OBJECTIVE: People with attentional problems are at increased risk of eating disorders. This paper aimed to systematically review and synthesize the existing evidence on stimulant medication in the management of patients with bulimia nervosa (BN) or anorexia nervosa (AN) with or without comorbid attention deficit hyperactivity disorder (ADHD).
METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A protocol for the review was registered with Open Science Framework (OSF) Registry and critical appraisal of the literature was conducted using Joanna Briggs Institute (JBI) Critical Appraisal Tools.
RESULTS: Thirteen articles met inclusion criteria including two quasi-experimental studies, one randomized controlled trial, four case series, and six case reports. 26 cases were included from studies and 32 from case series/reports. Only two cases from a single case report had a diagnosis of AN, while the remainder had BN. Stimulants included methylamphetamine, lisdexamfetamine, methylphenidate, dextroamphetamine sulphate and mixed amphetamine salt. In nearly all cases of BN there were reported reductions in eating disorder symptoms. The rates of adverse effects were high and included weight loss, decreased appetite, tachycardia, dry mouth, fatigue, insomnia, restlessness, nausea, bruxism, headache, palpitations, blood pressure changes, irritability, anxiety, depressed mood, and diaphoresis.
CONCLUSIONS: There is currently insufficient evidence to support the use of stimulant medications to treat symptoms of BN or AN. The authors recommend considering screening patients with BN for ADHD.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with disordered eating/eating disorders, but prior meta-analyses are limited by small numbers.
OBJECTIVE: To inform the 2023 International PCOS Guideline, we performed a systematic review and meta-analysis evaluating the prevalence of disordered eating/eating disorders among women with and without PCOS.
METHODS: Ovid MEDLINE, EMBASE, PsycInfo, and All EMB were searched from inception through February 1, 2024, for studies that compared prevalences of eating disordered/disordered eating in adolescent or adult women. Random effects meta-analyses were used to estimate the pooled odds ratios (OR) or standardized mean differences (SMD) of outcomes in women with PCOS compared to controls. Methodological quality was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system, and included studies were assessed for risk of bias.
RESULTS: Of 1352 articles identified, 20 were included, with a total of 28 922 women with PCOS and 258 619 controls. Individuals with PCOS had higher odds of any eating disorder (OR: 1.53 [1.29, 1.82], 8 studies), which persisted in studies where PCOS was diagnosed by Rotterdam criteria (OR: 2.88 [1.55, 5.34], 4 studies). Odds of bulimia nervosa, binge eating disorder, and disordered eating, but not anorexia nervosa, were increased in PCOS. Mean disordered eating scores were higher in PCOS (SMD: 0.52 [0.28, 0.77], 13 studies), including when stratified by normal and higher weight body mass index. Most included studies were of moderate quality, with no evidence of publication bias.
CONCLUSIONS: Our study informs the 2023 PCOS Guideline recommendations for consideration of the risk of disordered eating/ eating disorders in care of women with PCOS, regardless of weight, especially during providing lifestyle counseling.

UNASSIGNED: Evidence for anorexia and bulimia in relation to the risk of ulcerative colitis (UC) is limited and inconsistent. The objective of this research was to utilize bi-directional, two-sample Mendelian randomization (MR) analysis to predict the causal association between anorexia nervosa and bulimia nervosa with UC.
UNASSIGNED: The genome-wide association studies (GWAS) provided data for anorexia and bulimia from the UK Biobank, utilizing single-nucleotide polymorphisms (SNP) as instrumental variables. Additionally, genetic associations with UC were collected from various sources including the FinnGen Biobank, the UK Biobank and the International Inflammatory Bowel Disease Genetics Consortium (IIBDGC). The main analytical approach utilized in this study was the inverse-variance-weighted (IVW) method. To evaluate horizontal pleiotropy, the researchers conducted MR-Egger regression and MR-PRESSO global test analyses. Additionally, heterogeneity was assessed using the Cochran\'s Q test.
UNASSIGNED: This study found a negative association between genetically predicted bulimia (OR = 0.943, 95% CI: 0.893-0.996; p = 0.034) and the risk of UC in the IIBDGC dataset, indicating that individuals with bulimia have approximately a 5.7% lower risk of developing UC. No association was observed in the other two datasets. Conversely, genetically predicted anorexia was not found to be causally associated with UC. In bi-directional Mendelian randomization, UC from the IIBDGC dataset was negatively associated with the risk of anorexia (OR = 0.877, 95% CI: 0.797-0.965; p = 0.007), suggesting that UC patients have approximately a 12.3% lower risk of developing anorexia, but not causally associated with bulimia.
UNASSIGNED: Genetically predicted bulimia may have a negative association with the onset of UC, while genetically predicted anorexia does not show a causal relationship with the development of UC. Conversely, genetically predicted UC may have a negative association with the development of anorexia.

