Eating disorders: neurologic manifestations

Christina Mueller MD (Dr. Mueller of the University of Michigan has no relevant financial relationships to disclose.)
Zachary N London MD (Dr. London of the University of Michigan has no relevant financial relationships to disclose.)
Originally released August 28, 2000; last updated September 14, 2009; expires September 14, 2012
Notice: This article has expired and is therefore not available for CME credit.

This article includes discussion of eating disorders: neurologic manifestations, anorexia, bulimia, eating disorder, anorexia nervosa, and bulimia nervosa. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.


Two eating disorders – anorexia nervosa and bulimia nervosa – often go undetected, yet can, and often do, lead to a wide range of serious physical health complications, including neurologic complications. Eating disorders can have a profoundly negative impact on an individual's quality of life. Recognition of eating disorders as real and treatable diseases, therefore, is critically important.

Historical note and terminology

Two eating disorders – anorexia nervosa and bulimia nervosa – are recognized as diagnostic entities in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (American Psychiatric Association 1994), and a third category, binge-eating disorder, is proposed in the DSM-IV-TR as a possible new diagnostic entity. A recent article that analyzed data from the National Comorbidity Survey found that all 3 disorders are comorbid with many other DSM-IV disorders and can lead to a wide range of physical health complications, including neurologic complications (Hudson et al 2007).

Historical accounts have revealed that forms of voluntary self-starvation have existed for thousands of years. It was not until 1873, however, that Gull and Lasegue presented complete medical descriptions of anorexia nervosa, leading to the disorder being accepted as a true disorder in the late 1800s (Gull 1873; Lasegue 1873; Bemporad 1997). Some research has suggested that 3 major changes have been seen in eating disorders over the past few decades, including 1) an increased incidence, 2) a redirection of the purpose of anorexia nervosa as contemporary patients are more afraid of being overweight and less fearful of their sexuality or adult responsibility, and 3) the emergence of bulimia as a new form of eating disorder (Russell 1985).

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