[Nutrition and behavioral eating disorders: anorexia and bulimia nervosa].

Behavioral eating disorders (BED's) have shown an intense growth in the last years. They are considered to be caused by multiple factors, showing a bio-psycho-socio-cultural etiology. Although there are clinical signs that could alert the physician and allow an early diagnosis, their final diagnosis must meet certain criteria set in the DSM-IV (1994). Despite the fact that anorexia nervosa and bulimia nervosa in their typical forms, are the most known, there are atypical or incomplete forms of both that should be kept in mind when making the diagnosis. Anorexia nervosa is accompanied by somatic-nutritional problems that may condition the patient's life, requiring specific nutritional care. Bulimia nervosa is often accompanied by medical complications that require an exhaustive assessment. As for the nutritional support in anorexia nervosa, this must be proportional to the nutritional status of the patient and there should be no hesitation to resort to artificial nutrition using enteral nutrition through a tube in the case of severe malnutrition. In these cases there must be careful monitoring for the appearance of the re-nutrition syndrome, and this can be avoided by the slow and progressive administration of energetic nutrients, with special precautions in the supply of carbohydrates, and administering an adequate supplement of vitamins and electrolytes. Patients with a BED require a multi-disciplinary care with the simultaneous and coordinated action of a team of professionals. This type of care coupled with the experience of the team with regard to BED's and their treatment, and together with other actions and situations, may favor the final prognosis of a patient with a BED.