Cases reported "Bulimia"

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1/57. Changes in cerebral blood flow in bulimia nervosa.

    bulimia nervosa is an eating disorder of which characterized psychopathological symptoms are a recurrent episode of binge eating. The changes in cerebral blood flow (CBF) in a patient with bulimia nervosa between his or her different eating phases are presented. CBF was measured quantitatively by means of single photon emission computed tomography using I-123 N-isopropyl-p-iodoamphetamine. CBF of the global brain during a binge-eating phase was higher than that during an anorexic state phase. In the anorexic state, the CBF in the temporal, parietal, and occipital lobes on the right side was lower than that on the left side. In the binge-eating state, a lack of laterality between the right and left cerebral hemispheres was found. This finding suggests that cerebral activity differs between the two phases, and that asymmetry is dependent of the eating state.
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2/57. Complete recovery from intractable bulimia nervosa by the surgical cure of primary hyperparathyroidism.

    We document here the first case of bulimia nervosa associated with primary hyperparathyroidism. The binge eating and self-induced vomiting that occurred for more than 10 years disappeared completely after the surgical cure of primary hyperparathyroidism. Depressive and anxiety symptoms also improved dramatically. The possible influence of derangement in calcium metabolism on the neurobiochemical mechanism of bulimia nervosa is discussed.
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3/57. sertraline in underweight binge eating/purging-type eating disorders: five case reports.

    DISCUSSION: Control trials show that antidepressants are efficacious in eating disorders. Although selective serotonin reuptake inhibitors (SSRIs) are used in clinical practice, there are relatively few controlled or open trials demonstrating that SSRIs are effective. We report five cases of underweight women with binge eating/purging-type eating disorders who gained weight and had reduced core eating disorder behaviors in response to sertraline.
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4/57. binge-eating disorder and obesity. A combined treatment approach.

    patients presenting with both obesity and BED face multiple challenges: normalizing their eating, improving their physical health, and working to enhance their own acceptance of their body image. In an effort to feel better about themselves, they often have become trapped in a cycle of desperately attempting to diet, then losing control, binge eating, and gaining even more weight. Several psychological and pharmacologic treatment approaches have been used in this population. Most suppress binge eating in the short term, and some seem promising in the long term as well. However, sustained weight loss remains a largely unrealized goal. More recently, BED treatment programs have attempted to address these goals sequentially or in combination. In either approach, it is clear that adopting a long-term focus and promoting enhanced self-acceptance, which have so often been missing from these patients' previous attempts at recovery, are important tasks of treatment that are likely to lead to beneficial lifestyle changes and long-term improvements in physical and psychological health.
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5/57. Dialectical behavior therapy adapted for bulimia: a case report.

    OBJECTIVE: This case report describes the application of dialectical behavior therapy (DBT) to the treatment of bulimia nervosa in a 20-session manualized therapy. METHOD: The treatment, based on an affect regulation model of eating disorders, was developed to teach emotion regulation skills to replace eating-disordered behaviors. The patient, a 36-year-old woman, had a long history of binge eating and purging that had not responded to 2 years of counseling. In the 4 weeks before treatment began, she reported 13 objective binges and 21 purging episodes. RESULTS AND DISCUSSION: Upon initiating DBT, her binge eating and purging rapidly declined. She achieved abstinence by the fifth week of treatment and maintained it through treatment. In the 6 months following treatment, she reported a total of two objective binge episodes and two purge episodes.
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6/57. Binge eating disorder onset by unusual parasitic intestinal disease: a case-report.

    We report a case of binge eating disorder (BED) in a 19-year-old Spanish woman, whose onset followed a nowadays uncommon parasitic intestinal disease (taenia solium by cysticercosis). The patient exhibited bizarre and frequent hyperphagia episodes and extreme loss of weight, common symptoms of this condition. The patient continued to have frequent binge episodes and inappropriate eating patterns, gaining weight consequently over a normal range, despite successful treatment of the condition. No purging behavior was detected. A classical conditioning behavioral model, was useful for the understanding and formulation of this case. To the authors' knowledge, this is the first reported case where a parasitic infestation triggered the onset of BED.
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7/57. Oral rehabilitation of a bulimic patient: a case report.

    bulimia nervosa is among the most common health problems in contemporary society. It is a self-induced weight loss syndrome associated with distinct dental manifestations involving physical and psychologic symptoms. It is characterized by recurrent binge-purge episodes that occur at least once a day. This article describes the complete-mouth rehabilitation of a bulimic patient with a generalized enamel erosion of her dentition and a poor esthetic appearance. Porcelain-fused-to-metal restorations were used as the definitive treatment. Good esthetics and high self-esteem were the final results. Comprehensive restorative therapy was applied in this clinical case report to achieve both function and esthetics in a demanding situation.
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8/57. bulimia nervosa and misuse of orlistat: two case reports.

    OBJECTIVE: Orlistat (tetrahydrolipstatin) is an intestinal lipase inhibitor that was approved recently for the management and treatment of obesity. This is the first report of the misuse of orlistat in two normal-weight purging bulimia nervosa (BN) patients. METHOD AND RESULTS We report two diagnosed cases of BN in two Spanish women who used orlistat as a purging mechanism after binge episodes. In both cases, the onset of the eating disorder was in adolescence. From the beginning, a restrictive diet, binging, and purging behavior (vomiting and using laxatives) were present. Both patients misused this substance as their only purging mechanism after every binge episode. CONCLUSION: BN patients have used many substances and bizarre behaviors as purging mechanisms. Nevertheless, to the authors' knowledge, these are the first reported cases of orlistat misuse as the only purging mechanism in two BN patients.
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9/57. Imagery rescripting within cognitive behavior therapy for bulimia nervosa: an illustrative case report.

    OBJECTIVE: This case report describes the use of imagery rescripting as an adjunct to cognitive behavior therapy (CBT) for bulimia nervosa. methods: The patient was a 22-year-old woman, who had a 6-year history of diagnosable eating problems, with no comorbid diagnosis. She had a history of emotional abuse by her family. The single session of imagery rescripting was aimed at effecting change in the core beliefs that were hypothesized to result from that emotional abuse, and hence in the associated bulimic psychopathology. RESULTS: While eight sessions of conventional CBT reduced symptom behaviors by 50%, one session of imagery rescripting led to an almost complete cessation of the remaining binge-purge behaviors. This effect was maintained at 14 weeks post-imagery. CONCLUSIONS: Imagery rescripting appears to be a valuable adjunct to conventional CBT in working with cases where there is an early history of trauma. Implications for treatment of eating disorders using this technique are considered, and relevant research designs are discussed.
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10/57. bariatric surgery in a patient with possible psychiatric contraindications.

    Grade III obesity (BMI > 39.9 kg/m2) is considered a chronic disease where clinical and diet therapy show poor results, with high rates of relapse. The most consistent results are those obtained through surgical procedures. Several authors discuss the contraindications for the performance of anti-obesity operations. Psychiatric disorders are often considered contraindications to these operations, especially affective disorders, psychotic disorders and personality disorders. The authors report the case of a 37-year-old patient, with obesity history since the age of 12, and anorexiant abuse (amphetamine-derived substances) during 20 years, binge-eating episodes, purgative compensatory behaviors and recurrent depressive symptoms. She was submitted to anti-obesity surgery in August 2000 (BMI 40.2). The outcome is reported and a discussion of the possible psychiatric contraindications for the anti-obesity surgeries is proposed.
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