Restrictive Anorexia Research Articles

Emotional food craving across the eating disorder spectrum: an ecological momentary assessment study

PurposeEmotional eating during negative emotions might underlie disordered eating behavior (i.e., binge eating and food restriction). Positive emotions, by contrast, seem to promote healthier eating behavior. Naturalistic research on the links between emotions and eating across individuals with binge-eating disorder (BED), bulimia nervosa (BN), binge-purge anorexia nervosa (AN-BP), and restrictive anorexia nervosa (AN-R) is, however, lacking.MethodsIndividuals without eating disorders (comparison group, CG, n = 85), and patients with BED (n = 41), BN (n = 50), AN-BP (n = 26), and AN-R (n = 29) participated in an ecological momentary assessment study. Six daily notifications over eight days prompted ratings of momentary food craving and emotional states differing in valence and arousal.ResultsResults supported specific emotion-food-craving patterns in each group. Compared to the CG, arousing negative emotions and higher cravings co-occurred in patients with BN. In patients with AN-BP (at trend level also in patients with AN-R) less arousing negative emotions and lower cravings co-occurred. In patients with AN, positive emotions and higher cravings co-occurred whereas in patients with BED less arousing positive emotions and lower cravings co-occurred.ConclusionThe found emotion-craving associations may underlie group-specific (dys-)functional eating behaviors, i.e., binge eating and food restriction during negative emotions in patients with BN and AN, and normalized appetitive responses during positive emotions in patients with BED and AN. Therapeutic efforts could target arousing negative emotions in patients with BN, and less arousing negative emotions in patients with AN. Positive emotions could be used in a salutogenetic approach in patients with BED and AN.

Effects of repetitive transcranial magnetic stimulation of the right inferior parietal lobe on the body image perception in anorexia nervosa: A pilot randomized controlled study.

Restrictive anorexia nervosa (AN) is associated with distorted perception of body shape, previously linked to hypoactivity and reduced excitability of the right inferior parietal lobe (rIPL). Here, we investigated the impact of high-frequency repetitive transcranial magnetic stimulation (HF rTMS) of the rIPL on body shape perception in patients with AN. Seventeen patients with AN (median [Q1_Q3] age, 35 [27_39] years; disease duration, 12 [6_18] years) were randomly assigned to receive real or sham HF (10Hz) rTMS of the rIPL over a period of 2weeks, comprising 10 sessions. The primary outcome measure was the Body Shape Questionnaire (BSQ). Secondary outcomes included eating disorder symptoms, body mass index, mood, anxiety, and safety. Data collection were done at baseline, post-rTMS, and at 2weeks and 3 months post-rTMS. Following both real and sham rTMS of the rIPL, no significant differences were observed in body shape perception or other parameters. Both real and sham rTMS interventions were deemed safe and well tolerated. Notably, serious adverse events were associated with the underlying eating and mood disorders, resulting in hospitalization for undernutrition (five patients) or suicidal attempts (two patients). This pilot study does not support the use of rTMS of the rIPL as an effective method for improving body shape perception in individuals with the restrictive form of AN. Further research is warranted to comprehensively explore both the clinical and neurophysiological effects of HF rTMS in this population.

