Chapter 11: Eating disorders Flashcards
What does anorexia nervosa mean?
Anorexia- loss of appetite
Nervosa- the loss is due to emotional reasons
*but in reality, while starving themselves most people with the disorder become preoccupied with food they may read cookbooks constantly and prepare gourmet meals for their family
What are the three features required for the diagnosis of anorexia nervosa
- Restriction of behaviors that promote healthy body weight: the person’s weight is much less than the normal
- Intense fear of gaining weight and being fat: this fear is not reduced by weight loss.
- Distorted body image or sense of body shape: the view that they are overweight amd certain parts of the body are too fat.
What does amenorrhea mean?
It means loss of menstrual period.
it was one of the diagnostic criteria for anorexia nervosa but it was removed because there are many reasons why women can stop having their menstrual period which does not have anything to do with anorexia nervosa
What is the DSM-V criteria for anorexia nervosa
Restriction of food to promote healthy weight; bodyweight is significantly lower below normal
Intense fear of weight gain
Body image disturbance
What are the two types of anorexia nervosa distinguished by DSM-V?
restricting type where weight loss is achieved by severely limiting food intake
Binge eating or purging type where the person engage in binge eating and bridging
What are the physical consequences of Anorexia Nervosa?
Dropping bp Heart rate slows Kidney and gastrointestinal declines Bone mass declines The skin dries out Nails become brittle Hormone levels change Mild anemia may occur Loss of hair from the scalp And may develop lanugo--a fine soft hair on their bodies
How long do is it take for patients with anorexia nervosa often recover?
6 or 7 years
Relapses is common
Define bulimia nervosa
This disorder involves episodes of rapid consumption of a large amount of food followed by compensatory behaviors such as vomiting fasting or excessive exercise to prevent weight gain
What are the two characteristics of a binge defined by DSM?
- eating an excessive amount of food within a short period of time
- It involves a feeling of losing control over eating as if one cannot stop
Is bulimia nervosa also diagnosed if the binging and purging occur only in the context of anorexia nervosa?
No. Bulimia nervosa is not diagnosed if the binging and purging occur only in the context of anorexia nervosa and it’s extreme weight loss; the diagnosis in such a case is anorexia nervosaw, binge eating or purging type.
What is the key difference between the two?
The key difference between the two is weight loss: people with anorexia nervosa lose a tremendous amount of weight where people with bulimia nervosa do not
How do binges and bulimia typically occur?
It occurs in secret which may be triggered by stress and negative emotions they arouse and it continues until the person is uncomfortably full
What happens after the binge is over?
Feelings of discomfort disgust and fear of weight leads to purging as an attempt to undo the caloric affects of the binge
When does the bulimia nervosa typically begin?
It begins in late adolescence or early adult hood where 90% of cases are women.
What are the comorbidity diagnosis with bulimia nervosa?
Depression personality disorders anxiety disorders substance use disorders conduct disorder
What is the DSM five criteria for bulimia nervosa?
Recurrent episodes of binge eating
Recurrent compensatory behaviors to prevent weight gain
Body shape and weight are extremely important for self-evaluation
What is the DSM five criteria for binge eating disorder?
Reported binge eating episodes
Binge eating episodes include at least three of the following: eating more quickly than usual, eating until over full,
eating large amounts even if not hungry, eating alone due to embarrassment about large food quantity, feeling bad after the binge
No compensatory behavior is present
What is the BMI of people with binge eating disorder?
They have a BMI greater than 30 which is considered obese
What are the physical consequences of binge eating disorder?
Obesity, type two diabetes, cardiovascular problems breathing problems, insomnia, and joint or muscle problems
What are the genetic factors of anorexia nervosa and bulimia nervosa?
It runs in families and the key features of eating disorders, such as dissatisfaction with one’s body, a strong desire to be thin, binge eating, and preoccupation with weight are heritable
What are endogenous opioids and what role does is it play in eating disorders?
These are substances produced by the body that reduce pain sensations, enhance mood, and suppress appetite. They are released during starvation. So people with anorexia has increased levels if opioids resulting in a positively reinforcing euphoric state.
What are the cognitive behavioral factors of anorexia nervosa?
The fear of fatness and body image disturbance are the motivating factors that powerfully reinforce weight loss. These are positively reinforced by the sense of mastery or self control they create
Perfectionism and a sense of personal inadequacy
Criticism from peers and parents about being overweight
Schematic of Cognitive behavioral theory of bulimia nervosa
Low self-esteem ➡️ dieting to feel better about self ➡️ food intake is restricted too severly ➡️ diet is broken ➡️ binge ➡️ compensatory behaviors to reduce fear of weight gain
What are the social cultural factors of eating disorders?
Standards set by the society
Discuss perfectionism and anorexia nervosa
Perfectionism is higher among girls with anorexia than girl without anorexia. But even after anorexia, perfectionism remains high.
Mothers of girls with anorecia has high perfectionism than the mothers without anorexia. This suggests that what is genetically transmitted in anorexia could be personality perfectionism, increasing the vulnerability for the disorder rather than the disorder per se.
What medication is used to treat bulimia nervosa?
Antidepressants; as it is linked with depression (ex. Fluoxetine(Prozac))
How do you reduce the tendency to relapse after taking in medication gor eating disorders?
When the medication is given in the context of cognitive behavior therapy
