Talk:Bulimia nervosa/Archive 1
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Anti-psychotics
"Anti-psychotics are also used, but in smaller doses than are used for treating schizophrenia. With an eating disorder, the patient perceives reality differently and has difficulty grasping what it is like to eat normally."
I think this needs a goof reference, because I haven't read a word about sucessful pharmacological treatment with anti-psicotic drugs in BN in all my life. I mean in serious articles and books about Eating Disorders. The kind of "wrong perceptions" of reality that can experiment a posicotic person are completely different. Eating Disorders are NOT Psicotic Disorders at all!!!
I'd like to know why were my contributions deleted. They are completely logical!
Can we edit or take out the part about Homosexual males being at risk? The source cites "gender identity" which is not connected to homosexuality.
- I agree; I was just coming here to say that. The article refers to gay males as "gender-conflicted" which is extremely offensive. Ichelhof 16:03, 20 January 2006 (UTC)
DSM-IV critera
We've got one sentence saying "The following six criteria must all be met for a patient to be diagnosed", but then another saying "note that these diagnosis criteria are only a guide". So either the second sentence should be removed, or the word "must" in the first sentence should be changed. Also, why is "guide" in the second sentence in bold? Also, "many doctors will diagnose bulimia nervosa if only one is not present" would be clearer, I think, as "many doctors will diagnose bulimia nervosa if five of the six are present". (But the reason I'm not being bold and making this change is that the first three times I read the sentence, I read it as "many doctors will diagnose bulimia nervosa if only one is present", and I'm not sure that's not what was meant.)
Also, the parenthetical "Some anorectics may demonstrate bulimic behaviours in their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their disease. Alternatively, some individuals might switch from having anorexia to having bulimia..." is long and somewhat confusing. Would it be accurate to say "A patient expressing both sets of behaviors is generally considered anorexic, and indeed some anorectics may demonstrate binge-eating or other bulimic behaviours during the course of their disease. Alternatively, some individuals might switch from expressing primarily anorexic to primarily bumemic symptoms."?
The reason it sounds confusing is because it is, bulimics can have anorexic tendencies and anorexics can have bulimic tendencies. But a bulimic with anorexic tendencies is not considered simply anorexic unless (or until) they fit the definition of that disease. Therefore, a bulimic who engages in anorexic behavior is still a bulimic until they meet specified criteria. Make sense?
Also, are there truly six criteria in the DSM-IV? The section head used to say "The Five DSM-IV critera". Presumably one was added later -- is it legitimate?
Steve Summit (talk) 16:00, 26 February 2006 (UTC)
I added the word "classic" to the second part to make it a little better —The preceding unsigned comment was added by Stui (talk • contribs) 4 June 2006 (UTC)
In patients expressing both anorexic and bulimic behaviors, the final catagorazation is genarally made based on weight and status of amnorhia (anorexia being amnoria and BMI of <17.5)If the patient is sub-threshold for both weight and frequency requirements, that would be defined as ED-NOS. --Emiyorkie 02:30, 11 July 2006 (UTC)
As a practicing psychiatrist, let me clarify that the DSM is a research tool, used to help scientists obtain a reasonably homogenous group of study participants, since psychiatric diagnoses are clinical. You can't do a blood test or some other definitive diagnostic procedure, so to help increase the likelihood that your test subjects all actually have a certain disorder, the criteria are published. Even then, there is the very real possibility that a person who "meets criteria" will erroneously be included in the study, who actually suffers from a distinct (heterogeneous) condition of some sort and who should not be studied with the rest of the group because his response to treatment, other interventions will be different than the group under study. Clinically, psychiatrists do not (or should not, anyway) adhere to the DSM criteria rigidly. Diagnoses are based on many factors, including family history, presentation, and the overall differential diagnoses, regardless of how many "criteria" can be verified. If a checklist were sufficient for diagnosis, anybody could do it and we wouldn't need experienced experts like myself to weigh the entire clinical picture and decide if a person does or does not have an eating disorder (or any psychiatric syndrome), and how best then to proceed.
New resource link - Bulimia Nervosa Resource Guide for Family and Friends
I've used the Wikipedia in the past but this is the first time I've tried to contribute. ECRI recently published an online resource guide focusing on bulimia nervosa and I think it would be a valuable addition to your the list of external resources. The project was funded by a grant from the Hilda and Preston Davis Foundation and the reports and website are freely available to the public.
Here's the blurb from the site.
This Web site provides a one-stop comprehensive resource on bulimia nervosa for anyone who wants to understand the disorder and how to support a family member or friend with bulimia nervosa. This information was developed in response to questions and concerns voiced by patients and families affected by bulimia nervosa and clinicians treating bulimia nervosa. Patients seeking treatment for bulimia nervosa may also find this Web site useful. Included here are scientific findings on how well various treatments for bulimia nervosa work based on the most comprehensive analysis completed to date on treatments for bulimia nervosa. You'll also find easy-to-use check lists and tips on how to start a discussion about bulimia nervosa with a friend or family member who might have bulimia. If you are seeking bulimia nervosa treatment facilities, the find a treatment center database can help.
About this Resource Guide
The content presented here on bulimia nervosa was researched and developed by ECRI (www.ecri.org) an international independent nonprofit agency and Collaborating Center of the World Health Organization, under a grant from a private foundation, The Hilda and Preston Davis Foundation. An external advisory committee of bulimia nervosa patients, families, and clinical experts reviewed all content. ECRI is designated as an Evidence-based Practice Center (EPC) by the U.S. Agency for Healthcare Research and Quality. ECRI's mission is to improve the safety, quality, and cost-effectiveness of healthcare. It is widely recognized by the healthcare community as one of the world's leading independent organizations committed to advancing the quality and safety of healthcare.
bylie 14:19, 10 March 2006 (UTC)
- This looks like a good call. I reviewed the site, and it seems to contain some valuable information, from a somewhat less disease-centered perspective. In addition, ECRI is a credible agency with a demonstrable track record. I vote add. --Sadhaka 14:31, 10 March 2006 (UTC)
At risk groups: Females, Males???
