Adolescent Bulimia Nervosa

Rienecke, Renee D.; Labuschagne, Zandrè; Grange, Daniel Le

doi:10.1007/s11920-012-0280-0

Cited by 18 publications

(11 citation statements)

References 48 publications

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“…With the noted absence of clinical treatment trials in the context of adolescent BN (Hoste, Labuschagne, & Le Grange, 2012), these data provide preliminary support for an innovative new avenue for treatment development. BN is typically inclusive of ego-syntonic components (i.e., dietary restriction) and shame-based secretive symptomatology, for which motivation for disclosure and change may be very low (Hoste et al, 2012), alongside an elevated prevalence of impulsivity and suicidality (Crow, Swanson, Le Grange, Feig, & Merikangas, 2014). As such, the integration of direct and interventive parenting, alongside skills training to manage individual impulsivity and dysregulation, has been postulated to provide both structural and individual support to encapsulate all facets of BN symptomatology (Anderson et al, 2015).…”

Section: Discussionmentioning

confidence: 83%

Integrating Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Preliminary Outcomes of an Open Pilot Trial

et al. 2015

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Adolescent bulimia nervosa (BN) remains relatively understudied, and the complex interaction between core eating psychopathology and emotional regulation difficulties provides ongoing challenges for full symptom remission. In an open pilot trial, we aimed to investigate the efficacy of a program integrating family-based treatment (FBT) and dialectical behavior therapy (DBT) in treating adolescent BN, without exclusion criteria. Participants were 35 adolescents who underwent partial hospital treatment for BN, and outcomes included measures of core BN pathology and emotional regulation difficulties, as well as parental measures of self-efficacy, completed at intake and discharge. Results indicate significant improvements in overall eating disorder pathology, t(68) = 4.52, p = .002, and in core BN symptoms, including objective binge episodes, t(68) = 2.01, p = .041, and self-induced vomiting, t(68) = 2.90, p = .005. Results also illustrated a significant increase in parental efficacy throughout the course of treatment, t(20) = .081, p = .001, although no global improvement in difficulties in emotion regulation was noted, t(68) = 1.12, p = .285. These preliminary findings support the utility of this integration of FBT and DBT, although raise interesting questions as to the mechanism of symptom remission.

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Section: Discussionmentioning

confidence: 83%

Integrating Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Preliminary Outcomes of an Open Pilot Trial

et al. 2015

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“…5 AN has a mortality rate of at least 5% to 6%, 6,7 the highest mortality rate of any psychiatric illness. 8 The lifetime prevalence of BN is higher at between 0.9% and 3%, 9,10 with an older age of onset of 16 to 17 years. 11 Although mortality rates in BN are estimated to be ∼2%, 12 the risk of lifetime suicidality and suicide attempts in BN are much higher.…”

Section: Epidemiologymentioning

confidence: 99%

Eating Disorders in Children and Adolescents: State of the Art Review

2014

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This is the 3rd in our series on Adolescent Health. abstract Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. Many adolescents go untreated, do not recover, or reach only partial recovery. Higher rates of EDs are seen now in younger children, boys, and minority groups; EDs are increasingly recognized in patients with previous histories of obesity. Medical complications are common in both full and subthreshold EDs and affect every organ system. No single cause of EDs has emerged, although neurobiological and genetic predispositions are emerging as important. Recent treatment paradigms acknowledge that they are not caused by families or chosen by patients. EDs present differently in pediatric populations, and providers should have a high index of suspicion using new Diagnostic and Statistical Manual, 5th edition diagnostic criteria because early intervention can affect prognosis. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers has emerged as particularly effective; cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Pharmacotherapy is useful in specific contexts. Full weight restoration is critical, often involves high-calorie diets, and must allow for continued growth and development; weight maintenance is typically inappropriate in pediatric populations. Physical, nutritional, behavioral, and psychological health are all metrics of a full recovery, and pediatric EDs have a good prognosis with appropriate care. ED prevention efforts should work toward aligning with families and understanding the impact of antiobesity efforts. Primary care providers can be key players in treatment success.

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“…[25][26][27] Although the mortality rate associated with bulimia nervosa is lower, these patients have a high rate of suicide. [28][29][30][31]…”

Section: ■ Systemic Effects Of Malnutritionmentioning

confidence: 99%

Restrictive eating disorders in previously overweight adolescents and young adults

Rastogi

Rome

2020

CCJM

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Eating disorders are common in adolescents and young adults, including those with a history of overweight or obesity, and are associated with numerous systemic sequelae. Understanding the differences in presentation between these patients and those who have a more classic anorexia nervosa phenotype is critical to ensuring timely recognition and treatment. KEY POINTS Patients who are overweight or obese are as likely to experience disordered eating as their normal-weight peers. Patients with a history of premorbid overweight or obesity present differently than their previously healthy weight peers in clinic. Malnutrition resulting from restrictive eating disorders affects many systems in the body and can occur even in the face of obesity or overweight status.

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Adolescent Bulimia Nervosa

Cited by 18 publications

References 48 publications

Integrating Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Preliminary Outcomes of an Open Pilot Trial

Integrating Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Preliminary Outcomes of an Open Pilot Trial

Eating Disorders in Children and Adolescents: State of the Art Review

Restrictive eating disorders in previously overweight adolescents and young adults

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