Animal studies suggest that aging is associated with anorexia and disordered gastrointestinal transit. To determine whether there is a relationship between the effects of aging on appetite and gastrointestinal transit in humans, 19 young (age 23-50 yr) and 14 elderly (age 70-84 yr) normal volunteers underwent measurements of 1) desire to eat, hunger, and fullness (visual analog scales); 2) gastric emptying (scintigraphy); 3) orocecal transit (breath hydrogen); 4) total gut transit (radiopaque markers); and 5) autonomic nerve function (cardiovascular reflexes). We found that, postprandially, elderly subjects had less desire to eat (P < 0.05) and less hunger (P < 0.05), but not a significantly greater fullness than younger subjects. Gastric emptying (50% emptying time) for solid (182 +/- 26 vs. 127 +/- 13 min, P < 0.05) and liquid (47 +/- 4 vs. 35 +/- 3 min, P < 0.05) meal components was slower in elderly subjects. Postprandial hunger was inversely related (r = -0.39, P < 0.05) to solid gastric emptying. There were no significant differences in orocecal and total gut transit times between the two groups. Autonomic nerve function was abnormal in 11 elderly but none of the young subjects (P < 0.01). We conclude that aging is associated with 1) diminished desire to eat and hunger, 2) slowing of solid and liquid gastric emptying, 3 no change in orocecal and total gut transit, and 4) autonomic nerve dysfunction. The slowing of gastric emptying may contribute to anorexia in aging subjects.

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The aim of this study was to assess the possible relationship between the presence of a pathological family background and various eating disorders subgroups. A semi-structured interview was used to assess the socio-demographic and clinical characteristics and the presence of psychological complaints among family members of 79 subjects with anorexia nervosa (AN) and 34 subjects with bulimia nervosa (BN). The subjects were also administered the following self-assessment questionnaires: BITE, EDI, and HSCL-90. There were nonsignificant differences between AN and BN in terms of parental mental disorders. A further subdivision of the patients (as indicated in DSM-IV) revealed significant differences in the distribution of psychiatric family history. In particular, it seems that the presence of purgative behavior is associated with a higher incidence of a pathological family background. These results suggest that pathological family histories are not responsible for the development of ED, but they are an aggravating factor both in AN and BN.

SummaryThirty-one patients, 30 girls and 1 boy, who had suffered from anorexia nervosa, were re-evaluated at a minimum of 4 years (mean 7.6 years) after onset. Follow-up information was based on a semi-structured interview and 2 self-evaluation questionnaires, EAT-26 (1979) and HSCL-90 (1976). As well as using the Garfinkel and Garner criteria (1977) for assessing outcome, 2 psychiatrists independently evaluated the psychiatric state using DSM III criteria. The results demonstrated that 54.8% of the sample had a positive and 45% (including 3 deaths) a poor outcome. Of the 25 subjects interviewed, 20% presented chronic anorexia. Seventy-two percent, on the other hand, showed an evolution in clinical diagnosis, meeting the criteria for a mental disorder other than anorexia nervosa: Affective Disorders (40%), Somatoform Disorder (16%), Anxiety Disorder (12%), and Bulimia (8%). Two variables were significant, in terms of poor long-term prognosis: a larger number of hospitalizations for anorexia and an unsatisfactory educational and/or vocational adjustment at presentation.

A case of dysmorphophobia is described in a 24‐year‐old woman with a preexisting anorexia nervosa. The relationship between these two pathological conditions in which the disturbed body image is of primary importance is discussed.