132. ^ Young SE disinhibition: liability for externalizing spectrum disorders and its genetic and environmental relation to response inhibition across adolescence. J Abnorm Psychol. 2009 Feb;118(1):117-30.PMID 19222319
  133. ^ Emond V, Joyal C, Poissant H.Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD) Encephale. 2009 Apr;35(2):107-14. Epub 2008 Jul 7.PMID 19393378
  134. ^ Spiegel DR.,Qureshi N., The successful treatment of disinhibition due to a possible case of non-human immunodeficiency virus neurosyphilis: a proposed pathophysiological explanation of the symptoms and treatment.doi:10.1016/j.genhosppsych.2009.01.002
  135. ^ Aarsland D, Litvan I, Larsen JP Neuropsychiatric symptoms of patients with progressive supranuclear palsy and Parkinson's disease. J Neuropsychiatry Clin Neurosci. 2001 Winter;13(1):42-9.PMID 11207328
  136. ^ Zubieta JK. Obsessionality in eating-disorder patients: relationship to clinical presentation and two-year outcome. J Psychiatr Res. 1995 Jul-Aug;29(4):333-42.PMID 8847659
  137. ^ Salkovskis PM, Forrester E, Richards C. Cognitive-behavioural approach to understanding obsessional thinking. Br J Psychiatry Suppl. 1998;(35):53-63. PMID 9829027
  138. ^ Corcoran KM, Woody SR. Appraisals of obsessional thoughts in normal samples. Behav Res Ther. 2008 Jan;46(1):71-83. PMID 18093572
  139. ^ Horish N et al. Abnormal, psychosocial situations and eating disorders in adolescence. J.Am. Acad. Child Adolesc Psychiatry 1996 July;35(7) 921-7 PMID 8768353
  140. ^ Kopp et al.The fatal outcome of an individual with anorexia nervosa...OBJECTIVES:: To illustrate the close association between a disturbed psychosocial up-bringing, frequent physical illness, and medical interventions Int J Eat Disord. 2009 Feb 26;43(1):93-96. PMID 19247986
  141. ^ Rayworth BB, Wise LA, Harlow BL. Childhood abuse and risk of eating disorders in women. Epidemiology. 2004 May;15(3):271-8. PMID 15097006
  142. ^ Wonderlich SA,et, al., Relationship of childhood sexual abuse to eating disorders J. Am Acad Child Adolesc. Psychiatry Aug;36(8):110715 PMID 9256590
  143. ^ Feldman MB, Meyer IH.Childhood abuse and eating disorders in gay and bisexual men. Int J Eat Disord. 2007 Jul;40(5):418-23. PMID 17506080
  144. ^ Rohde of child sexual and physical abuse with obesity and depression in middle-aged women. Child Abuse Negl. 2008 Sep;32(9):878-87. Epub 2008 Oct 22. PMID 18945487
  145. ^ Williamson DF.Body weight and obesity in adults and self-reported abuse in childhood. Int J Obes Relat Metab Disord. 2002 Aug;26(8):1075-82.PMID 12119573
  146. ^ Waller G. Sexual abuse and the severity of bulimic symptoms. Br J Psychiatry. 1992 Jul;161:90-3. PMID 1638336
  147. ^ Waller G, Halek C, Crisp AH. Sexual abuse as a factor in anorexia nervosa: evidence from two separate case series. J Psychosom Res. 1993 Dec;37(8):873-9. PMID 8301627
  148. ^ Troop NA, Bifulco A. Childhood social arena and cognitive sets in eating disorders. Br J Clin Psychol. 2002 Jun;41 (Pt 2):205-11. PMID 12034006
  149. ^ Nonogaki K, Nozue K, Oka Y. Social isolation affects the development of obesity and type 2 diabetes in mice. Endocrinology. 2007 Oct;148(10):4658-66. Epub 2007 Jul 19. PMID 17640995
  150. ^ Esplen MJ et al..Relationship between self-soothing, aloneness, and evocative memory in bulimia nervosa. Int J Eat Disord. 2000 Jan;27(1):96-100. PMID 10590454
  151. ^ Larson R, Johnson C. Bulimia: disturbed patterns of solitude. Addict Behav. 1985;10(3):281-90. PMID 3866486
  152. ^ Johnson JG,et al.Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. Am J Psychiatry. 2002 Mar;159(3):394-400. PMID 11870002
  153. ^ Klesges RCJ Parental influences on children's eating behavior and relative weight. Appl Behav Anal. 1983 Winter;16(4):371-8.PMID 6654769
  154. ^ Galloway AT et al.Parental pressure, dietary patterns, and weight status among girls who are "picky eaters".J Am Diet Assoc. 2005 Apr;105(4):541-8. PMID 15800554
  155. ^ Jones C, Harris G, Leung N.Parental rearing behaviours and eating disorders: the moderating role of core beliefs. Eat Behav. 2005 Dec;6(4):355-64. Epub 2005 Jun 13. PMID 16257809
  156. ^ Children's eating attitudes and behaviour: a study of the modelling and control theories of parental influence. Brown R, Ogden J. Health Educ Res. 2004 Jun;19(3):261-71. PMID 15140846
  157. ^ Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics. 2007 Spring;35(1):22-34. PMID 17341215
  158. ^ Page RM, Suwanteerangkul J.Dieting among Thai adolescents: having friends who diet and pressure to diet. Eat Weight Disord. 2007 Sep;12(3):114-24. PMID 17984635
  159. ^ The McKnight Investigators. Risk factors for the onset of eating disorders in adolescent girls: results of the McKnight longitudinal risk factor study. Am J Psychiatry. 2003 Feb;160(2):248-54.PMID 12562570
  160. ^ Paxton SJ et, al. Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls. J Abnorm Psychol. 1999 May;108(2):255-66. PMID 10369035
  161. ^ Rukavina T, Pokrajac-Bulian A. Eat Weight Disord. 2006 Mar;11(1):31-7. Thin-ideal internalization, body dissatisfaction and symptoms of eating disorders in Croatian adolescent girls. PMID 16801743
  162. ^ Garner DM, Garfinkel PE.Socio-cultural factors in the development of anorexia nervosa. Psychol Med. 1980 Nov;10(4):647-56. PMID 7208724
  163. ^ Eisenberg ME, Neumark-Sztainer D, Story M, Perry C.The role of social norms and friends' influences on unhealthy weight-control behaviors among adolescent girls. Soc Sci Med. 2005 Mar;60(6):1165-73. PMID 15626514
  164. ^ Eddy crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. J Psychiatry. 2008 Feb;165(2):245-50. Epub 2008 Jan 15.Comment in: Am J Psychiatry. 2008 Jun;165(6):772-3; author reply 773. PMID 18198267
  165. ^ Nishimura H et al..Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa. Biopsychosoc Med. 2008 Feb 12;2:5. PMID 18267038
  166. ^ Daluiski A Subtle hand changes in patient with bulimia nervosa PMID 9345215
