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Rimonabant hcl is fda approved. Not on the doctors lists so theres no kick backs for him to push but if you ask for it it is available. My wife quit smoking in a week because it made her. Heres the true background information: Rimonabant also known as SR141716, is an anorectic drug primarily used for comprehensive anti-obesity treatment. It is an inverse agonist for the CB1 cannabinoid receptor.[1] The primary method of action is through reduced caloric intake, due to the anti-hunger effects of rimonabant. An inverse agonist refers to a chemical that binds to a receptor and, when compared to a known agonist for that receptor, shows approximately the same affinity and exhibits roughly inverse effects of one or more primary effects of the agonist.[2] One of the primary effects of cannabinoid receptor agonists is an increase in appetite; rimonabant reduces appetite, demonstrating an inverse effect. Some effects of rimonabant are admittedly under-studied or not well known or explorer; for example, rimonabant-dosed mice reduced voluntary wheel-running behavior when compared to a control group.[4] Rimonabant does have other uses besides weight loss; though the mechanism is not well understood it has been demonstrated to increase probability of quitting smokers by 50%: From the preliminary trial reports available, rimonabant 20 mg may increase the odds of quitting approximately 1(1/2)-fold. Adverse events include nausea and upper respiratory tract infections; the risk of serious adverse events is reported to be low. However, there is current concern (August 2007) over rates of depression and suicidal thoughts in people taking rimonabant for weight control. The evidence for rimonabant in maintaining abstinence is inconclusive. Rimonabant 20 mg may moderate weight gain in the long term.[5] Researchers hypothesized, in keeping with the inverse-agonist nature of rimonabant, that (because cannabinoids nearly univerally impair memory), rimonabant may improve memory; this is borne out thus far in rat studies: The positive influence of rimonabant on performance indicated that the action of endocannabinoids was to reduce SmR code strength, resulting in trials that were at risk for errors if the delay exceeded 10 s. Thus endocannabinoids, like exogenously administered cannabinoids, reduced hippocampal encoding necessary to perform long-delay trials. The findings therefore indicate a direct relationship between the actions of endocannabinoids on hippocampal processes and the ability to encode information into short-term memory.[6] Researchers speculate that due to the pervasive role of the endocannabinoid system in the reward (and therefore addiction-perpetuating) system, rimonabant might be successfully used to treat other addictions besides nicotine.[7] Rimonabant has been demonstrated to successfully block the psychological effects of cannabis use without interfering with the physiological effects.[8] Respective excerpts follow: Recent studies have shown that the endocannabinoid system is involved in the common neurobiological mechanism underlying drug addiction. This system participates in the primary rewarding effects of cannabinoids, nicotine, alcohol and opioids, through the release of endocannabinoids in the ventral tegmental area. Endocannabinoids are also involved in the motivation to seek drugs by a dopamine-independent mechanism, demonstrated for psychostimulants and opioids. The endocannabinoid system also participates in the common mechanisms underlying relapse to drug-seeking behaviour by mediating the motivational effects of drug-related environmental stimuli and drug re-exposure. In agreement, clinical trials have suggested that the CB(1) cannabinoid antagonist rimonabant can cause smoking cessation. Thus, CB(1) cannabinoid antagonists could represent a new generation of compounds to treat drug addiction.[7] Single oral doses of SR141716 produced a significant dose-dependent blockade of marijuana-induced subjective intoxication and tachycardia. The 90-mg dose produced 38% to 43% reductions in visual analog scale ratings of "How high do you feel now?" "How stoned on marijuana are you now?" and "How strong is the drug effect you feel now?" and produced a 59% reduction in heart rate. SR141716 alone produced no significant physiological or psychological effects and did not affect peak THC plasma concentration or the area under the time x concentration curve. SR141716 was well tolerated by all subjects. CONCLUSIONS: SR141716 blocked acute psychological and physiological effects of smoked marijuana without altering THC pharmacokinetics. These findings confirm, for the first time in humans, the central role of CB1 receptors in mediating the effects of marijuana.[8] Citations: [1]Fong TM, Heymsfield SB (September 2009).Cannabinoid-1 receptor inverse agonists: current understanding of mechanism of action and unanswered questions. Int J Obes (Lond) 33 (9): 947–55. [2]Kenakin T (2004). Principles: receptor theory in pharmacology. Trends Pharmacol. Sci. 25 (4): 186–92. [3]Suicide risk fears over diet pill. BBC News. 15 June 2007. (URL: http://news.bbc.co.uk/2/hi/health/6755665.stm). [4] Keeney BK, Raichlen DA, Meek TH, Wijeratne RS, Middleton KM, Gerdeman GL, Garland T, Jr. Differential response to a selective cannabinoid receptor antagonist (SR141716: rimonabant) in female mice from lines selectively bred for high voluntary wheel-running behavior. Behavioural Pharmacology 19: 812–820. 2008. [5] Cahill K, Ussher M. Cannabinoid type 1 receptor antagonists (rimonabant) for smoking cessation. Cochrane database of systematic reviews (On[line) (4): CD005353. 2007. [6]Deadwyler SA, Goonawardena AV, Hampson RE. Short-term memory is modulated by the spontaneous release of endocannabinoids: evidence from hippocampal population codes. Behavioural pharmacology 18 (5-6): 571–80. 2007. [7]Maldonado R, Valverde O, Berrendero F. Involvement of the endocannabinoid system in drug addiction. Trends Neurosci. 29 (4): 225–32. 2006. [8]Huestis MA, Gorelick DA, Heishman SJ, et al. Blockade of effects of smoked marijuana by the CB1-selective cannabinoid receptor antagonist SR141716. Arch. Gen. Psychiatry 58 (4): 322–8. 2001.

