Eating Disorders

Preface
Contents
About the Editors
Contributors
Part I: General Aspects, Overviews, and Setting the Scene
1 Enhanced Cognitive Behavior Therapy for Eating Disorders
Introduction
The Origins of CBT-E
Transdiagnostic Theory
Overview of CBT-E
Goals of CBT-E
General Treatment Strategy
Forms of CBT-E
Versions of CBT-E
Outpatient CBT-E for Adults
Outpatient CBT-E for Adolescents
Intensive Outpatient CBT-E
Inpatient CBT-E
Post-inpatient Outpatient CBT-E
The Status of CBT-E
Implications for Clinical Services
Remaining Challenges
Applications in Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Enhanced Cognitive Behavior Therapy for Eating Disorders
Summary Points
References
2 Eating Disorders During Pregnancy
Introduction
EDs and Fertility
EDs in Pregnancy
Gestational AN
Gestational BN
Binge Eating Disorder (BED) in Pregnancy
Pica in Pregnancy
Pregorexia
Bottlenecks for the Management of EDs and OFSED Before Fertility Treatment and During Gestation
Application to Other EDs
Mini-dictionary of Terms
Key Facts of EDs During Pregnancy
Summary Points
References
3 Eating Habits During Pregnancy
Introduction
Role of Maternal Anthropometrics and Nutrition on Short- and Long-Term Outcomes
Current Maternal Nutrition Is Inadequate Even in Industrialized Countries
Dietary Patterns and Feto-maternal Outcomes
Conclusion
Mini-Dictionary of Terms
Summary Points
References
4 Stress and Disordered Eating Patterns
Introduction
Stress Responses
Physiology of Stress
Role of the HPA Axis and Glucocorticoids in Eating Behaviors
HPA Axis and Dopamine Reward Pathway
Hedonics and Addictive Properties of Food
Stress and Eating Patterns
The Impact of Eating Patterns on Stress and Mood
Individual Differences and Disordered Eating
Stress and Undereating
Stress and Overeating
Coping Strategies
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Summary Points
References
5 Gene Variants Involved in the Etiopathogenesis of Eating Disorders: Neuropeptides, Neurotransmitters, Hormones, and Their Re...
Introduction
Family Studies
Candidate Gene Association Studies
Genome-Wide Association Studies
Gene Variants
Serotonin Pathway
Brain-Derived Neurotrophic Factor Gene
Dopamine Receptor Family
Opioids and Their Receptors
Endocannabinoid Pathway
Appetite Regulatory System
Other Genes
Rare Genetic Variants
Conclusions
Summary Points
References
6 Genes and Eating Disorders
Introduction
Role of Serotonin in Eating Disorders
Characteristics of the Serotonin Transporter (SERT)
SLC6A4 Serotonin Transporter Gene
Genetic Association Studies
Studies of Association of the SLC6A4 Gene and Psychopathological Traits in Eating Disorders
Gene x Environment Interaction Studies in Eating Disorder
Studies of Sequence of SLC6A4
Conclusions
Key Points
Key Facts of Genes and Eating Disorders: A Focus on the Solute Carrier Family 6 (Neurotransmitter Transporter, Serotonin), Mem...
Summary Points
Applications to Other Areas
Mini-Dictionary
References
7 Eating Disorders in Athletes
Introduction
Prevalence of EDs in Athletes
Risk Factors
Which Sports Disciplines Are at Higher Risk for EDs?
EDs in Male Athletes
Special Considerations on Anorexia Nervosa in Athletes
Special Considerations on Bulimia Nervosa and Binge Eating Disorder (BED) in Athletes
Special Considerations on Orthorexia Nervosa in Athletes
Relative Energy Deficiency in Sport (RED-S)
Tools for Screening EDs Specifically in Athletes
Application to Other EDs
Mini-Dictionary
Key Facts of EDs in Athletes
Summary Points
References
8 Eating Disorders in Children and Adolescents with Attention Deficit Hyperactivity Disorder
Introduction
ADHD: A Prevalent Neurodevelopmental Disorder in Children and Adolescents
ADHD Diagnosis and Etiology
ADHD Comorbidities
Eating Patterns of Children with ADHD
Loss of Control (LOC) Eating/Binge Eating
Binge Eating Disorder (BED)
Bulimia Nervosa (BN)
Anorexia Nervosa (AN) and Avoidant/Restrictive Food Intake Disorder (ARFID)
Prevalence of ED in Children and Adolescents with ADHD
The Role of Gender in the Prevalence of ED Among Children and Adolescents with ADHD
Risk Factors for ED in Children and Adolescents with ADHD
Psychiatric Comorbidities and Emotional Regulation Difficulties (ERD)
Sleep Disturbances: The Overlooked Factor for Disordered Eating
Digital Media Use Influences on Body Satisfaction and Eating Behaviors
Possible Mechanisms Underlying the Association Between ADHD and ED
Clinical Implications/Clinical Management of ADHD and Eating Disorder
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Eating Disorders in Children and Adolescents with ADHD
Key Facts of Reward Deficiency Syndrome (RDS)
Key Facts of Stimulant Drugs for ADHD
Summary Points
References
9 Insomnia in Eating Disorders
Insomnia in Eating Disorders
Defining Insomnia
Insomnia as Transdiagnostic Across Psychopathology
Insomnia Disorder and Symptoms in Eating Disorders
Hypotheses for Understanding the Underlying Mechanisms of Insomnia and Eating Disorders
Hypothesized Psychological Factors
Hypothesized Biological Factors
Hypothesized Social Factors
Treatment Implications
Conclusion
Applications to Other Eating Disorders
Mini-dictionary of Terms
Key Facts of Insomnia and Eating Disorders
Summary Points
References
10 Uric Acid Levels and Eating Disorders
Introduction
UA Physiological Roles and General Pathophysiological Aspects