  167. ^ Walsh JM The detection, evaluation and treatment of eating disorders the role of the primary care physician. J Gen Int Med.2000 Aug;15(8):577-90 PMID 10940151
  168. ^ Hirschberg AL Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecol Endocrinol. 2004 Aug;19(2):79-87. PMID 15624269
  169. ^ Naessén S.Polycystic ovary syndrome in bulimic women--an evaluation based on the new diagnostic criteria. Gynecol Endocrinol. 2006 Jul;22(7):388-94. PMID 16864149
  170. ^ McCluskey S. et. al. Polycystic ovary syndrome and bulimia. Fertil Steril. 1991 Feb;55(2):287-91. PMID 1991526
  171. ^ Jahanfar S, Eden JA, Nguyent TV. Gynecol Endocrinol. 1995 Jun;9(2):113-7. Bulimia nervosa and polycystic ovary syndrome. PMID 7502686
  172. ^ Morgan JF.Polycystic ovarian morphology and bulimia nervosa: a 9-year follow-up study. Fertil Steril. 2002 May;77(5):928-31. PMID 12009345
  173. ^ Lujan ME, Chizen DR, Pierson Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies. PMID 18786289
  174. ^ Malcolm A et. al,. Rumination syndrome. Mayo Clin Proc. 1997 Jul;72(7):646-52. PMID 9212767
  175. ^ Papadopoulos V, Mimidis K.The rumination syndrome in adults: a review of the pathophysiology, diagnosis and treatment. J Postgrad Med. 2007 Jul-Sep;53(3):203-6. PMID 17699999
  176. ^ RasquinA functional gastrointestinal disorders: child/adolescent. LS.Gastroenterology. 2006 Apr;130(5):1527-37. PMID 16678566
  177. ^ Ruth-Sahd LA,et al.,Diabulimia: what it is and how to recognize it in critical care. Dimens Crit Care Nurs. 2009 Jul-Aug;28(4):147-53; quiz 154-5. PMID 19546717
  178. ^ Chow LS, et al.,Mechanism of insulin's anabolic effect on muscle: measurements of muscle protein synthesis and breakdown using aminoacyl-tRNA and other surrogate measures. ,Am J Physiol Endocrinol Metab. 2006 Oct;291(4):E729-36. Epub 2006 May 16. PMID 16705065
  179. ^ Affenito SG Women with insulin-dependent diabetes mellitus (IDDM) complicated by eating disorders are at risk for exacerbated alterations in lipid metabolism. Eur J Clin Nutr. 1997 Jul;51(7):462-6. PMID 9234029
  180. ^ Flier JS, Hollenberg AN,ADD-1 provides major new insight into the mechanism of insulin action. Proc Natl Acad Sci U S A. 1999 Dec 7;96(25):14191-2. PMID 10588675
  181. ^ Crow SJ, Keel PK, Kendall D. Eating disorders and insulin-dependent diabetes mellitus. Psychosomatics. 1998 May-Jun;39(3):233-43. PMID 9664770
  182. ^ Ruderman NB, Williamson JR, Brownlee M.Glucose and diabetic vascular disease. FASEB J. 1992 Aug;6(11):2905-14. PMID 1644256
  183. ^ Zucchi P, Ferrari P, Spina ML.Diabetic foot: from diagnosis to therapy G Ital Nefrol. 2005 Jan-Feb;22 Suppl 31:S20-2. PMID 15786395
  184. ^ Tarren-Sweeney M. Patterns of aberrant eating among pre-adolescent children in foster care. J Abnorm Child Psychol. 2006 Oct;34(5):623-34.PMID 17019630
  185. ^ Nattiv A et al.American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007 Oct;39(10):1867-82. PMID 17909417
  186. ^ Otis CL et al.American College of Sports Medicine position stand. The Female Athlete Triad. Med Sci Sports Exerc. 1997 May;29(5):i-ix. PMID 9140913
  187. ^ Papanek PE.The female athlete triad: an emerging role for physical therapy. J Orthop Sports Phys Ther. 2003 Oct;33(10):594-614. PMID 14620789
  188. ^ Strumia R.Dermatologic signs in patients with eating disorders..Am J Clin Dermatol. 2005;6(3):165-73. PMID 15943493
  189. ^ Joyce JM Osteoporosis in women with eating disorders... J Nucl Med 2003 Mar;31(3):325-31 PMID 2308003
  190. ^ Drevelengas A Et. Al. Reversible brain atrophy and subcortical high signal on MRI in a patient with anorexia nervosa. Neuroradiology. 2001 Oct;43(10):838-40. PMID 11688699
  191. ^ Addolorato G et. al A case of marked cerebellar atrophy in a woman with anorexia nervosa and cerebral atrophy and a review of the literature Int J Eat Disord. 1998 Dec;24(4):443-7. PMID 9813771
  192. ^ Pellagra: a rare complication of anorexia nervosa. Eur Child Adolesc Psychiatry. 2007 Oct;16(7):417-20. PMID 17712518
  193. ^ Pompili M. Suicide and attempted suicide in anorexia nervosa and bulimia nervosa Ann Ist Super Sanita. 2003;39(2):275-81. PMID 14587228
  194. ^ Franko DL. et al.What predicts suicide attempts in women with eating disorders? Psychol Med. 2004 Jul;34(5):843-53. Evid Based Ment Health. 2005 Feb;8(1):20 PMID 15500305
  195. ^ Fedorowicz VJ et al. Factors associated with suicidal behaviors in a large French sample of inpatients with eating disorders. Int J Eat Disord. 2007 Nov;40(7):589-95. PMID 17607699
  196. ^ Pritts SD, Susman J.Diagnosis of eating disorders in primary care. Am Fam Physician. 2003 Jan 15;67(2):297-304. 12562151
  197. ^ Arch Gen Psychiatry-Vol 35, Nov 1978 Physical Illness as Psychiatric Disease—Hall et al 1319
  198. ^ Trummer M, Eustacchio S, Unger F, Tillich M, Flaschka G Right hemispheric frontal lesions as a cause for anorexia nervosa report of three cases. Department of Neurosurgery, Karl-Franzens University, Graz, Austria. Acta Neurochir (Wien). 2002 Aug;144(8):797-801; discussion 801. PMID 12181689
  199. ^ O'Brien A, Hugo P, Stapleton S, Lask B."Anorexia saved my life": coincidental anorexia nervosa and cerebral meningioma. Int J Eat Disord. 2001 Nov;30(3):346-9. PMID 11746295
  200. ^ Neill J. Whatever became of the schizophrenogenic mother? Am J Psychother. 1990 Oct;44(4):499-505. PMID 2285075
  201. ^ - CBC at Medline
  202. ^ Urinalysis at Medline
  203. ^ Kawabata M, Kubo N, Arashima Y, Yoshida M, Kawano K.Serodiagnosis of Lyme disease by ELISA using Borrelia burgdorferi flagellum antibodies. PMID 1920889
  204. ^ Western Blot use in Lyme Disease. CDC
  205. ^ Chem-20 at Medline
  206. ^ Lee H, Oh JY, Sung YA, Chung H, Cho WY.The prevalence and risk factors for glucose intolerance in young Korean women with polycystic ovary syndrome. Endocrine. 2009 Oct;36(2):326-32. Epub 2009 Aug 14.PMID 19688613
  207. ^ Takeda N investigation on the mechanism of glucose intolerance in Cushing's syndrome Nippon Naibunpi Gakkai Zasshi. 1986 May 20;62(5):631-48.PMID 3525245
