摘要:

AbstractWhat causes bulimia nervosa? Most authorities would respond that this question cannot be answered simply, in that bulimia nervosa has a multifactorial etiology in which psychological, sociocultural, biological, and other factors combine in different ways in different individuals to produce the syndrome. In other words, it has seemed axiomatic to many of us that bulimia nervosa is far too complex and heterogeneous to permit a simple, reductionistic explanation.However, a minority of researchers have argued, against the weight of opinion, that the etiology of bulimia may ultimately be explained more simply. Notable among these individuals are Drs. Harrison Pope and James Hudson, who are well known for their research on eating disorders in recent years. Accordingly, we have asked Drs. Pope and Hudson to present this “minority position,” as an exercise that may help to bring into relief the facts and philosophies behind some of the current controversies regarding the nature of bulimia nervosa. We are also pleased to present an equally thought‐provoking counterpoint on the heterogeneity of bulimia authored by P. J. V. Beumont of the University of Sydney, well known for his distinguished record of scholarly research in this

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<155::AID-EAT2260070202>3.0.CO;2-F

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA disturbance of eating may be symptomatic of other physical or psychiatric illness, for example the hypophagias associated with neoplastic disease or severe depression. In most instances of these secondary eating disorders there appears to be a true alteration in appetite, that is in the desire and relish for food. Primary eating disorders on the other hand are complex behavioral disturbances which do not result directly from changes in appetite. In this category are obesity, anorexia nervosa, and bulimia. The conditions of obesity and anorexia nervosa have been accepted for many years as clinical problems, and their history can be traced far back in the annals of medicine. The situation in regard to bulimia is rather different, since it has been recognized only recently as a subject of medical concern. The purpose of the present paper is to review the emergence of bulimia in the medical literature, discuss its status as a disorder, and advise caution before it is uncritically accepted as an illness entity.

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<167::AID-EAT2260070203>3.0.CO;2-7

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractBulimic binge‐purgers, bulimic binge‐eaters, nonbulimic obese presenting for treatment for obesity, obese not in treatment, and normal control subjects were compared using the Minnesota Multiphasic Personality Inventory (MMPI), Symptom Checklist‐90‐Revised (SCL‐90‐R), and Beck Depression Inventory (BDI). Results suggested a continuum of severity, with the binge‐purger group showing the highest levels of psychopathology, and the binge‐eaters and clinical obese showing significantly more distress than the two control groups. Analysis of the frequency of clinically elevated scores on each scale of the MMPI and SCL‐90R as well as the BDI as a function of group indicated that the clinical groups evidenced significantly greater psychopathology compared with their appropriate control groups. These results clarify some of the conflicting results of previous investigations of obesity which did not differentiate obese patients and nonpatients. The implications of these findings for treatment research on obesity are that perhaps a more broadspectrum form of treatment may be required in order to address the psychological problems of the

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<177::AID-EAT2260070204>3.0.CO;2-1

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThirty‐three bulimia nervosa patients were stratified by current and historical weight into three distinct groups and administered the Eating Disorders Inventory, Eating Attitudes Test, and Zung Self‐Rating Depression Scale. Few differences eventuated between groups: however, the underweight bulimics scored significantly lower on the EDI scales of drive for thinness and body dissatisfaction. The results replicate earlier work demonstrating that few behavioral and psychological dimensions of eating psychopathology differentiate between individuals with bulimia nervosa who are categorized by current weight and weight history. The findings also support Fairburn and Garner's (1986) nosological recommendation that individuals with the core features of bulimia nervosa receive the diagnosis “irrespective of their weight” (

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<185::AID-EAT2260070205>3.0.CO;2-Y

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractWe previously reported that the plasma beta‐endorphin of bulimics who vomit was higher than in normal controls. In this report data are presented which show that bulimics who do not vomit have plasma beta‐endorphin levels similar to controls. It is postulated that the increased levels of plasma beta‐endorphin in the bulimics who vomit is due to the stress of vomiting or to increased caloric i

