Bulimia Nervosa Flashcards
BN presents as…
persistent eating behavior
that results in maladaptive consumption of food
which has a serious impact on an individuals psychosocial functioning
Do individuals with BN tend to be underweight?
No
Is BN less serious than AN
No
BN in fact often leads to…
weight gain, as purging only loses 50% of the calories consumed in binging period
What are some of the medical complications that may arise with BN?
- bingeing => gastric dilation and delayed gastric emptying (life threating)
- purging => electrolyte imbalances, oesophagial tears, tooth decay
What are the most prevalent mood disorders associated with BN?
- Substance abuse (often initially used to control appetite/weight)
- Mood disorders (depression/bipolar)
- anxiety
- personality disorders (BPD common)
Factors affecting BN in SA
- more prevalent in urban settings than rural
- imposition of western values may lead to higher levels of body image distortion
- stress related to acculturation and identity confusion may increase vulnerability
Outline the typical onset of BN
- develops during adolescence
(rarely before puberty or after 40) - a bingeing episode generally occurs after a period of attempted weight loss
At its core, BN develops due to an…
It is a…
anxiety around physical appearance and a distorted body image
way of dealing with life’s challenges, and a belief that becoming thinned with solves these problem
BN has been described a way of dealing with life’s challenges, list four of these challenges
trauma
Shame/low self-esteem
emotional dysregulation
relational conflicts
Outline the biological risk factors forr BN
Biological:
- childhood obesity
- early pubescence
- female gender
- Genetic predisposition
Neurobio:
- decreased peptid secretion
- low serotonin (depressive symptoms)
- low dopamine (increase experience of hunger)
Outline the psychological causes of BN
Risk factors:
- low SE/dep/anx
- high impulsivity/poor emotional stability
- high reactivity to stress (and seeking soothing)
- seeks novel experiences
- Pre-disposing psychiatric disorders (dep/anx, OCD, ASD, PTSD)
Psych dev causes
- onset of puberty (phys/emot/soc adjustment)
Can be triggered by:
- episodes of attempted weight loss
- negative life events/emotions
Outline the social causes of BN
Soc risk factors:
- western country, high SES
- link between thinness success
A drive towards physical perfection
Peer and media influences
Activities with emphasis on weight (modeling, gymnastics etc)
What are 5 of the motivations for purging behavior in BN other than weight control
- cognitive distortions (guilt, shame, atonement)
- emotional regulation (provides comfort)
- alleviates physical discomfort after bingeing
- compulsion/ritual
- sense of control (after losing it in bingeing)
What are the 5 main diagnostic criteria for BN?
- Recurrent binge eating with:
- Eating a lot
- A sense of lack of control - Compensatory behaviors
- At least once a week, for three months.
- Self-evaluation based on
body - Not occur during episodes of anorexia nervosa
What are the two types of BN?
Purging type (vomiting, laxatives, enemas)
Non-purging type (excessive exercise, fasting)
Outline the psychological interventions for BN
CBT - thought process/beliefs around food, body image etc
FBT - psychoed, support etc
DBT - address and manage intense emotions
BWRT - resolve underlying emotions, re-organize brain processes
Outline the pharmacological treatments for BN
Anti-depressants (SSRI)
- use when therapy not enough
Others:
Medications to reduce binge eating and compensation (but long term effectiveness not clea)
Outline two other interventions for BN (than psych/pharma)
Nutritional support:
- eating suggestions and regular diet establishment
Online support:
- online information and support to improve reach
- done with consultation with med pros
- shown to improve recovery, soc interaction and decrease stigma
An individual with BN can be….
obese
Who’s view around food can cause Bulimia
One’s parents (esp. mothers)
Can BN be genetic?
yes
Since the 1990s….
EDs have been equal across black and white populations
Outline the bulimic cycle
Diet -> desire for food -> binge -> shame -> compensatory behavior -> Diet ->