  208. ^ Rolny P, Lukes PJ, Gamklou R, Jagenburg R, Nilson A.A comparative evaluation of endoscopic retrograde pancreatography and secretin-CCK test in the diagnosis of pancreatic disease. Scand J Gastroenterol. 1978;13(7):777-81. PMID 725498
  209. ^ Glasbrenner B dynamics in chronic pancreatitis. Relationship to exocrine pancreatic function, CCK, and PP release. Dig Dis Sci. 1993 Mar;38(3):482-9.PMID 8444080
  210. ^ Montagnese and other serum liver enzymes in underweight outpatients with eating disorders. Int J Eat Disord. 2007 Dec;40(8):746-50.PMID 17610252
  211. ^ Narayanan V, Gaudiani JL, Harris RH, Mehler PS.Liver function test abnormalities in anorexia nervosa-Cause or effect. Int J Eat Disord. 2009 May 7. PMID 19424979
  212. ^ Sherman BM, Halmi KA, Zamudio R.LH and FSH response to gonadotropin-releasing hormone in anorexia nervosa: Effect of nutritional rehabilitation. J Clin Endocrinol Metab. 1975 Jul;41(1):135-42. PMID 1097461
  213. ^ Salvadori A, Fanari P, Ruga S, Brunani A, Longhini E.Chest. Creatine kinase and creatine kinase-MB isoenzyme during and after exercise testing in normal and obese young people. 1992 Dec;102(6):1687-9. PMID 1446472
  214. ^ Walder A, Baumann Increased creatinine kinase and rhabdomyolysis in anorexia nervosa. P.Int J Eat Disord. 2008 Dec;41(8):766-7.PMID 18521917
  215. ^ BUN at Medline
  216. ^ Ernst AA, Haynes ML, Nick TG, Weiss S Usefulness of the blood urea nitrogen/creatinine ratio in gastrointestinal bleeding. JAm J Emerg Med. 1999 Jan;17(1):70-2. PMID 9928705
  217. ^ Sheridan AM, Bonventre JV. Cell biology and molecular mechanisms of injury in ischemic acute renal failure. Curr Opin Nephrol Hypertens. 2000 Jul;9(4):427-34.PMID 10926180
  218. ^ Nelsen DA Jr Gluten-sensitive enteropathy (celiac disease): more common than you think. .Am Fam Physician. 2002 Dec 15;66(12):2259-66.PMID 12507163
  219. ^ Pascual M et al.Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003 Oct;89(10):1152-6.PMID 12975404
  220. ^ Esposito Cet al.Hyperkalemia-induced ECG abnormalities in patients with reduced renal function. Clin Nephrol. 2004 Dec;62(6):465-8. PMID 15630907
  221. ^ [ Electroencephalogram at Medline]
  222. ^ Kameda K, Itoh N, Nakayama H, Kato Y, Ihda S.Frontal intermittent rhythmic delta activity (FIRDA) in pituitary adenoma. Clin Electroencephalogr. 1995 Jul;26(3):173-9.
  223. ^ Mashako MN et al.Crohn's disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. J Pediatr Gastroenterol Nutr. 1989 May;8(4):442-6. PMID 2723935
  224. ^ Kumar MS, Safa AM, Deodhar SD, Schumacher OP. PMID 579717
  225. ^ Nilsson P, Melsen F, Malmaeus J, Danielson BG, Mosekilde L.Relationships between calcium and phosphorus homeostasis, parathyroid hormone levels, bone aluminum, and bone histomorphometry in patients on maintenance hemodialysis. Bone. 1985;6(1):21-7.PMID 2581596
  226. ^ Barium Enema at Medline
  227. ^ Garfinkel PE Newman A the eating attitudes test: 25 years later J Eat Weight Disord 2001 Mar;6(1)1-24 PMID 11300541
  228. ^ Rueda of the SCOFF questionnaire for screening of eating disorders in university women. Biomedica. 2005 Jun;25(2):196-202. PMID 16022374
  229. ^ Probst M et al.Evaluation of body experience questionnaires in eating disorders in female patients (AN/BN) and nonclinical participants. Int J Eat Disord. 2008 Nov;41(7):657-65. PMID 18446834
  230. ^ Ben-Tovim DI, Walker MK. A quantitative study of body-related attitudes in patients with anorexia and bulimia nervosa. Psychol Med. 1992 Nov;22(4):961-9.PMID 1488491
  231. ^ Olson MS et al.Self-reports on the Eating Disorder Inventory by female aerobic instructors. Percept Mot Skills. 1996 Jun;82 (3 Pt 1):1051-8. PMID 8774050
  232. ^ Wilfley DE,Using the eating disorder examination to identify the specific psychopathology of binge eating disorder. PMID 10694711
  233. ^ Ehle G et al.Psychodiagnostic findings in anorexia nervosa and post-pill amenorrhea. Psychiatr Neurol Med Psychol (Leipz). 1982 Nov;34(11):647-56. PMID 7170321
  234. ^ Kennedy SH in anorexia nervosa and bulimia nervosa: discriminating depressive symptoms and episodes. J Psychosom Res. 1994 Oct;38(7):773-82. PMID 7877132
  235. ^ Camargo EE.Brain SPECT in neurology and psychiatry. J Nucl Med. 2001 Apr;42(4):611-23. PMID 11337551
  236. ^ Centers for Disease Control and Prevention (National Center for Health Statistics). Births and Deaths: Preliminary Data for 1998. National Vital Statistics Reports. 47(25):6, 1999.
  237. ^ Newman-Toker DE, Pronovost PJ, “Diagnostic Errors—The Next Frontier for Patient Safety,” JAMA. 2009;301(10):1060-1062.
  238. ^ National Comorbidity Survey
  239. ^ /
  240. ^ Britain apologizes for 'Third World' hospital
  241. ^ Okada F.Psychiatric aspects of acute pandysautonomia. Eur Arch Psychiatry Clin Neurosci. 1990;240(2):134-5.PMID 2149650
  242. ^ Feddersen B. Mitochondrial neurogastrointestinal encephalomyopathy mimicking anorexia nervosa. Am J Psychiatry. 2009 Apr;166(4):494-5.PMID 19339372
  243. ^ Mitochondrial Neurogastrointestinal Encephalomyopathy Mimicking Anorexia Nervosa Article
  244. ^ Mitochondrial Neurogastrointestinal Encephalopathy Disease
  245. ^ Riterrrich A,et al.Achalasia mimicking pre-pubertal anorexia. Int J Eat Disord 2003 Apr.33;(3):356-9 [PMID 12655633]
  246. ^ Gerasimidis T. Superior mesenteric artery syndrome, Wilkie Syndrome. Dig Surg 2009 26;(3):213-14 PMID 19468230
  247. ^ Kornmehl P.Superior mesenteric artery syndrome presenting as anorexia-like illness. J Adolscen Health Care 1988 Jul;9(4):30-3 PMID 3417512
  248. ^ Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness. Am J Psychiatry. 1994 Nov;151(11):1571-83. PMID 7943444
  249. ^ Pachner AR. Borrelia burgdorferi in the Nervous System: the New "Great Imitator." In Lyme Disease and Related Disorders. Annals New York Academy of Sciences 539: 56-64, 1988. PMID 3190104
  250. ^ Adams R et al.Prompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting. South Med J. 1998 Feb;91(2):208-11. PMID 9496878
