About a particular type of oral perversion in the female: Hyperphagia followed by vomiting

Abstract

We present a case (from a series) of a young woman suffering from a particular abnormality in her behavior with regards to food: She ingests large quantities of food to immediately vomit it. This behavior becomes progressively the central activity and concern of the patients. Both the desire of eating food and of vomiting it are imperious, but they are not experienced as foreign to the self, are considered as an “irresistible temptation.” Among the secondary symptoms we find pertinacious constipation and dysthymic states each time more intense and prolonged. (2) The clinical picture evolves toward a narrowing of existence and a greater limitation of social and work abilities. (3) A phenomenological analysis of the major symptom is attempted, in order to establish essential differences with regards to hysteric, obsessive, and delusional phenomena. A special place is granted to the differential diagnosis with regards to anorexia nervosa and psychogenic obesity. (4) The clinical picture presented by these patients is considered as constituting an independent syndrome. This syndrome can be subordinated to the broader group of addictions. © 1994 by John Wiley & Sons, Inc.

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.

“…(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances Although the definition of BN has been revised since its introduction to the psychiatric nomenclature, the above definition bears a striking resemblance to that given by Russell (1979) in his seminal description of the disorder. Slightly earlier, independent reports of a binge-purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994;Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994;Russell, 1979;Ziolko, 1994), no author described a large awareness of this syndrome before 1960.…”

“…Slightly earlier, independent reports of a binge–purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994; Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994; Russell, 1979; Ziolko, 1994), no author described a large awareness of this syndrome before 1960. Based on BN's recent appearance and dramatically increasing incidence, Russell (1997) concluded, “Bulimia nervosa is a new disorder” (p. 23).…”

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.

“…(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances Although the definition of BN has been revised since its introduction to the psychiatric nomenclature, the above definition bears a striking resemblance to that given by Russell (1979) in his seminal description of the disorder. Slightly earlier, independent reports of a binge-purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994;Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994;Russell, 1979;Ziolko, 1994), no author described a large awareness of this syndrome before 1960.…”

“…Slightly earlier, independent reports of a binge–purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994; Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994; Russell, 1979; Ziolko, 1994), no author described a large awareness of this syndrome before 1960. Based on BN's recent appearance and dramatically increasing incidence, Russell (1997) concluded, “Bulimia nervosa is a new disorder” (p. 23).…”

Transtornos alimentares: fundamentos históricos

“…24 Desde há quase um século, pacientes com Bulimia Nervosa, como o célebre caso Ellen West, descrito por Binswanger, aparecem na literatura psiquiátrica recebendo outros diagnósticos ("obsessão da vergonha do corpo", Janet) na ausência de um nome mais apropriado. 25 Mas ainda, o caso de Ellen West apresenta todo o corolário de sintomas que hoje nos permitiria o diagnóstico, como medo de engordar, marchas exageradas (20-25 milhas por dia), apetite voraz alternando-se com dietas restritivas e abuso de tabletes tireoideanos para perder peso.…”

Emergence of bulimia nervosa as a separate diagnostic entity: Review of the literature from 1960 to 1979

“…The source-a Chilean journal of psychiatry-also explains why the Spanish article by Otto Dorr-Zegers, professor of psychiatry at the University of Chile in Santiago, has remained unnoticed. Dorr-Zegers (1972) extensively discussed three cases of hyperphugia followed by vomiting in women, which he viewed as "a particular type of oral perversion in the female." The author stressed that the clinical picture constitutes an independent syndrome, with close ties to anorexia nervosa, obsessive-compulsive neuroses, and addictions.…”

“…The publications by Dorr-Zegers (1972) and Ziolko (1976) mark an interesting shift in the 1970s: The clinical diagnostic reasoning about bulimia moved from a symptom to a syndrome level. Independently from one another, clinicians became more and more intrigued by a peculiar pattern of overeating they couldn't fit in the existing diagnostic classification.…”

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.

