17. The Eating Disorders

  1. William M. Klykylo3 and
  2. Jerald Kay4
  1. Randy A. Sansone1 and
  2. Lori A. Sansone2

Published Online: 30 MAR 2012

DOI: 10.1002/9781119962229.ch17

Clinical Child Psychiatry, Third Edition

Clinical Child Psychiatry, Third Edition

How to Cite

Sansone, R. A. and Sansone, L. A. (2012) The Eating Disorders, in Clinical Child Psychiatry, Third Edition (eds W. M. Klykylo and J. Kay), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781119962229.ch17

Editor Information

  1. 3

    Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

  2. 4

    Department of Psychiatry, Wright State University School of Medicine, P.O. Box 927, Dayton, OH 45401-0927, USA

Author Information

  1. 1

    Sycamore Primary Care Center, 2115 Leiter Road, Suite 300, Miamisburg, OH 45342-3659, USA

  2. 2

    Wright-Patterson Air Force Base, 88 MDOS/SGOPC, 4881 Sugar Maple Drive, WPAFB, OH, 45433, USA

Publication History

  1. Published Online: 30 MAR 2012
  2. Published Print: 30 MAR 2012

ISBN Information

Print ISBN: 9781119993346

Online ISBN: 9781119962229

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Keywords:

  • anorexia nervosa;
  • bulimia nervosa;
  • binge eating disorder;
  • binge/purge cycle;
  • starvation;
  • eating disorder;
  • Russell's sign;
  • body image;
  • refeeding;
  • selective serotonin reuptake inhibitor (SSRI)

Summary

In this chapter, we review the epidemiology, etiology, diagnosis, treatment, and outcome of eating disorders. In synthesizing this material, we note that the eating disorders truly underscore the relevance of a biopsychosocial perspective in the evaluation and treatment of psychiatric disorders. The epidemiology of the main eating disorders, anorexia nervosa (AN) and bulimia nervosa (BN), is considered in terms of prevalence, age of onset, gender, race, socioeconomic profile, etc. Etiology appears to be multi-determined and probably results from the complex intersection of a variety of biological, psychological, and social variables, which vary from case to case. The diagnoses of AN and BM are examined in detail, assessment tools enumerated, and the medical complications summarized. The treatment of AN and BN are dealt with in turn. With AN, the importance of engagement with the patient and determination of the appropriate treatment environment are underscored, and strategies for behavior modification outlined, with the initial focus being weight restoration. The roles of psychotherapy and psychotropic medications are described. For BN, the normalization of eating patterns and the interruption of the binge/purge cycle are the initial treatment goals. Treatment options include behavioral strategies, psychotherapy, and psychotropic medication. The difficulties in assessing outcome in these patients are discussed, and the potential impact on fertility and pregnancy. Finally, binge eating disorder is briefly reviewed.