Episode of renal dysfunction in a child with eating disorder: a case report

Among the various organ dysfunctions seriously affected by eating disorders (EDs) is kidney damage. The kidneys are vital organs responsible for several essential functions, including the balance of the body's acid-base and mineral metabolism, the removal and excretion of substances, and the regulation of blood volume and pressure. Eating disorders are a widespread and clinically relevant class of multiorgan disorders that occur mainly in adolescence. EDs often have serious clinical manifestations, which are determined by electrolyte imbalance, endocrine and mental disorders, renal failure, and other disorders. Common eating disorders discussed in the literature and frequently encountered in clinical practice are anorexia nervosa and bulimia nervosa. Anorexia nervosa is a type of abnormal eating behaviour that involves the consumption of very little food and may include intentional vomiting or the misuse of laxatives or diuretics. Kidneys perform a number of vital functions to maintain homeostasis in our body. One of the main functions of the kidneys is blood filtration and the removal of metabolic products. This allows you to maintain the optimal level of fluid and electrolytes and remove toxins. Restriction of fluid intake and abuse of diuretics can cause a decrease in blood flow to the kidneys and further renal failure. The result of the latter is the development of serious violations of vital functions. Low dietary protein intake in people following a restricted diet (restrictive anorexia) leads to a decrease in glomerular filtration rate (GFR) and renal plasma flow. Treatment of acute kidney injury on the background of volume deficit due to fluid loss involves its termination and hydration orally or with the help of intravenous infusions of physiological solution depending on the severity of volume deficit and kidney damage, which was observed and described in this clinical case. Aim. To analyze the peculiarities of kidney injury in a child with an eating disorder. Materials and Methods. A detailed analysis of the case history of a pediatric patient diagnosed with eating disorder complicated with an acute episode of renal dysfunction was done. Basic anamnestic, clinical, laboratory, and instrumental data were analyzed and given in the paper. A graphic presentation is done with PowerPoint. Results. We describe a 14-year-old female patient diagnosed with ED and acute kidney injury (AKI) leading to intensive care unit interventions. Conclusions. AKIs can result from a number of conditions that are common among anorexics and include dehydration, high blood pressure, toxins, inadequate nutrition and possibly altered electrolytes. Serum creatinine, blood urea nitrogen (BUN), glomerular filtration rate (GFR), and electrolytes are among the kidney function markers that need to be monitored in the early stages of AKI linked to anorexia. The right medical care, which includes normalizing blood pressure and adequate hydration, leads to the patient's recovery. Further follow-ups on kidney function in such patients are of high importance

Inflammatory profiles in women with eating disorder: Linking inflammatory biomarkers to clinical phenotypes

IntroductionEating disorders (ED) represent a group of very complex and serious diagnoses characterized by emotional dysregulation and impulsivity. New approaches are necessary to achieve effective diagnosis and treatments. Shifting biomarker research away from the constraints of diagnostic categories may effectively contribute to a dimensional differentiation across disorders according to neurobiology (e.g., inflammatory biomarkers). Thus, the aim of our study was to identify inflammatory profiles in patients with ED. MethodsA sample of 100 women with an ED (23.4 ± 8.55 years) and 59 healthy controls (HC) (20.22 ± 4.18 years) was used. K-means cluster analysis was followed to identify inflammatory clusters considering seven blood biomarkers (iNOS, TNFα, COX2, p38, ERK, TBARS and PPARγ). Moreover, a wide assessment of clinical features was conducted. ResultsTwo distinct clusters were identified. Cluster 1 patients were characterized by higher inflammatory levels of TNF-α, COX2, p38, and ERK, and had more restrictive anorexia diagnosis than cluster 2. Cluster 2 participants showed higher inflammatory levels of iNOS and were older than cluster 1 and controls and had lower BMI than HC. In addition, they had higher levels of bulimic symptoms than those from the cluster 1 and HC, and higher impulsivity than HC. All ED patients (regardless of cluster) showed higher ED symptoms and more trauma than HC. ConclusionsOur study revealed that inflammatory dysfunction may be linked with clinical endophenotypes in ED, one more restrictive (cluster 1) with an inflammation/oxidative endophenotype more cytokine and MAPK/ERK mediated, and the other more impulsive, with more bulimic symptoms (cluster 2) with NO free radical high output source iNOS. Trauma seems to be a vulnerability factor for both endophenotypes.

The Role of the Media in the Construction of Body Image and its Contribution to the Development of Restrictive Anorexia in Female Adolescents

The Role of the Media in the Construction of Body Image and its Contribution to the Development of Restrictive Anorexia in Female Adolescents

Musicothérapie réceptive et anorexie mentale. Évaluation du dispositif DéPi-AM de détente psychomusicale dans l’accompagnement d’adolescentes hospitalisées : étude pilote auprès de 8 patientes

