12. Eating Disorders Flashcards
What is the Screening Tool used for Eating Disorders?
SCOFF Questionnaire:
Sick - Because you feel uncomfortably full?
Control - Lost control over how much you eat?
One - Recently lost > 1 stone in a 3 month period?
Fat - Believe yourself to be FAT?
Food - Dominates your life?
Note - Score of 2+ = Likely Eating Disorder
What are the Clinical Features of Anorexia Nervosa?
- Restriction of Intake to Reduce Weight
- Rely on Compulsive Compensatory Behaviours when Food can’t be Avoided
- Anorexic if they are 15% below Ideal Body Weight
- Fear of Weight Gain
- Amenorrhoea - Post-Menarchal Females
What are the Clinical Features of Bulimia Nervosa?
- Episodes of Binge Eating & Sense of Loss of Control
- Binge Eating followed by Compensatory Behaviours
- Must occur 2 times per week for 3 months
- Dissatisfaction with Body Shape / Weight
What Compulsive Compensatory Behaviours are used when Food Cannot be Avoided / After Binge Eating?
- Self-Induced Vomiting
- Laxative Abuse
- Abuse of Appetite Suppressants / Diuretics
- Exercise Abuse
- Fasting / Strict Diets
Note - 1-3 = Purging Type / 4-5 = Non-Purging Type
What are common ways of Avoidance of Calorie Intake?
- Diets - Vegetarian / Vegan
- Not touching Food / Grease
- Developing Dislikes / Pickiness / “Allergies”
- Interpreting all Symptoms as Allergy / Indigestion
- Eating Very Slowly / Only Eating at Certain Times
- Spoiling / Messing of Food (Bizarre Combinations)
- Refusing to Eat more than the person who eats last
- Medication Abuse - Appetite Suppressants
What are common ways of Getting Rid of Calroies?
- Self-Induced Vomiting / Chewing & Spitting Out
- Overexercise / Overactivity
- Cooling
- Blood Letting
- Medication Abuse
What are the Consequences of Eating Disorders?
- Psychological Consequences
- Social Consequences
- Physical Consequences
What is the Psychopathology of an Eating Disorder?
- Extreme Overvaluation of Low Weight and Thin / Lean Shape
- Obsessive Weight Losing feels like a Solution (Not a Problem)
- Cognitive Style shows Reduced Central Coherence and Narrowed Focus of Interest
- A Starved Person is unable to interpret emotion - As in Asperger’s
What are the Psychological Consequences of an Eating Disorder?
Malnourished Brains experience:
- Depression - Poor Response to medication
- Anxiety
- Obsessionality
- Loss of Concentration - on anything but Food
What are the Social Consequences of an Eating Disorder?
- They turn other people into obstacles to the Disorder
- Forced to Lie / Cheat / Steal about Concerns
- Withdraw from Friendships
What are the Physical Consequences of an Eating Disorder?
- Starvation causes Physical Damage - Poor Repair / Reduced Immunity / Anaemia / Heart Damage
- Purging Behaviours cause Neuro-Chemical Disruption - Seizures / Arrhythmias
- Young People need Good Nutrition to allow Growth - Height / Pubertal Development / Brain Growth
What is the Pathology of an Eating Disorder?
- High Risk / Obsessionality
- Life Events - Transitions / Conflicts / Losses / Stresses
- Anorexia Nervosa
- a) Prepetuating / Amplifying Factors - Back to 3
- b) Resilience and Protective Factors - To 5
- Health
What are the Causes of Eating Disorders?
- Genetic Predisposition - Anxiety Disorders / OCD
- Perinatal Factors
- Life-Events (and Traumas)
- Perpetuating Consequences of Starvation and of Avoidance
What are the Precipitating Factors of an Eating Disorder?
- Puberty:
- a) Physical Effects of Hormonal Changes on the Brain
- b) Psychological Response to the Body Changes
- Dieting / Non-Deliberate Weight Loss
- Increased Exercise
- Stressful Life Events - Neglect / Abuse / Difficult Transitions
What are the Perpetuating Factors of an Eating Disorder?
Consequences of Starvation Syndrome:
- Delayed Gastric Emptying
- Narrowing of Focus
- Obsessionality