[Treatment history of eating disorders between 1984-2008 at the Department of Psychiatry and Psychotherapy, Semmelweis University].

The authors summarize their experiences collected from psychotherapeutic treatment of anorectic and bulimic patients treated at the outpatient and inpatient clinics of the Department of Psychiatry and Psychotherapy, Semmelweis University in the period of 1984-2008. The introduction provides an overview of the literature, that represents a theoretical background to their therapeutic strategies. Afterwards, insights are given about the authors own treatment strategies, that varied, although only slightly in different time periods. Therapeutic outcomes are summarized separately for groups of restrictive and purging anorexia patients, bulimia patients and bulimia patients suffering from other impulse control problems. Results are evaluated on the basis of clinical assessments, symptomatic reductions of eating disorders after treatment, and based on two years follow-up data. Finally results are analysed critically, concerning the used methods and further opportunities for relapse prevention.

Reading Disorders: Pro-Eating Disorder Rhetoric and Anorexia Life-Writing.

This article explores the relationship between eating disorders and reading behaviors, arguing that there is a meaningful difference in a minority of readers' approach to and understanding of anorexia life-writing, and of literary texts more broadly. To illuminate this distinction, this article begins by considering the reported deleterious influence of Marya Hornbacher's anorexia memoir, Wasted, elaborating the ways Hornbacher offers a positive presentation of anorexia nervosa that may, intentionally or not, induce certain readers to "try it" themselves. This is followed by an exploration of how Hornbacher's own reading praxis is implicated in a discursive feedback loop around anorexia narratives. It concludes with a discussion of disordered reading attitudes in relation to the emergence of the "pro-anorexia" phenomenon.

Disordered eating in African American and Caucasian women: the role of ethnic identity.

The influential roles of culture and ethnic identity are frequently cited in developing disordered eating and body dissatisfaction, constituting both protective and risk factors. For African American women, strongly identifying with African American cultural beauty ideals may protect against disordered eating to lose weight, but may actually increase risk in development of disordered eating directed at weight gain, such as binge eating. This study compares African American and Caucasian women on disordered eating measures, positing that African American women show greater risk for binge eating due to the impact of ethnic identity on body dissatisfaction. Findings indicate low levels of ethnic identity represent a risk factor for African American women, increasing the likelihood of showing greater binge eating and bulimic pathology. In Caucasian women, high levels of ethnic identity constitute a risk factor, leading to higher levels of both binge eating and global eating pathology. Implications for prevention and treatment are discussed.

[Eating disorders in a historical perspective]. / Spiseforstyrrelser i et historisk perspektiv.

Disordered eating has been known since antiquity and is mentioned in medical journals as well as in popular literature. The holy anorectics in the Middle Ages wanted to achieve spiritual perfection, while the anorectics of today are seeking bodily perfection. Hilde Bruch and Mara Selvini Palazzoli were the first to focus on anorectic symptoms like leanness and body image disturbance. The breakthrough in clinical and scientific work on bulimia nervosa came around 1980, primarily due to Russell's achievements. In 1874, Sir William Gull was the first to use anorexia nervosa as a diagnosis, while bulimia nervosa was first used in 1979. In the history of Norwegian psychiatry, several psychiatric disorders were described at an early stage, yet eating disorders have only been discussed in the scientific literature from the 1980s and onwards. Eating disorders have now become a cause of concern on the part of health authorities; their policy is to improve clinical skills at all levels rather than to build up specialised clinics.

Bulimia nerviosa (Parte 1). Historia. Definición, epidemiología, cuadro clínico y complicaciones / Bulimia nervosa (Part 1): History, definition,epidemiology, clinical picture and complications

Se provee al pediatra una revisión de bulimia nerviosa (Parte 1), enfocada en medicina basada en la evidencia, alertando con respecto a la alarmante epidemiología y a las proteiformes manifestaciones clínicas de este desorden cíclico y secreto. Además se comparte información que facilita la detección de este trastorno por medio de una historia clínica dirigida, el reconocimiento de los signos típicos en el examen físico y el análisis cuidadoso de los datos de laboratorio. Finalmente, se describe la variedad de complicaciones, así como la frecuente comorbilidad asociada.

