The Changing Faces of Eating Disorders

More men are turning not to illegal anabolic steroids but to legal appearance- and performance-enhancing drugs, ones that pose a health threat all their own.

Binge eating disorder is more common than anorexia and bulimia combined, according to a national survey, but many physicians are unaware of the problem. The guidance and evidence discussed here highlight the key issues in recognizing and managing the disorder.

Eating disorders among adolescents and children are agrowing problem in the United States; the number of caseshas steadily increased over the last 50 years. Up to 5% offemale adolescents have bulimia nervosa, and an estimated0.5% have anorexia nervosa.1

A 23-year-old woman has had 2 episodesof syncope during the past month.Her mother witnessed 1 episode inwhich the patient collapsed and lostconsciousness for a few minutes. Sheexperienced tonic-clonic seizure activitybut no subsequent confusion.

A 30-year-old woman was brought to the hospital with syncope, bradycardia, and hypotension. For the past 6 years, she had vomited after eating meals and after occasional episodes of binge eating.

Evaluation of intermittently discolored, cold fingers was sought by a 39-year-old woman with long-standing anorexia nervosa. The patient had never smoked and was not taking any vasoconstrictive drugs.