238
U N I T 2
Integrative Body Functions
Binge-Eating Disorder
Binge-eating disorder is characterized by eating too
much in a short period of time, eating too fast, eating
alone, eating when not hungry, and feeling uncomfort-
ably full. Unlike bulimia nervosa, persons with binge
eating do not engage in compensatory behaviors such
as vomiting and laxative abuse. The great majority of
persons with binge-eating disorder are overweight, and
in turn, obese persons have a higher prevalence of binge-
eating disorder than the nonobese populations.
56–59
The
physical complications associated with binge-eating dis-
orders are usually secondary to attendant obesity.
The primary goal of therapy for binge-eating disorders
is to establish a regular, healthy eating pattern. Persons
with binge-eating disorders who have been successfully
treated for their eating disorder have reported that mak-
ing meal plans, eating a balanced diet at three regular
meals a day, avoiding high-sugar foods and other binge
foods, recording food intake and binge-eating episodes,
exercising regularly, finding alternative activities, and
avoiding alcohol and drugs are helpful in maintaining
their more healthful eating behaviors after treatment.
R E V I EW E X E R C I S E S
1.
Stability of body weight and composition over time
requires that energy (food) intake match energy
utilization.
A.
Define the terms
hunger
and
appetite
and
describe their role in regulating food intake.
B.
Differentiate between short- and long-term
control of food intake and the neural and
hormonal mechanisms involved in their
regulation.
2.
A 25-year-old woman is 65 inches (165 cm) tall
and weighs 300 pounds (136 kg). She works as a
receptionist in an office, brings her lunch to work
with her, spends her evenings watching television,
and gets very little exercise. She reports that she has
been fat ever since she was a little girl, she has tried
“every diet under the sun,” and when she diets she
loses some weight but gains it all back again.
A.
Calculate her BMI using the website referred to
in Table 10-1.
B.
How would you classify her obesity?
C.
What are her risk factors for obesity?
D.
What would be one of the first steps in helping
her develop a plan to lose weight?
3.
A 16-year-old high school student is brought into
the physician’s office by her mother, who is worried
because her daughter insists on dieting because she
thinks she is too fat. The daughter is 67 inches tall
and weighs 96 pounds. Her history reveals that
she is a straight A student, plays in the orchestra,
and is on the track team. She is given a tentative
diagnosis of anorexia nervosa.
A.
What are the characteristic behaviors associated
with anorexia nervosa?
B.
What are some of the physiologic manifestations
of the malnutrition and severe weight loss
associated with this disorder?
R E F E R E N C E S
1. Hall JE.
Guyton and Hall’s Textbook of Medical Physiology
. 10th
ed. Philadelphia, PA: W.B. Saunders; 2011:843–858, 859–866.
2. Ross MH, Pawlina W.
Histology
. 6th ed. Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins; 2011:254–264.
3. Casteilla L, Dani C. Adipose tissue-derived cells: from physiology to
regenerative medicine.
Diabetes Metab.
2006;32(5 pt 1):393–401.
SUMMARY CONCEPTS
■■
Undernutrition, which can range from a selective
deficiency of a single nutrient to starvation, is
among the most widespread causes of morbidity
and mortality in the world. Protein-energy
malnutrition in this population is commonly
divided into two distinct conditions: marasmus,
(protein and calorie deficiency) in which there
is a great loss of protein from the skeletal
muscle compartment; and kwashiorkor (protein
deficiency), in which there is a greater loss of
visceral proteins, particularly those of the liver.
■■
Malnutrition is also common during illness,
recovery from trauma, and hospitalization.The
effects of malnutrition and starvation on body
function are widespread, including loss of muscle
mass, impaired immunologic function and wound
healing, decreased appetite, loss of calcium
and phosphate from bone, anovulation and
amenorrhea in women, and decreased testicular
function in men.
■■
Eating disorders, which include anorexia
nervosa, bulimia, and binge-eating disorder, are
psychiatric disorders characterized by severe
disturbances in eating, such as willful restriction
of intake and binge eating, as well as excessive
concern over body weight and shape. Anorexia
nervosa is characterized by a refusal to maintain
a minimally normal body weight; bulimia nervosa
is characterized by secretive episodes of binging
followed by compensatory behaviors such as
self-induced vomiting; and binge eating disorder
is characterized by the consumption of unusually
large quantities of food in a short period of time
that is not followed by compensatory behaviors.