Bulimia nerviosa (Parte 1). Historia. Definición, epidemiología, cuadro clínico y complicaciones / Bulimia nervosa (Part 1): History, definition,epidemiology, clinical picture and complications

Se provee al pediatra una revisión de bulimia nerviosa (Parte 1), enfocada en medicina basada en la evidencia, alertando con respecto a la alarmante epidemiología y a las proteiformes manifestaciones clínicas de este desorden cíclico y secreto. Además se comparte información que facilita la detección de este trastorno por medio de una historia clínica dirigida, el reconocimiento de los signos típicos en el examen físico y el análisis cuidadoso de los datos de laboratorio. Finalmente, se describe la variedad de complicaciones, así como la frecuente comorbilidad asociada.(AU)

Transtornos alimentares: classificação e diagnóstico / Classification and diagnosis of eating disorders

O presente artigo apresenta os critérios diagnósticos atuais dos transtornos alimentares: anorexia nervosa e bulimia nervosa. Os aspectos controversos da anorexia nervosa são discutidos.

Hábitos alimentarios en población adolescente femenina / Diet among teenage girls

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Bulimia: a historical outline.

The frequent occurrence of the eating disorder bulimia and major scientific contributions raise the question as to its origins, history, and course. Considerable information exists on bulimia. This paper reviews the historical references to the disorder from the first recorded report to the present (2,500 years ago to ca. 1970). The concept of bulimia has undergone various changes, beginning with a monosymptomatic, and leading to a polymorphous clinical picture. In addition, after being fused with the concept of kynorexia (incessant voracious eating followed by vomiting), the concept of bulimia has again attained a unified manifestation. Some symptoms appear to have taken on a different evaluation in time. All this must be seen in the context of the multiple changes which the concept of bulimia has undergone. Its characteristics justify neither a "new" disorder nor, as a consequence, an additional name.

Were the Roman emperors Claudius and Vitellius bulimic?

OBJECTIVE: To investigate the eating habits of Romans during the first two centuries A.D. and their attitudes towards these eating habits in the light of contemporary Latin literary and historical sources and influential Greek medical sources. METHOD: An extensive search of sources on the Roman Empire and emperors in the first two centuries A.D. was carried out. Two historical cases of binging and self-induced vomiting, namely the Emperors Claudius and Vitellius, were identified and described in translated extracts from the original Latin source. DISCUSSION: It is noted that cultural and social factors are important influences on eating habits which would now be considered pathological.

Was late-nineteenth-century nervous vomiting an early variant of bulimia nervosa?

We studied a wide variety of medical publications to find out whether late-nineteenth-century nervous or hysterial vomiting was clinically consistent with modern bulima nervosa. Since modern diagnostic criteria of bulimia nervosa my be time- and culture-bound, we made use of adapted criteria, focusing on the more overt, physical and behavioural features of the syndrome. In retrospect, it became obvious that only some of these specific diagnostic requirements were met. Indeed, late-nineteenth-century nervous or hysterical vomiters most likely have been non-organically-ill neurotics. However, their disorder was more closely associated with food abstinence in general and anorexia nervosa in particular than with overeating. Only in a few cases doctors made mention of recurrent episodes of binge eating, but there was no convincing evidence of any concern for body shape and weight. Obviously, late-nineteenth-century nervous or hysterial vomiting was still located at the crossing between classic hysteria, the 'new' clinical entity of anorexia nervosa, and forms of psychogenic vomiting.

Emergence of bulimia nervosa as a separate diagnostic entity: review of the literature from 1960 to 1979.

With Russell's description of bulimia nervosa in 1979, followed by the DSM-III diagnosis of bulimia, a "new" eating syndrome found its official acceptance in the scientific world. In the two preceding decades clinicians and researchers gradually payed more attention to special forms of overeating. In the 1970s the nosographic conceptualizations of binge eating, bulimia, compulsive eating, or hyperorexia clearly shifted from a symptom level--closely connected to anorexia nervosa and/or obesity--to a syndrome level. Around the same time and independently from one another, clinicians from different countries proposed various descriptive labels for this new diagnostic entity, which, finally, became accepted as bulimia nervosa.

Early descriptions of eating disorders in the Norwegian medical literature.

By the end of the nineteenth century, anorexia nervosa had acquired a certain amount of recognition in the medical literature in many countries. In Norway, however, little attention had been paid to this eating disorder. Some anorexic-like conditions can be found in case reports on "hysteria" in children, of which the article by Selmer, from 1891, is quoted in extenso.

Self-mutilation in four historical cases of bulimia.

Current theories suggest that there is a relatively frequent association of self-mutilative behaviour with eating disorders, particularly with the modern binge-purge syndrome, bulimia nervosa. In order to consider this association on a historical dimension, 25 bulimic cases, reported from the late 17th to the late 19th century, were investigated. These were found to include four examples of self-mutilative behaviour, in three males and one female: these cases are described and discussed. The historical evidence lends some support for the suggested connection between eating pathology and self-mutilation.