Graham RedgraveMD and Angela GuardaMD

Anorexia nervosa (AN) and bulimia nervosa (BN) are serious behavioral disorders associated with a wide range of gastrointestinal (GI) complications (Chami et al, 1995). Because AN and BN are characterized by frequent denial and ambivalence towards treatment, individuals with these disorders may present first (or exclusively) to gastroenterolo-gists with secondary GI complaints (Winstead and Willard, 2001). Recognizing signs and symptoms of eating disorders, directing patients to appropriate psychiatric treatment, and assisting them in acknowledging their eating disorder is vital. For patients whose AN or BN is characterized by somatic complaints and denial of illness, a working alliance between an eating disorder specialist and a gastroenterologist is often a key factor in successful treatment.

This chapter will cover definitions of AN, BN, and other eating disorders, GI complications of eating disorders and of refeeding, management recommendations, clinical screening questions, recommendations regarding when to refer and to whom, and how to set limits on treatment of patients who refuse psychiatric intervention. Finally, we will discuss effective behavioral treatments.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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