Eating disorders in adolescents: A background paper

Fisher, Martin; Golden, Neville H.; Katzman, Debra K.; Kreipe, Richard E.; Rees, Jane M.; Schebendach, Janet; Sigman, Garry; Ammerman, Seth; Hoberman, Harry M.

doi:10.1016/1054-139x(95)00069-5

Cited by 278 publications

(179 citation statements)

References 137 publications

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“…[1][2][3][4][5][6][7][8][9] Fisher reports that the presence of amenorrhea is an important characteristic of anorexia nervosa, being associated with a combination of factors such as hypothalamic dysfunction, stress, excessive exercises, and weight and fat loss. 10 Differently from anorexia, bulimia nervosa does not result in a greatly depleted nutritional status. Bulimic patients often maintain a near-normal weight or sometimes are slightly overweight, alternating between bouts of hyperphagia and self-induced vomiting.…”

Section: Introductionmentioning

confidence: 99%

“…Resting bradycardia, hypotension, and reduced metabolic rate are observed in some bulimic patients, possibly indicating reduced activity of the sympathetic nervous system and of the thyroid axis. 1,2,10 Albeit yet unknown, the etiology of eating disorders is provably associated with social, psychological, and biological factors. 2 The fact that our culture venerates women with a slim body is related to an increase in the occurrence of such disorders.…”

Section: Introductionmentioning

confidence: 99%

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Transtornos alimentares em escolares

Vilela¹,

Lamounier²,

Filho³

et al. 2004

J. Pediatr. (Rio J.)

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Objective: To determine the prevalence of possible eating disorders and inappropriate eating behaviors in school children from six municipalities in the state of Minas Gerais, Brazil.Methods: Cross-sectional study. The Bulimic Investigatory Test of Edinburgh (BITE), Eating Attitude Test (EAT), and Body Image Test were applied to 1,807 public school students with age ranging from 7 to 19 years.Results: According to the EAT, 241 students (13.3%), mostly females, had inappropriate eating behaviors. Nineteen students (1.1%) had a BITE score indicating a possible diagnosis of bulimia nervosa. We found that 1,059 students (59%) were unhappy with their body image; 731 students (40%) were on a diet; and 1,014 (56%) exercised to loose weight. In addition, 218 students (12%) presented binge-eating and 175 students (10%) used purgative methods to control weight. Conclusions:We observed a high prevalence of possible eating disorders and inappropriate eating behaviors in the study population, especially among female adolescents. These results are similar to those reported for developed countries. The present findings are relevant for the clinical care of children and adolescents and can serve as the basis for future works aimed at increasing our understanding of the risk factors for these illnesses.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transtornos alimentares em escolares

Vilela¹,

Lamounier²,

Filho³

et al. 2004

J. Pediatr. (Rio J.)

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“…A restauração do peso está associada com a melhora dos sintomas da anorexia e a melhora das funções física e cognitiva 25 . Essa melhora cognitiva permitirá a intervenção psicoterapêutica e psicotrópica.…”

Section: Artigo Originalunclassified

Algumas questões éticas no tratamento da anorexia nervosa

Moreira

Oliveira

2008

J. bras. psiquiatr.

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De acordo com o DSM IV 1 , os critérios diagnósticos para a anorexia nervosa (AN) são: a manutenção do peso corporal abaixo de 85% do esperado para a altura e a idade, grande medo de engordar (ainda que o indivíduo esteja com baixo peso), alteração da imagem corporal e amenorréia em, no mínimo, três ciclos consecutivos. Entre os transtornos alimentares (TA), representa o menos comum, porém o mais grave 2 . Nos pacientes com a doença, as principais causas de morte são o suicídio e os efeitos diretos do jejum 3,4 .É uma patologia com relativa baixa prevalência (0,5% a 1% em alguns estudos nos Estados Unidos), incidindo, mais comumente, em mulheres com idades entre 15 a 29 anos 5 ; no entanto, sua mortalidade é alta. Sullivan 6 , em uma metanálise englobando 42 estudos sobre mortalidade na AN estimou que a mortalidade fosse de 5,6% por década desde o início da doença. Cerca de 20% dos afetados apresentarão doença crônica com grave comprometimento na qualidade de vida e cerca de 30% a 40% terão recuperação completa com o tratamento 7 . Em geral, os adolescentes, quanto mais precocemente forem tratados, melhor será a evolução [8][9][10] .os PAcientes com AnorexiA nervosA são "comPetentes" PArA tomAr Decisões?O critério legal para definir capacidade tem como foco o entendimento do paciente sobre sua doença e suas conseqüências, os vários tratamentos disponíveis e seus riscos e benefícios, a credibilidade nas informações para que seja tomada uma decisão por parte do indivíduo afetado pela doença, o que, obviamente, requer grande habilidade intelectual 11 . A competência é o equivalente clínico da capacidade 12 . Os fatores relevantes para julgar competência, principalmente em pacientes psiquiátricos, englobam uma série de variáveis que não estão incluídas nas definições legais de capacidade, como a interpretação das informações por indivíduo e a influência da doença mental sobre essa 13 .Os pacientes com TA não são globalmente incompetentes, mas o comprometimento de seus pensamentos, percepções, julgamentos, comportamentos e a capacidade de atender às demandas para a manutenção da vida os colocam sob risco da intervenção 14 . Muitos pacientes que recusam o tratamento parecem ter a capacidade de decidir sobre o fato. Ao mesmo tempo, freqüentemente estão gravemente doentes e se beneficiarão com o tratamento se estão sob risco de vida significativo. Os pacientes com TA apresentam comorbidades (depressão, transtornos de personalidade) que podem impedi-los de procurar tratamento 15 .

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“…Prevalence estimates suggest that up to 2% of adolescent and young adult women suffer from anorexia nervosa (AN) while an additional 3% to 6% suffer from bulimia nervosa (BN) (Drewnowski, Yee, & Krahn, 1988;Fisher, et al, 1995;Lucas, Beard, O'Fallon, & Kurland, 1991). The unusual, if not bizarre, constellation of behaviors associated with AN and BN exert a devastating toll on the lives of women afflicted with the disorders.…”

mentioning

confidence: 99%

“…As many as 18% of women with an eating disorder die of medical complications (Patton, 1988;Theander, 1985). Others experience serious physical problems including SELF-SCHEMA MODEL tN EATING DISORDERS 97 mology (American Psychiatric Association, 1993;Fisher, et al, 1995).…”

mentioning

confidence: 99%

The self-schema model: A theoretical approach to the self-concept in eating disorders

Stein

1996

Archives of Psychiatric Nursing

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Over the last several decades, the self-concept has been implicated as a important determinant of eating disorders (ED). Although considerable progress has been made, questions remain unanswered about the properties of self-concept that distinguish women with an ED from other populations, and mechanisms that link the self-concept to the disordered behaviors. Markus's self-schema model is presented as a theoretical approach to explore the role of the self-concept in ED. To show how the schema model can be integrated with existing work on the self-concept in ED, a framework is proposed that addresses the number, content, and accessibility of the self-schemas. More specifically, it is posited that a limited collection of positive self-schemas available in memory, in combination with a chronically and inflexibly accessible body-weight self-schema, lead to the disordered behaviors associated with anorexia nervosa and bulimia nervosa.

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Eating disorders in adolescents: A background paper

Cited by 278 publications

References 137 publications

Transtornos alimentares em escolares

Transtornos alimentares em escolares

Algumas questões éticas no tratamento da anorexia nervosa

The self-schema model: A theoretical approach to the self-concept in eating disorders

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