Id wait and do both at once. Cosmetic surgery is a big upheval with a band and brings quite a risk of weight gain. I didnt unfill for my TT nine weeks ago but have suffered suchdiscomfort since that i advise doing so. Ive unfilled my band once for a major surgery and it has never been the same, i definitely would not choose to unfill it twice. Its taken me a loooooong time to be running and spinning and bodypumping again at anything like my previous schedule. Avoiding weight gain has been HARD. Alo, its common to get a little depressed after. Your new body is still not perfect, and changes take a long time to see. Nothing else in your life changes eithet, you kind of have a post surgery letdown. I also ouldnt want that twice. Then theres the money. Cheaper to have one anaesthtic.

Well, don't laugh... Pre-weight gain, I was a 32A, I am now a 36 D to DD. I am also very cheap since I have gained all of this weight (it's going on 14 years). I have tried them all, I love enell, but I found that wearing 2 hanes walmart sports bras works great for me when I need a little extra support. Gotta keep the girls close!

It's all about the FOOD! If u ask me ne ways. When I'm @ restriction I don't count calories. Also u will plateau. Everyone does. I personally loose for 2 wks then hold steady for 2 wks. I'm down 120 lbs in 13 months. I've had a lil set back due to be unfilled & unable to exercise bc of plastic surgery. So currently I am counting cals to help get the last 13 lbs of my 30 lb weight gain off! Surgery was 3 wks ago... I had a ton of swelling. But right b4 surgery I hit 120 lbs lost & was 14 lbs from my 150 lb goal weight

I was told 85% also. If they do not take enough of the stomach, then the stretchy part of the stomach will remain and can stretch back out again causing weight gain. They have to take out enough to get down to the non-stretchy part to keep good restriction. (I'm not very eloquent tonight, cheeeez!)

K33, it has been my experience that antidepressants do cause some weight gain but not all of them. Depression can also be a chemical imbalance such as bipolar. Antidepressants help the chemical imbalance in the brain. I can tell you from experience that depression can be present when you are skinny or fat. I suffered for year with untreated depression when I was skinny and finally was diagnosed and put on medication that really helped me. Not sure of any research but I plan on staying on meds with probably the same dose after my VSG. To me it is much better than being depressed. I know this probably didn't answer your question but I feel for you.

Hello everyone! It's been quite some time. This thread is pretty much dead. But if any of you are still around, I thought I'd share... My second LapBand placed in Feb 2009 became disconnected!! I mean really?? How many LapBands should one girl have to mess with? LOL....so, I started gaining weight pretty fast and had to bicker quite a bit with the insurance company. But ultimately I was approved to have the Band removed and get the Vertical Sleeve. I had surgery almost 2 weeks ago and so glad it's over. I am so frustrated with the weight gain, but so glad that there won't be any more fills/unfills or getting stuck!! I'm on the mend and tired of mushies....for the third time! hahaha I hope all is going well for the rest of you!!! Best to all, Carol

