Chapter 11: Eating disorders

Question 1

What does anorexia nervosa mean?

Answer 1

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

Question 2

What are the three features required for the diagnosis of anorexia nervosa

Answer 2

1. Restriction of behaviors that promote healthy body weight: the person’s weight is much less than the normal
2. Intense fear of gaining weight and being fat: this fear is not reduced by weight loss.
3. Distorted body image or sense of body shape: the view that they are overweight amd certain parts of the body are too fat.

Question 3

What does amenorrhea mean?

Answer 3

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

Question 4

What is the DSM-V criteria for anorexia nervosa

Answer 4

Restriction of food to promote healthy weight; bodyweight is significantly lower below normal

Intense fear of weight gain

Body image disturbance

Question 5

What are the two types of anorexia nervosa distinguished by DSM-V?

Answer 5

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

Question 6

What are the physical consequences of Anorexia Nervosa?

Answer 6

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

Question 7

How long do is it take for patients with anorexia nervosa often recover?

Answer 7

6 or 7 years

Relapses is common

Question 8

Define bulimia nervosa

Answer 8

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

Question 9

What are the two characteristics of a binge defined by DSM?

Answer 9

1. eating an excessive amount of food within a short period of time
2. It involves a feeling of losing control over eating as if one cannot stop

Question 10

Is bulimia nervosa also diagnosed if the binging and purging occur only in the context of anorexia nervosa?

Answer 10

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.

Question 11

What is the key difference between the two?

Answer 11

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

Question 12

How do binges and bulimia typically occur?

Answer 12

It occurs in secret which may be triggered by stress and negative emotions they arouse and it continues until the person is uncomfortably full

Question 13

What happens after the binge is over?

Answer 13

Feelings of discomfort disgust and fear of weight leads to purging as an attempt to undo the caloric affects of the binge

Question 14

When does the bulimia nervosa typically begin?

Answer 14

It begins in late adolescence or early adult hood where 90% of cases are women.

Question 15

What are the comorbidity diagnosis with bulimia nervosa?

Answer 15

Depression
personality disorders 
anxiety disorders
 substance use disorders 
 conduct disorder

Question 16

What is the DSM five criteria for bulimia nervosa?

Answer 16

Recurrent episodes of binge eating
Recurrent compensatory behaviors to prevent weight gain
Body shape and weight are extremely important for self-evaluation

Question 17

What is the DSM five criteria for binge eating disorder?

Answer 17

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

Question 18

What is the BMI of people with binge eating disorder?

Answer 18

They have a BMI greater than 30 which is considered obese

Question 19

What are the physical consequences of binge eating disorder?

Answer 19

Obesity, type two diabetes, cardiovascular problems breathing problems, insomnia, and joint or muscle problems

Question 20

What are the genetic factors of anorexia nervosa and bulimia nervosa?

Answer 20

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

Question 21

What are endogenous opioids and what role does is it play in eating disorders?

Answer 21

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.

Question 22

What are the cognitive behavioral factors of anorexia nervosa?

Answer 22

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

Question 23

Schematic of Cognitive behavioral theory of bulimia nervosa

Answer 23

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

Question 24

What are the social cultural factors of eating disorders?

Answer 24

Standards set by the society

Question 25

Discuss perfectionism and anorexia nervosa

Answer 25

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.

Question 26

What medication is used to treat bulimia nervosa?

Answer 26

Antidepressants; as it is linked with depression (ex. Fluoxetine(Prozac))

Question 27

How do you reduce the tendency to relapse after taking in medication gor eating disorders?

Answer 27

When the medication is given in the context of cognitive behavior therapy