  251. ^ Leffler DA, Dennis M, Edwards George JB, Kelly CP.The interaction between eating disorders and celiac disease: an exploration of 10 cases. Eur J Gastroenterol Hepatol. 2007 Mar;19(3):251-5. PMID 17301653
  252. ^ Siew LC, Huang C, Fleming J.Gastric adenocarcinoma mistakenly diagnosed as an eating disorder: Case report. Int J Eat Disord. 2009 Apr 13. [Epub ahead of print] PMID 19365820
  253. ^ Pacifico L, Anania C, Osborn JF, Ferrara E, Schiavo E, Bonamico M, Chiesa C.Long-term effects of Helicobacter pylori eradication on circulating ghrelin and leptin concentrations and body composition in prepubertal children. Eur J Endocrinol. 2008 Mar;158(3):323-325 PMID 18299465
  254. ^ Weigt J, Malfertheiner P.Influence of Helicobacter pylori on gastric regulation of food intake. Curr Opin Clin Nutr Metab Care. 2009 Sep;12(5):522-5. PMID 19584718/
  255. ^ Tariq A Madani, MD. Colonic tuberculosis clinically misdiagnosed as anorexia nervosa, and radiologically and histopathologically as Crohn's disease Can J Infect Dis. 2002 Mar–Apr; 13(2): 136–140. PMCID: PMC2094857
  256. ^ Blanchet C, Luton JP.Anorexia nervosa and Crohn disease: diagnostic intricacies and difficulties. 3 cases 3 cases Presse Med. 2002 Feb 23;31(7):312-5. PMID 11899685
  257. ^ Holaday M, Smith KE, Robertson S, Dallas J. Adolescence. An atypical eating disorder with Crohn's disease in a fifteen-year-old male: a case study. 1994 Winter;29(116):865-73. PMID 7892797
  258. ^ Wellmann W, Pries K, Freyberger H. [Combination of Crohn's disease and anorexia nervosa signs and symptoms. Dtsch Med Wochenschr. 1981 Nov 6;106(45):1499-502. PMID 7307984
  259. ^ Rickards H, Prendergast M, Booth IW. Psychiatric presentation of Crohn's disease. Diagnostic delay and increased morbidity. Br J Psychiatry. 1994 Feb;164(2):256-61. PMID 8173832
  260. ^ Grant CS.Insulinoma. Best Pract Res Clin Gastroenterol. 2005 Oct;19(5):783-98. PMID 16253900
  261. ^ Shanmugam V, Zimnowodzki S, Curtin J, Gorelick PB.Hypoglycemic hemiplegia: insulinoma masquerading as stroke. J Stroke Cerebrovasc Dis. 1997 Jul-Aug;6(5):368-9. PMID 17895035
  262. ^ Morgan JR.A case of Down's syndrome, insulinoma and anorexia. J Ment Defic Res. 1989 Apr;33 ( Pt 2):185-7. PMID 2542562
  263. ^ Olsen DB, Abraham JH.Neuropsychiatric disorders in insulinoma Ugeskr Laeger. 1999 Mar 8;161(10):1420-1. PMID 10085751
  264. ^ Vig S, Lewis M, Foster KJ, Stacey-Clear A.Lessons to be learned: a case study approach insulinoma presenting as a change in personality. J R Soc Promot Health. 2001 Mar;121(1):56-61. PMID 11329699
  265. ^ Mannucci E et al..Eating behavior and thyroid disease in female obese patients. Eat Behav. 2003 Aug;4(2):173-9.PMID 15000980
  266. ^ Byerley B, Black DW, Grosser BI. Anorexia nervosa with hyperthyroidism: case report. J Clin Psychiatry. 1983 Aug;44(8):308-9. PMID 6874653
  267. ^ Krahn D. Thyrotoxicosis and bulimia nervosa. Psychosomatics. 1990 Spring;31(2):222-4. PMID 2330406
  268. ^ Tiller J et al.The prevalence of eating disorders in thyroid disease: a pilot study. J Psychosom Res. 1994 Aug;38(6):609-16. PMID 7990069
  269. ^ Fonseca V, Wakeling A, Havard CW.Hyperthyroidism and eating disorders. BMJ. 1990 Aug 11;301(6747):322-3. PMID 2393739
  270. ^ Birmingham CL, Gritzner S, Gutierrez E. Hyperthyroidism in anorexia nervosa: case report and review of the literature. Int J Eat Disord. 2006 Nov;39(7):619-20. PMID 16958126
  271. ^ D Mattingly and S Bhanji Hypoglycaemia and anorexia nervosa. J R Soc Med. 1995 April; 88(4): 191–195. PMCID: PMC1295161
  272. ^ Ozawa Y, Koyano H, Akama T. Complete recovery from intractable bulimia nervosa by the surgical cure of primary hyperparathyroidism. J Eat Disord. 1999 Jul;26(1):107-10. PMID 10349592
  273. ^ Dick B. Encephalomyelitis disseminata: a rare, but challenging differential diagnosis of anorectic disorder. World J Biol Psychiatry. 2002 Oct;3(4):225-8.PMID 12516315
  274. ^ Lino RS Jr, Reis MA, Teixeira VP. Occurrence of encephalic and cardiac cysticercosis Cysticercus cellulosae in necropsy. Rev Saude Publica. 1999 Oct; 33(5):495-8. PMID 10576752
  275. ^ Sheth TN, Pillon L, Keystone J, Kucharczyk W. Persistent MR contrast enhancement of calcified neurocysticercosis lesions. AJNR Am J Neuroradiol. 1998 Jan;19(1):79-82. PMID 9432161
  276. ^ Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features. Alao AO, Chlebowski S, Chung C. Psychosomatics. 2009 Sep-Oct;50(5):543-7. PMID 19855042
  277. ^ Kar N, Misra B.Toxoplasma seropositivity and depression: a case report. Kar N, Misra B. BMC Psychiatry. 2004 Feb 5;4:1. PMID 15018628
  278. ^ Ritchie MA, Perdigao JA. Neurosyphilis: Considerations for a Psychiatrist. Louisiana State University School of Medicine Department of Psychiatry Neurosyphilis
  279. ^ Lipsitz JD, Fyer AJ, Paterniti A, Klein DF. Emetophobia: preliminary results of an internet survey. Depress Anxiety. 2001;14(2):149-52. PMID 11668669
  280. ^ Boschen MJ. Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda. Anxiety Disord. 2007;21(3):407-19. Epub 2006 Aug 4. PMID 16890398
  281. ^ Shapiro J, Franko DL, Gagne A. Phagophobia: a form of psychogenic dysphagia. A new entity. Ann Otol Rhinol Laryngol. 1997 Apr;106(4):286-90.PMID 9109717
  282. ^ Gabbay V. New onset of body dysmorphic disorder following frontotemporal lesion. Neurology. 2003 Jul 8;61(1):123-5.PMID 12847173
  283. ^ Phillips KA,et al.A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases. Psychopharmacol Bull. 1994;30(2):179-86.PMID 7831453
  284. ^ Feusner JD, Townsend J, Bystritsky A, Bookheimer S.Visual information processing of faces in body dysmorphic disorder. Arch Gen Psychiatry. 2007 Dec;64(12):1417-25.PMID 18056550
  285. ^ Feusner JD, Yaryura-Tobias J, Saxena S.Body Image. The pathophysiology of body dysmorphic disorder. 2008 Mar;5(1):3-12. Epub 2008 Mar 7.PMID 18314401
  286. ^ Feusner JD, Townsend J, Bystritsky A, Bookheimer S. Arch Gen Psychiatry. 2007 Dec;64(12):1417-25. Visual information processing of faces in body dysmorphic disorder. PMID 18056550