UA Measurement in Body Fluids
Gender Effects on SUA
UA in the Central Nervous System (CNS)
UA in Neuropsychiatric Disorders
UA in Eating Disorders (ED)
Conclusion
Applications to Other Areas
Mini-Dictionary of Terms
Key Facts
Summary Points
References
11 The Virtually Delivered Body Project (vBP): A Viable Option for Large-Scale Prevention of Eating Disorders
Introduction
Eating Disorders in Context
Prevention
The Main Prevention Strategies for EDs
Cognitive Dissonance Theory and Its Implication for Prevention
Dissonance-Based Intervention and Body Project
The Efficacy and Effectiveness of the Body Project
Influencing Public Health: Prevention on Broad Basis
The Promise of Internet and Digital Techniques
vBP
Applications to Other EDs
Mini-Dictionary of Terms
Key Facts of the Virtually Delivered Body Project (vBP) and EDs
Summary Points
References
12 Time-Related Changes in Eating Disorders
Introduction
Changes in the Concept and Diagnosis of EDs
Anorexia Nervosa (AN)
Bulimia Nervosa (BN)
Transition of Diagnostic Criteria for AN and BN
Time Trend of Incidence and Prevalence
Western Countries
Anorexia Nervosa
Bulimia Nervosa
Non-Western Countries
East Asia
West Asia
Latin America
Africa
Changes in Clinical Picture
Middle-Aged Women
Men
Conclusion
Applications to Other Eating Disorders
Mini-dictionary of Terms
Key Facts of Time-Related Changes in Eating Disorders
Summary Points
References
13 The Connection Between Eating Disorders and Substance Use Disorders
Introduction
Eating Disorders
Substance Use Disorders
Genetics
The Role of Serotonin
The Role of Dopamine
Genetics and ED-SUD
Neurobiology
Neurobiology of SUD
Neurobiology of ED
Neurobiology of ED-SUD
Neuroimaging Findings in SUD and ED
Temperament
Impulsivity in SUD and ED
Executive Function Deficits
Executive Function Deficits in SUD and ED
Emotion Regulation
Emotion Regulation in SUD and ED
Additional Shared Risk Factors for SUD and ED
Adverse Events, Trauma, and SUD
Adverse Events, Trauma, and ED
Adverse Events, Trauma, and ED-SUD
Clinical Implications
Conclusions
Mini-dictionary of Terms
Key Facts of Substance Use Disorders
Summary Points
References
14 Fluid Restriction in Eating Disorders
Introduction
Recognizing Intentional Fluid Restriction
How Much Fluid Does a Patient Need?
Who Restricts Fluids?
Why Do Patients Restrict Fluids?
Clinical Cases
Case 1: Adele
Case 2: Bianca
Case 3: Celia
Treatment of Fluid Restriction
Fluid Replacement
Behavioral Interventions
Psychological Interventions
Applicability to Other Eating Disorders
Mini-dictionary of Terms
Key Facts About Fluid Restriction
Summary Points About Fluid Restriction
References
15 Features of Medical Consultations Before the Onset of Eating Disorders
Introduction
Risk Factors and Prodromes as Predictors for Future Emergence of EDs
Features of Medical Consultations Before the Onset of EDs
Other Important Features of EDs
Prevention of EDs, Intervention Programs, and Impact
Applications to Other EDs
Mini-Dictionary of Terms
Key Facts of Features of Medical Consultations Before the Onset of EDs
Summary Points
References
16 The Role of Parents and Other Caregivers in the Early Detection of Eating Disorders
Introduction
The Early Intervention Continuum
The Role of Parents in Early Detection
Earliest Detectable Symptoms
Barriers to Early Detection of Eating Disorders
Parent-Led Early Intervention Programs
Parent-Led Risk Factor Reduction
Parent-Led Treatments for the Prodromal Phase
Parent Support in the Early Eating Disorder Phase
Conclusion
Applications to Other Eating Disorders
Mini Dictionary of Terms
Key Facts of Parent-Led Early Detection
Summary Points
References
17 Alexithymia in Eating Disorders: A Narrative Review
Introduction
Types of Alexithymia
Impact of Alexithymia Assessment on Research Findings
Structure and Rationale of the Current Review
Findings from Case-Control Studies
Findings in Cohort Studies with Community Samples Showing ED Symptoms
Findings from Clinical Samples: Alexithymia Differences According to AN and BN Diagnosis
Longitudinal Findings and the Impact of Alexithymia on ED Treatment Outcomes
The Longitudinal Variation of Alexithymia: Does It Have an Effect?
Therapeutic Implications and Applications
Limitations and Future Lines of Research
Conclusions
Mini-Dictionary of Terms
Key Facts of Alexithymia
Summary Points
References
18 Eating Disorder and Quality of Life
Introduction
General Characteristics of EDs
Comorbidities of ED
Relationship Between QoL and ED
Relationship Between System of Organs and EDs
Dynamics of ED and QoL
Considerations for Targeted Interventions for QoL in the Treatment of Patients with EDs
Conclusion
Mini Dictionary of Terms
Key Facts of Eating Disorders and Quality of Life
Summary Points
References
19 The Role of Denial in Eating Disorder Development, Assessment, and Treatment
Introduction
Defining Denial of Disordered Eating
Etiology of the Denial of Disordered Eating
Consequences of Denial of Disordered Eating
Assessment
Treatment
Future Directions
Summary
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Denial of Disordered Eating
Summary Points
References
20 The Role of the Dietitian
Overview of Dietetic Treatment for Eating Disorders
Nutrition Assessment
Nutritional Issues in Individuals with Eating Disorders
Nutrition Assessment for Eating Disorders
