Characteristic of 275 patients with bulimia
The authors present data on 275 patients who met DSM-III criteria for bulimia. The mean age of the patients was 24.8 years, and the average duration of illness was approximately 7 years. These patients reported a variety of abnormal eating-related behaviors: binge eating (100%), self-induced vomiting (88.1%), laxative abuse (60.6%), diuretic abuse (33.1%), and chewing and spitting out food (64.5%). Over one-third reported a history of problems with alcohol or other drugs and most indicated substantial social impairment.
Available from: Valentina Cardi
- "Food craving has been identified as a precursor to binge eating in obese individuals   and in patients with BN  . Proof of concept studies have investigated whether imagery can disrupt food cravings  . "
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ABSTRACT: The aim of this paper is to map the possibility of new treatment approaches for eating disorders.
Eating disorders have a protracted trajectory with over 50% of cases developing a severe and enduring stage of illness. Although a good response to family-based interventions occurs in the early phase, once the illness has become severe and enduring there is less of a response to any form of treatment. Neuroprogressive changes brought about by poor nutrition and abnormal eating patterns contribute to this loss of treatment responsivity.
We have summarised the profile of symptoms at the various stages of illness and considered new treatments that might be applied.
In the enduring stage of illness in addition to problems with body image, food and eating, there are additional problems of low mood, high anxiety and compulsivity and problems in social functioning. This suggests that there are dysfunctions in circuits subsuming reward, punishment, decision-making and social processes. New approaches have been developed targeting these areas.
New interventions targeting both the primary and secondary symptoms seen in the enduring stage of eating disorders may improve the response to treatment.
Copyright © 2015. Published by Elsevier Inc.
Available from: Julien Lacaille
- "Although not necessarily problematic, food cravings are associated with maladaptive consequences. They can lead to unhealthy weight gain via snacking and binge eating (Basdevant, Craplet, & Guy-Grand, 1993; Drewnowski, 1991; Gendall , Joyce, Sullivan, & Bulik, 1998), are associated with bulimia (Mitchell, Hatsukami, Eckert, & Pyle, 1985), guilt (Hetherington & Macdiarmid, 1995), depression (Gendall et al., 1998), decreased quality of life (Gendall et al., 1997), and have been shown to impair cognitive performance (Kemps, Tiggemann, & Grigg, 2008; Tiggemann , Kemps, & Parnell, 2010). Therefore, finding effective ways through which people can manage food cravings is of importance. "
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ABSTRACT: There is accumulating evidence that mindfulness-based interventions are useful in reducing food cravings. However, existing studies have applied many mindfulness skills together, rendering it unclear which skills are essential and which are unnecessary. Based on recent investigations into the efficacy of individual mindfulness skills at managing cravings, the goal of the present study was to compare the efficacy of two-week mindfulness-based interventions, targeting different combinations of specific mindfulness skills (awareness, acceptance, disidentification), at reducing trait and state chocolate cravings. We compared the efficacy of the mindfulness interventions to an active control intervention (distraction). Overall, disidentification emerged as the most efficacious mindfulness skill. After two weeks of practice, those trained in disidentification reported less intense state cravings after a craving induction task compared with those trained in distraction. Mediation analyses revealed that this effect was mediated first by a greater increase in the disidentification skill, and subsequently by a greater decrease in trait chocolate cravings. Manipulation checks revealed that training the disidentification skill was more successful than training the other skills. Disidentification is shown to be a crucial mindfulness skill that can be taught to help better cope with food cravings.
Available from: Cynthia Bulik
- "Bulimia nervosa (BN) and alcohol use disorder (AUD; alcohol abuse/dependence) frequently co-occur (Bulik, 1987; Garfinkel et al., 1995; Bulik et al., 1997; Lilenfeld et al., 1998; Herzog et al., 1999; Dansky et al., 2000; Wade et al., 2004; Pereyra et al., 2010; Root et al., 2010). Estimates of the lifetime prevalence of AUD in women with BN have ranged from approximately 9% (Pyle et al., 1981) to 49% (Bulik, 1987), with the majority of investigations reporting between 20% and 25% (Mitchell et al.,1985; Holderness et al., 1994; Bulik et al., 2004; Baker et al., 2010; Root et al., 2010). Yet, the nature of this association is incompletely understood. "
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ABSTRACT: Bulimia nervosa (BN) and alcohol use disorder (AUD) frequently co-occur and may share genetic factors; however, the nature of their association is not fully understood. We assessed the extent to which the same genetic and environmental factors contribute to liability to BN and AUD. A bivariate structural equation model using a Cholesky decomposition was fit to data from 7241 women who participated in the Swedish Twin study of Adults: Genes and Environment. The proportion of variance accounted for by genetic and environmental factors for BN and AUD and the genetic and environmental correlations between these disorders were estimated. In the best-fitting model, the heritability estimates were 0.55 (95% CI: 0.37; 0.70) for BN and 0.62 (95% CI: 0.54; 0.70) for AUD. Unique environmental factors accounted for the remainder of variance for BN. The genetic correlation between BN and AUD was 0.23 (95% CI: 0.01; 0.44), and the correlation between the unique environmental factors for the two disorders was 0.35 (95% CI: 0.08; 0.61), suggesting moderate overlap in these factors. The findings from this investigation provide additional support that some of the same genetic factors may influence liability to both BN and AUD.
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