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Grunewald W, Smith AR, Brown TA. Treatment of avoidant-restrictive food intake disorder in an older adult: A proof-of-concept case study. Int J Eat Disord 2023; 56:1795-1800. [PMID: 37097823 DOI: 10.1002/eat.23973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT-AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT-AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube. METHODS G was a 71-year-old male who completed eight sessions of CBT-AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre- and post-treatment. RESULTS Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed. DISCUSSION This study provides proof of concept that CBT-AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT-AR. PUBLIC SIGNIFICANCE Cognitive behavior therapy for ARFID (CBT-AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single-patient case study demonstrates that CBT-AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube.
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Affiliation(s)
- William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Tiffany A Brown
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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Althaiban MA, Aljefree NM, Almoraie NM, Shatwan IM. Malnutrition is associated with increased disease risk in older people in the Makkah region of Saudi Arabia: A cross-sectional study. Front Public Health 2023; 11:1149739. [PMID: 37077189 PMCID: PMC10106578 DOI: 10.3389/fpubh.2023.1149739] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
IntroductionThere is little research on the nutritional status of older people in Saudi Arabia. This study investigated the factors associated with the nutritional status of older people in the Makkah region, Saudi Arabia. We hypothesized that older people who are at risk of malnutrition are at higher risk of different diseases.Materials and methodsThis cross-sectional study surveyed 271 people aged ≥60 years from October 2021 to January 2022. We collected data on demographics, body mass index, the Geriatric Depression Scale-Short Form, Geriatric Oral Health Assessment Index, Mini Nutritional Assessment, Eating Attitudes Test, and Household Dietary Diversity score.ResultsAmong the 271 participants, 13.3% were malnourished and 53.9% were at risk of malnutrition. The oral health (P < 0.001), depression (P < 0.001), and eating disorder (P < 0.002) scores were significantly associated with malnutrition. Congestive heart failure, asthma, peripheral vascular disease, Alzheimer's disease, and hypertension were more prevalent among malnourished participants—this supports our original hypothesis. The HDD score showed no significant differences between men and women.ConclusionMalnutrition was associated with overweight or obesity, poor oral health, and depression. Older people in the Makkah region, Saudi Arabia, had a high risk of malnutrition.
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Hambleton A, Pepin G, Le A, Maloney D, Touyz S, Maguire S. Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature. J Eat Disord 2022; 10:132. [PMID: 36064606 PMCID: PMC9442924 DOI: 10.1186/s40337-022-00654-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate of EDs is significantly elevated compared to other psychiatric conditions, primarily due to medical complications and suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any psychiatric and medical comorbidities of eating disorders. METHODS This paper forms part of a rapid review) series scoping the evidence base for the field of EDs, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised. RESULTS A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and 42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to 27%). The review also noted associations between specific EDs and non-suicidal self-injury, personality disorders, and neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal, nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or emerge as a complication of the ED. CONCLUSIONS This review provides a thorough overview of the comorbid psychiatric and medical conditions co-occurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning as well as treatment outcomes. Early identification and management of psychiatric and medical comorbidities in people with an ED may improve response to treatment and overall outcomes.
