Cases reported "Hyperphagia"

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1/4. Characteristics of family background in bulimia.

    21 women consulting for bulimia were followed in individual psychotherapy and assessed for family background characteristics. Two sets of data are reported: objective data concerning the incidence of 'broken homes', i.e., with a history of separation or divorce or death of parents; subjective data concerning the image of the family and the identifications which are worked through in psychotherapy. Among our 25 bulimic patients, 13 patients came from 'broken homes' in which, in 9 cases, separations were so radical that it was impossible to maintain relationships with both parents; 12 patients came from close-knit families which in 6 cases were actually 'closed families' hiding massive internal tensions. The proportion of broken homes is significantly higher than in a population of 25 overweight patients without bulimia also undergoing individual psychotherapy. There exists a sharp discrepancy between the actual family failings and the wish of patients to maintain their 'family unit' fantasy. The hypothesis is made that the occurrence of bulimia may be related to the combination of a history of violent separations (or threats of violent separation) in the family, and the endless denial of these separations.
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2/4. Dental sequelae to the binge-purge syndrome (bulimia): report of cases.

    The "thin-is-in" syndrome that obsesses many young people today leads to many severe medical and dental complications. Dental damage that follows the binge-purge episodes is reduced by strict management of oral hygiene; the damage is not totally correctable until the habit is well controlled through proper psychotherapy.
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3/4. Diabetic hyperglycemia and glycosuria as a manifestation of bulimia.

    This is the first reported case of insulin dose manipulation as a manifestation of bulimia. The patient was diabetic, with fluctuations in control. Despite the guarded prognosis in bulimia, the patient's diabetic control improved with psychotherapy.
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4/4. Binge eating disorder: response to naltrexone.

    Binge eating disorder (BED) is characterized by a bulimic binge eating pattern without the compensatory behaviors of purging or laxative abuse. It is often associated with obesity. The treatment response characteristics are more like bulimia than other forms of obesity. We have shown the opiate antagonist naltrexone to attenuate bulimia nervosa in controlled clinical trials. We report here a response to naltrexone in a subject with BED similar to that previously reported for the larger population of bulimic subjects. Three consecutive periods of drug, placebo and double dose drug were used, with the order of the first two periods double blind until after the data analysis. Symptoms were reduced in the naltrexone compared to placebo period. Statistical significance was demonstrated using time series analysis for this 'n of one' study. psychotherapy was carried out throughout all periods. naltrexone plus psychotherapy may be more efficient than psychotherapy alone.
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