Anorexia and Bulimia

Question 1

Why is Amenorrhea no longer a symptom of Anorexia?

Answer 1

Makes the definition more developmentally sensitive - including loss of menstrul cycle ruled out individuals who were to young to have a menstrul cycle in the first place.

Question 2

What is Pica?

Answer 2

Persistent eating of non-nutritive substances

Question 3

How long does a child have to show signs of Pica to be diagnosed?

Answer 3

Repeated ingestion for at least one month

Question 4

What is Rumination disorder?

Answer 4

Repeated regurgitation and re-chewing of food without an explanatory medical problem

Question 4

What is Rumination disorder?

Answer 4

Repeated regurgitation and re-chewing of food without an explanatory medical problem

Question 5

How long does a child have to demonstrate rumination disorder before they can be diagnosed?

Answer 5

At least one month. Must have a period of normal function before the onsent.

Question 6

What did Avoidant/Restrictive Food Intake Disorder used to be called?

Answer 6

Failure to thrive

Question 7

What is Avoidant/Restrictive Food Intake Disorder?

Answer 7

• Persistent failure to meet appropriate nutritional or energy needs associated with 1 of the following:
  
  • Feeding or eating disturbance before age 6
  • Significant weight loss
  • Significant nutritional deficiency
  • Dependence on enteral feeding or oral nutrition supplement
  • Marked interference with psychosocial function

Question 8

What is a normal amount of weight for a new born to loose?

Answer 8

10% of their birth weight

Question 9

How much weight should a baby averagely gain after birth?

Answer 9

1oz per day

Question 10

What is anorexia nervosa?

Answer 10

Restriction of energy intake leading to failure to maintain body weight at or above minimal level for age, height, developmental trajectory, or physical health

Question 11

What are the two types of anorexia nervosa?

Answer 11

Restricting and Binge eating/purging type

Question 12

How does anorexia present men to women?

Answer 12

anorexia presents 10:1 women to men

Question 13

What are the mortality rates of anorexia?

Answer 13

5-15%

Question 14

how many of the general population had at least one symptom of anorexia? who said this?

Answer 14

17% of women. 13% of men (Callen et al., 2020)

Question 15

What is bulimia nervosa?

Answer 15

Recurrent episodes of binge eating which is characterized by eating in discrete period of time an amount of food larger than most would eat in similar circumstances. Sense of lack of control over eating during the episode. Inappropriate compensatory behaviors

Question 16

What are the similarities between anorexia and bulimia?

Answer 16

• Both deal with disordered eating
• Over concern about weight
• Distortion of body image

Question 17

What are the differences between anorexia and bulimia?

Answer 17

• Weight differs
• Bulimia fluctuates & anorexia stays low
• In control versus out of control feelings
• anorexia measures severity by weight, bulimia by episodes of over compensatory behavior

Question 18

Who coined the developmental psychopathology model for anorexia?

Answer 18

Steiner et al., 2003

Question 19

What did Steiner et al., 2003 say?

Answer 19

There are special developmental periods where ‘risk factor exposure’ influences developmental trajectory. Psychiatric problems lead to an inability to catch up with typical developmental course. All risk factors are transacting. they are:

• Environment & Culture
• Genetic risk
• Body dissatisfaction
• Impulse control
• Weak central coherence

Question 20

Why is puberty a critical period for eating disorders?

Answer 20

Prior to the development of puberty body image disturbance and weight preoccupation is rare. Other changes occurring with negative body image (e.g. parent influence down, peer influence up, new schools, self-consciousness increase).
During this time developing negative body image may substantially increase risk of eating disorder in a way that might not during another developmental period.
At puberty depression rates increase in girls. At puberty eating disorders rates increase in girls

Question 21

Who talks about eating disorder assessments?

Answer 21

Stice & Peterson, 2007; Youngstrom, 2020

Question 22

What are the six assessments needed for accurate eating disorder diagnosis?

Answer 22

• Medical
• Psychological
• Behavioral
• Nutritional
• Interpersonal
• Psychosocial

Question 23

What medical tests should be done when testing for anorexia? why?

Answer 23

• BMI to test severity (can be done blind)
• Blood testing for hypokalemia immediately: Blood potassium (electrolyte = nerve and muscle cell function) too low can cause cardiac conduction disturbances and informs whether adolescent needs hospitalization & intravenous calcium

Question 24

What scale can you use to test for eating disorder? what does it test for?

Answer 24

Eating disorder diagnostic scale - for anyone 13-65. It tests for Anorexia, Bulimia, Binge eating disorder.

Question 25

What did Bakland et al 2020 say?

Answer 25

About 50% of eating disorder treatment patients do not respond to treatment. Why? Felt they were too different to other group members, unmet expectations with content and intensity.

Question 26

When should you use inpatient treatment for anorexia?

Answer 26

• weight 15-25% below average & dehydration / malnutrition
• Serious metabolic instability due to disordered behavior
• Psychiatric emergencies
• Non responsive to outpatient treatment