An increase in BMI from adolescence to adulthood was associated with higher levels of concern over shape and weight and more intense dietary restraint, especially among females. Overt eating disorders were no more prevalent in these patients than in the general population, but milder forms of disordered eating were common and had implications for diabetes management. Insulin omission for weight control was frequent among females and may contribute to poor glycemic control and to risk of complications.
Six hundred and twenty women who were currently practising self-induced vomiting to control their weight were identified with the help of a women's magazine. Nineteen women (31%) fulfilled diagnostic criteria for anorexia nervosa. Of the remainder, 499 (83 0%) fulfilled diagnostic criteria for bulimia nervosa, a recently described eating disorder. Of these, 56-1% practised self-induced vomiting at least once daily; the mean duration of vomiting was 4-5 years. Most women were of normal body weight. On standardised measures, 68 1% of women showed pronounced psychiatric morbidity and 89% had profoundly disturbed attitudes to food and eating. 564% thought they definitely needed medical help, though only 30-1% had ever discussed any aspect of their eating difficulties with a doctor.This study highlights the secrecy that surrounds bulimia nervosa and suggests that it is an important undetected source of psychiatric morbidity. Introduction Self-induced vomiting as a means of weight control is well recognised in anorexia nervosa. It is also a feature of the recently described eating disorder bulimia nervosa.' This syndrome has three diagnostic criteria: the patients have powerful and intractable urges to overeat; they seek to avoid the "fattening" effects of food by induced vomiting or abusing purgatives or both; and they have a morbid fear of becoming fat. The condition has a notable physical and psychological morbidity. '-3
I D RITCHIE, BSC, MB, house surgeon G P STARK, MB, house surgeon Corrections Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth An error occurred in this paper by Dr 0 G Brooke and others (15 March, p 751). Table II, row 6 should have read "Heat-labile (non-placental) alkaline phosphatase activity (IU/I)." Fluid deprivation due to Althesin solution affecting drop size An error occurred in this article by Dr W J Wraight and Mr D Cox (29 March, p 904). The formula given in the article should have been described as the formula for determining drop volume, not drip rate.
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