“…(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances Although the definition of BN has been revised since its introduction to the psychiatric nomenclature, the above definition bears a striking resemblance to that given by Russell (1979) in his seminal description of the disorder. Slightly earlier, independent reports of a binge-purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994;Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994;Russell, 1979;Ziolko, 1994), no author described a large awareness of this syndrome before 1960.…”

“…Slightly earlier, independent reports of a binge–purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994; Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994; Russell, 1979; Ziolko, 1994), no author described a large awareness of this syndrome before 1960. Based on BN's recent appearance and dramatically increasing incidence, Russell (1997) concluded, “Bulimia nervosa is a new disorder” (p. 23).…”

Transtornos alimentares: fundamentos históricos

“…24 Desde há quase um século, pacientes com Bulimia Nervosa, como o célebre caso Ellen West, descrito por Binswanger, aparecem na literatura psiquiátrica recebendo outros diagnósticos ("obsessão da vergonha do corpo", Janet) na ausência de um nome mais apropriado. 25 Mas ainda, o caso de Ellen West apresenta todo o corolário de sintomas que hoje nos permitiria o diagnóstico, como medo de engordar, marchas exageradas (20-25 milhas por dia), apetite voraz alternando-se com dietas restritivas e abuso de tabletes tireoideanos para perder peso.…”

Emergence of bulimia nervosa as a separate diagnostic entity: Review of the literature from 1960 to 1979

“…The source-a Chilean journal of psychiatry-also explains why the Spanish article by Otto Dorr-Zegers, professor of psychiatry at the University of Chile in Santiago, has remained unnoticed. Dorr-Zegers (1972) extensively discussed three cases of hyperphugia followed by vomiting in women, which he viewed as "a particular type of oral perversion in the female." The author stressed that the clinical picture constitutes an independent syndrome, with close ties to anorexia nervosa, obsessive-compulsive neuroses, and addictions.…”

“…The publications by Dorr-Zegers (1972) and Ziolko (1976) mark an interesting shift in the 1970s: The clinical diagnostic reasoning about bulimia moved from a symptom to a syndrome level. Independently from one another, clinicians became more and more intrigued by a peculiar pattern of overeating they couldn't fit in the existing diagnostic classification.…”

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.

“…(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances Although the definition of BN has been revised since its introduction to the psychiatric nomenclature, the above definition bears a striking resemblance to that given by Russell (1979) in his seminal description of the disorder. Slightly earlier, independent reports of a binge-purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994;Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994;Russell, 1979;Ziolko, 1994), no author described a large awareness of this syndrome before 1960.…”

“…Slightly earlier, independent reports of a binge–purge syndrome in normal-weight young women were published in German and Spanish (Ziolko, 1996) and have since been translated into English by the original authors (Doerr-Zegers, 1994; Ziolko, 1994). Notably, among these first descriptions of BN (Doerr-Zegers, 1994; Russell, 1979; Ziolko, 1994), no author described a large awareness of this syndrome before 1960. Based on BN's recent appearance and dramatically increasing incidence, Russell (1997) concluded, “Bulimia nervosa is a new disorder” (p. 23).…”

Transtornos alimentares: fundamentos históricos

“…24 Desde há quase um século, pacientes com Bulimia Nervosa, como o célebre caso Ellen West, descrito por Binswanger, aparecem na literatura psiquiátrica recebendo outros diagnósticos ("obsessão da vergonha do corpo", Janet) na ausência de um nome mais apropriado. 25 Mas ainda, o caso de Ellen West apresenta todo o corolário de sintomas que hoje nos permitiria o diagnóstico, como medo de engordar, marchas exageradas (20-25 milhas por dia), apetite voraz alternando-se com dietas restritivas e abuso de tabletes tireoideanos para perder peso.…”

Emergence of bulimia nervosa as a separate diagnostic entity: Review of the literature from 1960 to 1979

“…The source-a Chilean journal of psychiatry-also explains why the Spanish article by Otto Dorr-Zegers, professor of psychiatry at the University of Chile in Santiago, has remained unnoticed. Dorr-Zegers (1972) extensively discussed three cases of hyperphugia followed by vomiting in women, which he viewed as "a particular type of oral perversion in the female." The author stressed that the clinical picture constitutes an independent syndrome, with close ties to anorexia nervosa, obsessive-compulsive neuroses, and addictions.…”

“…The publications by Dorr-Zegers (1972) and Ziolko (1976) mark an interesting shift in the 1970s: The clinical diagnostic reasoning about bulimia moved from a symptom to a syndrome level. Independently from one another, clinicians became more and more intrigued by a peculiar pattern of overeating they couldn't fit in the existing diagnostic classification.…”