Harrison's Internal Medicine Chapter 76. Eating Disorders Eating Disorders: Introduction Anorexia nervosa and bulimia nervosa are characterized by severe disturbances of eating behavior. The salient feature of anorexia nervosa (AN) is a refusal to maintain a minimally normal body weight. Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating followed by abnormal compensatory behaviors, such as self-induced vomiting. AN and BN are distinct clinical syndromes but share certain features in common. Both disorders occur primarily among previously healthy young women who become overly concerned with body shape and weight. Many patients with BN have past histories of anorexia. | Chapter 076. Eating Disorders Part 1 Harrison s Internal Medicine Chapter 76. Eating Disorders Eating Disorders Introduction Anorexia nervosa and bulimia nervosa are characterized by severe disturbances of eating behavior. The salient feature of anorexia nervosa AN is a refusal to maintain a minimally normal body weight. Bulimia nervosa BN is characterized by recurrent episodes of binge eating followed by abnormal compensatory behaviors such as self-induced vomiting. AN and BN are distinct clinical syndromes but share certain features in common. Both disorders occur primarily among previously healthy young women who become overly concerned with body shape and weight. Many patients with BN have past histories of anorexia nervosa and many patients with AN engage in binge eating and purging behavior. In the current diagnostic system the critical distinction between AN and BN depends on body weight patients with AN are by definition significantly underweight whereas patients with BN have body weights in the normal range or above. Binge eating disorder BED is a more recently described syndrome characterized by repeated episodes of binge eating similar to those of BN in the absence of inappropriate compensatory behavior. Patients with BED are typically middle-aged men or women with significant obesity. They have an increased frequency of anxiety and depression compared to similarly obese patients without BED. It is not established that patients with BED are at increased risk for medical complications or that they require specific treatment interventions. Anorexia Nervosa Epidemiology Among women the lifetime prevalence of the full syndrome of AN is approximately 1 . AN is much less common in males. AN is more prevalent in cultures where food is plentiful and in which being thin is associated with attractiveness. Individuals who pursue interests that place a premium on thinness such as ballet and modeling are at greater risk. The incidence of AN has increased in recent .
