Metformin abuse: A novel and dangerous purging behavior in anorexia nervosa

2019 ◽  
Vol 52 (3) ◽  
pp. 319-321 ◽  
Author(s):  
Bashir Geer ◽  
Dennis Gibson ◽  
Daniela Grayeb ◽  
Jodie Benabe ◽  
Shelby Victory ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Purging Behavior

Predictability of a favorable outcome in anorexia nervosa

2005 ◽  
Vol 20 (2) ◽  
pp. 165-172 ◽  
Author(s):  
HC Deter ◽  
D. Schellberg ◽  
W. Köpp ◽  
HC Friederich ◽  
W. Herzog
Keyword(s):  
Anorexia Nervosa ◽  
Clinical Presentation ◽  
Rank Test ◽  
Data Sets ◽  
Social Variables ◽  
Social Pathology ◽  
Social Predictors ◽  
Long Term Follow Up ◽  
Purging Behavior

AbstractObjectiveIn a long-term follow-up of anorexia nervosa (AN) patients, somatic, psychological and social variables at clinical presentation should be investigated using a multilevel approach.MethodsThis study isolated predictors known from the literature over longer time periods and carried out a separate investigation of predictors in a sample of 81 AN patients of the Heidelberg–Mannheim study over a mean period of 12 years (range 9–19 years). Separate hierarchic regression analyses on the basis of the course of the Morgan–Russell categories were calculated for four individually recorded areas: anamnestic, psychological, somatic and social data sets.ResultsAge at the onset of the disease, purging behavior, low serum albumin, high glutamic-oxalo acetic transaminase (GOT) psychopathology (ANSS) and social pathology had the highest predictive value qualities. In survival analysis overall assessment of all six main predictors at clinical presentation could differentiate all patients who recovered from those who remained ill (log-rank test P = 0.019).ConclusionsA small number of variables were important for detecting a good or poor long-term course of AN. At onset of the disease, it seems necessary to evaluate these psychological, somatic and social predictors.

scholarly journals Ghrelin and Obestatin Circadian Levels Differentiate Bingeing-Purging from Restrictive Anorexia Nervosa

2010 ◽  
Vol 95 (6) ◽  
pp. 3057-3062 ◽  
Author(s):  
Natacha Germain ◽  
Bogdan Galusca ◽  
Dominique Grouselle ◽  
Delphine Frere ◽  
Stephane Billard ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Peptide Yy ◽  
Regulatory Peptides ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Acylated Ghrelin ◽  
Cross Sectional ◽  
Orexigenic Peptide ◽  
Purging Behavior ◽  
Total Ghrelin

Abstract Context: Anorexia nervosa (AN) patients present with restrictive food behavior (AN-R). Some of them develop episodes of bulimia (AN-BP) without any clear pathophysiological explanation to date. Their clinical differentiation is important but not easily performed. Orexigenic/anorexigenic peptides measurements could provide some clues for that matter. Objective: The objective of the study was to determine whether the circadian profile of total and acylated ghrelin, obestatin, and peptide YY (PYY) levels is different in AN-R subjects when compared with AN-BP patients. Design and Settings: This was a cross-sectional study in an endocrinological unit. Patients and Control Subjects: Four groups of age-matched young women: 22 AN-R, 10 AN-BP, 16 normal-weight bulimia nervosa (BN), and nine controls. Main Outcome Measures: Twelve-point circadian profiles of plasma total and acylated ghrelin, obestatin, and PYY were measured. Results: Total and acylated ghrelin and obestatin circadian levels were increased in AN-R when compared with controls but decreased in both AN-BP and BN groups (P < 0.001). PYY was decreased in all groups with eating disorders. Acylated to total ghrelin ratio was decreased in AN-BP and BN (P < 0.001), whereas obestatin to acylated ghrelin and PYY to acylated ghrelin ratios were increased in both groups with bingeing-purging behavior (P < 0.0001). Conclusions: Patients with AN-associated bingeing-purging behavior present a very different profile of appetite regulatory peptides when compared with the pure restrictive type. The assessment of ghrelin (and eventually obestatin) could be of particular interest for differential diagnosis. Very low ghrelin levels and increased anorexigenic to orexigenic peptide ratios suggest either a lack of adaptation to a starvation state or a higher facility to cope with undernutrition.

Mediastinal Emphysema in an Adolescent With Anorexia Nervosa and Self-Induced Emesis

PEDIATRICS ◽  
1988 ◽  
Vol 81 (1) ◽  
pp. 134-136 ◽  
Author(s):  
Kim J. Overby ◽  
Iris F. Litt
Keyword(s):  
Anorexia Nervosa ◽  
Gastrointestinal Tract ◽  
Esophageal Perforation ◽  
Radiographic Evaluation ◽  
Increased Risk ◽  
Purging Behavior ◽  
Life Threatening ◽  
History Of ◽  
Boerhaave Syndrome ◽  
Upper Gastrointestinal

A case of asymptomatic pneumomediastinum in a 14-year-old girl with anorexia nervosa and self-induced emesis is reported to emphasize the atypical aspects of this case and the importance of differentiating benign from potentially life-threatening sources of mediastinal air. Individuals who engage in purging behavior are not only at increased risk for both alveolar (primary pneumomediastinum) and esophageal perforation (Boerhaave syndrome) but may also obscure or delay the diagnosis by denying symptoms and/or previous emesis. Because esophageal perforation is serious, the presence of free mediastinal air in a patient with a known or suspected history of emesis should provoke prompt radiographic evaluation of the upper gastrointestinal tract.

