pica and Hyperphagia

Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating disorders--anorexia nervosa, pica, rumination disorder of infancy, and bulimia/bulimarexia--are discussed. Detailed attention is given to the potential medical hazards of bulimarexia. These hazards may be categorized according to the organ system affected or the individual behavioral components of bulimarexia. Because bulimarexia is commonly practiced in secrecy, its presentation may be in the form of one of its medical complications. Therefore, physicians must know the behavioral components of bulimarexia and its potential medical hazards. Optimal care of these patients requires collaborative efforts from a physician and behavioral therapist.

Topics: Adolescent; Adult; Anorexia Nervosa; Cathartics; Diuretics; Feeding and Eating Disorders; Female; Gastroesophageal Reflux; Humans; Hyperphagia; Infant; Male; Nutrition Disorders; Pica; Substance-Related Disorders; Vomiting

This case report addresses the problem of underreporting negative results and adverse side effects in animal testing. We present our findings regarding a hyperphagic mouse model associated with unforeseen high mortality. The results outline the necessity of reporting detailed information in the literature to avoid duplication. Obese mouse models are essential in the study of obesity, metabolic syndrome and diabetes mellitus. An experimental model of obesity can be induced by the administration of gold thioglucose (GTG). After transcending the blood-brain barrier, the GTG molecule interacts with regions of the ventromedial hypothalamus, thereby primarily targeting glucose-sensitive neurons. When these neurons are impaired, mice become insensitive to the satiety effects of glucose and develop hyperphagia. In a pilot study for optimising dosage and body weight development, C57BL/6 mice were treated with GTG (0.5 mg/g body weight) or saline, respectively. Animals were provided a physiological amount of standard diet (5 g per animal) for the first 24 hours after treatment to prevent gastric dilatation. Within 24 hours after GTG injection, all GTG-treated animals died of gastric overload and subsequent circulatory shock. Animals developed severe attacks of hyperphagia, and as the amount of provided chow was restricted, mice exhibited unforeseen pica and ingested bedding material. These observations strongly suggest that restricted feeding is contraindicated concerning GTG application. Presumably, the impulse of excessive food intake was a strong driving force. Therefore, the actual degree of suffering in the GTG-induced model of hyperphagia should be revised from moderate to severe.

Topics: Animals; Aurothioglucose; Blood Glucose; Disease Models, Animal; Eating; Fatal Outcome; Gastric Dilatation; Hyperphagia; Male; Mice; Mice, Inbred C57BL; Mice, Obese; Pica; Pilot Projects

The paper reports epidemiological and phenomenological investigations of aberrant eating among 347 pre-adolescent children in court-ordered foster and kinship care, in New South Wales, Australia. A quarter of children displayed clinically significant aberrant eating problems, with no evidence of gender or age effects. Two distinct patterns were identified. The first is a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity (termed Food maintenance syndrome), resembling the behavioral correlates of Hyperphagic Short Stature (Psychosocial Dwarfism). Various data suggest this pattern is primarily triggered by acute stress, including maltreatment in care, against a background of complex psychopathology and developmental disabilities. The second is a cluster of pica-type eating behaviors that correlates with self-injurious behavior, and is closely associated with developmental disabilities. The paper includes recommendations for clinicians working with pre-adolescent children in care.

Topics: Child; Comorbidity; Factor Analysis, Statistical; Feeding and Eating Disorders; Female; Foster Home Care; Humans; Hyperphagia; Male; Mental Disorders; Models, Psychological; New South Wales; Pica; Prevalence; Risk Factors

Topics: Adult; Atrophy; Brain Diseases; Fatal Outcome; Frontal Lobe; Humans; Hyperphagia; Male; Middle Aged; Pica; Psychomotor Agitation; Status Epilepticus; Syndrome

A 28-year-old woman with acquired brain damage suffered subsequent profound mental disability and an intense hyperphagic syndrome complete with life-threatening pica. She was the single subject of two consecutive experiments. In the first, Naltrexone, an orally administered opiate blocker, was given to reduce hyperphagia and distress, but was associated with even greater urgency when eating meals and a manifest increase in distress. While distress reduced to premedication levels on withdrawal of treatment, urgency of eating did not reduce so quickly. In the second experiment a laser acupuncture procedure was used at 2.5 Hz and 10 Hz for 10 days each with an intervening 10-day placebo condition to increase the availability of the subject's endogenous opiates, and thus hopefully produce opposite effects to the first experiment and effect a positive treatment. The 10 Hz condition produced a significant but transient reduction in pica measured by attempts at pica on a supervised walk shortly after each treatment. The subject was also easier to manage on walks, and appeared happier. Further studies using physical exercise or acupressure to achieve similar or better results are discussed.

Topics: Acupuncture Therapy; Adult; Brain Damage, Chronic; Dose-Response Relationship, Drug; Drug Administration Schedule; Feeding Behavior; Female; Humans; Hyperphagia; Lasers; Naltrexone; Narcotic Antagonists; Opioid Peptides; Pica; Treatment Outcome; Ventromedial Hypothalamic Nucleus

It is suggested that chlorosis, or the 'green-sickness', was not a single disease entity, but a name applied to at least two distinct conditions affecting young females in the past. The first ('chloro-anaemia') was a form of hypochromic anaemia possibly associated with gastric ulceration and poor diet. This form predominated in the late nineteenth and early twentieth centuries. The second ('chloro-anorexia') was a disorder of psychogenic origin resembling, but not identical to, anorexia nervosa. The latter form predominated in earlier periods but also occurred throughout the nineteenth century; it was also known as 'the virgin's disease' or 'febris amatoria'. The 'green' of 'green-sickness' may originally have indicated innocence rather than a green colour of the skin.

Topics: Adolescent; Adult; Age Factors; Anemia, Hypochromic; Anorexia Nervosa; England; Female; France; History, 17th Century; History, 19th Century; History, 20th Century; Humans; Hyperphagia; Pica; Social Class; Terminology as Topic