Nutrition Intervention, Monitoring, and Evaluation
Nutrition Education and Counselling
Outpatient Dietetic Treatment for Eating Disorders
Calcium Foods
Protein
Carbohydrates
Fruits and Vegetables
Fluids
Nuts, Oils, and Fats
Diet Foods and Fillers
Inpatient Dietetic Treatment for Eating Disorders, Including Considerations for Individuals with Anorexia Nervosa
Refeeding Syndrome
Nutrition Support for Inpatients
Considerations for Individuals with Bulimia Nervosa
Treatment Considerations for Individuals with Bulimia Nervosa
Considerations for Individuals with Binge Eating Disorder
Considerations for Individuals with Co-occurring Binge Eating Disorder and Obesity
Application to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Key Facts Regarding the Role of Dietitians in Eating Disorder Treatment
Summary Points
References
Part II: Anorexia Nervosa
21 A Research Approach to Self-Report and Objective Measurements of Physical Activity in Eating Disorders
Introduction
Assessment Tools for Measuring Objective and Psychological Components of PA in EDs
Self-Report Measurement of PA in EDs
Self-Report Measures of Objective Components of PA
Self-Report Measures of General PA Motivations
Self-Report Measures of Maladaptive PA
Strengths and Weaknesses of Self-Report Measures of PA
Ecological Momentary Assessment of PA in EDs
EMA of Objective Components of PA
EMA of General PA Motivations
EMA Maladaptive PA
Strengths and Weaknesses of EMA Measures of PA
Semi-structured Interviews of PA in EDs
Semi-structured Interviews of Maladaptive PA
Strengths and Weaknesses of Semi-structured Interviews of PA
Assessment Tools for Measuring Objective Components of PA in EDs
Objective Measurement: Types of Sensor Technology
Objective Measurement Outcome Variables
Strengths and Weaknesses of Objective PA Measurement
Future Directions of Assessment of Psychological and Objective Components of PA in EDs
Mini-Dictionary of Terms
Key Facts
Summary Points
References
22 Body Mass Index and Body Fat in Anorexia Nervosa
Introduction
Definitions of BMI and BF
BMI
BF
Methods of Assessment in AN Clinical Settings
Weight, Height, and Standard for BMI Determination
BF Estimation and Measurement
Skinfold Thickness (ST)
BIA
DXA
Changes in BMI and BF Before and After Weight Gain and Normalization
Relationship Between BMI, BF, and Clinical Outcomes
Remission, Recovery, and Risk of Relapse
Resumption of Menses and Reproductive Functions
Osteoporosis and Restoration of BMD
Summary
References
23 Modeling Anorexia Nervosa
Introduction
AA-Derived eiCs Pathways
eiCs Receptors
eiCs and Neuroinflammation
Animal Models of AN
Neuroinflammation in Animal Models of AN
eiCs in the ABA Model
Conclusion
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Anorexia Nervosa
Summary Points
References
24 Anorexia Nervosa and Impact After Three Decades
Introduction
Sten Theander´s Study in the Southern Part of Sweden
The Gothenburg Anorexia Nervosa Study
Background and Methods
Neurofilament Light Chain Protein in Serum
Facial Emotion Recognition Task
Definition of Full Eating Disorder Recovery
Results
General Outcome
Eating Disorder Outcome
Psychiatric Morbidity
Neurodegenerative Findings
Facial Emotion Recognition Task
Comparisons Between Theander´s Study and the Gothenburg AN Study
Discussion
Conclusions
Key Facts
Summary Points
References
25 Linking Anorexia Nervosa with the Gut Microbiota
Introduction
The Microbiota-Gut-Brain Axis
Gut Microbiota Link to AN
Intestinal Microbial Metabolites in AN
Gut Microbiota Adaptation to Diet
Manipulating the Gut Microbiota
Antibiotics
Probiotics, Prebiotics, and Psychobiotics
Fermented Food
Fecal Microbiota Transplantation
Immunity Involvement
Potential Mechanisms in AN Development
Applications to Other Eating Disorders
Mini-dictionary of Terms
Key Facts of Human Microbiota
Key Facts of Microbiota in Patients with AN
Key Facts of Gut Microbiota Modifications
Summary Points
References
26 Gender Aspects of Anorexia Nervosa: the Male
Introduction
Prevalence
Risk Factors, Symptom Onset, and Age of Presentation
Symptoms and Comorbidities
Medical Complications
Course and Prognosis
Treatment
Role of the Dietitian
Future Directions and Need for Awareness
Application to Other Eating Disorders
Mini-dictionary of Terms
Key Facts
Key Facts of DSM (Diagnostic and Statistical Manual of Mental Disorders)
Key Facts of BMI
Summary Points
References
27 The Biology of Anorexia Nervosa
Introduction
Clinical Presentation of Anorexia Nervosa
Neurohormonal Regulation of Appetite and Metabolism
Brain Centers of Energy Homeostasis
Hypoleptinemia in Anorexia Nervosa: A Chicken or an Egg?
Interaction of Metabolic State and Gonadal Function
Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Anorexia Nervosa
Summary Points
References
28 The Hippocampus in Anorexia Nervosa
Introduction
Hippocampus in Animal Model of AN
Structural Studies
Functional Studies
Hippocampus in Other Eating Disorders
Applications to Other Areas
Mini-Dictionary of Terms
Key Facts of Hippocampus in Anorexia Nervosa
Summary Points
References
29 Endocrine Disturbances in Anorexia Nervosa
Introduction
Physiological Functions of Ghrelin
Ghrelin and Reward Signaling in AN
Clinical Evidence of Ghrelin Resistance
Ghrelin Resistance: Antagonism by Other Ghrelin-Derived Peptides?
Physical Activity: The Patients´ Option to Induce Ghrelin Resistance?
Genetic Factors Involved in Ghrelin Resistance
Chronicity and Ghrelin Levels in AN
Application to Other Eating Disorders
Summary Points
Mini-Dictionary
References
30 Anorexia Nervosa and Eye Movements
Introduction
Neurobiology of Saccadic Eye Movements
Saccade Characteristics
Saccade Tasks
Fixation Task
Prosaccade Task
Antisaccade Task
Go/No-Go Saccade Task
Memory-Guided Saccade Task
Self-Paced Saccade Task
Visual Scan Path Tasks
Attentional Bias Tasks
Conclusions and Implications
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Eye Movements in AN
Summary Points
References
31 Anorexia Nervosa: Reproduction and Consequences for Mother and Child
Introduction
Anorexia Nervosa and Fertility
Functional Hypothalamic Amenorrhea
Management and Treatment of Functional Hypothalamic Amenorrhea
Long-Term Effect on Fertility
The Prevalence of Anorexia Nervosa in Pregnancy
Disease Course in Pregnancy
Anorexia Nervosa and Pregnancy Complications
Anorexia Nervosa and Adverse Perinatal Outcomes
The Postpartum Period
Children to Mothers with Eating Disorders
Management of Pregnant Women with Anorexia Nervosa
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Key Facts of Amenorrhea in Anorexia Nervosa
Key Facts of Pregnancy and Perinatal Outcomes in Women with Anorexia Nervosa
Key Facts of Management of Pregnant Women with Anorexia Nervosa
Summary Points
References
32 Anorexia Nervosa in the Acute Hospitalization Setting
Introduction
Hospitalization Criteria
Integrated Treatment
Nutritional Rehabilitation
Refeeding Process
Caloric Prescription
Nutrient Quality and Nutrient Supplementation
Nasogastric Feeding and Parenteral Nutrition
Psychological Treatment
Psychopharmacological Treatment
Behavioral Management
Motivation to Treatment
Treatment Outcomes
Renutrition
Psychopathology
Quality of Life
Rehospitalization
Discharge and Follow-up
Applications to Other Eating Disorders
Mini Dictionary of Terms
Summary Points
References
33 Anorexia Nervosa and Comorbidities
Introduction
Feeding and Eating Disorders
Anorexia Nervosa
Mental Health Comorbidities in Individuals with AN
Autism Spectrum Disorder
AN and ASD
General Considerations
Epidemiology
Psychodiagnostics
Clinical Traits and Theories
Treatments and Outcomes
Conclusions
Applications to Other Eating Disorders
Mini Dictionary of Terms
Key Facts of Anorexia Nervosa and Comorbidities: Linking Autism
Summary Points
References
34 The Electrocardiogram in Anorexia Nervosa
Introduction
Background
Heart Rate and Heart Rhythm
The Electrocardiogram
The Electrocardiogram in Anorexia Nervosa
The ECG in Anorexia Nervosa
Bradycardia
Heart Rate Variability
QTc Interval
T-Wave Changes
Special Circumstances
Impact of Refeeding
The Electrocardiogram during Exercise
Psychopharmacotherapy and the Electrocardiogram
Sudden Unexpected Death
Clinical Use of the ECG in AN
Conclusion
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of the Electrocardiogram in Anorexia Nervosa
Summary Points
References
35 Anorexia Nervosa and Concurrent Psychiatric Comorbidity
Introduction
Psychiatric Comorbidity in Anorexia Nervosa
Population-Based Studies
Clinical-Based Studies
Theoretical Implications
Clinical Implications
Anorexia Nervosa and Depressive Disorders
Anorexia and Bipolar Disorders
Anorexia Nervosa and Anxiety Disorders
Anorexia and Obsessive-Compulsive Disorder
Anorexia Nervosa and Psychosis
Anorexia Nervosa and Other Disorders
Application to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Key Facts of Depressive Disorders
Key Facts of Bipolar Disorders
Key Facts of Anxiety Disorders
Key Facts of Obsessive-Compulsive Disorders
Key Facts of Psychosis
Summary Points
References
Part III: Bulimia Nervosa
36 The Growth Hormone-IGF-1 Axis in Anorexia Nervosa
Introduction
GH and IGF-1 Levels in Anorexia Nervosa
Potential Causes and Mechanisms of GH Resistance in Anorexia Nervosa
Protein Deficiency
Ghrelin
Sirtuin 1
CREBH
Fibroblast Growth Factor (FGF)-21
Insulin
Triiodothyronine
Leptin
Estradiol
Testosterone
Effects of GH Resistance on Bone Mineral Density
Effects of GH and IGF-1 Replacement in Anorexia Nervosa (Table 1)
Recombinant Human GH
Recombinant Human IGF-1
Applications to Other Eating Disorders
Conclusions
Mini-Dictionary of Terms
Key Facts of the GH/IGF-1 Axis
Summary Points
Conflict of Interest
References
37 Relationship Between Bulimia Nervosa and Psychological Problems in Period of Adolescence
Introduction
Adolescence: A Risky Period for the Development of Bulimia Nervosa
Psychodynamics of Bulimia Nervosa
Bulimia Nervosa, Adolescence, and Psychological Profile of the Person
Psychological Problems in Adolescence and Bulimia Nervosa
The Image of One´s Own Body as a Predictor for the Development of Bulimia Nervosa in the Period of Adolescence
Self-Esteem and Bulimia Nervosa
Perfectionism and Bulimia Nervosa
Anxiety, Depression, and Bulimia Nervosa
Other Psychological Problems in Adolescence and Bulimia Nervosa
Our Experience
What Questionnaires Did We Use for Evaluation?
What Do the Obtained Results Show Us?