If you were taking anti depressants pre-op, have you found less need for the medicines post op? This does not include changes from XR to Regular absorption meds, or a change in your medicine schedule. But, have you felt less depressed after surgery? I know it's possible PO to feel a let down 6-12 months out, and am not really talking about that either. . I gained 50# in the throws of my depression, probably from carb craving that comes when I am depressed. Yet I was taking medication, too. Hard to get a straight answer from the medical field about to what extent anti depressants provoke weight gain, so I am turning for answers to my VSG buddies. Naturally you may have guessed I take antidepressant medication pre-op. Not counting the mood lift and feeling the thrill of being thin (which could wear off once the reality day to day of living sets in 2-3 years out), I am hoping to take less anti depressants when I am years out as well. What is your experience? Does anyone have research sources about this topic?

I never thought to ask those questions either! Once you are at proper restriction you need fewer and fewer fills. You may have been gaining for a couple of reasons. You started eating higher caloric foods or larger amounts of foods. The reason for larger amounts of foods with the same fill can be that as you lose weight, you lose it everywhere, including the fat around your stomach beneath your band. When that happens, your band feels looser. Like what happens to a belt as you lose weight. When your band feels looser you get hungrier. For me hungrier means I eat more, eating more means weight gain. I seem to just get a teensie tune up fill yearly. About 0.25cc. It's good though, because I see my surgeon this way, and he checks everything out. He does an upper GI each time to check placement is still good. I had my last top-off in September. According to my surgeon the older bands seemed to have a bit of Fluid that seeps through the bladder of the bands over time. Not so much in the newer bands. He said my AP Standard 10cc band is one of the newer ones. For me, I've reached a fill level where what I eat is appropriate to maintain my weight. At this point, I could not take any more fill in my band. I am far from the capacity of it. I have a 10cc band, I have less than 7cc in it, not sure of the total. My surgeon has the total in his notes, it doesn't really matter to me, what matters to me is that I can eat and maintain my weight.

I was unfilled for nine months while I had chemo. It was hard work but I didnt gain. I ran and went to the gym (rpm and bodypump) like normal during treatment, yeah I was pretty run down but I had to do it! I couldnt let myself gain! If I can do that through two surgeries, radiation and chemo and keep the weight gain away for nine months you CAN do this!

When I'm at good restriction I don't count cals. I eat prob an ave of 600/day. I recently had an unfil for plastic surgery & with that came weight gain, plus I couldn't exercise, so I'm currently counting cal & trying to stay @ 1200. As long as ut loosing weight wouldn't stress to much about it. For a while I became so obsessed with cals in cals out. I had a body bugg & tracked everything religiously. One day I just decided I had wls so I wouldn't habe to do all this crap... & stopped. My weight loss actually picked up once I put all of that energy into exercise & making healthy choices But I do believe when u find urself slipping sometimes u need to get back on track with cal counting

Allison0927 the weight gain was caused by a combination of unfil and being unable to exercise. The biggest factor probably was the unfil though. But protein intake for proper healing is more important than worrying about weight gain... Hard to do though! Bayougirlmrsc it's good to hear you got all healed up! I had a massage with rheke (?sp) and I feel like that has really helped speed up the healing process, along with a lot of Vit C

I really believe it is a multi-layered issue - I know that I am much better to able to control my own, as well as my family's weight gain and moods by eliminating processed carbs and sugar from the house. I read a great book last year about these issues called The End of Overeating: Taking Control of the Insatiable American Appetite - by David Kessler, former head of the FDA. http://www.amazon.com/The-End-Overeating-Insatiable-American/dp/1605297852 He himself wanted to lose a few lbs and found it quite challenging, as a scientist he started to do research as to why humans have been roughly the same body composition since the beginning of time (with considerations for improved hygiene, advances in medicine etc.) and why in the 1980's obesity numbers began to skyrocket. He talks about how the combination of sugar and fat is one that does not exist in nature - two substances that we are genetically hardwired to want to consume in quantity when available - our biology has not had time to catch up with our industry in nutshell. Lab rats consume 'rat chow' as their main form of nutrition, when scientists started to feed them layered combinations of fat, sugar, salt (as restaurants such as Cheesecake Factory, Red Robin, and the like do.) these rats no longer would eat their nutritious yet bland rat chow - their dopamine centers lit up like a Christmas tree, setting up a cycle of addiction - so much so that these rats would cross electrified floors that would almost kill them to get to the bad stuff. These substances do the same things to us. It is a good read. One thing that the nutritionist at my surgeon's office said is that there are no essential carbohydrates - our bodies will make what we need from Protein and fats. I have noticed that when I drop the carbs down to 20g or less a day - which is akin to Atkin's induction levels and my pre-surgical recommendation - I am always satisfied with very little and do not have hunger cravings like I do when I consumed carbs, sugar, caffeine, and diet soda.