Purging behavior in anorexia nervosa and eating disorder not otherwise specified: A retrospective cohort study

2012 ◽  
Vol 198 (2) ◽  
pp. 253-258 ◽  
Author(s):  
René Klinkby Støving ◽  
Alin Andries ◽  
Kim Torsten Brixen ◽  
Niels Bilenberg ◽  
Mia Beck Lichtenstein ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cohort Study ◽  
Eating Disorder ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Not Otherwise Specified ◽  
Purging Behavior

Eine internationale neuropsychologische Testbatterie für Kinder, Jugendliche und Erwachsene mit Anorexia nervosa – die deutsche Adaptation des Ravello Profils

2013 ◽  
Vol 41 (6) ◽  
pp. 371-381 ◽  
Author(s):  
Betteke Maria van Noort ◽  
Ernst Pfeiffer ◽  
Ulrike Lehmkuhl ◽  
Viola Kappel
Keyword(s):  
Anorexia Nervosa

Fragestellung: Erwachsene mit Anorexia nervosa (AN) zeigen vor und nach Gewichtsrehabilitation Beeinträchtigungen kognitiver Funktionen. Im Bereich der kindlichen und früh-adoleszenten AN besteht ein großer Bedarf an strukturierten Untersuchungen der kognitiven Funktionen. Bisherige Studien weisen methodische Inkonsistenzen bezüglich der Testauswahl und der Operationalisierung kognitiver Funktionen auf, die die Interpretierbarkeit und Vergleichbarkeit der Befunde deutlich einschränken. Um diese Inkonsistenzen zu verringern, wurde eine neuropsychologische Testbatterie, das sogenannte „Ravello Profil“ entwickelt, das bisher jedoch nicht für den deutschen Sprachraum zur Verfügung steht. Die vorliegende Arbeit stellt daher eine für den deutschen Sprachraum adaptierte Version des Ravello Profils vor und überprüft dessen Anwendbarkeit im Kindes- und Jugendalter. Methodik: Das Ravello Profil wurde für den deutschen Sprachraum adaptiert. Anhand von drei Fallbeispielen wurde die Durchführbarkeit des Ravello Profils bei Kindern und Jugendlichen mit AN überprüft. Ergebnisse und Schlussfolgerungen: Die Fallbeispiele verdeutlichen die Anwendbarkeit des adaptierten Ravello Profils bei Kindern und Jugendlichen mit AN. Das Ravello Profil ermöglicht somit auch im deutschen Sprachraum methodisch konsistente Untersuchungen kognitiver Funktionen bei Kindern, Jugendlichen und Erwachsenen mit AN. Mithilfe des Ravello Profils kann die Rolle kognitiver Funktionen bei der Entstehung einer AN über eine umfassende Altersspanne systematisch untersucht werden.

Perception of Autonomy and Connectedness Prior to the Onset of Anorexia Nervosa and Bulimia Nervosa

2012 ◽  
Vol 40 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Julia Huemer ◽  
Maria Haidvogl ◽  
Fritz Mattejat ◽  
Gudrun Wagner ◽  
Gerald Nobis ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Risk Factor ◽  
Bulimia Nervosa ◽  
Family Environment ◽  
Significant Influence ◽  
Diagnostic Interview ◽  
Individual Autonomy ◽  
Mothers And Fathers ◽  
Image Test ◽  
Restrictive Type

Objective: This study examines retrospective correlates of nonshared family environment prior to onset of disease, by means of multiple familial informants, among anorexia and bulimia nervosa patients. Methods: A total of 332 participants was included (anorexia nervosa, restrictive type (AN-R): n = 41 plus families); bulimic patients (anorexia nervosa, binge-purging type; bulimia nervosa: n = 59 plus families). The EATAET Lifetime Diagnostic Interview was used to establish the diagnosis; the Subjective Family Image Test was used to derive emotional connectedness (EC) and individual autonomy (IA). Results: Bulimic and AN-R patients perceived significantly lower EC prior to onset of disease compared to their healthy sisters. Bulimic patients perceived significantly lower EC prior to onset of disease compared to AN-R patients and compared to their mothers and fathers. A low family sum – sister pairs sum comparison – of EC had a significant influence on the risk of developing bulimia nervosa. Contrary to expectations, AN-R patients did not perceive significantly lower levels of IA compared to their sisters, prior to onset of disease. Findings of low IA in currently ill AN-R patients may represent a disease consequence, not a risk factor. Conclusions: Developmental child psychiatrists should direct their attention to disturbances of EC, which may be present prior to the onset of the disease.

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