ObjectivesThis pilot study aims at evaluating the effectiveness of music therapy in decreasing anxiety and dysmorphophobia experienced in a care unit during the institutional and distressful moment of weighing. Patients and methodWe adapted a technique of receptive music therapy, the so-called DéPi-AM for psychomusical relaxation, with eight adolescent girls (14;8±2 years;4) hospitalized for four months on average for restrictive anorexia nervosa. The participants received eight music therapy sessions followed by eight control evaluation sessions without music therapy. Quantitative data were collected in three evaluation conditions (pre-session, post-session, and no music therapy). ResultsResults suggest that music therapy significantly reduces perceived anxiety (as measured by the STAI-Y A; P=0.01, and the “EVN”; P=0687). Moreover, compared to the control condition, music therapy significantly contributed to a reduction in the systolic blood pressure (P=0.03) and heart frequency (P=02). Results additionally showed that this weighing time significantly increases all physiological constants (systolic blood pressure; P=0.01, diastolic blood pressure; P=0.05, and heart frequency; P=0.04) in contrast to another trivial, emotionally “neutral” day. DiscussionThis first quantitative study on the effectiveness of music therapy in adolescents suffering from anorexia nervosa shows encouraging results. The proved anxiety-provoking effect of this strategic institutional time in the care of these adolescents legitimizes the use and benefits of this type of therapeutic group. Undoubtedly, methodological limitations constrain the generalization of findings. Future studies should adopt a mixed (quantitative and qualitative) and transversal methodology. They would surely contribute to refine the profile of those patients, for whom this therapy appears to represent a promising care approach. ConclusionsOverall findings suggest a positive impact of receptive music therapy in decreasing experienced and perceived anxiety. Integrating programs such as the “DéPi-AM” into the therapeutic intervention offered by the care unit could therefore represent a key element when accompanying hospitalized patients during a key and anxious period.

The prevalence of laxative and diuretic abuse in patients with anorexia nervosa and bulimia nervosa

The article is devoted to the study of laxative and diuretic abuse among patients with anorexia nervosa (AN) and bulimia nervosa (BN). The medical records of 152 patients with AN and NB, who were hospitalized in a specialized clinic for the treatment of eating disorders, were studied. Of 152 patients, 52 % (N=79) had restricting anorexia nervosa, 29.6 % (N=45) had purgative anorexia nervosa, and 18.4 % (N=28) had bulimia nervosa. The number of people abusing laxatives and diuretics in the groups with AN purgative type and BN did not differ significantly. Laxative abuse accounted for 42.2 % (N=19) and 42.9 % (N=12) in AN purgative type and BN, respectively. Diuretics abuse accounted for 20 % (N=9) and 17.9 % (N=5) in AN purgative type and BN, accordingly. The total number of laxative and diuretic abusers among the patients with eating disorders was 20.4 % (N=31) and 9.2 % (N=14), respectively.

Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history.

Nesidioblastosis is a rare condition of organic persistent hyperinsulinaemic hypoglycaemia, with fewer than 100 cases since it was first recorded. However, an increasing prevalence suggests previous underdiagnosis due to poor knowledge and awareness. This case describes the presentation, clinical decision-making and unique challenges in diagnosis and care of a 21-year-old female with nesidioblastosis and extensive psychiatric comorbidities. She was repeatedly misdiagnosed until 2021, despite having presented to emergency departments with hypoglycaemic symptoms for over 7 years. Her symptoms were often misattributed to behaviours secondary to restrictive anorexia nervosa and borderline personality disorder. Even after appropriate diagnosis and management, she suffered a complicated post-operative course. Patients with psychiatric comorbidities are at higher risk of distress, communication difficulties and inadequate social support, all of which could be better managed with increased multidisciplinary collaboration between endocrine, surgery, psychiatry, pain management and social work. This study highlights the importance of well-rounded patient care that addresses all facets of patient health. This approach not only improves quality of care, but also reduces overall readmissions, revisions, morbidity and mortality.