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Affiliation(s)
- Ashlea Hambleton
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Genevieve Pepin
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, VIC, Australia
| | - Danielle Maloney
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
| | | | - Stephen Touyz
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
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Academy of Nutrition and Dietetics: Revised 2020 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Eating Disorders. J Acad Nutr Diet 2021; 120:1902-1919.e54. [PMID: 33099403 DOI: 10.1016/j.jand.2020.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/21/2022]
Abstract
Eating disorders (ED) are complex mental illnesses and are not a result of personal choice. Full recovery from an ED is possible. The severity and inherent lethality of an ED is undisputed, and the role of the registered dietitian nutritionist (RDN) is essential. Clinical symptomology presents at varying developmental milestones and is perpetuated through a sociocultural evaluation of beauty and drive for ascetic idealism. ED are globally prevalent in 4.4% of the population aged 5 to 17 years, yet affect individuals across the entire lifespan, including all cultures and genders. The Behavioral Health Nutrition Dietetic Practice Group, along with the Academy of Nutrition and Dietetics Quality Management Committee, revised the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs in Eating Disorders. Including the RDN in ED treatment is vital for all levels of care. The RDN must be perceptive to negative symptoms indicative of psychological triggers when exploring food belief systems, patterns of disinhibition, and nutrition misinformation with clients. Through a conscious awareness of medical, psychological, and behavioral strategies, the implementation of the SOP and SOPP supports a dynamic and holistic view of ED treatment by the RDN. The SOP and SOPP are complementary resources for RDNs and are intended to be used as self-evaluation tools for assuring competent practice in ED and for determining potential education, training, supervision, and mentorship needs for advancement to a higher practice level in a variety of settings.
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Donahue JM, DeBenedetto AM, Wierenga CE, Kaye WH, Brown TA. Examining day hospital treatment outcomes for sexual minority patients with eating disorders. Int J Eat Disord 2020; 53:1657-1666. [PMID: 32808329 DOI: 10.1002/eat.23362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Epidemiological data support that sexual minorities (SM) report higher levels of eating pathology. Theories suggest these disparities exist due to stressors specific to belonging to a minority group; however, few studies have specifically explored differences between SM and heterosexual individuals in clinical eating disorder samples. Thus, the present study compared SM and heterosexual patients with eating disorders on demographic characteristics and eating disorder and psychological outcomes during day hospital treatment. METHOD Patients (N = 389) completed surveys of eating pathology, mood, anxiety, and skills use at treatment admission, 1-month post-admission, discharge, and 6-month follow-up. Overall, 19.8% of patients (n = 79) identified as SM, while 8.0% (n = 32) reported not identifying with any sexual orientation. SM were more likely to present across genders (17.7% of females, 24.2% of males, 33.3% of transgender patients, and 87.5% of nonbinary patients). RESULTS SM patients were significantly more likely to endorse major depressive disorder, panic disorder, and self-harm at admission than their heterosexual counterparts. Multilevel models demonstrated that across time, SM patients demonstrated greater eating pathology, emotion dysregulation, depressive symptoms, and anxiety symptoms. Significant interactions between sexual orientation and time were found for eating pathology and emotion dysregulation, such that although SM patients started treatment with higher scores, they improved at a faster rate compared to heterosexual patients. DISCUSSION Consistent with minority stress theory, SM patients report greater overall eating disorder and comorbid symptoms. Importantly, results do not support that there appear to be significant disparities in treatment outcome for SM patients in this sample of day hospital patients.
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Affiliation(s)
- Joseph M Donahue
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Anthony M DeBenedetto
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
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Dooley-Hash S, Adams M, Walton MA, Blow FC, Cunningham RM. The prevalence and correlates of eating disorders in adult emergency department patients. Int J Eat Disord 2019; 52:1281-1290. [PMID: 31322755 PMCID: PMC7047774 DOI: 10.1002/eat.23140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/05/2019] [Accepted: 07/05/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. METHOD Emergency department patients aged 21-65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. RESULTS Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. DISCUSSION Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.
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Affiliation(s)
- Suzanne Dooley-Hash
- department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- The Center for Eating Disorders, Ann Arbor, Michigan
| | - Mackenzie Adams
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Maureen A. Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Rebecca M. Cunningham
- department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan
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Abstract
OBJECTIVE The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men. METHOD We distributed anonymous questionnaires to men aged 40-75 years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males' Symptoms scale (AMS), and classified respondents as "high-AMS" (AMS score ≥37; N = 82) or "low-AMS" (AMS score <37; N = 386). RESULTS High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men. DISCUSSION We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported "purging" via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.