Weight stigma, racism, and sexism (social devaluation due to body weight, race or ethnicity, and sex or gender), have been linked to increased maladaptive eating behaviors; however, no research has investigated the unique associations between different forms of stigma and eating concurrently. We analyzed within-group (by race/ethnicity and sex) effects of different forms of stigma on maladaptive eating behaviors to test whether there is some unique relationship between weight stigma and maladaptive eating across identities. Additionally, we explored differences by racial/ethnic group and sex, as well as BMI category, in levels of reported weight stigma, racism, sexism, and maladaptive eating. Participants (N = 1051) were recruited so that there were approximately even numbers of participants identifying as Black (33.3%), Hispanic or Latino (32.8%), and White (33.9%). Overall, participants reported similar amounts of weight stigma by race/ethnicity and sex, but different levels of racism and sexism. Weight stigma, but not racism or sexism consistently predicted binge eating and eating to cope across groups, controlling for education, income, BMI, and age. Restricted dieting, however, was only predicted by weight stigma for Hispanic/Latino and Black men. These findings suggest that weight stigma is a unique predictor of maladaptive eating, even when considering the effects of racism and sexism. This study provides evidence of a more focused model of weight stigma and eating outcomes, rather than a more general model of the effect of stigma on eating outcomes due to overall stress. Future research should investigate when and why weight stigma drives restricted dieting, since this relationship seems strongest in men, going against many common inclinations about weight stigma.

Two most common causes of elevated serum calcium levels, which together account for nearly 90% of all cases, are primary hyperparathyroidism and malignancy. Thus, it is necessary to consider other disorders in the diagnostic evaluation of patients with hypercalcemia. We report the case of a 40-year-old female patient with an intellectual disability who was admitted to the Emergency Department with severe symptomatic hypercalcemia and acute renal failure, caused by recurrent intentional vomiting. The aim of this report is to help clinicians make an accurate diagnosis by considering recurrent vomiting habits as a potential cause of hypercalcemia and acute renal failure. Our case provides a comprehensive diagnostic work-up and multidisciplinary treatment strategies for patients with symptomatic hypercalcemia.

BACKGROUND: Eating disorders (EDs) are mental health illnesses with a multifactorial origin. At present, no review of indexed publications studying their prevalence in Spain is available.
METHODS: A scoping review (PROSPERO -CRD42019140884-) was carried out through systematic searches (MEDLINE, EMBASE and PsycINFO) until January 2022. Papers published in Spanish/English analysing the prevalence of EDs in Spain (population < 65 years) were selected.
RESULTS: A total of 766 articles were identified (186 eliminated as duplicates). A total of 580 articles were analysed on the basis of title and abstract, and 67 articles were selected for full-text analysis. A total of 37 studies analysed the prevalence of EDs in Spain.
CONCLUSIONS: This is the first scoping review to analyse the prevalence of EDs in Spain. Puberty and adolescence are the most extensively studied stages. There is a high heterogeneity in the use of ED screening tools and a paucity of information on diagnostic tools.

BACKGROUND: Abdominal compartment syndrome (ACS) is typically attributed to critically unwell patients with trauma, burns, post surgery, and massive ascites. A rare but fatal cause of ACS is bulimia nervosa (BN), which is an eating disorder characterized by bingeing, followed by methods to avoid weight gain, including purging.
METHODS: We present a case of a 20-year-old woman who presented with abdominal pain and distension after consuming a large quantity of food the previous night and was unable to purge. She was initially managed conservatively and discharged home, but returned subsequently on the same day with clinical features of ACS secondary to acute gastric distension. Decompression resulted in life-threatening reperfusion injury with critical electrolyte abnormalities and fatal cardiac arrest in the operating theatre. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A systematic review of the literature found only 11 case reports of ACS secondary to BN, of which only 6 patients survived due to early diagnosis and decompression. Inability to purge and lower limb ischemia appeared to be associated with increased mortality. As BN is a common emergency presentation, the case and systematic review highlights the need to consider ACS as a potentially life-threatening complication of binge eating, particularly when there is unsuccessful purging.