  287. ^ Halmi KA.The multimodal treatment of eating disorders. World Psychiatry. 2005 Jun;4(2):69-73. PMID 16633511
  288. ^ Pike km Cognitive behavioral therapy in the post hospital treatment of anorexia nervosa Am J Psychiatry 2003 Nov 160(11):2146-9 PMID 14594754
  289. ^ Heh HW et al. Cognitive behavioral therapy for eating disorders. Hu Li Za Zhi 2006 Aug;53(4)65-73 PMID 16874604
  290. ^ Schmidt U et al.A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatry. 2007 Apr;164(4):591-8.Comment in:Evid Based Ment Health. 2007 Nov;10(4):122. PMID 17403972
  291. ^ Safer DL,Dialectical behavior therapy for bulimia nervosa. Am J Psychiatry. 2001 Apr;158(4):632-4. PMID 11282700
  292. ^ Eisler I et al.Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry. 2000 Sep;41(6):727-36. PMID 11039685
  293. ^ JRhodes P, Brown J, Madden S. The Maudsley model of family-based treatment for anorexia nervosa: a qualitative evaluation of parent-to-parent consultation. Marital Fam Ther. 2009 Apr;35(2):181-92. PMID 19302516
  294. ^ Wallis A et al.Five-years of family based treatment for anorexia nervosa: the Maudsley Model at the Children's Hospital at Westmead. Int J Adolesc Med Health. 2007 Jul-Sep;19(3):277-83. PMID 17937144
  295. ^ Gray JJ, Hoage CM. Bulimia nervosa: group behavior therapy with exposure plus response prevention. Psychol Rep. 1990 Apr;66(2):667-74. PMID 1971954
  296. ^ McIntosh VV et al. Interpersonal psychotherapy for anorexia nervosa. Int J Eat Disord. 2000 Mar;27(2):125-39. PMID 10657886
  297. ^ Frisch MJ, Franko DL, Herzog DB. Arts-based therapies in the treatment of eating disorders. Eat Disord. 2006 Mar-Apr;14(2):131-42. PMID 16777810
  298. ^ Latner JD, Wilson GT. Cognitive-behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating. Eat Behav. 2000 Sep;1(1):3-21. PMID 15001063
  299. ^ Medical nutrition therapy for the treatment of obesity Plodkowski Endicrinol Metab RA Clin North Am 2003 Dec;32 (4)935-65 PMID 12711069
  300. ^ Whisenant SL Smith BA Eating disorders: current nutrition therapy and perceived needs in dietetics education and research. J Am Diet Assoc. 1995 Oct;95(10):1109-12 PMID 7560681
  301. ^ Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa and other eating disorders. J Am Diet Assoc. 2006 Dec;106(12):2073-82 PMID 17186637
  302. ^ Casper RC How useful are pharmacological treatments in eating disorders? Phamocolgical Bulletin 2002;36(2) PMID 12397843
  303. ^ Goldberg SC et al Cyproheptadine in anorexia nervosa. Br J Psychiatry. 1979 Jan;134:67-70.PMID 367480
  304. ^ Walsh BT et al.Medication and psychotherapy in the treatment of bulimia nervosa. Am J Psychiatry. 1997 Apr;154(4):523-31. PMID 9090340
  305. ^ Marrazzi MA et. al Binge eating disorder: response to naltrexone. Int J Obes Relat Metab Disord. 1995 Feb;19(2):143-5. PMID 7735342
  306. ^ Vandereycken W, Pierloot R.Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa. A double-blind placebo-controlled cross-over study. Acta Psychiatr Scand. 1982 Dec;66(6):445-50. PMID 6758492
  307. ^ Birmingham CL, Gritzner S.How does zinc supplementation benefit anorexia nervosa? Eat Weight Disord. 2006 Dec;11(4):e109-11.PMID 17272939
  308. ^ Perkins SJ.Self-help and guided self-help for eating disorders. Cochrane Database Syst Rev. 2006 Jul 19;3:CD004191.PMID 16856036
  309. ^ Carter JC.Self-help for bulimia nervosa: a randomized controlled trial. Am J Psychiatry. 2003 May;160(5):973-8.PMID 12727703
  310. ^ Schmidt U. randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatry. 2007 Apr;164(4):591-8. PMID 17403972
  311. ^ Thiels C, Schmidt U, Treasure J, Garthe R.Four-year follow-up of guided self-change for bulimia nervosa. Eat Weight Disord. 2003 Sep;8(3):212-7. PMID 14649785
  312. ^ Peterson efficacy of self-help group treatment and therapist-led group treatment for binge eating disorder. Am J Psychiatry. 2009 Dec;166(12):1347-54. Epub 2009 Nov 2. PMID 19884223
  313. ^ Self-help on par with therapy for binge-eatersArticle
  314. ^ Schipkowensky N. Hum Biol. 1971 May;43(2):346-51.Iatrogenic effects of psychoanalysis PMID 5138287
  315. ^ Cialdella P. A reply to Perron regarding the Inserm report "Psychotherapy. The assessment of three approaches" Encephale. 2007 Oct;33(5):783-90. PMID 18357849
  316. ^ Unauthorized freud: doubters confront A legend BMJ. 1999 Apr 3;318(7188):949A. PMID 10102890
  317. ^ Agras WS.The consequences and costs of the eating disorders. Psychiatr Clin North Am. 2001 Jun;24(2):371-9.PMID 11416936
  318. ^ Palmer RL et al.. A dialectical behavior therapy program for people with an eating disorder and borderline personality disorder--description and outcome. Int J Eat Disord. 2003 Apr;33(3):281-6.PMID 12655624
  319. ^ Bulik CM et al. Anorexia nervosa treatment: a systematic review of randomized controlled trials. Int J Eat Disord. 2007 May;40(4):310-20.PMID 17370290
  320. ^ Baran SA, Weltzin TE, Kaye WH.Low discharge weight and outcome in anorexia nervosa. Am J Psychiatry. 1995 Jul;152(7):1070-2.PMID 7793445
  321. ^ Eating disorders treatment plea in Wales
  322. ^ NHS Tayside apologizes for death of girl with eating disorder
  323. ^ Vandereycken W Prognosis of anorexia nervosa. Prognosis of anorexia nervosa. Am J Psychiatry. 2003 Sep;160(9):1708; author reply 1708. Erratum in: Am J Psychiatry. 2003 Nov;160(11):2076. comment on: Am J Psychiatry. 2002 Aug;159(8):1284-93. PMID 12944354
  324. ^ Bergh C, Brodin U, Lindberg G, Södersten P.Randomized controlled trial of a treatment for anorexia and bulimia nervosa Proc Natl Acad Sci U S A. 2002 Jul 9;99(14):9486-91. Epub 2002 Jun 24. PMID 12082182
  325. ^ Herzog DB et al.Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):829-37. PMID 10405500
  326. ^ Peterson CB et al.,The efficacy of self-help group treatment and therapist-led group treatment for binge eating disorder. Am J Psychiatry. 2009 Dec;166(12):1347-54. Epub 2009 Nov 2. PMID 19884223

