Chapter 10 - eating disorders Flashcards
Criteria for BN?
- Recurrent episodes of binge eating & feeling out of control.
- Recurrent inappropriate compensatory behavior in order to prevent weight gain
- once a week for 3 months
- Self-evaluation is unduly influenced by body shape and weight
Associated features of BN? relation to AN?
- daily routine centers on weight, diet, and appearance
- Sensitive to comments about their weight or appearance
- Often have history of anorexia
Binge eating characteristics?
- Individual eats rapidly
- Uncomfortably full
- Done alone
- triggered by unhappy moods*
- Maybe temporarily comforting
- Lack of control
- Followed by guilt/shame
2 types of compensatory behaviors?
- purging
- non-purging
Purging examples?
- Vomiting
- Laxative
- Diuretics
- Enemas
Non-purging examples?
- extreme exercise
- restricted fasting
BN effects on body?
- Irritated throat
- Acid erosion on enamel / throat
- Low electrolytes **
- Heart problems
- Scarring on the back of the knuckles due to vomiting
- Enlarged salivary glands → producing extra saliva to throw up
Binge Eating Disorder (BED) criteria / characteristics?
what don’t they have? what are most patients like?
- Binge eating once a week on average for three months WITHOUT compensatory behaviors
- Marked distress regarding binge eating
- eat more than others
- NO AN or BN
- Most often patients are overweight/obese
Anorexia criteria?
- restriction → significantly low weight
- Intense fear of being fat
- disturbance in body weight/shape experience / undue influence
OR
don’t recognize seriousness of problem, proud of it
AN specifiers? controversial…?
- Restricting:
→ NO binging or purging - Binge-eating/purging Type:
→ recurrent episodes of binging OR purging
Controversial bc there’s no differences between them in comorbidities, outcomes, response to treatment, etc
AN cognitive/mental problems?
- preoccupation with food
- struggle for control of hunger
- loss of interest in or sexual difficulties
- risk of suicide
- Inability to concentrate
- Depression
- Memory problems
AN medical problems?
- Heart failure
- Constipation/bloating
- Kidney stones/failure
- Swollen joints/brittle bones
- Brittle hair
- Anemia/blood problems
- Lanugo:
→ Fine hairs on face and body
Difference between AN binging/purging type and BN??
AN is underweight!!
OSFED meaning? why does it exist? what are the 3 OSFED diagnoses?
Other Specified Eating Disorder
- used to be ED not specified
- got rid of unnecessary criteria, changed categories / diagnoses
Diagnoses:
- atypical anorexia
→ AN w/o weight requirement
- BN (&BED) w/ LOW frq
- Purging disorder
→ compensatory disorder w/o binge
Onset for EDs?
BN & AN → late adolescence / early adulthood
BED → late 20s/early 30s
Lifetime prevalence of AN/BN?
AN → increase in risk for…?
AN → ~1-1.5%
BN → ~3%
AN → increase in risk for incidence risk of 15-19 yr old girls!
Cohort effect? What does it effect most?
- Certain cohort (in this case age group) has highest lifetime prevalence & risk for ED
- affects women born after 1960
Where are EDs most common??
- industrialized nations
- Americas / Europe
- Asia: china, taiwan, korea, japan, singapore
Groups of men most at risk for “classic” EDs?
- gay men
- wrestlers
- body builders
- jockeys
- sport involves gaining & losing weight, focusing on body image & weight
Possible alternative type of ED in men?
- body dysphoric disorder
- pressure to be muscular, rather than thin
- compulsive weight lifting &/or steroid use
Highest comorbidity for AN?
For BN?
AN → OCD, MDD
BN → AUD, MDD, PTSD
Mortality AN?
- 3% medical complications, starvation
- suicide common, even if in remission
- mortality 12X higher for AN than women W/O AN
Mortality BN?
- a lot less than AN
- still more suicide attempts than gen pop
Long term course:
AN 21 yr after diagnosis
really bad
- 16% dead
- 10% AN
- 21% partial recovery
- 51% full remission