It has been almost 3 yrs since I had been banded and I have started gaining weight!! I have have no major issues with the band, NO pain, NO anything out of the normal except major STRESS for the past year sitting all day working at a job I absolutely hate. I moved, working hard at getting my life in order. NONE the less there is a problem here I am so not sure what is going on. I do not seem to be eating anything out of the norm of what I had been but maybe what I had been has been wrong from the get go. I moved to NJ a little over a year ago and although my doctor is one of the best in the state I really feel as if he is not the best for me. I had a couple very small fills and it has been almost 8 or 9 months since he filled my band the last time. Now with the weight gain he seems to think that the band has reached its point of no use. It has NOT even been 3 yrs! He now wants to remove it and put in a sleeve..WHAT another surgery I DON'T THINK SO>> Now keep in mind that since I have found him when I moved here, He has not one time done an ultra sound to make sure all was ok with the band, not one time did he even do any kind of xray! Really how would he know anything was up or not.. So bottom line here is this, I have gained weight and I mean like 10 lbs of weight and I am angry with me and at him because his quick fix is to take out the band and do another surgery without every getting to the root of the problem. I am going to a new surgeon here closer to my home who once again has come to me highly recommend from many different directions and hopefully we can figure out what is going on. Maybe I just need a fill! Maybe there is a leak in the band, maybe something horrible is going on and I just don't know. Although if something very bad was going on I think I might know, don't you? I have been getting a bit of heartburn as of late so I am really a bit nervous about it... Please help..any thoughts or personal insight would be helpful. My appointment is at 2pm Est today Michele

Thats good news! Did the weight gain,occur because of an unfill for surgery? I want the same surgery just curious thaanks!

So two weeks ago I had brachioplasty, I had a substantial unfil per my lb doctors suggestion to decrease risk for aspiration. Prior to this I was super tight & hit 120 weight loss bringing me 14 lbs from my goal weight. Immediatly after surgery I weighed myself & had a 13 lb weight gain. I know it was all fluid. So I decided to have my husband hide my scale & just let myself focus on healing noy my weight. So 2 weeks later & I'm up 23 lbs!!!!! Ahhhh!!!! I realize my eating has not been the greatest. I have indulged a bit to much. Pizza, steak, bread... things I haven't ate in about 10 months. I'm disappointed in myself:( I feel like a failure & that I haven't overcome my battle with food in the slightest. A combination of being able to eat anything & not being able to exercise has taken a hefty toll & quick! So my plastic surgeon has cleared me for light exercise as long as I don't work up a heavy sweat, my incision in my armpit is gaping & needs resutured. Tonight I did go for a mile walk & tomorrow I'm checking my eating habits. Tracking my calories & staying away from fast food! So I asked my husband tonight to unhide my scale...t hey refused & told me he doesn't want me obsessing over it. I'm kinda pissed @ him & am half tempted to go buy a new one!

Surgery 03/27/12,and I must say that my post op course has been pretty uncomplicated. I've lost 30 lbs,with what appears to be a 3 lb weight gain over the past two weeks. I've been so hungry and it's taken all the self restraint I could muster to control myself. First fill yesterday morning bringing my total to 4.6ml......Very simple process,and totally painless. Liquids yesterday without any problems,and I just had a cup of crab chowder(pureed) and I feel completely full. Very optomistic!

