Ch7- Feeding and Eating Disorder

Question 1

Feeding and Eating Disorders

Answer 1

• Pica
• Rumination Disorder
• Avoidant/Restrictive Food Intake Disorder
• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorder
• Other Specified Feeding or Eating Disorder
• Unspecified Feeding or Eating Disorder

Question 2

Anorexia Nervosa

Answer 2

Either an intense fear of gaining weight or of
becoming fat, or persistent behavior that
interferes with weight gain (even though
significantly low weight)

Characteristics:
* Self-esteem is linked to thinness
* People with Anorexia tend to overestimate their size
* They may consider an extremely thin figure to be ideal or even overweight
* Preoccupation with food-related activities
* Excessive exercise
* Frequent comorbidities: Anxiety/depression/suicidal thoughts
* Heightened sensitivity to comments about shape and weight

Question 3

Mortality in Eating Disorders

Answer 3

Anorexia is a life-threatening condition

Anorexia is associated with a 25-year reduction in life expectancy

Question 4

Bulimia Nervosa

Answer 4

Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Binge: large amount of food AND a sense of loss of control over eating
- Purging: Recurrent inappropriate compensatory behavior in order to prevent
weight gain

The binge eating and compensatory behaviours both occur at least once
a week for three months.

Self-evaluation is unduly influenced by body shape and weight

Question 5

Diagnosis of Binge Eating Disorder

Answer 5

Recurrent episodes of binge eating

Binge eating occurs, on average, at least once a week for three months

Question 6

Etiology of Eating Disorders

Answer 6

Both anorexia nervosa and bulimia seem to have a genetic component

The hypothalamus is a key brain centre in regulating hunger and eating

The levels of some hormones regulated by the hypothalamus, such as cortisol, are abnormal in people with anorexia but return to normal
following weight gain

Low levels of serotonin metabolites and serotonin in people with bulimia

Serotonin metabolites have been linked with the negative mood and self-concept changes that precipitate binge episodes

Question 7

CBT for Bulimia

Answer 7

• Psycho-education
• Formulation
• Self-Monitoring
• Regular eating (addressing
  restraint)
• Involving significant others
• Addressing overvaluation of body
  shape and weight (pie chart)
• Addressing body checking (stopping
  unusual forms of checking)
• Addressing body avoidance
  (changing only in the dark)
• Addressing “feeling fat”
• Addressing mood problems and
  triggers
• Addressing dysfunctional thoughts
• Relapse prevention

Question 8

Treatment for Anorexia

Answer 8

*Limited motivation (examine pros and cons of change)
* Hospitalization may often be needed with the immediate goal to restore a safe weight
* Psycho-education
* Formulation
* Elements of the psychological components of CBT for bulimia can be incorporated in the psychological treatment (e.g., addressing body
image distortions, over valuing etc)

Question 9

Outcomes

Answer 9

• CBT is the leading treatment (most studies focus on bulimia)
• Interpersonal therapy also shows promise
• 50% of patients with bulimia may relapse after treatment
• Research on psychological treatments for anorexia is limited
• At least 40% relapse within a year (Carter et al., 2012)
• Antidepressant fluoxetine has an effect on binging and purging
• Drug therapy has not been shown to be effective in anorexia
• More people drop out of drug treatment compared to CBT