6.44 Examining the Utility of Fasting Plasma Ferritin and Cortisol as a Biomarker of Restrictive Anorexia Nervosa in Adolescents

6.44 Examining the Utility of Fasting Plasma Ferritin and Cortisol as a Biomarker of Restrictive Anorexia Nervosa in Adolescents

제한형 신경성 식욕부진증의 발병 및 치료 개시 요인에 관한 다중회귀분석

Objectives This study aimed to predict the onset of Restrictive Anorexia Nervosa (AN-R) and identify influential symptom variables for treatment initiation.
 Methods We collected 333 comments from Korean YouTube videos related to eating disorders, focusing on AN-R. Through ChatGPT assessment, we extracted 1,210 symptomatic pieces of evidence, categorizing them into psychological, physical, behavioral, and social symptoms. Regression analysis at α=0.5 revealed a negative correlation between psychological and physical symptoms.
 Results Psychological symptoms were highest at the early onset of AN-R, gradually decreasing as physical symptoms emerged. Self-perception of symptom severity was primarily influenced by physical and social symptoms, especially appearance changes. Treatment initiation showed a positive correlation with appearance changes and a negative correlation with psychological symptoms.
 Conclusions Our findings confirm that AN-R onset can be predicted when physical symptoms appear after progressing psychological symptoms, highlighting the dominant influence of psychological symptoms in treatment initiation.

Bodily self-recognition and body size overestimation in restrictive anorexia nervosa: implicit and explicit mechanisms.

It is widely known that among others, a pervasive symptom characterizing anorexia nervosa (AN) concerns body image overestimation, which largely contributes to the onset and maintenance of eating disorders. In the present study, we investigated the nature of the body image distortion by recording accuracy and reaction times in both a group of healthy controls and AN patients during two validated tasks requiring an implicit or explicit recognition of self/other hand stimuli, in which the perceived size of the stimuli was manipulated. Our results showed that (1) the perceived size of hand stimuli modulated both the implicit and explicit processing of body parts in both groups; (2) the implicit self-advantage emerged in both groups, but the bodily self, at an explicit level (perceptual, psycho-affective, cognitive) together with the integration and the distinction between self and other, was altered only in restrictive anorexia patients. Although further investigations will be necessary, these findings shed new light on the relationship between the different layers of self-experience and bodily self-disorders.

Strategic avoidance of food stimuli in patients with restrictive anorexia nervosa: An eye-tracking evaluation.

A biased attentional processing of food stimuli may represent a disorder maintenance factor in patients with anorexia nervosa (AN). The present study aimed at investigating the temporal course of attentional deployment towards both high-calorie and low-calorie foods in patients with AN using eye-tracking. Fifty-two patients with restrictive AN and 54 healthy controls (HC) performed a dot-probe task while their gaze was recorded with an eye-tracking system. The direction bias (percentage of trials in which the gaze was directed towards the food at first fixation, 500, and 1500ms), and the duration bias (percentage of time spent looking at the food) were extracted. Regarding the direction bias, a group by time interaction emerged (F=3.29, p=0.038): while in the control group the bias continued to increase over the course of the trial, patients with AN showed a reduction of the bias between the 500 and 1500ms. No group differences were observed on the duration bias. In advanced stages of attentional deployment patients with AN start to differ from HC by diverting their attention away from food stimuli, a strategic process that may contribute to food avoidance and calorie restriction.

Food induced distractibility in restrictive anorexia nervosa: Different motor patterns for different foods as revealed by a mouse tracker evaluation.

An altered automatic processing of food stimuli may contribute to the maintenance of calorie restriction in patients with restrictive Anorexia Nervosa (AN-R). The present study aimed to assess whether task-irrelevant food distractors elicited a different interference effect in the motor actions of patients with AN-R compared to healthy controls (HC). 40 patients with acute AN-R and 40 HC performed an irrelevant distractor task in which they were required to perform a reaching movement from a starting point to a green dot, while an irrelevant distractor (a high-calorie food, low-calorie food, or neutral object) was presented in the middle of the screen. Mouse trajectories and response times (RT) were recorded. The analyses conducted on the kinematic variables revealed that while the trajectories of HC veered similarly toward the three categories of stimuli, AN-R patients showed an increased deviation toward low-calorie foods and a reduced deviation toward high-calorie foods compared to neutral objects. No significant results emerged as regards RT. The pattern of responses observed in patients with AN-R (deviation increased toward low-calorie and reduced toward high-calorie) is consistent with their eating habits and may thus represent an implicit mechanism sustaining calorie restriction in patients with AN-R.