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<191::AID-EAT2260070206>3.0.CO;2-W

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe present paper reviews some of the historical references to the concept of bulimia found in the medical literature of the last 300 years. Bulimia is an eating disorder that is widely believed to be of very recent, historical origin. The current diagnostic category of bulimia may be denoted as “new”, largely because of increased prevalence, and changes that have occurred in symptoms seen as constituting the syndrome. However, available references show clearly that various conceptualizations of bulimia extend back several hundred years. Also, treatment approaches that are consistent with presumed etiology have been offered by several early writers. While bulimia has recently been viewed as an emergent variant of anorexia nervosa, historical evidence suggests that earlier conceptualizations of the term describe a symptom as well as a discrete syndrome. Despite the fact that the diagnosis and use of the concept of bulimia has been variable historically, its dramatic fundamental feature has remained consist

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<201::AID-EAT2260070207>3.0.CO;2-I

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe majority of patients with bulimia report a history of having used over‐thecounter drugs for purposes of weight control. Diet pills are quite commonly used, but usually at low dosages. Laxative abuse is also relatively common and poses significant risks in terms of fluid and electrolyte abnormalities, gastrointestinal bleeding and other systemic effects. Diuretic abuse and use of ipecac are less common but are also associated with serious health consequences. Ipecac is of particular concern because of the risk of cardiomyopath

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<211::AID-EAT2260070208>3.0.CO;2-C

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractLiterature concerning Bartter's syndrome, pseudo‐Bartter's syndrome, idiopathic edema, and diuretic abuse is reviewed. The authors suggest that many of the patients who present with the physiological disturbances associated with pseudo‐Bartter's syndrome or with diuretic abuse, and a subgroup of those who use diuretics for idiopathic edema, have an underlying eating disorder. The pharmacology and physiology of diuretics are revie

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<225::AID-EAT2260070209>3.0.CO;2-2

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractAlthough “disordered eating,” as a set of psychiatric conditions, implicitly evaluates components of a social phenomenon, little attention has been paid to the boundaries between socially accepted and abnormal eating. Lay knowledge and evaluations of the formal criteria for a diagnosis of anorexia nervosa or bulimia were therefore examined. The results show that although males and females know more about anorexia nervosa than bulimia, the DSM‐III criteria for anorexia nervosa, which involve the determined pursuit of slimness and a body image disturbance, were judged by very few people to be both uncommon and abnormal. Bulimia, however, seems to be much closer to what is commonly judged to involve unusual beh

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<239::AID-EAT2260070210>3.0.CO;2-L

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractExercise responses were evaluated in 42 primary anorexic females (Pri‐AN; mean age 18.8 years) and 33 bulimic females (Bul‐AN; mean age 19.7 years) and compared with 14 healthy unconditioned lean females (Lean Control; mean age 19.6 years). All subjects performed isometric handgrip at 50% of maximum voluntary contraction (MVC) for 90 seconds and treadmill exercise to subjective exhaustion (Balke Protocol). Resting heart rate (HR) and blood pressure (BP) were not different in the three groups. Maximal grip strength and 90 second isometric handgrip systolic blood pressure (SBP) was significantly lower (p<.05) in Pri‐AN compared with Bul‐AN and Lean Controls. With treadmill exercise, maximal HR and BP were similar for all groups. However, estimated treadmill work capacity (METs) for Pri‐AN (10.7 ± 3) and Bul‐AN (10 ± 8.3) was significantly lower (p<.05) than lean Control subjects (12.3 ± 3). There was a positive correlation between maximal SBP and body weight (wt), percent body fat (% fat) and lean body mass (LBM). These findings indicate that Pri‐AN and Bul‐AN are associated with a substantial reduction in aerobic capacity. The attenuated BP response to exercise seen in both anorexia groups appears to be a general function of tissue mass and may be an appropriate adaptat

ISSN:0276-3478    

DOI:10.1002/1098-108X(198803)7:2<253::AID-EAT2260070211>3.0.CO;2-I

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY