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Clinical
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Atlanta Medical
Psychology
The clinical
practice of Dr. David B. Adams is located in The Medical Quarters in
the northside of Atlanta at the junction of Scottish Rite, Northside
and Saint Joseph's Hospitals. Dr. Adams consults to occupational
medicine, surgeons, nurse case managers, insurers and employers
regarding the psychological impact of work-related injury and the
role of psychological factors in short- and long-term
disability. |

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Anorexia
Nervosa
Bulimia
Nervosa
Eating Disorder Not Otherwise Specified
Anorexia Nervosa - can be separated into two types:
the restricting type in which the individual dangerously limits food intake but
does not binge eat or purge (self-induced vomiting or use of laxatives, diuretics, enemas,
etc), and the binge-eating/purging type. In both cases there is a refusal to
maintain a minimally normal body weight, and the individual weighs less than 85% of ideal
body weight. The individual has an intense fear of weight gain or obesity even though they
present to others as markedly underweight. Such individuals deny the severity of their
condition, and they have a disturbance in perception as to the appearance of their body.
In females this is often accompanied by the absence of menstrual cycle. The dangers are
apparent since the body is deprived of needed nutrients and the use of purging procedures
can increase the health hazards.
Bulimia Nervosa - involves recurrent episodes of
binge eating in which the quantity of food consumed is definitely larger than most would
eat during a similar period and under similar circumstances and there is an apparent lack
of control over the eating (the person cannot stop). To prevent weight gain, the person
will engage in self-induced vomiting, use of laxatives and/or diuretics, enemas, fasting,
excessive exercise, etc. Bulimia is characterized not by a distortion in body image as
much as this binge eating and compensatory attempts to avoid weight gain from the binging.
For the formal diagnosis, this must occur twice a week for three months, and the
individual's assessment of their body shape and weight influences the cycle of eating and
then compensating. The are the purging type bulimic individuals in which the person uses
the laxatives, diuretics, etc. and the nonpurging type in which the individual fasts or
excessively exercises to compensate.
Eating Disorder Not Otherwise Specified
is reference to a combination of unhealthy behaviors which in
combination do not fit specific criteria for a disorder but which
obviously limit the social and/or occupational functioning of the
individual. For example, in the case of eating disorders, there are
individuals who meet the criteria for Anorexia Nervosa but have
regular menses, who have lost appreciable weight but are still within
average weight limits for their height, who engage in purging
activities but do so with less frequency than necessary to meet
diagnostic criteria, who engage in purging activities after small
amounts of food and/or who chew and spit out small amounts of food.
Human behavior and psychological problems are a continuum and even
when all criteria are not met, the behaviors can still be maladaptive.
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