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Bulimia Nervosa
Summary Points
References
38 Visuospatial Abilities in Eating Disorders
Introduction
Visuospatial Abilities and Mental Rotation
Central Coherence
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Tasks Description
Clinical Implications
Treatment Implications
Conclusion
Application to Other Areas
Mini-dictionary of Terms
Key facts of Visuospatial Abilities in Eating Disorders
Summary Points
References
39 Androgens and Their Role in Bulimia Nervosa and Eating Disorder Not Otherwise Specified of Purging Type (EDNOS-P)
Introduction
Androgens and Their Mechanism of Action
The Action of Sex Steroid Hormones in the Pathophysiology of Bulimia Nervosa
Binging and Purging: Hormonal Changes
Polycystic Ovarian Syndrome: A Hyperandrogenic Condition with Associations with Bulimia Nervosa
Antiandrogenic Treatment in Bulimia Nervosa
Androgen´s Role in Relation to Psychiatric Disorders and Bulimia Nervosa
Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Summary Points
References
40 Bulimic Symptomatology
Introduction
Understanding the Dental Implications: An Outlook for Erosive Tooth Wear
Concepts and Epidemiology
Biological and Clinical Aspects
Etiology
Understanding the Dental Implications: An Outlook for Dental Caries
Concepts and Epidemiology
Biological and Clinical Aspects
Etiology
Time to Link Bulimic Symptomatology with Oral Health and Food Choices
Food Choices and Erosive Tooth Wear vs. Bulimic Symptomatology
Scientific Evidence
Hypotheses
Food Choices and Dental Caries vs. Bulimic Symptomatology
Hypotheses
The Role of Professionals Toward Oral Health Preventive Approach
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Bulimic Symptomatology, Food Choices, and Oral Health
Summary Points
References
41 Emotion Regulation in Bulimia Nervosa and Purging Disorder
Introduction
Conceptual and Theoretical Underpinnings
Clinical Observation and Comorbidity
Theoretical Models of Bulimia Nervosa as a Disorder of Emotion Regulation
Affect Regulation Model
Escape Theory
Mood Intolerance and the Transdiagnostic Cognitive Behavioral Model of Eating Disorder Maintenance
Manifestations of Emotion Regulation Difficulties in Bulimia Nervosa and Purging Disorder
Relationship Between State Negative Affect and Binge Eating/Purging Behaviors: Ecological Momentary Assessment Research
Interventions Targeting Emotion Regulation Difficulties for Bulimia Nervosa and Purging Disorder
Cognitive Behavioral Therapy (CBT) and CBT-Based Intensive Treatments
Dialectical Behavior Therapy
Integrative Cognitive-Affective Therapy for Bulimia Nervosa
Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Emotion Regulation in Bulimia Nervosa and Purging Disorder
Summary Points
References
42 Pharmacology Options for Bulimia Nervosa
Introduction
Antidepressants
Antiepileptics
Stimulants
Other Medications
Hormonal
Other Medications with Mixed/Negative Findings
Pharmacology Youth with BN
Psychotherapy and Pharmacology Combination in BN
Conclusions
Mini-Dictionary of Terms
Key Facts of Pharmacology Options for Bulimia Nervosa
Summary Points
References
43 Linking Embodiment Disorder and Bulimia Nervosa
Introduction
The Lived Body, The Embodied Being
Bulimia Nervosa as a Disorder of Embodiment
Visceral Interoception
Neural Correlates
Attachment Style
Tempo-spatial Dynamics
Embodiment and the Definition of the Self
Embodiment and Sexuality
Embodiment, Clinical Perspectives
Applications to Other Areas
Mini-Dictionary of Terms
Key Facts
References
44 Treating Adolescent Bulimia Nervosa
Introduction
BN Diagnostic Criteria
Prevalence, Onset, and Demographics
Transdiagnostic View of BN
Comorbidity
BN Treatment
Other Promising Avenues for Psychotherapy Treatments in Youth
Pharmacotherapy for BN
Treatment Moderators
Research and Clinical Future Directions
Summary/Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Treatment for Bulimia Nervosa
Summary Points
References
45 A Narrative Review on the Dual Pathway Model of Bulimic Pathology
Introduction
The Risk Factors Included in the DPM for BN
Body Mass Index
Sociocultural Pressures to Be Thin
Thin-Ideal Internalization
Body Dissatisfaction
Dietary Restraint
Negative Affect
Dietary Restraint and Negative Affect
Empirical Studies Assessing the Dual Pathway Model
Cross-Sectional Studies
Longitudinal Studies
A Note on the Predictive Utility of the DPM for BN
Limitations of Previous Studies and Future Directions
Clinical and Prevention Implications
Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Summary Points
References
46 Bulimia Nervosa: Reproduction and Consequences for Mother and Child
Introduction
Bulimia Nervosa and Fertility
Polycystic Ovary Syndrome
Polycystic Ovary Syndrome in Bulimia Nervosa
Management and Treatment of Amenorrhea in Bulimia Nervosa
Long-Term Effect on Fertility
The Prevalence of Bulimia Nervosa in Pregnancy
Disease Course in Pregnancy and Pregnancy and Perinatal Outcomes in BN
The Postpartum Period
Children to Mothers with Eating Disorders
Management of Pregnant Women with Bulimia Nervosa
Applications to Other Eating Disorders
Key Facts
Key Facts of Amenorrhea in Bulimia Nervosa
Key Facts of Pregnancy and Perinatal Outcomes in Women with Bulimia Nervosa
Key Facts of Management of Pregnant Women with Bulimia Nervosa
Summary Points
References
Part IV: Binge Eating Disorder
47 Long-Term Outcome of Inpatients and Outpatients with Bulimia Nervosa
Introduction
The Studies
Remission from Bulimia Nervosa
Persistence of Bulimia Nervosa at Follow-Up
Cross-Over to Other Eating Disorders at Follow-Up
Chronicity of Eating Disorders
Aspects of Social Functioning at Follow-Up
Mortality
Outcome of Bulimia Nervosa in Males
Application to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Bulimia Nervosa
Key Facts of Follow-Up
Key Facts of Mortality
Summary Points
References
48 Parental Care and Binge-Eating Disorder
Introduction
Psychopathological Aspects
Epidemiology
Attachment Liability in the Pathogenesis of BED
Parenting Style as a Measure of Early Attachment in Psychiatric Disorders
Parenting Correlates in Eating Disorders, BED, and Obesity
Parenting Influence on Personality Traits of Obese Participants With and Without BED
Evidences About Combined Maternal and Paternal Parenting Styles
No Specific Parental Style for BED Expression
Clinical Implications
Preventions Issues
Conclusion
Implications for Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Parental Care and Binge-Eating Disorder
Summary Points
References
49 DeltaFosB and Preclinical Binge Eating
Introduction
ΔFosB and BE
ΔFosB: What, When, and How?
What Is the Effect of ΔFosB Expression on Behavior?
What Is the Effect of ΔFosB on Neuronal Activity?
BE: What, When, and How?
What Do We Know from Human Studies?
What Do We Know from Animal Studies?
Animal Models of BE
Overview of the Reward System
Similarities Between Human and Animal Studies
Implications for Clinical Contextual Applications
Application to Other EDs
Mini-Dictionary of Terms
Key Facts of ΔFosB
Summary Points
References
50 Characterization of Binge Eating Days in Daily Life
Introduction
Binge Eating in Eating Disorders
Measuring Binge Eating: State of the Art and Its Limitations
Example of Studying Binge Eating through EMA
Affect
General and Specific Negative and Positive Affect in Daily Life
Stress
Affective Lability, Emotion Dysregulation, and Dissociation
Dietary Restraint and Weight Loss Dieting
Food Craving/Hunger and Urge to Binge
Physical Appearance and Body Dissatisfaction
Cognitive States: Expectancy and Executive Functioning
External Context
The Aftermath: Consequences of Binge Eating
Future Directions in EMA Research on Binge Eating Prediction
Methodological Considerations in the Affect-Binge Eating Relationship
Moderators in the Relationship Between Antecedents and Binge Eating
Including Objective Assessment Measures
Individualized Approaches (``N of One Studies´´)
Interventions/Clinical Implications
Application to Other Eating Disorders
Mini Dictionary of Terms
Key Facts of Emotional Eating
Key Facts of Ecological Momentary Assessment
Summary Points
References
51 Cancer and Binge Eating
Introduction
Behavioral Risk Factors for Cancer
Associations with Binge Eating and Related Disorders
Mental and Emotional Health, Binge Eating, and Cancer
Conclusions and Future Directions
Application to other Areas
Mini-dictionary of Terms
Key Facts
Summary of Points
References
52 Fat Mass and Obesity-Related Gene (FTO) and Binge Eating Disorder in Adults and Adolescents
Introduction
FTO and Eating Disorders in Adults
FTO and Binge Eating Disorder in Children and Adolescents
Neural Studies in Homeostatic and Reward Circuits and FTO
Limitations and Strengths
Summary and Conclusions
Mini-dictionary of Terms
Key Facts of Binge Eating
Summary Points
References
53 Neuroimaging in Binge Eating Disorder
Introduction
Structural MRI Studies
Functional MRI Studies
Diffusion Tensor Imaging and Magnetoencephalography Studies
PET-SPECT Studies
Future Directions
Mini-Dictionary of Terms
Key Facts
Summary Points
References
54 Binge Eating
Introduction
Definitions and Indications of BMS
BED
Prevalence of BED in Bariatric Patients
Instruments Used to Diagnose BED
Psychological Aspects: Behavioral and Dietary Reorganization
Mini-Dictionary of Terms
Key Facts
Summary Points
References
55 Linking Sleep Deprivation and Binge Eating: Empirical Evidence and Underlying Mechanisms
Introduction
The Detrimental Effects of Sleep Deprivation
Association Between Sleep Deprivation and Increased Food Intake and Impaired Dietary Behavior: Underlying Mechanisms
Biological Pathway
Cognitive and Neural Pathways
Emotional and Behavioral Pathways
Sleep Deprivation and Binge Eating: Still Little Evidence
Chronic Sleep Deprivation and Binge Eating
Poor Sleep Quantity and Quality in Night Eating Syndrome Are Associated with Binge Eating
Novel Empirical Evidence Exploring Both Sleep Deprivation and Binge Eating
Conclusions
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Sleep Deprivation and Binge Eating
Summary Points
References
56 The Criterion B Binge-Eating Symptoms
Introduction
The BED Diagnostic Criteria
The Development of Criterion B in BED
The Validity and Clinical Utility of the Criterion B Three-Symptom ``Threshold´´
Research Supporting the Validity of Individual Criterion B Symptoms
Eating more Rapidly during Binge Eating
Eating to the Point of Having Physical Discomfort
Eating Large Quantities in the Absence of Physical Hunger
Eating Alone Due to Embarrassment about Binge Size
Feeling Depressed, Disgusted, or Guilty Following Binge Eating
Relevance of Criterion B Symptoms to Special Populations
The Criterion B Symptoms in Non-pharmacological BED Treatment
Summary
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of the Criterion B Binge-Eating Symptoms
Summary Points
References
Part V: Other Specified and Unspecified Feeding or Eating Disorders
57 Cognitive-Behavioral Therapy and Purging Disorder
Introduction
Defining Purging Disorder
Etiopathogenesis and Risk Factors
Clinical and Personality Features
Medical Complications for Purging Behaviors
Treatment Approaches
Medical and Pharmacological Approach
Cognitive-Behavioral Therapy
CBT Outcome for Purging Disorder
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Purging Disorder
Summary Points
References
58 Purging Disorder
Introduction
Definition of Purging Disorder
Prevalence and Age of Onset
Biological Correlates
Summary
Effects of Dietary Restraint
What Is Dietary Restraint?