I've always guessed that I have some food sensitivities - but, being the snack-fiend that I was, I largely ignored them and ate whatever the heck I wanted anyways. In the years before surgery, I struggled with frequent, painful edema in my hands and feet (sometimes to the point that I could barely open doorknobs, containers, etc), itchy skin after eating, weight gain, general fluid retention.... A couple of timeperiods, I became frustrated and cut out entire food groups in an attempt to find some relief: wheat, corn, dairy...these were popular. I had really hoped that post-op, I wouldn't have to deal with these issues. After all - I was going to be eating a fraction of the amount of food that I ate before, I would have no reactions to worry about! WRONG. I have already documented numerous places my new and total intolerance of anything vaguely dairy related. Even butter and hard cheese are consumed in small quantities at my own peril. But what is really starting to annoy me is the exacerbation of reactions to miniscule amounts of corn and wheat. The scale says I've now lost 43lbs since surgery, which is great! But there have been days where that painful, warm edema has returned to my hands and feet, making sleeping an uncomfortable and fruitless proposition. Finally realized I was drinking a ton of Crystal Light...which uses maltodextrin, which comes from....corn. Drat. Cut out the Crystal Light, switched to tea. Better. I'm finding that eating food out is a challenge. I had some mashed potatoes (and a smidge of gravy) from Boston Market, and puffed up like a Macy's parade balloon. Logged on to their website to peruse ingredients: Milk solids, wheat starch, corn starch.....wtf. Got desperate for variety at one point, and had a Morningstar Farms Chik'n Patty, which at various semi-vegetarian times in my life I loved. I was able to eat all but 2 bites of the patty and felt very satisfied! ....until about 30 minutes later, when my hands started to puff up and my skin began to itch. Ingredients? Wheat gluten is pretty high on the list. Dammit. I have no idea why my body has become MORE sensitive rather than less so since surgery. But all I can say is that I am annoyed and frustrated beyond comprehension. I feel like I'll have to become one of those neurotic people that read every package label and have no fun with life. Small favors, body....that's all I'm asking of you.

I am not at my personal goal yet, but am with my Surgeon's goal. I do admire how you have reached your goal and also am worried about myself being at goal and letting my guard down, and then the weight gain begins. So for me, I suspect I will always have to watch what I'm eating. I'm also going to weight myself 2 times a week at least. I am curious to know how others are with maintenance. Sleeve of Steel,you have done a great job and CONGRATS! You are very successful and will continue to be successful with maintenance.

I am new here. I have been approved for the sleeve surgery and will be having it done pretty quick. My original surgery date was July 3rd at the hospital. The called last Friday with a cancellation and the surgery date has been moved up to May 22nd !! I am both excited and scared at the same time! My employer is quite okay with the change and my coworkers are quite supportive. Here is brief history about me. I have only been heavy since I was 25/26. I have a history of brittle asthma. I was exposed to field burning smoke after harvest while at school. I was constantly on prednisone and gained a lot of weight. as a result. I came home from school and lost a little weight. However, I was living in an apartment while sustained a crack in the ceiling and subsequent Water leak (winter 2003). I started having increased asthma trouble shortly afterwards. I suspected trouble with the apartment and a pulse oximeter confirmed them. January 2003 - A lab tested and confirmed that I was being exposed to toxic mold (Stachybotris chartrum). The improperly repaired apartment after major water damage (which I found out after I moved out – March 2005). I have gained over 100 pounds with the prednisone weight gain. Has anyone else experienced this? Anyways, my efforts to lose weight have been futile. I would lose the weight just to gain it all back and more. I tried diets, mild exercise, portion control, diabetes diets, Byetta. None of them had any long lasting positive results. I decided I have had enough dealing with the weight and pursue weight loss surgery Dec 2011. I originally pursued getting the lapband. However after further consultations and research I decided to go with the sleeve. I am doing okay right now despite the pain and the asthma has stabilized. I still have to be on prednisone bursts sometimes but have been off of them for several months. I am looking forward to changing my life for the better. I deal with diabetes, high blood pressure, high cholesterol, sleep apnea, chronic back/neck/shoulder pain(car accidents), hip pain, foot pain, bad knee, and asthma. I have hope that this will improve the weight loss. I have lost a little weight already from the pre-op diet. 3 out of my 4 meals are Protein shakes and I have one sensible meal a day the dr was okay with this). I work different hours (3am-11am) hence I need the 4th meal. I am quite used to the shift. I work as a telecomm tech that has the responsibility fixing and maintaining 3 room-sized dial tone computers so I have to work these hours. They are quite demanding but I do love my job. Sorry about the long introduction. I just wanted you to know where I was coming from and tell you my unique story. I am looking forward to taking my life back from morbid obesity and the adverse effects. I hope that everyone is doing well. Have a nice day.