Grip strength data for individuals with severe anorexia nervosa

Objective: This retrospective study compiled grip strength data of patients with severe anorexia nervosa to assess associations among grip strength, anorexia nervosa severity, depression, and physiological comorbidities. Design: 475 patients with severe anorexia nervosa admitted to an inpatient hospital and completed a grip strength assessment at admission and discharge. Depression was diagnosed via clinical interview. Independent sample t-tests and Mann-Whitney U tests compared difference in grip strength and anthropometric measures between anorexia nervosa subtypes. Linear and logistic regressions assessed associations among grip strength, depression, and physiological measures. Results: The cohort was 91.8% female (M age: 31.8 ± 11.7 years). At admission, patients had an average body mass index of 13.8 ± 2.4 kg/m2 with 97.7% exhibiting impaired right-hand grip strength for their sex and age. Weaker right grip strength was associated with admission lower body mass index, worsening bone mineral density z-scores, and lower serum prealbumin (all p’s<.05) for both sexes. Patients with binge-purge anorexia nervosa had significantly stronger right grip strength (M:19.0 ± 7.8 kg) compared to patients with restricting anorexia nervosa (M:16.9 ± 7.9 kg), p=0.003. Conclusion: Severe malnutrition from anorexia nervosa was associated with profound deficits in grip strength, medical comorbidities and disease severity, but was not associated with depression.

Altered processing of conflicting body representations in women with restrictive anorexia nervosa.

Cognitive and affective impairments in processing body image have been observed in patients with Anorexia Nervosa (AN) and may induce the hypercontrolled and regulative behaviors observed in this disorder. Here, we aimed to probe the link between activation of body representations and cognitive control by investigating the ability to resolve body-related representational conflicts in women with restrictive AN and matched healthy controls (HC). Participants performed a modified version of the Flanker task in which underweight and overweight body images were presented as targets and distractors; a classic version of the task, with letters, was also administered as a control. The findings indicated that performance was better among the HC group in the task with bodies compared to the task with letters; however, no such facilitation was observed in AN patients, whose overall performance was poorer than that of the HC group in both tasks. In the task with body stimuli, performance among patients with AN was the worst on trials presenting underweight targets with overweight bodies as flankers. These results may reflect a dysfunctional association between the processing of body-related representations and cognitive control mechanisms that may aid clinicians in the development of optimal individualized treatments.

Executive dysfunction in eating disorders: Relationship with clinical features

Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed. Method75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests. ResultsPatients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype. ConclusionsExecutive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED.

Emotional dysregulation and linguistic patterns as a defining feature of patients in the acute phase of anorexia nervosa

PurposeThis research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind–body integration. The purposes of this study are to investigate whether participants of the AN group will show greater alexithymia and emotional dysregulation than the non-clinical group; and whether the specific linguistic and symbolic features, such as somato-sensory words, affect words, and difficulty in the symbolizing process will predict the AN group.MethodsTwenty-nine female participants hospitalized with AN during an acute phase (mean age 19.8 ± 4.1) and 36 non-clinical female participants (mean age 21 ± 2.4) were selected through snow-ball sampling. The participants completed the Toronto Alexithymia Scale (TAS-20), the Profile of Mood of State (POMS), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interview was audio-recorded and transcribed to apply the Referential Process (RP) Linguistic Measures. A T test for paired samples and a logistic binary regression was performed.ResultsAN presented a significantly higher emotional dysregulation through the ERQ, TAS20 and POMS measures. Specifically, AN showed higher ER expression/suppression strategies, fewer functional cognitive strategies, higher alexithymia, and higher mood dysregulation. Specific linguistic features such as sensory-somatic, word affect, and difficulty in RP symbolizing predict the AN group (R2 = 0.349; χ2 = 27,929; df = 3; p = .001).ConclusionsEmotional dysregulation is connected to AN symptoms and autobiographical narratives. The results can help a clinical assessment phase showing specific linguistic features in AN patients.Level of evidenceLevel II, controlled trial without randomization.