Micronutrient Deficiencies Associated with Dietary Restraint
Macronutrient Deficiencies Associated with Dietary Restraint
Effects of Purging
Nutritional Consequences of Self-Induced Vomiting
Nutritional Consequences of Laxative Misuse
Nutritional Consequences of Diuretic Misuse
Role of the Dietitian
Conclusion
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Purging Disorder
Summary Points
References
59 Purging Disorder
Introduction
Purging Disorder Defined
Prevalence of Purging Disorder
Impact of Purging Disorder
Differences between PD and Other Eating Disorders
Potential Mechanisms
Overvaluation of Body Shape and Weight
Hunger and Satiety
Emotion Dysregulation
Impulsivity
Treatment Considerations
Conclusion
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Purging Disorder
Summary Points
References
60 Body Weights and Mass and Links with Nighttime Eating
Introduction
Circadian Rhythm of Food Intake and Changes in Nighttime Eating
Delayed Timing in NE and Its Consequences
Hormone Profiles in NE
Assessment of NE
Effects of NE on Weight Management and Diabetes Management
NE and BMI
NE and Diabetes
Etiology of Nighttime Eating and Links to BMI
Psychological Factors
Genetic Components
Hypocretin Receptors and NE
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Night Eating Syndrome
Summary Points
References
61 Night Eating Syndrome and Network Analysis of Features
Introduction
Night Eating Syndrome
History of Night Eating Syndrome
Development of the Research Diagnostic Criteria
Prevalence and Comorbidities
Etiology and Medical Model Conceptualization
Network Theory of Psychopathology
Weaknesses of the Medical Model
Network Theory
Advantages of Network Theory
Modeling the Network Approach to Psychopathology: Network Analysis
Network Structure
Approaches to Modeling Network Structure
Network Properties
Centrality
Accuracy and Stability
Network Approach to Psychopathology in Eating Disorders
Outline of Emerging Research
Network Approach to Psychopathology in NES
Clinical Implications
Future Directions in Network Analysis of NES
Network Comparisons
Temporal Network Analysis Models
Refine Intervention Targets
Applications to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Night Eating Syndrome and Network Analysis of Features
Key Facts of Night Eating Syndrome
Summary Points
References
62 Avoidant/Restrictive Food Intake Disorder in Children
Introduction
ARFID in Children
Characteristics
Prevalence of ARFID
Impact of ARFID
Differential Diagnosis
Etiology
Assessment of ARFID
Treatment of ARFID
Family-Based Treatment
Cognitive-Behavioral Approaches
Parent-Based Treatments
Hospital-Based Feeding Programs
Pharmacotherapy
Summary
Mini-Dictionary of Terms
Summary Points
References
63 The Brain in Prader-Willi Syndrome
Introduction: Hyperphagia in Prader-Willi Syndrome
PWS and Behavioral Phenotypes
PWS Overview
Diagnostic Criteria and Neurological Features
Behavioral Characteristics
Hyperphagia and Complex Behavioural Phenotypes
Psychiatric Disturbances and Genetic Susceptibility
Major Hypothetic Focuses on Brain Developmental Pathophysiology
Hypothalamic Dysfunction with Altered HPA Axis
Gene-Behavior Relationship: ``Behavioral Phenotype´´ Concept
Schaaf-Yang Syndrome
BP1-BP2 Microdeletion Syndrome
Neurochemical Alterations
5-Hydroxytryptamine and Gamma Amino Butyric Acid
Oxytocin and Vasopressin
Ghrelin
Neuroanatomical and Microstructural Structures of the Brain in PWS
Hypothalamus and Pituitary Gland
Brain Stem and the Midbrain
Cerebellum
Cerebrum
Evidence on Altered Brain Structural and Functional Connectivity
Structural Connectivity
Functional Connectivity
Electrophysiological Studies
Functional Imaging Studies
Future Avenues for Research
Molecular, Cellular, and Pharmacological Approaches Combined with Advanced Imaging Technology
Neuromodulation
Multidisciplinary Approach Toward Longitudinal Analysis of the Brain and Behavior
Suggested Areas to Be Included in the Chapters as Background
Applications to Other Eating Disorders
Cerebellar Contribution to Eating Disorders
Neurodevelopmental and Psychiatric Comorbidities in Eating Disorders
Neuroendocrinological and Musculoskeletal Assessments and Interventions in Eating Disorders
Mini Dictionary of Terms
Key Facts of Genetic Imprinting in PWS
Key Facts of Nutrition in PWS
Key Facts of Behavioral Phenotypes in Genetic Syndromes
Summary Points
References
64 Behavioral Phenotype of Patients with Prader-Willi Syndrome
Introduction
Behavioral Phenotype in Patients with PWS across Lifespan
Prenatal Period
Neonatal and Infancy Period
Early Childhood Period
Teenage and Adolescent Period
Adulthood
Distinctive Features of the PWS Behavioral Phenotype
PWS Phenotype and Intellectual Disability
Self-Injurious Behavior
Nutritional Stages
The Relationship Between the Genotype and Phenotype of PWS
Interventions Targeting Challenging Behaviors in PWS Patients
Impact of Pharmacotherapy on PWS Patients´ Behavior
Application to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts
Summary Points
References
65 Body Dysmorphic Disorder: Links with Eating Disorders and Gender-Related Factors
Introduction to Body Dysmorphic Disorder
Prevalence, Onset, and Course
Core Symptoms
Insight
Comorbidities
Functional Impairment
Gender Differences in BDD
Muscle Dysmorphia (MD): A Subtype of BDD
Characteristics of MD
MD and Steroid Abuse
Gender Differences Associated with MD
Relationships Between BDD and Eating Disorders
Differential Diagnosis: Distinguishing BDD from Eating Disorders
Comorbidity of BDD and Eating Disorders
Clinical Characteristics Common to BDD and EDs
Associated Features Common to BDD and AN
Overlaps Between MD and AN
Overlaps of BDD and EDs: Gender-Related Factors
Considering Comorbid BDD and EDs in Treatment
Role of Dysmorphic Concerns in Comorbid BDD and EDs
Future Treatment Research Directions for Comorbid BDD and AN
Conclusions
Applications to Other Eating Disorders
Mini-dictionary of Terms
Key Facts of Body Dysmorphic Disorder: Links with Eating Disorders and Gender-Related Factors
Summary Points
References
66 Orthorexic Eating and Addictions: Links with Substance Use, Behavioral Addictions, and Research Gaps
Introduction
Definition and Clinical Aspects
From the Healthy Interest in Diet to the Unhealthy Obsession with Diet
Epidemiology, Risk Factors, and Clinical Relevance
The Current Debate About the Behavior´s Pathological Relevance
Differential Diagnosis and Differentiation from Other Diseases
Orthorexia Nervosa and Obsessive-Compulsive Symptoms
Orthorexic Eating Within the Eating Disorder Spectrum
Orthorexia Nervosa and Addictive Behaviors
Comorbidity Between Orthorexia Nervosa and Substance-Related Addictions
Empirical Evidence for a Link Between Orthorexia Nervosa and Substance (Ab)Use
Comorbidity Between Orthorexia Nervosa and Behavioral Addictions
Phenomenological Overlap of Orthorexia Nervosa and Behavioral Addictions
The Link Between Orthorexia Nervosa and Exercise (Addiction)
The Link Between Orthorexia Nervosa and Food Addiction
The Link Between Orthorexia Nervosa and Social Media Addiction
Conclusion
Open Questions and Future Directions
Application to Other Eating Disorders
Mini-Dictionary of Terms
Key Facts of Orthorexia Nervosa Within the Debate of Categorization as New Mental Disorder
Summary Points
References
67 Linking Orthorexia and Obsessive-Compulsive Symptoms
Introduction
Symptoms of Orthorexia Nervosa
Negative Effects of Orthorexia on Health and Functionality
Prevalence of Orthorexia Nervosa
Diagnostic Criteria of Orthorexia Nervosa
Definition of Obsessive-Compulsive Disorder and Its Relationship with Eating Disorders
Association of Orthorexia Nervosa with Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder-Related Cognitive Features of Orthorexia Nervosa
Association of Orthorexia Nervosa with Eating Disorders
Association of Orthorexia Nervosa with Anorexia Nervosa and Bulimia Nervosa
Distinguishing Features of Orthorexia Nervosa from Anorexia Nervosa and Bulimia Nervosa
Association of Orthorexia Nervosa with Avoidant-Restrictive Food Intake Disorder
Association of Orthorexia Nervosa with Other Mental Disorders
Association of Orthorexia Nervosa with Obsessive-Compulsive Personality Disorder
Association of Orthorexia Nervosa with Somatoform Disorders
Association of Orthorexia Nervosa with Psychotic Disorders
Unique Features of Orthorexia Nervosa
Orthorexia Nervosa and Healthy Living Behaviors
Orthorexia Nervosa and Exercise
Orthorexia Nervosa and Social Media
Smoking and Alcohol Use
Vegetarian Diet
Is Orthorexia Nervosa a Separate Mental Disorder?
