Chapter 10 - Eating Disorders Flashcards
What are the disorders that fall under the ‘Eating Disorders’ category?
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
What are Eating Disorders?
Disorders involving disordered eating behaviours and maladaptive ways of controlling body weight.
What percent of women and men does Anorexia effect?
Men = .02% Women = .3%
What percent of women and men does Bulimia effect?
Men = .1% Women = 1-3%
What does the word ‘anorexia’ mean?
‘Without desire for food’
At what age does anorexia typically develop?
Between the ages of 12 and 18
What are the clinical features required for a diagnosis of Anorexia Nervosa?
- Restriction of food intake leading to significantly low weight
- Fear of becoming fat or gaining weight
- Disturbance in how one experience’s their body weight. A distorted perception of one’s body shape and excessive valuation based on weight.
What are ‘safe foods’?
Foods that are defined by the client as ok to eat such as celery, rice cakes, green tea and black coffee
What are the two subtypes of Anorexia?
- Restricting type: excessive food restriction, fasting and exercise
- Binge Eating/Purging type: regular objective binge/purge behavior
What is the major distinction between the Anorexia Binge Eating and Bulimia?
The weight of the person. Anorexic clients have significantly lower than normal body weight while Bulimics are more likely to have normal or high body weight.
What are some medical complications of Anorexia?
- Dermatological problems (esp. Women): dry cracking skin, fine downy hair (lanugo)
- Cardiovascular complications: heart irregularities, hypotension, dizziness/blackouts
- Osteoporosis
- Lethargy
- Renal Failure
- Decreased fertility
What is Bulimia Nervosa characterized by?
- Recurrent binge/purge episodes
- Purging can be self-induced vomiting or use of laxatives, diuretics and enemas. Also fasting and excessive exercise
What are the clinical features for diagnosis of Bulimia Nervosa?
- Recurrent binge episodes: excessive amount of food in 2 hours or less, sense of lack of control while binging
- Binging/purging occurs 2x/week for 3 months
- Self-evaluation excessively influenced by weight & body shape
What are the subtypes of Bulimia Nervosa?
- Purging
2. Non-purging - use of exercise/fasting, only in 6-8% of cases
What are some medical complications of Bulimia?
- Skin irritation around the mouth from vomiting
- Russell’s signs: knuckles skinned or rubbed raw
- Electrolyte imbalance: result of improper digestion/nutrient absorption
What is EDNOS?
Eating Disorders Not Otherwise Specified
- disturbances in eating behaviour that do not fall into another specific category
What characterizes Binge Eating Disorder?
- Objective binge eating without compensation
- Distress about binging
- Feelings of lack of control
- Occurs on average 2x/week for 6 months
What is Pica?
An eating disorder involving persistent eating/chewing/licking of non-nutritive substances
What is Rumination Disorder?
An eating disorder involving repeated regurgitation of food for a period of at least one month.
What is Avoidant/Restrictive Food Intake Disorder?
An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs
What is the typical course and prognosis of someone with an eating disorder?
- Notoriously difficult to treat: Highest mortality rate of all disorders
- 70% eventually recover
- High relapse rates
- Residual food issues after treatment
What are the possible biological causes of eating disorders?
- Genetics: genes on chromosomes 1&10 linked to greater risk
- Neurochemistry: Endogenous opioids
- Serotonin (for regulating satiety) dysregulation - Hormones: ED’s develop in puberty
What are the possible psychosocial causes of eating disorders?
- Social pressure to conform to ‘ideal’ body
- Dieting as an admired/socially accepted practice
- Family Dynamics
- Personality traits
- Emotional factors
What type of family dynamics can contribute to development of an eating disorder?
- High levels of coerciveness/criticism
- Family attention to weight/appearance
- High parental expectations
- Childhood abuse
- Parents who don’t promote independence (esp. in girls) or allow autonomy
What type of personality traits can contribute to the development of an eating disorder?
- Perfectionism (high in those with Anorexia/Bulimia, also predictive of successful treatment)
- Negative effect
What emotional factors can contribute to the development of an eating disorder?
- Using food intake restriction to relieve upsetting emotions by having ‘control’
- Negative emotional states linked to binge eating, may indicate an attempt at coping
What are some cognitive factors in the development of an eating disorder?
- Perfectionism
- Unreasonable pressure on oneself to achieve ‘perfect body’
- In Bulimia, patients tend to think in dichotomous ‘black or white’
- Body dissatisfaction
What has proven to be the most effective treatment for bulimia?
Cognitive Behavioral Therapy
- not as effective for anorexia
What are the stages of CBT for bulimia?
- Behavioral - focus on control over eating
- Cognitive - focus on distorted thoughts about food/body
- Maintenance & relapse
What is the most effective treatment for Anorexia?
- Family Therapy
2. Hospitalization and behavioural therapy
How is Binge-Eating Disorder treated?
Cognitive Behavioural Therapy is the treatment of choice