External links

Eating Disorder
Classification and external resources
ICD-10 F50.
ICD-9 307.5
MeSH D001068

An eating disorder is to eat, or avoid eating, in a manner which negatively affects both one's physical and mental health. Eating disorders are all encompassing. They affect every part of the person's life. According to the authors of Surviving an Eating Disorder, "feelings about work, school, relationships, day-to-day activities and one's experience of emotional well being are determined by what has or has not been eaten or by a number on a scale."[1] Anorexia nervosa and bulimia nervosa are the most common eating disorders generally recognized by medical classification schemes,[2] with a significant diagnostic overlap between the two.[3] Together, they affect an estimated 5-7% of females in the United States during their lifetimes.[4]There are several other eating disorders which are prevalent amongst certain demographics that are being investigated and defined - Rumination syndrome, Compulsive overeating, and Selective eating disorder.



Anorexia nervosa

Anorexia nervosa is deliberate and sustained weight loss driven by a fear of distorted body image. It is a serious disorder that can lead to death.[5] It is not to be confused with anorexia, which is a symptomatic general loss of appetite or disinterest in food. DSM-IV characterizes anorexia nervosa as:
  • An abnormally low body weight (the suggested guideline ≤ 85% of normal for age and height, or BMI ≤ 17.5).
  • For postmenarcheal females, amenorrhea (the absence of three consecutive menstrual cycles).
  • An intense fear of gaining weight or becoming fat and a preoccupation with body weight and shape.[6]

The appearance of anorexia often occurs during adolescence, with 76% reporting onset of the disorder between the ages of 11 and 20.[7] It is about ten times more likely to occur with females than males.[5] The mortality rate for those diagnosed with anorexia nervosa is approximately 6%—the highest of any mental illness—with roughly half of those due to suicide.[8]

Anorexics have a distorted view of their body. Even when they are extremely thin, they see themselves as too fat.[5] Anorexics are commonly perfectionists, driven to succeed; yet they set unattainable standards of performance for themselves. When they fail to meet these standards, they look for a part of their lives they can control; food and weight become that “control” for them. Low self-esteem and constant self-criticism cause anorexics to constantly fear losing control, and even consuming a small amount of food could be considered a loss of control.[5]

Bulimia nervosa

Bulimia nervosa is a cyclical and recurring pattern of binge eating (uncontrolled bursts of overeating) followed by guilt, self-recrimination and overcompensatory behavior such as crash dieting, overexercising and purging to compensate for the excessive caloric intake.[5]

Bulimics often have "binge food," which is the food they typically consume during binges. Some describe their binge episodes as a physical high they feel, numbing out, going into auto-pilot, losing all control, immediate comfort, etc. The reasoning or triggers behind a binge may serve different purposes for different people. This binge episode leads the individual to feel guilt, shame, embarrassment, and complete failure. Bulimics try to regain control of themselves and the situation by purging the food (either by self-induced vomiting or using a laxative), making up for their mistake.[5] This leads to feeling famished and empty again, and therefore, another uncontrollable binge, followed by feeling powerless, and the vicious binge/purge cycle continues. Bulimics have extreme eating and exercising habits, instead of demonstrating moderation. This compulsive behavior is often echoed in similar destructive behavior such as sexual promiscuity, pathological lying, and shoplifting. Some bulimics not only struggle with the eating disorder, but these other harmful behaviors as well.

The appearance of bulimia nervosa often occurs during late adolescence or early adulthood.[5] 90 Percent of bulimics are women.[5] Roughly 70 percent of individuals who develop bulimia nervosa eventually recover.[5]

Compulsive exercising is a type of bulimia nervosa, where those afflicted exercise excessively in order to purge excess calories.[9][9] One that struggles with this disorder takes part of vigorous physical activity to the point that it is unhealthy and unsafe. It is often referred to as obligatory exercise or anorexia athletic. The individual usually feels compelled to exercise and has problems with anxiety and guilt until exercising. Someone that has compulsive exercising disorder will still force themselves to work out even when sick or injured. He or she will often calculate how much they have eaten and exercise on the amount of calories they have eaten and usually have low energy because of all the calories they have burned.[10] People who struggle with this disorder usually do it to have more control in their life. Praise is often given to the individual about how in shape he/she may look which gives that person more of a drive to continue to work out. Females most commonly have compulsive exercising disorder and measure their self worth through their performance. They often take out their emotions like anger, depression, or frustration when exercising by pushing their bodies to the limit.[11]

Rumination syndrome

Rumination Syndrome is a rarely diagnosed chronic eating disorder of unknown prevalence. Though classically described as an illness of infancy or people with cognitive disabilities, its effects on otherwise healthy adults and adolescents is gaining increasing awareness in the medical community. Patients of this disorder experience effortless post-prandial (after ingestion) regurgitation of meals without the smells and tastes associated with normal vomitting. There is no nausea or retching preceding the event. Rumination syndrome is often misdiagnosed as bulimia nervosa by doctors, due to the lack of awareness of the disorder, the similarity in symptoms, and the common teenage onset of the disorder.[12]

Orthorexia nervosa

Orthorexia nervosa is a recently discovered disease previously thought to be Anorexia. This type of disorder is an obsession with eating only healthy types of foods. This disorder derives from the drive to become pure, so that a sufferer begins to become obsessed with everything that he or she is consuming. Someone who struggles with orthorexia nervosa will do things like planning out their meals for the next day. This means that they will have a strict planned schedule of breakfast, lunch and dinner. Thinness often results due to the restricted types and amounts of food eaten, but is a side effect rather than an intended result. People who have orthorexia nervosa are often critical of what others eat, and usually isolate themselves from surroundings.[13]

Selective eating disorder

Selective Eating Disorder (SED) prevents the consumption of certain foods. Although it is often viewed as a phase of childhood that is generally overcome with age, one may continue to be afflicted with SED throughout his or her adult life. Those with the disorder eat a "highly limited range of foods" and are unlikely to try new foods, as well. When the disorder persists into middle childhood and adolescence, it can result in conflict, anxiety, and social avoidance.[14]

Sufferers of SED have an inability to eat certain foods based on texture or aroma. "Safe" foods may be limited to only certain types of food or even specific brands. Afflicted individuals may exclude whole food groups, such as fruits or vegetables.

Compulsive overeating

Obsessive Compulsive Overeating [OCO] (Also known as binge eating) is one of the most common mental disorders and is linked with Obsessive Compulsive Disorder (OCD). It involves the consumption of very large amounts of food in a short period of time. About 2 percent of all adults in the United States struggle with binge eating. People at any age can develop this particular disorder, but it is seen most in young adults. Clinical studies have continued to find that obese binge eaters have much higher levels of depression than other obese individuals that do not have a binge eating disorder.[15] The individual has feelings of disgust and guilt that lead to depression.

People that struggle with binge eating are likely to have alcohol problems and engage in impulsive behavior, such as not thinking before acting out.[citation needed] They do not feel that they can control themselves, are typically not close with their community, and have difficulty discussing their problems and feelings. They also have more health problems, a hard time sleeping at night, joint pain, muscle pains, menstrual problems, and headaches. Affected people often have suicidal thoughts, struggle digesting their food, and are stressed. People that have a binge eating disorder are usually ashamed and become very good at hiding the fact that they have it. They become so good at hiding that most people around them, including close friends and family members, do not even know about their disorder. ("Binge Eating Disorder", 2008)

Although it is not diagnosed very often, several factors can make it more difficult to diagnose than other eating disorders. Because COE is an eating disorder which is less commonly taught in school or talked about, a large amount of people who have the disorder just blame their weight on their binges and don't consider that there might be a psychological reason behind their binge eating, or are not even aware that the disorder exists altogether. One way to determine if a person has COE is by looking at their eating patterns. It is not uncommon in some that their food habits can be completely random: healthy foods a few days, attempted dieting or even crash dieting, which are followed by a relapse into binge eating. A very common misconception is that people who have COE do not know healthy eating habits or simply "don't know better," however, what makes this specifically an eating disorder is the addiction of eating large amounts of food and repeated relapsing in attempts to changing to healthy eating habits.[citation needed] Binge eating sometimes is because of a certain emotion (boredom, anger, sadness, etc.).