Treatment and Management
Conclusion
Applications to Other Eating Disorders
Key Facts of Orthorexia Nervosa with Obsessive-Compulsive Symptoms
Summary Points
References
68 Cardiac Vagal Imbalance and Emotional Eating
Introduction
Emotional Eating and Body Mass Index (BMI)
Emotional Eating and Food Image Stimuli
Emotional Eating and Food Craving
Emotional Eating and Loss of Control Eating
Emotional Eating and Hunger Inhibitory Control
Neural Basis of Emotional Eating
Emotional Eating and HRV
Applications to Other Areas
Mini Dictionary of Terms
Summary Points
References
69 Biologic Aspects of Rumination Syndrome, Eosinophils, and Beyond
Introduction
Physiology of a Rumination Episode
Pathophysiology of Rumination
GERD
Functional Dyspepsia
Rumination Syndrome
Summary
Mini-Dictionary of Terms
Summary Points
References
70 Picky Eating in Normally Developing Children and Young Adults
Introduction
Definitions of Picky Eating
Measurement of Picky Eating
What Is Not Eaten by Picky Eaters?
Prevalence of Picky Eating
Continuity from Childhood to Young Adulthood
Trajectories of PE
Parental Feeding Practices: Pressure to Eat
Sensory Sensitivity
Temperament, Fearfulness, and Inhibition
Less-Studied Issues
Practical Advice
Applications to Other Eating Disorders
Mini Dictionary of Terms
Key Facts of Picky Eating in Children and Young Adults
Summary
References
Part VI: Diagnosis, Delective Questionnaires, and Resources
71 Assessing Orthorexia Nervosa by Questionnaires
Introduction
Which Questionnaires Are Used in Orthorexia Nervosa Studies?
Bratman Orthorexia Test
ORTO-15
Body Image Screening Questionnaire (BISQ)
Düsseldorf Orthorexia Scale (DOS)
Orthorexia Nervosa Scale (ONS)
Burda Orthorexia Risk Assessment (B-ORA)
Teruel Orthorexia Scale (TOS)
The Barcelona Orthorexia Scale (BOS)
Orthorexia Nervosa Inventory (ONI)
Test of Orthorexia Nervosa (TON-17)
Application to Other Eating Disorders
Mini-Dictionary
Key Facts of Assessing Orthorexia Nervosa by Questionnaires
Summary Points
References
72 The Eating Disorder Quality of Life (EDQoL) Scale
Introduction
Quality of Life in Eating Disorders
Applications to Other Eating and Feeding Disorders
Comorbidities
Treatments and Quality of Life
The Eating Disorder Quality of Life (EDQoL) Questionnaire
The EDQoL Domains
Interpersonal Domain
Application to Other Areas
Future Directions
Mini-dictionary of Terms
Key Facts on Quality of Life in EDs
Summary Points
References
73 Binge Eating Scoring Systems
Introduction
Bariatric Surgery and the Prevalence of Disorders
BED Diagnosis
Effect of BED in Pre- and Postsurgery Patients
Types of Bariatric Surgery and the Effect on Eating Behavior
Binge Eating Assessment in Bariatric Patients
Pros and Cons of Instruments for the Assessment of Eating Disorders
Applications to Other Areas
Mini-Dictionary of Terms
Key Facts of Scoring Systems for Bariatric Patients
Summary Points
References
74 Conceptualizing and Evaluating the Healthy Orthorexia Dimension
Introduction
Conceptualizing Orthorexia
Knowing Orthorexia Symptomatology
Investigating the Frequency and Risk Factors of Orthorexia
Evaluating Orthorexia from Psychometric Instruments
What Is the Best Way to Investigate HeOr Symptomatology?
What Is the Best Way to Management Symptomatology of Orthorexia?
Final Considerations
Applications to Other EDs
Mini-Dictionary of Terms
Key Facts of Orthorexia
Summary Points
References
75 The Binge Eating Scale
Introduction
Diagnosis and Scales
Binge Eating Scale
Scoring
Other Uses of BES
Limitations
Other Versions
Modified Versions of BES
Applications to Other Eating Disorders
Mini-Dictionary
Key Facts
Key Summary Points
Conclusion
Questions in Binge Eating Scale and Scoring
References
76 Health-Related Quality of Life Questionnaires
Introduction
The Short Form-36 (SF-36)
Eating Disorder Examination-Questionnaire (EDE-Q)
Short Form-12 Health Status Questionnaire (SF-12)
Weissman Scale of Social Adjustment
BDI
The Eating Disorder Diagnostic Scale (EDDS)
Health-Related Quality of Life in ED-Short Form (HeRQoLED-S)
Conclusion
Mini-Dictionary of Terms
Key Fact of Health-Related Quality of Life Questionnaires: Applications to EDs
Summary Points
References
77 Resources in Eating Disorders
Introduction
Resources
Other Resources
Summary Points
Contributions to the Development of This Resource
References
Index