The Void InsidePub Date : 2020-07-01DOI: 10.1093/med-psych/9780190061166.003.0001
P. Keel
{"title":"Do We Need Another Eating Disorder?","authors":"P. Keel","doi":"10.1093/med-psych/9780190061166.003.0001","DOIUrl":"https://doi.org/10.1093/med-psych/9780190061166.003.0001","url":null,"abstract":"Most people know about anorexia and some know about bulimia, but very few have ever heard of purging disorder. Purging disorder is an eating disorder characterized by self-induced vomiting or misuse of laxatives, diuretics, or other medications to influence weight or shape in individuals who are not underweight and who do not have large binges. This chapter describes how and when purging disorder was first identified, placing it in the context of the identification of other eating disorders and the factors that determine whether a condition should be considered a new mental disorder. It describes how purging disorder came to be included as an “other specified feeding or eating disorder” in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.","PeriodicalId":184426,"journal":{"name":"The Void Inside","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132004050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Void InsidePub Date : 2020-06-01DOI: 10.1093/med-psych/9780190061166.003.0002
P. Keel
{"title":"Who, When, and Where?","authors":"P. Keel","doi":"10.1093/med-psych/9780190061166.003.0002","DOIUrl":"https://doi.org/10.1093/med-psych/9780190061166.003.0002","url":null,"abstract":"Answering “who, when, and where?” establishes the public health burden associated with purging disorder and gives us insight into why someone develops the illness. Right now, over 2 million girls and women in the United States have purging disorder, and they are joined by another half-million boys and men. Cases of hysterical vomiting from the late 1800s resemble purging disorder in some respects, but vomiting in purging disorder is intentional and directed toward influencing weight or shape, supporting the influence of modern idealization of thinness. Finally, we see the emergence of purging to control weight and purging disorder following the introduction of Western cultural ideals into non-Western contexts. Non-Western cultures further shape the clinical presentation of purging disorder with misuse of traditional herbal emetics to produce purging.","PeriodicalId":184426,"journal":{"name":"The Void Inside","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132167955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Void InsidePub Date : 2020-06-01DOI: 10.1093/med-psych/9780190061166.003.0008
P. Keel
{"title":"What Happens in Treatment","authors":"P. Keel","doi":"10.1093/med-psych/9780190061166.003.0008","DOIUrl":"https://doi.org/10.1093/med-psych/9780190061166.003.0008","url":null,"abstract":"Effective treatment requires a team of health professionals working together. Team members should include, at minimum, a physician, a dietitian, and a therapist. Many treatments begin with psychoeducation to explain what maintains purging disorder, the consequences of the illness, and why a chosen therapy facilitates recovery. This chapter describes therapies that have been used to treat patients with purging disorder, including family-based treatment in adolescents, cognitive-behavioral therapy in adolescents and adults, and integrated cognitive affective therapy in adults. Most treatments require adaptation to effectively address purging as a primary symptom rather than as a response to binge eating. At this time, there are no randomized controlled trials focused on treatment for purging disorder. This means clinicians bear the responsibility of identifying a first line of treatment for their patients with purging disorder and evaluating the treatment’s effectiveness.","PeriodicalId":184426,"journal":{"name":"The Void Inside","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116409936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Void InsidePub Date : 2020-06-01DOI: 10.1093/med-psych/9780190061166.003.0003
P. Keel
{"title":"Fear of Fat","authors":"P. Keel","doi":"10.1093/med-psych/9780190061166.003.0003","DOIUrl":"https://doi.org/10.1093/med-psych/9780190061166.003.0003","url":null,"abstract":"Fear of fat drives people with purging disorder to engage in extreme methods to rid their body of weight. Our social context creates and reinforces that fear by linking weight to health, beauty, moral character, and popularity. Multiple levels in our environment convey these messages, including mass media, peers, and family, and influence the likelihood of purging. Although these beliefs are widely held, they deviate from facts. Behaviors rather than body weight are the strongest determinant of health. The association between weight and beauty is highly subjective and malleable. There is no association between body weight and moral character. The majority of the U.S. population is not living in social isolation despite possessing body weights that deviate from the thin/muscular ideal. Interventions designed to improve healthy behaviors and reduce internalization of the thin ideal have demonstrated success in reducing purging, supporting the value of recognizing and rejecting fear of fat.","PeriodicalId":184426,"journal":{"name":"The Void Inside","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133927601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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