Family and friends are very influential when it comes to eating disorders. The media may be a significant influence on eating disorders through its impact on values, norms, and image standards accepted by modern society.[16] The media sends a message that "thin is beautiful" in their choice of fashion models, which many young girls want to emulate.[5] Both society’s exposure to media and eating disorders have grown immensely over the past decade. Researchers and clinicians are concerned about the relationship between these two phenomena and finding ways to reduce the negative influence thin-ideal media has on women’s body perception and susceptibility to eating disorders. The dieting industry makes billions of dollars each year by consumers continually buying products in an effort to be the ideal weight. Hollywood displays an unrealistic standard of beauty that makes the public feel incredibly inadequate and dissatisfied and forces people to strive for an unattainable appearance.[17] This takes an enormous toll on one's self-esteem and can easily lead to dieting behaviors, disordered eating, body shame, and ultimately an eating disorder.[5] The surrounding culture in which an adolescent is raised greatly affects how they feel they are supposed to look, potentially contributing to an eating disorder.[5]


Patients with severe obsessive compulsive disorder, depression or bulimia were all found to have abnormally low serotonin levels.[18] Neurotransmitters such as serotonin, dopamine and norepinephrine are secreted by the intestines and central nervous system during digestion.[19]

Researchers have also found low cholecystokinin levels in bulimics. Cholecystokinin is a hormone that causes one to feel full and decreases eating. Low levels of this hormone are likely to cause a lack of satiative feedback when eating, which can lead to overeating. Another explanation researchers found for overeating is abnormalities in the neuromodulator peptides, neuropeptide Y and peptide YY. Both of these peptides increase eating and work with another peptide called leptin. Leptin is released by fat cells and is known to decrease eating. Research found the majority of people who overate produced normal amounts of leptin but they might have complications with the blood-brain barrier preventing an optimal amount to reach the brain.[19]

Cortisol is a hormone released by the adrenal cortex which promotes blood sugar and increases metabolism.[19] High levels of cortisol were found in people with eating disorders. This imbalance may be caused by a problem in or around the hypothalamus.[20] A study in London at Maudsley Hospital found that anorexics were found to have a large variation of serotonin receptors and a high level of serotonin.[21]

Many of these chemicals and hormones are associated with the hypothalamus in the brain.[22] Damage to the hypothalamus can result in abnormalities in temperature regulation, eating, drinking, sexual behavior, fighting, and activity level. Uher & Treasure (2005) performed a study researching brain lesions effects on eating disorders. They evaluated 54 formally published cases of eating disorders and brain damage. They found many correlations between eating disorders and damage to the hypothalamus. People with brain lesions in the hypothalamus had abnormal eating behaviors; unprovoked and self induced vomiting, over concern with becoming fat, cheating with eating, frequent sleepiness, depression, obsessive compulsive behavior and diabetes insipidus.[23]

While scientists have determined that there are possible biochemical or biological causes leading to eating disorders because certain chemicals which control hunger, appetite or digestions are out of balance, experts such as Dr. Edward J. Cumella, executive director of the Remuda Treatment Programs, states that there are three components to eating disorders: 1. The genetic component; 2. The unique environmental factors, such as personal experiences; and 3) The shared environmental factors, such as culture. According to Dr. Cumella, "Some people are born with a predisposition to having an eating disorder and there are genetic markers that can push a person in the direction of anorexia or bulimia...but it does not guarantee that a person will automatically suffer from an eating disorder. The environment - a person's life experience - still has to pull the trigger."[24]

Developmental etiology

Research from a family systems perspective indicates that eating disorders stem from both the adolescent's difficulty in separating from over-controlling parents, and disturbed patterns of communication. When parents are critical and unaffectionate, their children are more prone to becoming self-destructive and self-critical, and have difficulty developing the skills to engage in self-care giving behaviors. Such developmental failures in early relationships with others, particularly maternal empathy, impairs the development of an internal sense of self and leads to an over-dependence on the environment. When coping strategies have not been developed in the family system, food and drugs serve as a substitute.[25]


Eating disorders should also be understood in the context of experienced trauma, with many eating problems beginning as survival strategies rather than vanity or obsession with appearance. According to sociologist Becky Thompson, eating disorders stemming from women of varying socio-economic status, sexual orientation and race, and finds that eating disorders and a disconnected relationship with one's body is commonly a response to environmental stresses, including sexual, physical, and emotional abuse, racism, and poverty. This reality is further detrimental for women of color and other minority women, since they are forced to live in a culture that embraces a narrowly defined conception of beauty: "people furthest from the dominant ideal of beauty, specifically women of color, may suffer the psychological effects of low self-esteem, poor body image, and eating disorders."[26]

Gender differences

"Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly."[27]

Exercise addiction is common in men and women, especially in those who suffer from eating disorders and obsessive-compulsive disorder. It is the result of a fear of becoming fat, and allowing their need to stay fit to overtake their lives. Exercise addicts are risking their health in order to get a "runner's high". [28] They are in search of the ideal body type and place the importance of exercise above the needs of their children, parents, friends and health.

In male and female sports there are different reasons to lose weight.[citation needed] For a female many of the eating disorders are for more dancing related sports such as poms, cheerleading, and many other forms of competitive forms of dance.[citation needed] While in many male predominant sports it is also necessary such as wrestling, mixed martial arts, and sports where weigh-ins are necessary.[citation needed] This puts a lot of stress on the male to make the cut leading to many of the eating disorders such as bulimia and anorexia nervosa.[original research?]

Education sources that we depend on don't always give us the accurate information on eating disorders. Eating disorders affect women and men but we don't recognize that fact.[original research?] Men suffer from a different type of eating disorders than women.[citation needed] They may not starve themselves[original research?] but sometimes they use drugs to bulk up. They have the pressure of being "strong, bulk, hot".[dubious ][original research?]"A survey published in Psychology Today reported that only 15% of men said that they are unhappy with their weight. Increasingly, men feel the same pressure that women feel to be attractive and slender. If these trends continue, the incidence rate for eating disorders among men will increase" (Pipher 16).

Pipher, Mary. Hunger pains: The moderns woman's tragic quest for thinness. New York: Ballantine Books, 1995.


