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Field, 2012 Prospective Association of Common Eating Disorders and Adverse Outcomes


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COMMENT: Study abstract does not state what drugs were used for treatment and implies (to me) illicit drug use and alcohol as cause of obesity. I believe SSRIs used to be mainstay of treatment and suspect neuroleptics are used now. That would certainly explain the obesity. I'm posting this because it is another example of blaming the disease state or person for (what I highly suspect) is result of TREATMENT.

Also, this article emphasizes importance of primary care physicians catching it at "subthreshold" severity to prevent eating disorder.






PEDIATRICS, Published online July 16, 2012


Alison E. Field, ScD a , b , c , Kendrin R. Sonneville, RD, ScD a , Nadia Micali, MD, PhD d ,


Ross D. Crosby, PhD e , Sonja A. Swanson, ScM c , Nan M. Laird, PhD f ,


Janet Treasure, PhD g , Francesca Solmi, MA d , and Nicholas J. Horton, ScD h




OBJECTIVE: Anorexia nervosa and bulimia nervosa (BN) are rare, but eating disorders not otherwise specified (EDNOS) are relatively common among female participants. Our objective was to evaluate whether BN and subtypes of EDNOS are predictive of developing adverse outcomes.


METHODS: This study comprised a prospective analysis of 8594 female participants from the ongoing Growing Up Today Study. Questionnaires were sent annually from 1996 through 2001, then biennially through 2007 and 2008. Participants who were 9 to 15 years of age in 1996 and completed at least 2 consecutive questionnaires between 1996 and 2008 were included in the analyses. Participants were classified as having BN (≥weekly binge eating and purging), binge eating disorder (BED; ≥weekly binge eating, infrequent purging), purging disorder (PD; ≥weekly purging, infrequent binge eating), other EDNOS (binge eating and/or purging monthly), or nondisordered.


RESULTS: BN affected ∼1% of adolescent girls; 2% to 3% had PD and another 2% to 3% had BED.

*Girls with BED were almost twice as likely as their nondisordered peers to become overweight or obese (odds ratio [OR]: 1.9 [95% confidence interval: 1.0–3.5])

*or develop high depressive symptoms (OR: 2.3 [95% confidence interval: 1.0–5.0]).

*Female participants with PD had a significantly increased risk of starting to use drugs (OR: 1.7) and starting to binge drink frequently (OR: 1.8).


CONCLUSIONS: PD and BED are common and predict a range of adverse outcomes. Primary care clinicians should be made aware of these disorders, which may be underrepresented in eating disorder clinic samples. Efforts to prevent eating disorders should focus on cases of subthreshold severity.


Key Words: adolescents eating disorders epidemiology obesity substance use




BED —binge eating disorder BN —bulimia nervosa CI —confidence interval DSM-IV —Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition DSM-5 —fifth edition of the Diagnostic and Statistical Manual of Mental Disorders EDNOS —eating disorder not otherwise specified GEE —generalized estimating equations GUTS —Growing Up Today Study MRFS —McKnight Risk Factor Survey OR —odds ratio PD —purging disorder


Accepted April 5, 2012.


Copyright © 2012 by the American Academy of Pediatrics

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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