Anorexia Nervosa and Gender Dysphoria: A Clinical Case

IntroductionEating disorders (ED) and gender dysphoria (GD) are associated with a change in body perception. Therefore, body dissatisfaction plays a common and central role in these disorders. In GD, body image concerns are related to the features of the biological sex. In ED, body dissatisfaction comes from a distorted perception of weight and body shape and plays an important role in the development and maintenance of the psychopathology.ObjectivesTo present and discuss the clinical case of a patient with a previous diagnosis of GD who presented with a clinical condition suggesting a restrictive anorexia nervosa (AN).MethodsPatient´s clinical files consultation and literature review using Pubmed and the keywords: eating disorders and gender dysphoria.ResultsWe present the case of a 25-year-old patient who was living in a shelter for victims of domestic violence and was admitted for severe restrictive AN. The patient was discharged after 40 days and medicated with sertraline, diazepam and olanzapine, as well as her previous medication (hormonal therapy): cyproterone, finasteride, estradiol, oxybutynin.ConclusionsAlthough studies on this subject are still scarce, there has been some progress and the literature recognizes the coexistence of these conditions. However ED symptoms in patients with GD could have a different meaning: they may represent a dysfunctional coping strategy adopted to block features of the biological sex. Therefore health professionals may take a more holistic approach to body image. Additional studies will be necessary, allowing the establishment of cause-consequence interactions between weight loss and psychopathology related to GD.DisclosureNo significant relationships.

Augmentation strategy fluoxetine and lurasidone in the treatment of OCD with comorbid Restrictive Anorexia: a case report

IntroductionObsessive-Compulsive Disorder (OCD) is characterized by the presence of intrusive thought (obsessions) and ritualistic behaviour (compulsions). First-choice psychopharmacological treatment is based on serotonin reuptake inhibitors (SRIs). However, about half of OCD do not or partially respond to SRIs (TR-OCD) and need an augmentation strategy with second-generation antipsychotics (SGAs).ObjectivesWe report a case of severe OCD with comorbid anorexia nervosa, restrictive type (AN-r) treated with fluoxetine (up to 40 mg daily) and lurasidone (37 mg daily bedtime) augmentation.Methods At baseline and monthly 4-months-follow-up were administered Y-BOCS-II (Yale-Brown Obsessive Compulsive Scale), CGI-S (Clinical Global Impression-Severity), SCL-90 (Symptom Checklist-90 items) and EDI-3 (Eating Disorder Inventory-3).ResultsCompared to the baseline, a clinically significant clinical response was observed on OC at Y-BOCS-II (≥35% Y-BOCS reduction) and eating symptomatology at EDI-3 after 1 month of augmentation treatment, while a full remission after 3 months (Y-BOCS scoring ≤ 14)(p&lt;0.01). We also noticed, throughout clinical follow up interviews, improvement in patient’s social skills and life satisfaction.ConclusionsFurther longitudinal and real-world effectiveness studies are needed to confirm these preliminary findings and investigate the potential of lurasidone augmentation strategy in attenuating OC symptomatology in TR-OCD and whereas a comorbid AN-r is present.DisclosureNo significant relationships.

My stomach is full

IntroductionAnorexia nervosa is an eating behavior disorder that is often related to various personality factors. The relationship between obsessive compulsive disorder and eating Disorders has been highlighted.Objectives To present a clinical case of a patient with eating disorder and gastric bezoar, secondary to compulsive hair ingestion.MethodsBibliographic review of articles published in relation to the comorbidity of these disorders, based on articles published in the last 5 years in Pubmed.Results 26-year-old female. Diagnosis of restrictive anorexia nervosa. She was admitted to the hospital on two occasions for nutritional disorders. In the last admission, she reported greater anxiety and significant weight loss. She reports that she has limited her food intake, but she does feel thin and is unable to eat for fear of gaining weight. Ruminative thoughts about her body image. During admission, the patient expressed a sensation of fullness, nausea and vomiting, later observing in abdominal X-ray and gastroscopy, the presence of a gastric trichobezoar, which was finally resolved conservatively.ConclusionsTrichotillomania is observerd in 1 in 2000 people, trichophagia is even less frequent. According to DSM- V, these disorders are grouped within obsessive-compulsive spectrum disorders. A Trichobezoar is a conglomerate that can be found in the stomach or intestine, composed mainly of hair, previously ingested. Trichotillomania can be associated with anorexia nervosa, especially in patients with obsessive personality traits, which occurs frequently. The gastric slowing that patients with anorexia often present is a factor that favors the formation of the bezoarDisclosureNo significant relationships.