A special collection of current clinical work and issues surrounding eating disorders-specifically comorbidity, prevalence in men, and mortality.
Working With Patients Who Have Eating Disorders
Special Report Chair Pauline Powers, MD introduced this special collection of current clinical work and issues surrounding eating disorders-specifically comorbidity, prevalence in men, and mortality risk..
1. COMORBIDITY:The Interplay of Mood Disorders and Eating Disorders
An eating disorder diagnosis raises many questions for the treating clinician about appropriate diagnosis and treatment, as well as how best to understand the etiology and interconnectedness of these difficulties. This article features a 20-year-old college sophomore with “depression and anxiety” who exercises nonstop and is literally dying to lose more weight.
Significance for the practicing psychiatrist: Recovery from an eating disorder still brings an elevated risk of obsessive behavior compared with patients without a history of an eating disorder. [For a mobile-friendly view of the Monarch Notes, click here]
2. PREVALENCE IN MEN:Eating Disorders in Men
Not just a “female problem,” 25% of those with anorexia and 36% of those with bulimia are males. While a number of complex factors prevent families from seeking treatment earlier, the belief that men and boys do not suffer from eating disorders and the stigma and shame associated with that possibility are important ones.
TREATMENT FOR MALES: The treatment process for patients with eating disorders can be divided into 4 stages: engagement, alliance building, diagnosis, and ongoing treatment. Many males fail to recognize that behaviors such as weight loss, purging, binge eating, and compulsive exercise are symptoms of an eating disorder. And when they do recognize this, males are slow to seek help due to stigma and shame.
3. MORTALITY:Diagnosis and Assessment Issues in Eating Disorders
It is essential to detect the presence of an eating disorder because of high associated mortality. Knowing how to conduct a differential diagnosis is important; and it necessitates first asking questions to assess eating behaviors. A highly complex array of diagnostic issues are presented here to clarify coding concerns.