I've been big virtually all my life. I started gaining massive weight when I was 7 years old, even though I was active in my local Boys and Girls club playing soccer and basketball. I never dropped the weight. I was so big during elementary school, I couldn't fit into a size 52 pants, and my elementary school days (specifically grades 3-6) I had to wear sweat pants and sweat shirts, that how overweight I was. As I grew up, though, through middle school and high school, I was able to fit into pants and t-shirts, though I never wore smaller than a 42 waist. Post-high school, I managed to lose about 30 pounds during summer by walking 6 miles round trip to my local mall and play Dance Dance Revolution all day. After a while, I moved closer to the mall (litterally 2 blocks away), so I stopped walking, and then I got a car, and virtually stopped walking and playing Dance Dance Revolution altogether. I didn't watch what I ate, and that was a tri-fecta of weight gain. I went from 250 to 380 pounds in a little over a year. I was wholly disgusted with myself, but never did anything active about it, until I started the process for the Lapband procedure.

I am or I was between 2 programs. The nutritionist I was seeing, on my last visit, tried to convince me the band was now working despite being unfilled and why would I want a revision?? I was slightly ticked since I have had weight gain, SEVERE reflux, dilatation and a slipped band. I was dumbstruck! Why would I change my mind now that I can see the light at the end of the tunnel!!! If I have to go back to school myself, I will teach myself what I need to know nutritionally speaking.

I was thinking of when I weighed 169 pounds right before I had my daughter, although I was only 17 I remember being very firm and very athletic. I would deff describe my built as a large frame. I haven't been under 200 pounds in over 29 years so I have no clue what it even feels like. The closest I ever got down to was 259, I have to say I really felt good and comfortable even at that weight, even though it didn't last long before I would jump right back up to 300. This is my heaviest ever right now, i had gained 70 pounds in 9 months of 2011. I was soon diagnosed with having an underactive thyroid and I don't know if that amount of weight gain contributed to it. I think out of everything I learned with my ups and downs with the weight is how tiring it becomes, the feeling of being so uncomfortable has to be the worse. Moving, simple things like bending and just getting around is complicated at this weight.

It is not bulemia (which you know already is vomiting). It is closer to anorexia if anything (because you never actually ingest your food), but either way it is an unhealthy relationship with food. Taking this to an extreme is what makes it an eating disorder. If you want the flavor but are so adverse to the calories that you would rather spit out your food (hence your nutrients) it is bound to cause a problem eventually. Below I have listed the diagnostic criteria for an eating disorder from the DSM IV: Eating Disorder Diagnostic Criteria from DSM IV-TR 307.1 Anorexia Nervosa * Refusal to maintain body weight at or above a minimally normal weight for age and height, for example, weight loss leading to maintenance of body weight less than 85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected. * Intense fear of gaining weight or becoming fat, even though underweight. * Disturbance in the way one's body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight. * In postmenarcheal females, amenorrhea, i.e., the absence of at least 3 consecutive menstrual cycles. A woman having periods only while on hormone medication (e.g. estrogen) still qualifies as having amenorrhea. Type Restricting Type: During the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives, diuretics, or enemas). Binge Eating/Purging Type: During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior. 307.51 Bulimia Nervosa * Recurrent episodes of binge eating characterized by both 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. 2. A sense of lack of control over eating during the episode, (such as a feeling that one cannot stop eating or control what or how much one is eating). * Recurrent inappropriate compensatory behavior to prevent weight gain, such as selfinduced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise. * The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months. * Self evaluation is unduly influenced by body shape and weight. * The disturbance does not occur exclusively during episodes of Anorexia Nervosa. Type Purging Type: During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. Nonpurging Type: During the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behavior but has not regularly engaged in selfinduced vomiting or misused laxatives, diuretics, or enemas. 307.50 Eating Disorder Not Otherwise Specified This diagnosis includes disorders of eating that do not meet the criteria for the above two eating disorder diagnoses. Examples include 1. For female patients, all of the criteria for Anorexia Nervosa are met except that the patient has regular menses. 2. All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the patient's current weight is in the normal range. 3. All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months. 4. The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies). 5. The patient engages in repeatedly chewing and spitting out, but not swallowing, large amounts of food. 6. Binge-eating disorder: recurrent episodes of binge eating in the absence if regular inappropriate compensatory behavior characteristic of Bulimia Nervosa. So this would classify as something known as EDNOS (eating disorder not otherwise specified). I don't believe chewing gum and this have anything to do with one another from what I read above. The DSM IV references psychological requirements for EDNOS (which is where this disorder is placed) but both psychological and physical requirements for Anorexia and Bulemia.