Chapter 12: eating disorders

Question 1

what is other specified feeding or eating disorder

Answer 1

individuals with characteristics of one or more eating disorders without meeting full criteria of one specific diagnosis

Question 2

define anorexia nervosa

Answer 2

starve themselves by going long periods of time with little to no food - convinced they need to lose more weight

have issue with conscious motivation to restrict food intake and body’s need to stay at healthy weight

• have highest mortality rate with highest deaths from ages 16-29 (1/4 suicide and 50% from the eating disorder)

Question 3

hornbacher- restricting type of anorexia nervosa

Answer 3

dieting, fasting, and/ or excessive exercise as way to prevent weight gain

Question 4

bing/purge type of anorexia nervos

Answer 4

substantially below health weight usually from binge eating and then inducing ways to remove food from body. believe normal eating is binging

Question 5

what are some noted differences between restriction AN and binge AN

Answer 5

impulsivity, neurocognitive functioning, emotional regulation, self-regulatory behaviors and brain activity

Question 6

what are the BMI classifications for anorexia nervous

Answer 6

mild: 18.5-17
moderate: 16-16.99
severe: 15-15.999
extreme: less than 15

Question 7

onset to remission for Anorexia nervosa depending on gender

Answer 7

women: 7 years
men: 3 years
after 20 years 51-76 percent no longer qualify for diagnosis but still have eating-related problems

those with binge/purge are more likely to also struggle with impulsivity, and self-harming

Question 8

define bulimia nervosa

Answer 8

uncontrolled eating followed by ways to prevent weight gain such as vomiting, misuse of laxatives, or over exercising

mild: 1-3 episodes per week
more extreme: 14+ per week

usually within 1-2 hrs of eating

to people even amounts around 1,200-2,000 calories may feel like a binge per their own dietary rules they have set for themselves and feel they have no control over eating and need to even when they are not hunger

dont see a distorted image of their body like anorexia nervosa but still do not like their weight and shape

men more likely to use exercise and want a lean muscular look

Question 9

Binge eating disorder

Answer 9

binging food without the purging that can lead to excessive weight gain and obesity. report eating faster than normal and almost in daze
- usually presents in early adulthood

Question 10

sub-threshold binge-eating

Answer 10

less frequent episodes usually during adolescent that full disorder is not given. Females usually do not over eat to the defined extent but feel distress and severe loss of control

Question 11

some risk factors for BED

Answer 11

• weight-based teasing during youth (60% say this occurred to them)
• family history of obesity (psychosocial risk factor)
  can have long prevalence between 8-14.4 years

Question 12

define other specified feeding or eating disorder

Answer 12

eating disorder that causes clinically significant distress but does not meet full criteria (partial syndrome eating disorder would fit in this criteria)

Question 13

what are some eating disorders that fit within other specified feeding or eating disorder

Answer 13

• partial syndrome (not enough symptoms for full disorder)
  -atypical anorexia nervosa (meet anorexia nervosa criteria but weight is still within or above normal range) and can still experience medical complications associated with AN
• bulimia of low frequency/ limited duration (behavior occurs once a week on average and/ or less than 3 months)
  -night eating disorder: regularly eat excessive amounts of food after dinner and into the night feel they cannot control their behavior

Question 14

what are the role of genes in obesity

Answer 14

impact number of fat cells and likelihood of fat storage, tendency to overeat, and activity level in brain in response to food.