Clinically, eating disorders are evaluated using instruments such as the Questionnaire of Eating and Weight Patterns (QEWP), which has specialized versions for adolescents and parents (QEWP-A, and QEWP-P). In addition to evaluating eating patterns, these tests also diagnose depression.[29]


  1. ^ Siegel, Michaele, Brisman, Judith and Weinshel, Margot. Surviving an Eating Disorder. New York: Harper and Row Publishers. 1988.
  2. ^ "ICD-10: Behavioural syndromes associated with physiological disturbances and physical factors". World Health Organization. 2006-04-05. Retrieved on 2007-03-08. 
  3. ^ Milos, G; Spindler, A; Schnyder, U; Fairburn, C G (2005), "Instability of eating disorder diagnoses: prospective study", The British Journal of Psychiatry 187 (6): 573–578, doi:10.1192/bjp.187.6.573, PMID 16319411 
  4. ^ "Practice guidelines for the treatment of patients with eating disorders", American Journal of Psychiatry (American Psychiatric Association) 157 (1): 1–39, January 2000 .
  5. ^ a b c d e f g h i j k l Santrock, J. W. (2005). Nutrition and Eating Behavior. In Mike Ryan (Ed.). A Topical Approach to Life-Span Development, Fourth Edition (pp 156-157). New York City: McGraw-Hill.
  6. ^ American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (4th ed.). American Psychiatric Association. ISBN 0890420629. 
  7. ^ "Facts About Eating Disorders". National Association of Anorexia Nervosa and Associated Eating Disorders. Retrieved on 2008-03-15. 
  8. ^ Herzog, David B; Greenwood, Dara N; Dorer, David J; Flores, Andrea T; Ekeblad, Elizabeth R; Richards, Ana; Blais, Mark A; Keller, Martin B (2000), "Mortality in eating disorders: A descriptive study", International Journal of Eating Disorders 28 (1): 20–26, doi:10.1002/(SICI)1098-108X(200007)28:1<20::AID-EAT3>3.0.CO;2-X 
  9. ^ a b Barlow, David H; Durand, V Mark (July 2004), Abnormal Psychology: An Integrative Approach, Thomson Wadsworth, ISBN 0534633625 
  10. ^ Tiemeyer, 2008
  11. ^ Mary L. Gavin, 2007
  12. ^ Papadopoulos, Mimidis, V., K. (2007), "The rumination syndrome in adults: A review of the pathophysiology, diagnosis and treatment", Journal of Postgraduate Medicine 53 (3): 203–206, ISSN 0022-3859 
  13. ^ "Eating Disorders", 2001
  14. ^ Clinical Child Psychology and Psychiatry, Vol. 6, No. 2, 257-270 (2001) (available at
  15. ^ Susan Himes, 2005
  16. ^ Harrison, K; Cantor, J (1997), "The relationship between media consumption and eating disorders", Journal of Communication (Oxford University Press) 47 (1): 40–68, doi:10.1111/j.1460-2466.1997.tb02692.x 
  17. ^ Australian Idol Starlet: Shocking Anorexic Revelations
  18. ^ Long, Phillip W (1993). "Eating Disorders". National Institute of Mental Health. Retrieved on 2006-03-03. 
  19. ^ a b c Kalat, James W (2006). Biological Psychology (8th ed.). Houston: Wadsworth Publishing. ISBN 0495090794. 
  20. ^ Long, Phillip W. (1993). Eating Disorders. Retrieved March 3, 2006, from the National Institute of Mental Health website:
  21. ^ Yager, Joel & Anderson, Arnold E. (2005). Anorexia Nervosa. The New England Journal of Medicine, 353 (14), 1481-1488, Retrieved March 3, 2006, from Ovid web:
  22. ^ Uher, R., & Treasure, J. (2005). Brain Lesions and Eating Disorders. Journal of Neurology, Neurosurgery, & Psychiatry, 76 (6). June 2005, pp 852-857.
  23. ^ Uher, R; Treasure, J (June 2005), "Brain Lesions and Eating Disorders", Journal of Neurology, Neurosurgery & Psychiatry 76 (6): 852–857, doi:10.1136/jnnp.2004.048819, PMID 15897510 
  24. ^ Overcoming Eating Disorders
  25. ^ Weiner, Sydell (1998), "The Addiction of Overeating: Self-Help Groups as Treatment Models", Journal of Clinical Psychology 54 (2): 163–167, doi:10.1002/(SICI)1097-4679(199802)54:2<163::AID-JCLP5>3.0.CO;2-T, ISSN 0021-9762 
  26. ^ Hall, C. I. (1995), "Asian Eyes: Body Image and Eating Disorders of Asian and Asian-American Women", Eating Disorders (Taylor & Francis) 3 (1): 8–19, doi:10.1080/10640269508249141 
  27. ^ "Risk Factors for Eating Disorders Vary by Gender: Rejecting media images, resilience to negative comments should be focus of prevention", Kevin McKeever, HealthDay, June 3, 2008.
  28. ^ "Exercise addiction and dependence" Hollyann E. Jenkins, BrainPhysics, August 29, 2008.
  29. ^ Johnson, William G.; Grieve, Frederick G.; Adams, Christina D.; Sandy, Jamie (January 1998). "Measuring Binge Eating in Adolescents: Adolescent and Parent Versions of the Questionnaire of Eating and Weight Patterns". International Journal of Eating Disorders 26: 301. doi:10.1002/(SICI)1098-108X(199911)26:3<301::AID-EAT8>3.0.CO;2-M. ISSN 0276-3478. PMID 10441246. 


  • Natenshon, Abigail, ed. (1999), When Your Child Has an Eating Disorder: A Step-By-Step Workbook for Parents and Other Caregivers, Jossey Bass, ISBN 0-7879-4578-1 
  • Thompson, K. J., ed. (2003), Body Image, Eating Disorders, and Obesity: An Integrative Guide for Assessment and Treatment, APA Books, ISBN 1-55798-726-2 
  • Agras, W. Steward (2004), "The consequences and costs of the eating disorders", The psychiatric clinics of North America 24 (2): 371, doi:10.1016/S0193-953X(05)70232-X 
  • Crow, S.; Praus, B; Thuras, P (1999), "Mortality from Eating Disorders—A 5- to 10-Year Record Linkage Study", International journal of eating disorders 26: 97, doi:10.1002/(SICI)1098-108X(199907)26:1<97::AID-EAT13>3.0.CO;2-D 
  • Crow, S; Nyman, J. (2004), "The Cost-Effectiveness of Anorexia Nervosa Treatment", International journal of eating disorders 35 (2): 155, doi:10.1002/eat.10258 
  • Lauer, C. J.; Krieg, J. C. (2004), "Sleep in eating disorders", Sleep Medicine Review 8 (2): 109, doi:10.1016/S1087-0792(02)00122-3 
  • Meads, C.; Gold, L.; Burls, A. (2001), "How effective is outpatient care compared to inpatient care for the treatment of Anorexia Nervosa? A systemic review", European eating disorders review 9 (4): 229, doi:10.1002/erv.406 
  • = Zeeck, A.; Herzog, T.; Hartman, A. (2004), "Day clinic or inpatient care for severe Bulimia Nervosa", European eating disorders review 12 (2): 79, doi:10.1002/erv.535 
  • Zipfel, S (2000), "Long-term prognosis in anorexia nervosa: Lessons from a 21-year follow-up study", Lancet (North American Edition) 355 (9205): 721 

External links

Simple English

Eating Disorder
Classification and other resource links
ICD-10 F50.
ICD-9 307.5
MeSH D001068

An eating disorder is when someone begins eating too much, or when someone begins to avoid eating. This affects one's mental and physical health. Anorexia nervosa and bulimia nervosa are two of the most common eating disorders today. Eating disorders affect 5-7% of American women, only a small percent of men are affected.

Other websites

Got something to say? Make a comment.
Your name
Your email address