Chapter 10: Eating Disorders

Question 1

Describe how anorexia nervosa presents.

Answer 1

Restriction of energy intake which leads to critically low weight levels. Often characterized by unhealthy lack of weight and negative misappraisals such as “I am too fat” or avoiding mealtimes.

Physical changes may include dizziness, difficulty concentrating, feeling cold, sleep problems, thinning hair/hair loss, and muscle weakness, to name a few.

Question 2

Describe how bulimia nervosa presents.

Answer 2

Binge-eating episodes followed by compensatory behavior to rid the body of excess calories which includes vomiting, excessive exercise, medications, laxatives, and extreme fasting. These behaviors must be present at least once a week for three months for a diagnosis.

They tend to hide their symptoms and compensatory behaviors. Such as choosing specific times to purge and hiding candy wrappers.

These behaviors are often provoked by stress.

Question 3

Describe how binge-eating disorder (BED) presents.

Answer 3

Excess eating till uncomfortably full, quickly eating, and eating when not hungry. They don’t purge or exercise. They occur at least once a week for three months for a diagnosis. They often avoid eating in public and eat in mass in private till the point of morbid obesity.

Question 4

What does mutually exclusive mean? What does it mean with respect to eating disorders?

Answer 4

That they can’t both be diagnosed. Basically, with eating disorders, you can’t be both Anorexic and Bulimic and have BED. You can only be diagnosed as one of the three

Question 5

What are the key differences in diagnostic criteria for anorexia, bulimia, and binge eating disorder?

Answer 5

Anorexia: Restriction of calorie intake to dangerous levels of weight loss

Bulimia: Binge Eating with compensatory behaviors

BED: Binge-eating only

Question 6

Define compensatory behavior. What disorder is this found in?

Answer 6

A behavior we use to compensate for the person we want to be. Its found in bulimia. The purging “compensates” for the excess eating

Question 7

Describe the epidemiology of anorexia nervosa.

Answer 7

Prevalent in industrialized, high income countries. According to the National Eating Disorder Alliance (NEDA) website, 0.3-0.4% of women and 0.1% of men have Anorexia

Question 8

Describe the epidemiology of bulimia nervosa.

Answer 8

National Eating Disorder Alliance (NEDA) website 1% of women and 0.1% of men meet the diagnosis of bulimia. Also more prevalent in high-income industrialized countries

Question 9

Describe the epidemiology of binge eating disorder.

Answer 9

BED is three times more common than bulimia and anorexia, also more common than HIV schizophrenia and breast cancer. Between 0.2-3.5% of females and 0.9-2.0% of males develop BED

Question 10

Which feeding and eating disorder is most common?

Answer 10

B.E.D

Question 11

What gender differences occur with regards to the eating disorders?

Answer 11

Women are at higher rates than men for all three disorders

Question 12

Are there any other noteworthy similarities or differences in the prevalence rates of the three disorders?

Answer 12

They are all in high-income and industrialized countries

Question 13

Describe the comorbidity of anorexia nervosa.

Answer 13

Suicidal ideation, mood disorders, anxiety disorders, OCD

Question 14

Describe the comorbidity of bulimia nervosa.

Answer 14

Social Anxiety, bipolar and depressive disorders, alcohol use and other substance abuse is high with bulimia. Often they meet the criteria for a personality disorder, most frequently BPD (Borderline Personality Disorder)

Question 15

Describe the comorbidity of BED.

Answer 15

Suicidal ideation, MDD and alcohol use

Question 16

Describe the biological causes of feeding and eating disorders.

Answer 16

Twin studies show a concordance rate of 70% with Anorexia and a 23% rate with bulimia.

The hypothalamus which is involved with hunger management of the body is a potential factor as the neuroendocrine system is disturbed. But it’s hard to state if this disruption caused the disorder or was caused by the disorder

Question 17

Describe the cognitive causes of feeding and eating disorders.

Answer 17

Share many similarities with OCD to the point where Eating disorders are argued to be a variant of OCD due to the obsession with body weight. Impulsivity is involved with binging episodes and feeling disgust post-eating is a sign of an OCD relation as well

Question 18

Describe the sociocultural causes of feeding and eating disorders.

Answer 18

Overwhelmingly found in Western, Industrialized countries with high emphasis on thinness.

Media highly emphasizes thinness with attractiveness

Once thought to be a white person problem, it’s now seen that anorexia and bulimia are prominent among wealth black women suggesting SES is involved
Women are overwhelmingly more likely to have a eating disorder likely due ot stigma for women to be thin. Men develop them more often than not for sports like wrestling or boxing.

Family influence is strong. If a family member give positive feedback on appearance while unknowing about the disorder, it can perpetuate it.

Families that place high emphasis on thinness also perpetuate the disorders. Also destructive families.

Question 19

Describe how personality traits are the cause of feeding and eating disorders.

Answer 19

Perfectionism magnifies the body’s imperfections and gives a strong compulsion to remedy the flaw

Self-esteem being low leads to over-examination of the body

Question 20

Define multidimensional disorders?

Answer 20

A multidimensional set of disorders, its hard to put the finger at a single cause. Such as genetics, environment, family, SES, etc.

Question 21

What evidence is there to suggest eating disorders are biologically driven?

Answer 21

Twin studies show a concordance rate of 70% with Anorexia and a 23% rate with bulimia.

Question 22

According to the cognitive theory, eating disorders may be a variant of what other disorder?

Answer 22

OCD

Question 23

Discuss the four sociocultural subgroups that explains development of eating disorders.

Answer 23

Media, Ethnicity, gender and Family

Question 24

What are the two personality traits most commonly used to describe behaviors associated with eating disorders?

Answer 24

Self Esteem and perfectionism. One theory called the transdiagnostic model suggests overall low self-esteem creates an overvaluation of the body

Question 25

Describe treatment options for anorexia nervosa.

Answer 25

CBT focusing on Maladaptive thoughts towards food

Family Based therapy (FBT) which is 16-18 sessions in three phases (1) Parents take charge of weight restoration, (2) client’s gradual control of overeating, and (3) addressing developmental issues including fostering autonomy from parents

Question 26

Describe treatment options for bulimia nervosa.

Answer 26

CBT, ERP, and Interpersonal therapy

Question 27

Describe treatment options for binge eating disorder.

Answer 27

CBT and antidepressants but they are not usually effective for weight loss

Question 28

What is the initial (main) goal of treatment for anorexia?

Answer 28

Recovery from malnourishment and weight gain so that the client’s life is not at risk.

Question 29

What are the three phases of family-based treatment?

Answer 29

(1) Parents take charge of weight restoration, (2) client’s gradual control of overeating, and (3) addressing developmental issues including fostering autonomy from parents

Question 30

What is the goal for interpersonal psychotherapy? Discuss the three phases of IPT.

Answer 30

Interpersonal Therapy’s goal is to improve interpersonal functioning with those with the eating disorder. The three phases are phase 1 is psychoeducation, phase two is problem solving interpersonal issues and phase 3 is making sure the lessons stuck from the first two phases

Question 31

What is the overall treatment effectiveness of eating disorders?

Answer 31

IPT-E is considered effective for bulimia, CBT is effective for all, and antidepressants are effective for BED. Anorexia is more successful if treated early. However, the overall deaths of these disorders is 10% mainly from suicide. While BED treatment is in its infancy, they do show higher rates of remission than Bulimia or Anorexia