physio-psy

OBJECTIVE: Overweight is a serious health problem in children and adolescents. Some investigators fear that dieting, the principal method of reducing body weight, may precipitate eating disorders and related complications. This review examined the literature on the effects of dieting on eating behavior and psychological status in youth. METHOD: Electronic databases were searched for articles containing combinations of the following keywords: weight loss, dieting, treatment, overweight, obesity, anorexia, bulimia, binge eating, eating disorder, children, and adolescents. A manual search of reference lists also was conducted. RESULTS: Five relevant studies were found. Their findings suggest that a professionally administered weight loss poses minimal risks of precipitating eating disorders in overweight children and adolescents. Significant improvements in psychological status also were observed in several studies. DISCUSSION: Concerns about potential ill effects of dieting should not dissuade overweight youth from pursuing sensible methods of weight loss. (Copyright 2005 by Wiley Periodicals, Inc) Number of References:70

Appetite Regulation/*physiologyBody Weight/*physiologyEating Disorders/*physiopathologyEmotions/*physiologyLeptin/*physiologyalpha-MSH/*physiologyAnimals; Antipsychotic Agents/adverse effects; Diabetes Mellitus/chemically induced; Diabetes Mellitus/physiopathology; Eating Disorders/genetics; Energy Metabolism/physiology; Homeostasis/ id

Adequate nutrition is essential during adolescence, since growth and development during this period play key roles in achieving normal adult size and reproductive capacity. This article briefly reviews recommended caloric intake; the healthy balance of carbohydrates, fat and protein; and the appropriate dietary intake of iron, folic acid and calcium for the adolescent. A major potential obstacle to good nutrition for an adolescent is the development of an eating disorder such as anorexia nervosa or bulimia nervosa. Anorexia nervosa, characterized by severe underweight, fear of gaining weight, and low self-esteem and amenorrhea, is associated with many physiological and psychological complications with which the provider must be familiar. Similarly, bulimia nervosa, which presents with eating binges followed by compensatory behaviors such as vomiting, diet pill abuse and overexercise, may be harder to detect, but can also have devastating consequences, both physically and emotionally, for a young person. Both of these disorders are best treated by a multidisciplinary team of specialists to address the medical, psychological, and nutritional components of these illnesses.

ulimia nervosa The main feature that distinguishes bulimia nervosa from anorexia nervosa is that attempts to restrict food intake are punctuated by repeated binges (episodes of eating during which there is an aversive sense of loss of control and an unusually large amount of food is eaten). The amount consumed in these binges varies, but is typically between 4.2 MJ (1000 kcals) and 8.4 MJ (2000 kcals).[9,10] In most instances, binge eating is followed by compensatory self-induced vomiting or laxative misuse, but there is a subgroup who do not purge. The combination of undereating and binge eating results in bodyweight being generally unremarkable, providing the other obvious difference from anorexia nervosa. Most patients with bulimia nervosa are distressed by their loss of control over eating and ashamed of it, which makes them easier to engage in treatment than those with anorexia nervosa, although there is typically a delay of many years before they seek help. Symptoms of depression and anxiety disorders are often prominent and, as in the case of anorexia nervosa, there is a subgroup who engage in substance misuse or self-injury, or both.[11-13] This subgroup is probably over-represented in specialist treatment centres.[14]