What's the point of specifically stating that females and males are at risk groups for bulimia? Almost everyone is included in these two categories, making the mentioning of females and males meaningless. Theshibboleth 03:38, 14 May 2006 (UTC)
You know how people can be, picky picky picky.
"Males are just as prone to having eating disorders as women" This is absolutely WRONG. False, false, false. The statistics show an overwhelmingly greater prevalence among females than males. Additionally (though perhaps anecdotally) many males with eating disorders are gay.
Cleanup tag
Hi there,
I'm going to add a 'cleanup' tag to this page, as it is badly in need of it. It lacks coherent referencing to scientific studies, is unstructured, confused in places and contains lots of personal advice from someone. There's plenty of great information in the article, I think it just needs thorough going through by specialist in the field.
- Vaughan 10:34, 30 May 2006 (UTC)
Added a link to "See also"
I added "Eating disorder not otherwise specified" to the "see also" section, as EDNOS also covers binging and purging behaviors. Please let me know if you believe this is inappropriate.
Melange fiesta 00:41, 31 May 2006 (UTC)
POV?
This seems irrelovent: 5% or less of bullimics are male. Assuming 10% (a rather high estimate) of men are gay, that puts the percentage of gay bullimics much lower than 5%. Not to mention it does not effect homosexuals more than straight people, but people people who find it a 'female condition' are less likely to have it recognized/diagnosed. Homosexuals are not "gender identity conflict" victims. Homosexuality should not be mentioned. The paragraph should read, "Some males, who find Bulimia nervosa a female disorder, are at a higher risk of the disorder not being recognized and diagnosed. Dark jedi requiem 03:41, 2 July 2006 (UTC)
In my opinion homosexuals are far more at risk, gay men are in a world where image is pushed to the extreme and many forms of research back this up
Your opinion doesn't really matter in this forum, we need facts. Can you cite just one of these "many forms of research" to back up your claim? I did a Google search and came up with nothing.
Tapeworms???
Okay... who the heck added tapeworms to purging methods? I've talked with a LOT of bulimics, and not a single one has ever used a tapeworm. I don't think it is even possible for people to obtain tapeworms! Can we please remove this ridiculous "purging method"??? Melange fiesta 15:00, 21 April 2007 (UTC)
I didn't add that part to the page but, oddly enough, I have heard of people using tapeworms. In fact, try doing a google search with the words "tapeworm" and "diet" and you'll be quite suprised at the results, I know I was. I am a practicing bulimic, and I would never use tapeworms as a method to control my weight... but again, I know people who have. I think we should leave it.
if u use tapeworms....wont it kill u?? y shove a tapeworm up into ur stomach when some ppl who actually have tapeworms are trying 2 get rid of them??
Another small thing ...
The use of "Caucasian race" is problematic, for several reasons; 1) This is a medical article and "Caucasian" is not a scientific term. 2) It is not an Environmental Factor. 3) It is American-centric and this is an international encyclopedia. If the intention is to describe a White American demographic, simply use "White American". See Caucasian race.
I would consider the use of the term "Caucasian" to be far more appropriate than the use of the political division "American"; I can only assume that this comment has previously been edited to obscure the original author's intent, because as it stands, it makes little sense. —Preceding unsigned comment added by 172.159.52.99 (talk) 16:57, 18 October 2007 (UTC)
Stop trying to make it sound normal...
Bulimia is common especially among young women of normal or nearly normal weight.[1]
This is a misquote. Here's the reference text:
...a habitual disturbance in eating behavior mostly affecting young women of normal weight
All it shows is that the group it most affects is young women, not that the problem is commonplace. —Preceding unsigned comment added by 86.151.235.32 (talk) 14:17, 26 November 2007 (UTC)
Shortened form
Who say, "mia?" is that an official word or just some guy's slang? 64.191.211.54 (talk) 21:44, 7 February 2008 (UTC)
NPOV and otherwise very bad paragraph removed
I am removing the following paragraph for reasons of very poor language, NPOV and breaching several Wikipedia standards:
High mortality rates might be directly related to Western society's routine grave denial of the seriousness and widespread effect of eating disorders. In a culture where diet and weight loss industries ever grow along side obesity rates, and where thinness is glamourized in every magazine on every stand, it is no wonder that those with eating disorders aren't treated as seriously as say individuals with schizophrenia. Mental illnesses such as schizophrenia offer huge profits for pharmaceutical companies and inpatient treatment centers. In simple economic terms, a recovering schizophrenic means profit. A recovered bulimic does not. Bulimics that lose weight are often congratulated by others for their weight loss and "control". Losing weight is usually associated with success rather than illness in Western culture. And further, the general misconception of eating disorders being just a temporary adolescent trend remains. In some cultural circles, it isn't just thinness that is glamourized, but the eating disorder itself, as seen on pro-ana/mia and thinspiration websites. Unfortunately, all of these attitudes, misconceptions and market forces only perpetuate the growing epidemic of eating disorders and the likelihood of death for those afflicted
The text is of some, although not crucial value to the article. Its content should be rewritten, large parts left out and better parts added, but I do not have the expertise to do so. 81.93.102.185 (talk) 22:16, 21 February 2008 (UTC)
- Edit: The title of this said "hardly NPOV", I changed it later.
