Annotated Bibliography On Eating Disorder

EPIDEMIOLOGY

Eating disorders and related behaviours are a common problem in pre-adolescents and adolescents. A recent study on a large sample of American young people (aged 9-14 years) found that 34% of boys and 43.5% of girls had some eating disorder trait. The pivotal effect on health has led to the inclusion of eating disorders among the priority mental illnesses for children and adolescents identified by WHO. The lifetime female prevalence rates (percentage of the population) are approximately 0.9% for AN, 1.5% for BN, 3.5% for BED, and 10% for subclinical disorders. However, fewer than 20% of cases of eating disorder present for treatment. The incidence of cases of BED presenting to primary care in the UK increased to 25 per 100,000 between

It has been suggested that adverse experiences influence brain development and increase the risk for AN. Particular parenting styles which are high in overprotection increase susceptibility to AN. Childhood adversity, including exposure to parental depression and substance and alcohol abuse, appears to increase the risk of developing BN. In some developed countries, the excess value placed on thinness encourages extreme dieting and weight control practices. Negative comparisons between an individual’s body shape and that of the ideal contributes to poor self-esteem. Criticism, teasing, and bullying focused on food, weight, and shape issues specifi cally increase the risk of developing an eating disorder. The tension between the stigmatisation of fatness, idealisation of thinness, and easy access to highly palatable foods, perhaps eaten in secret, could lead to weight control behaviours that can have a destabilising eff ect on the biology of appetite control. In addition to food-related and weight-related harmful experiences, general adversity (neglect and physical and sexual abuse) also increases the risk of developing an eating disorder. Early adversity appears to increase the risk for developing an ED, although the mechanism is not entirely understood. Alterations to the neuroendocrine system could be a pathway by which early adversity confers risk for ED. Early adversity may alter the developing oxytocin system. For example, people with AN have been shown to have lower levels of nocturnal serum oxytocin and cerebrospinal fluid levels of oxytocin are low during the starvation phase of AN. A review summarised the evidence for altered oxytocin functioning in AN. Early adversity may underlie risk for ED, through changes to the oxytocin