1. Eating Disorders Flashcards
What percentage of women + men compare their bodies to images they see on social media?
87% of women and 65% of men
What percentage of the population have Bulimia Nervosa?
How many are female?
- About 1-1.5% population overall
- 90-95% are female
What percentage of college women is affected by Bulimia Nervosa?
25% of all college women
What ethnicity is BN most prominent in?
White; Middle-to-Upper Middle Class
Where does BN peak? What weight is often observed?
- Peaks in adolescence/ young adulthood
- Often w/in normal weight range
What often precedes BN? What happens if it’s left untreated?
- Preceded by dieting/ efforts to lose weight
- Chronic if left untreated
Over time, what percentage of people fully recover from Bulimia Nervosa?
How many people improve or settle into chronic behavior?
- About 50% fully recover
- Another 25% improve
- The rest (25%) settle into lifetime of chronic behavior
According to the DSM-5, what are the basic features of Bulimia Nervosa?
Binging + compensatory behaviors
How long must basic features be present to suspect for BN?
Weekly for 3+ months
What are methods of binging?
- Eating large amts of food
- Eating is out of control
What are some compensatory behaviors?
- Purging via self-induced vomiting
- Use of diuretics, laxatives, exercise
- Fasting, food restriction
How many calories might an avg bulimic binge consist of?
Avg bulimic binge may consist of 1,500-3,000 calories
(Some individuals have reported eating up to 60,000 or more during one binge)
The majority of bulimics purge by what means?
70-80% of bulimics purge by self-induced vomiting
30% use laxatives
What qualifies as a Binge?
- Often eat “forbidden” or “avoided” foods
- Often in secret - linked w/ shame + guilt
- Binge < 2 hrs, but can be extended over time
- Must include lack of control - includes giving up
What comes before the Binge?
- Negative feelings related to body weight, shape, food
- Interpersonal stressors
- Dietary restraint - many restrict/fast b/w binges
What does the cycle of Bulimia Nervosa look like?
Anxiety → binging → fear of weight gain → purging → loss of fear of fat gain → guilt
(cycle repeats)
How can you help those struggling w/ the BN cycle?
- Help people regulate their emotions better
- Being more mindful of eating
- Making good choices
- Healthier relationship w/ body
What are some medical consequences of BN?
- Swollen salivary glands
- Severe tooth decay
- Electrolyte imbalances + dehydration
- Intestinal problems - IBS, peptic ulcers
- Calluses on fingers + hands
- Binging damages cells in stomach
What is the more severe form of BN?
Purging Type
Why does purging NOT work to lose weight?
- As soon as we chew food, our body is absorbing 50% of the calories already digested
- The more you restrict/fast, the more the body will hold onto anything it can (absorbing as much of the calories as it can)
What disorder is closely related to BN?
Binge-Eating Disorder
What’s the difference b/w those with BN vs. those who have a Binge Eating Disorder?
Those with BED feel out of control, but they DON’T engage in compensatory behaviors (eg. purging), so they tend to gain significant weight over time
What % of females have a 12-month prevalence of Anorexia Nervosa?
1.4% in females
What strong association is present w/ those who have AN?
Strong association w/ cultures that value thinness
How is the onset of AN different from Bulimia?
Onset of AN similar to Bulimia, but linked w/ stressful life event!
What do nutritional compromises affect in those with AN?
Every major organ system!
* AN is the only disorder linked w/ life-threatening consequences
What are some common symptoms of Anorexia Nervosa?
- Amenorrhea & vital sign abnormalities
- Depressogenic symptoms due to starvation
- Obsessive-compulsory behaviors linked w/ food
*What are the 3 key features of Anorexia Nervosa?
- Phobic fear of gaining weight/ becoming “fat”
- Food restriction; restricting caloric intake
- Distorted body image
How does distorted body image differ for those with BN vs AN?
For bulimics, distortion can happen only after eating food, but for those w/ AN, they see themselves as someone who is heavy/ still fat
According to the DSM-5, what criteria must be met to be diagnosed with AN?
- Deliberate food restriction/ starvation (weight loss < 85% of normal)
- Morbid fear (gaining weight, losing control over eating)
- Distorted body image
What are the 2 subtypes of AN?
What does each one include?
- Restricting Type
- excessive dieting - Binge-Eating-Purging Type
- rely on purging
- 50% of all cases
- show more impulsive behaviors
What is the duration for both subtypes of AN?
3 months or more
What are the medical consequences of Anorexia Nervosa?
- Amenorrhea
- Dry skin (brittle hair or nails)
- Sensitivity to cold
- Lanugo (growing hair on body)
- Heart problems
- Electrolyte imbalance
- DEATH
When does AN begin?
Begins early in adolescence
What are characteristics of those w/ AN?
- Perfectionist high-achievers
- All-or-none thinking
- Obsessive and orderly
- Comorbid DSM disorders (eg. OCD, substance abuse)
What are the social + cultural factors of AN?
- Thinness equals success
How has media influenced the development of AN?
Sets unrealistic idealized standards
What are family influences of AN?
- Successful + driven
- Concerned about appearances
- Eager to maintain harmony
- Deny/ignore conflicts
- Lack of open communication
What biological influences may cause AN?
- Runs in families
- Unclear what’s inherited
What psychological influences may cause AN?
- Diminished sense of control
- Low self-esteem
- Perfectionism
- Psychological inflexibility
What interpersonal problems may cause AN?
- Lower social competence, linked w/ social anxiety
- Ineffective interpersonal problem-solving skills
- Fear of negative evaluation/ hiding emotions (especially for AN)
- Insecure attachment style (linked w/ intimacy)
- Negative social comparison
Prior to the DSM-5, how would you get diagnosed with ED NOS?
You were diagnosed with ED NOS if you did not meet the criteria for BN or AN
What is an Unspecified Eating Disorder?
Symptoms of an eating disorder which cause clinically significant distress/impairment in functioning
(but you don’t meet criteria for other feeding/eating disorders)
What are examples of Specified Eating Disorders?
- Atypical anorexia nervosa
- Bulimia nervosa of low frequency and/or limited duration
What criteria must be met to be diagnosed w/ Atypical anorexia nervosa?
All criteria for AN are met except that despite significant weight loss, the person’s weight is within/> the normal range
What criteria must be met to be diagnosed w/ Bulimia nervosa for low frequency/ limited duration?
All criteria for BN are met, except that binge eating + compensatory behaviors occur, on avg, < 1 wk &/or for < 3 months
What treatments are available for BN? Does it work?
- Education about eating behavior
- Scheduled eating
- Change thinking (shape, eating, and weight)
- Teach adaptive emotion regulation skills
Treatment works!
How do you treat AN? Does it work?
- Must restore normal weight!
- Most will gain weight (easy)
- Keeping the weight on (hard)
(similar treatment to bulimia) Treatment can work!
What is the recommended intake of sugar by the AHA?
- 6 tsp for women (100 cal)
- 9 tsp for men (150 cal)
What is the perpetual cycle of sugar addiction? (4 steps)
- You eat sugar (you like it, you crave it; has addictive properties)
- Blood sugar lvls spike (dopamine released in brain = addiction; mass insulin secreted to drop blood sugar lvls)
- Blood sugar lvls fall rapidly (high insulin lvls cause immediate fat storage, body craves lost sugar)
- Hunger & cravings (low blood sugar lvls cause increased appetite)