Question 15

define obesity

Answer 15

BMI of 30 or over now roughly 40% of adults in US are considered obese and do not meet recommended daily exercise of 30 minutes and eat highly addictive fast foods

Question 16

how to help loose weight (obesity)

Answer 16

diet change and exercise
-BMI 30-39: low calories diets usually prepackaged so they know correct portions
BMI 40 and over: bariatric surgery

Question 17

biological factors around eating disorders

Answer 17

-genetic component to risk of eating disorders in general not just a specific type
- possible hormones at puberty for girls

Question 18

role of hypothalamus in eating

Answer 18

regulates hunger, satiety, etc. receives messages about the body’s recent food consumption and tells when to stop eating usually using neurotransmitters like serotonin, dopamine, norepinephrine or hormones like cortisol and insulin

Question 19

how dysfunction of hypothalamus relates to anorexia nervosa

Answer 19

lower functioning and abnormalities in serotonin and dopamine have been found in those with AN

Question 20

role of dopamine AN

Answer 20

regulate motor activity, feeding behaviors and reinforcement/reward learning (found altered reward area for brain in those with AN)

Question 21

social pressures and cultural norms as part of eating disorders

Answer 21

across time eating disorders have changed with what are the beauty standards for women during that time and their culture. media shown in culture easily illustrates what society deems is appropriate and desired body image
- social media: constantly looking at photos of others with thousands of them being thin and making symptoms worse because of constant comparison
- thin ideal and body dissatisfaction: higher body dissatisfaction with increased viewing of thin body ideals
-if friends are struggles and are dissatisfied with their body more likely others around them will be too

Question 21

what neurotransmitter has been found deficient in those with bulimia

Answer 21

serotonin and can lead to body’s craving of carbs which is usually what individuals will binge

Question 21

what is the strongest predictor of eating disorder in young women

Answer 21

body dissatisfaction from pressure of being thin seen everywhere

Question 22

what common sports have the pressure of body image as well

Answer 22

gymnastics, ice skating, dancing, horse racing, wrestling, and bodybuilding, diving

• women felt they had a decreased competitive edge after puberty and needed to change this

Question 23

cognitive factors related to eating disorders

Answer 23

low self-esteem, are overtly concerned with other’s opinions and will conform to what those around them are saying and doing
- anxious temperaments
- perfectionistic traits
- conditioned reward if view weight loss as a measure of success which can be reinforced

Question 24

what is dichotomous thinking style

Answer 24

judging things as all good or all bad

Question 25

emotional regulation difficulties

Answer 25

eating disorders have been seen as maladaptive strategies for dealing with painful emotions
- those who ate to try and feel better were significantly more likely to develop chronic binge eating

Question 26

what are the two subtypes involved in binge eating

Answer 26

• dieting: excessive attempts to lose weight by following a strict regime but usually abandon and engage in binge eating followed by purging
• depressive: concerned about weight and body size but are plagued by depression and low self-esteem so they eat to quell these feelings. are more likely to suffer social and psychological consequences compared to dieting subtype

Question 27

how does family relationships impact anorexia in adolescent

Answer 27

quality of family relationships, level of conflict/dysfunction, poor communication and inappropriate boundaries

Question 28

how family relationships impact eating disorders

Answer 28

• negative experiences with food, weight related teasing, perceived pressure from parents to be thin and low emotional expressions
• authoritarian parenting styles
• usually the “perfect” daughter who is high achieving can struggle the most because she is concerned about the desires of others and needed to comply to them over identifying her own feelings (can show control over body weight and presents to peers as distant, untouchable) so they do not have to interact
• those who cannot ignore their hunger may fall into binge/purge type of AN or BN

Question 29

treatment options for eating disorders: psychotherapy for Anorexia nervosa

Answer 29

• most lethal can persist for 20 years or longer in more than 1/2 of those with the disorder
• can be difficult to engage individual because thinness is highly valued and dont want to change attitude or behavior. Need to create trust between client
• usually can have an initial period of recovery but then have setback and fall into old habits and continue to struggle with self-esteem, family problems, depression, and anxiety
  -CBT: identify overvaluation of thinness and have rewards set for gaining weight. taught relaxation techniques for when eating
• family therapy: 10-20 sessions over 6-12 months parents are taught how to coach and control child’s eating and weight gain over time child takes over control of own eating

Question 30

psychotherapy for bulimia nervosa and binge-eating disorder