The association between body mass index (BMI) and binge-eating disorder (BED) is well-established. However, data on the extent to which BMI is associated with progression from binge-eating behavior into BED among adolescents are limited, which was the aim of this investigation. Participants were 9964 U.S. adolescents from the Adolescent Brain Cognitive Development (ABCD) Study, aged 9-13 at the time of study enrollment. A computerized parent-reported assessment was used to establish adolescents\' binge-eating behaviors and BED. Cox proportional hazards models adjusting for sociodemographic covariates were used to examine prospective associations between BMI and likelihood of BED onset among a) adolescents with binge-eating behavior, and b) adolescents with no binge-eating behavior. Of 975 adolescents who met the study criteria for binge-eating behavior, 89 (9.1%) subsequently met the study criteria for BED. Of 8989 adolescents with no binge-eating behavior, 82 (0.9%) subsequently met the study criteria for BED. BMI percentile was significantly associated with the likelihood of BED onset in participants with (adjusted HR = 1.03, 95% confidence interval [CI] 1.00, 1.06) and participants without (adjusted HR = 1.05, 95% CI 1.03, 1.07) binge-eating behavior. Results were also significant when examining BMI as a dichotomous predictor (above and below 85th percentile) among those with (adjusted HR = 2.60, 95% CI 1.00, 6.68) and those without (adjusted HR = 6.01, 95% CI 3.90, 11.10) binge-eating behavior. Overall, results indicate that elevated BMI is prospectively associated with a greater risk for BED onset among U.S. adolescents with or without binge-eating behavior. Adolescents with a higher BMI may benefit from screening for binge eating, and prevention/early intervention strategies to mitigate the risk for developing BED.

The aim of the present study was to evaluate depressive-like, anxiety-like, and perseverative-like behaviors in a binge eating model. Juvenile Wistar rats, using the binge eating model, were compared to caloric restriction, induced stress, and control groups. Rats of the induced stress group presented binge-like behaviors in standard food intake in the second cycle of the experiment when compared to the caloric restriction group and the binge eating model group. Depressive-like behavior was observed in the binge eating model group with longer immobility time (p < 0.001) and less swim time (p < 0.001) in comparison to the control group. Anxiety-like behavior was observed by shorter duration of burying latency in the binge eating model group when compared to the induced stress group (p = 0.04) and a longer duration of burying time when compared to the control group (p = 0.02). We observed perseverative-like behavior by the binge model group, who made more entries to the new arm (p = 0.0004) and spent a longer time in the new arm when compared to the control group (p = 0.0001). Our results show differences in behaviors between the groups of rats studied. These results suggest that calorie restriction-refeeding, along with stress, may lead to depressive-like, anxiety-like, and perseverative-like behavioral changes in male Wistar rats.

BACKGROUND: Eating-related problems (e.g., binge eating (BE)) and impaired quality of life (QoL) is more prevalent in children with overweight and obesity. This study aimed to investigate changes in self-reported overeating (OE), BE, and QoL in children with overweight or obesity attending multicomponent 10-week lifestyle camps with a 52-weeks follow-up. Additionally, the study sought to investigate whether self-reported OE/BE before camp was associated with changes in QoL.
METHODS: Children aged 7 to 14-years could attend camp if they had overweight/obesity, were lonely, unhappy, or had social or family-related problems. In this study only children with overweight and obesity were included (n:185). OE, BE, and QoL were measured using self-reported questionnaires.
RESULTS: In total, 38 % of the children reported regular BE at baseline. Regular OE, occasional BE, and occasional OE was reported by 14 %, 13 %, and 11 %, respectively, while 24 % reported no eating-related problems. The relative risk of experiencing eating-related problems decreased at 10-weeks compared to baseline. Additionally, the probability of regular OE (RR 0.12 (95 % CI 0.04;0.38) (X2 = 8.44, p = 0.004)) and regular BE (RR 0.01 (95 % CI 0.00;0.11) (X2 = 9.91, p = 0.002)) remained lower at 52-weeks relative to baseline. All QoL dimensions improved after camp, and the presence of self-reported OE and regular BE at baseline was significantly associated with lower QoL at baseline, 10 and 52-weeks.
CONCLUSIONS: Children self-reporting OE and BE may be a particular vulnerable group that needs more support from camp staff and healthcare professionals to improve QoL.
BACKGROUND: clinicaltrials.gov with ID: NCT04522921.