Subject(s)
Crohn Disease/complications , Obsessive-Compulsive Disorder/complications , Age of Onset , Child , Humans , Male , Risk FactorsSubject(s)
Adolescent Psychiatry/education , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Bulimia/psychology , Bulimia/therapy , Career Choice , Child Psychiatry/education , Countertransference , Fellowships and Scholarships , Specialization , Adolescent , Anorexia Nervosa/diagnosis , Autobiographies as Topic , Body Image , Bulimia/diagnosis , Child , Comorbidity , Female , Hierarchy, Social , Humans , Managed Care Programs , Physician-Patient Relations , Psychotherapy/education , Residential Treatment , Thinness/psychologyABSTRACT
OBJECTIVE: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The authors attempt to explain the historical context of the problem and explore potential avenues for change. METHOD: The authors review changes in ideal female body type throughout history, comment on current attitudes toward shape and weight in both men and women, and outline interventions aimed at increasing healthy habits and fostering self-esteem in youth. RESULTS: Throughout history, the ideal of beauty has been difficult to achieve and has been shaped by social context. Current mass media is ubiquitous and powerful, leading to increased body dissatisfaction among both men and women. CONCLUSION: Parents need to limit children's exposure to media, promote healthy eating and moderate physical activity, and encourage participation in activities that increase mastery and self-esteem. Funding for high-quality, visible advertising campaigns promoting healthy life styles may increase awareness.
Subject(s)
Body Image , Feeding and Eating Disorders/psychology , Mass Media , Adult , Beauty , Child , Feeding and Eating Disorders/etiology , Feeding and Eating Disorders/prevention & control , Female , Health Promotion/methods , Humans , Male , Motor Activity/physiologyABSTRACT
We report on a 28-year-old white woman with chronic psychotic-affective illness who abruptly stopped her decade-long habit of heavy daily cigarette smoking while maintained on clozapine at 450 mg/d. Within several days, she developed dry mouth, muscle spasms, dizziness, and blurred vision with dilated and sluggish pupils, with worsening sedation and confusion. Her combined serum concentration of clozapine + norclozapine was 2.5 microg/mL, compared with levels of about 600 ng/mL at daily doses of 350 mg at other times while smoking. Reducing the dose of clozapine led to rapid alleviation of these symptoms. Additional experience with and without smoking in this case further documented the effect of smoking to decrease circulating levels of clozapine. These observations add to the conclusion that cigarette smoke can increase clearance of many drugs, calling for special caution during treatment with potentially toxic substances and dose reduction in anticipation of smoking cessation.
