Acute poisonings among adolescents and young adults with anorexia nervosa

Article Abstract:

Anorexia nervosa is an eating disorder in which the patient fears gaining weight and engages in extreme dieting and fasting practices. These persons are frequently psychologically disturbed and under treatment with various prescription medicines. The prevalence of depression in this group is reported to be as high as 50 percent, and as many as 20 percent make serious suicide attempts. This study was specifically designed to describe the female anorectic patient who intentionally poisons herself. Twenty-one cases (involving 23 poisonings) were identified from the records of the Massachusetts Poison Center from November 1987 to November 1988. The patients' ages varied from 12 to 36 years. Referring physicians were asked to provide baseline clinical and laboratory data, which were added to other demographic information that was available. The patients overdosed on prescription psychotherapeutic drugs, cathartics and analgesics. Deliberate, delayed reporting to a hospital emergency room or to a physician point up the serious effort to commit suicide. These persons frequently develop electrolyte imbalances, which often exacerbate the toxicity of the ingested material. Detoxication efforts are frequently impeded by the clinical condition of the patient, delayed bowel emptying and renal insufficiency, and the inactivity of specific medications (ie. ipecac) in the individual because of their previous abuse. This study points out the need to be alert to the risk of poisoning in anorectics. These cases are often complicated by any or all of the following: (1) delays in obtaining medical care; (2) misrepresentation of the identity of the toxicant; (3) ready availability of potentially poisonous medications (antidepressants, aspirin); (4) frequent electrolyte imbalance; and (5) decontamination and treatment problems relating to patient mental status. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Care and treatment, Complications and side effects, Suicide, Poisoning, Self-poisoning, Self poisoning

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Long-term outcome of adolescents with anorexia nervosa

Article Abstract:

Anorexia nervosa is a complex eating disorder in which the patient stops eating, inaccurately perceiving his/her body as fat. This obsession with becoming thinner is more common among adolescent girls. Although the number of deaths from anorexia has decreased, the incidence of the disease has increased. Since anorexia can last for long periods of time, the outcome of treatment is best evaluated by long-term follow-up. The long-range prognoses for 49 adolescent girls admitted to a hospital for treatment of anorexia nervosa by a pediatric service were evaluated. Body weight increased from 72.1 percent to 96.1 percent of ideal between admission and follow-up. A common complication of anorexia is amenorrhea, the absence of menstruation. Menstruation had ceased in all patients prior to hospital admission, and resumed in 80 percent of the patients after admission, at the point where they had attained about 90 percent of their ideal body weights. Pregnancy was achieved in 15 patients; two of the pregnancies were electively terminated, three were still in progress, and 10 resulted in healthy infants. Binge eating and vomiting affected 22 out of 45 patients after hospitalization. Education and employment were not adversely affected. Most patients returned to normal weight, with return of menstruation with no obvious effect on fertility. Overall, developmentally oriented treatment was successful in 86 percent of the adolescents treated by this pediatric health service. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies

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Outcome for patients with bulimia and breast hypertrophy after reduction mammaplasty

Article Abstract:

Breast reduction surgery in young women with markedly overlarge breasts may help treat eating disorders. Researchers interviewed five young women with bulimia four years after they had breast reduction surgery. All women experienced relief from symptoms such as pain or rashes and improved ability to find clothes, exercise, and have a normal social life. Only one has required ongoing treatment for her eating disorder, and she has improved. This suggests that adolescents with markedly overlarge breasts may be at risk for eating disorders resulting from attempts to reduce breast size through weight loss.

Health aspects, Bulimia, Mammaplasty, Breast reconstruction

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