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Affiliation(s)
- Kai K Kummer
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | - Harrison G Pope
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - James I Hudson
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - Georg Kemmler
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | | | - Barbara Mangweth-Matzek
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
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Disordered eating in three different age groups in Cyprus: a comparative cross-sectional study. Public Health 2018; 162:104-110. [PMID: 30007171 DOI: 10.1016/j.puhe.2018.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/11/2018] [Accepted: 05/18/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate disordered eating behaviours (DEBs) in different age groups in a Cypriot non-clinical population sample. STUDY DESIGN Comparative cross-sectional study. METHOD A total of 1716 participants from the Cyprus component of the I.Family study completed the Eating Attitudes Test-26 (EAT-26). The EAT-26 score ≥20 was used to define participants at risk for DEBs. Participants were divided according to age: adolescence (12-18 years old), young adulthood (25-45 years old) and middle adulthood (46-60 years old). RESULTS Mean EAT-26 total scores were higher for middle adulthood men and women compared with the two younger age groups. Young adulthood women had the highest percentage of behavioural symptoms of DEBs: binge eating (35%) and laxatives/diet pills/diuretics (12%) compared with the other age groups. Men and women in young adulthood had the highest percentage of participants with EAT-26 scores ≥20. In logistic regression analysis, age group did not prove a significant predictor of DEB risk in a model adjusting for sex, body mass index and physical activity. CONCLUSION DEB can present at any age and was not confined to adolescence.
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Midlarsky E, Marotta AK, Pirutinsky S, Morin RT, McGowan JC. Psychological predictors of eating pathology in older adult women. J Women Aging 2017; 30:145-157. [PMID: 28368780 DOI: 10.1080/08952841.2017.1295665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Eating pathology is generally considered to affect females during adolescence and early adulthood. However, in recent years, there has been an increased recognition that disordered eating occurs in middle-aged and elderly women and that the presentation is similar to that of eating disorders in younger women. In the research presented here, results of an Internet survey of older adult women (N = 245; aged 60-90 years) indicate that the factors significantly associated with eating pathology-perfectionism, depression, and sociocultural pressures to be thin-closely parallel those reported for both younger and middle-aged women.
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Affiliation(s)
- Elizabeth Midlarsky
- a Department of Counseling and Clinical Psychology , Teachers College, Columbia University , New York , New York , USA
| | - Ashley Kronen Marotta
- a Department of Counseling and Clinical Psychology , Teachers College, Columbia University , New York , New York , USA
| | - Steven Pirutinsky
- a Department of Counseling and Clinical Psychology , Teachers College, Columbia University , New York , New York , USA
| | - Ruth T Morin
- a Department of Counseling and Clinical Psychology , Teachers College, Columbia University , New York , New York , USA
| | - Joseph C McGowan
- a Department of Counseling and Clinical Psychology , Teachers College, Columbia University , New York , New York , USA
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Watson HJ, Joyce T, French E, Willan V, Kane RT, Tanner-Smith EE, McCormack J, Dawkins H, Hoiles KJ, Egan SJ. Prevention of eating disorders: A systematic review of randomized, controlled trials. Int J Eat Disord 2016; 49:833-62. [PMID: 27425572 DOI: 10.1002/eat.22577] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/25/2016] [Accepted: 05/31/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This systematic review evaluated the efficacy of universal, selective, and indicated eating disorder prevention. METHOD A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library databases to January 2016. Studies were included if they were randomized, controlled trials (RCT) and tested an eating disorder prevention program. We retrieved 13 RCTs of universal prevention (N = 3,989 participants, 55% female, M age = 13.0 years), 85 RCTs of selective prevention (N = 11,949 participants, 99% female, M age = 17.6 years), and 8 RCTs of indicated prevention (N = 510 participants, 100% female, M age = 20.1 years). Meta-analysis was performed with selective prevention trials. As there were a limited number of universal and indicated trials, narrative synthesis was conducted. RESULTS Media literacy had the most support for universal prevention. Most universal approaches showed significant modest effects on risk factors. Dissonance-based was the best supported approach for selective prevention. Cognitive-behavior therapy (CBT), a healthy weight program, media literacy, and psychoeducation, were also effective for selective prevention and effects were maintained at follow-up. CBT was supported for indicated prevention and effects were maintained at follow-up. DISCUSSION The modest effects for universal prevention were likely due to floor effects. The evidence for selective prevention suggests that empirically supported approaches should be disseminated on a wider basis. Our findings suggest CBT should be offered for indicated populations. Overall, results suggest efficacy of several prevention programs for reducing risk for eating disorders, and that wider dissemination is required. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hunna J Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. .,Department of Health in Western Australia, Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia. .,Department of Health in Western Australia, Centre for Clinical Interventions, Perth, Australia. .,Faculty of Medicine, Dentistry, and Health Sciences, School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia. .,Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | - Tara Joyce
- Department of Health in Western Australia, Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
| | - Elizabeth French
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Vivienne Willan
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Robert T Kane
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Emily E Tanner-Smith
- Department of Human and Organizational Development, Peabody Research Institute, Vanderbilt University, Nashville
| | - Julie McCormack
- Department of Health in Western Australia, Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
| | - Hayley Dawkins
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Kimberley J Hoiles
- Department of Health in Western Australia, Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
| | - Sarah J Egan
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Guerdjikova AI, O'Melia AM, Mori N, McCoy J, McElroy SL. Binge eating disorder in elderly individuals. Int J Eat Disord 2012; 45:905-8. [PMID: 22576715 DOI: 10.1002/eat.22028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2012] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To preliminarily describe the clinical features of elderly individuals with binge eating disorder (BED). METHOD The psychological and general medical characteristics of 20 elderly individuals (65 years of age and older) who met DSM-IV-TR for BED were systematically evaluated. RESULTS Elderly individuals with BED reported an average (SD) of 4.5 (2.9) binge eating episodes per week. Weight and shape concerns were of significant importance for participants' schema for self-evaluation. Mood disorders were the most frequent co-occurring psychiatric disorders. Despite having a mean (SD) body mass index of 36.4 (10.6), most participants presented in good general medical health. DISCUSSION Regarding eating pathology, psychiatric comorbidity, and associated obesity, BED in this group of elderly individuals was similar to BED in younger adults. However, other than presenting with obesity, the participants reported good general medical health. BED might be a problem for a subset of physically healthy elderly individuals. Studies further examining psychiatric and medical presentation, including metabolic profile, of elderly individuals with BED may be warranted.
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Eating disorder behaviors are increasing: findings from two sequential community surveys in South Australia. PLoS One 2008; 3:e1541. [PMID: 18253489 PMCID: PMC2212110 DOI: 10.1371/journal.pone.0001541] [Citation(s) in RCA: 230] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Accepted: 01/02/2008] [Indexed: 02/07/2023] Open
Abstract
Background Evidence for an increase in the prevalence of eating disorders is inconsistent. Our aim was to determine change in the population point prevalence of eating disorder behaviors over a 10-year period. Methodology/Principal Findings Eating disorder behaviors were assessed in consecutive general population surveys of men and women conducted in 1995 (n = 3001, 72% respondents) and 2005 (n = 3047, 63.1% respondents). Participants were randomly sampled from households in rural and metropolitan South Australia. There was a significant (all p<0.01) and over two-fold increase in the prevalence of binge eating, purging (self-induced vomiting and/or laxative or diuretic misuse) and strict dieting or fasting for weight or shape control among both genders. The most common diagnosis in 2005 was either binge eating disorder or other “eating disorders not otherwise specified” (EDNOS; n = 119, 4.2%). Conclusions/Significance In this population sample the point prevalence of eating disorder behaviors increased over the past decade. Cases of anorexia nervosa and bulimia nervosa, as currently defined, remain uncommon.
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