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PS276 > Chapter 13 - Eating Disorders > Flashcards

Chapter 13 - Eating Disorders Flashcards

1
Q

What is the EAT-26?

A

screening tool for eating disorders

honesty and accuracy needed
- best done privately to avoid social desirability/self-consciousness

score provides indication of risk and is intended to be used to determine if an individual should be referred to specialist for full evaluation of eating disorder

does not provide or replace diagnosis

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2
Q

What are the 3 main categories of eating disorder?

A

anorexia nervosa
bulimia nervosa
binge eating disorder

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3
Q

How many Canadian adolescent girls are obese? How many girls wish to lose weight?

A

25% are obese

40% of grade 8 girls want to lose weight even though most were not overweight

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4
Q

What is the Canadian prevalence for eating disorders?

A

0.3-1% for AN
1-2.5% for BN
2% for BN

AN least common despite being most well known

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5
Q

What are the sex differences in ED prevalence?

A

80-95% are female

70% of children with ED are female

less well known in males

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6
Q

What age has the highest rate of ED?

A

21 year olds/14-25 age group

95% of 1st time cases appear by 25

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7
Q

What is the mortality rate for ED? Which disorder is highest?

A

10-15%, highest mortality rate of any mental illness

AN has highest mortality rate, 10% will die within 10 years of onset

females 15-24 with AN have mortality 12x greater than all other causes of death combined

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8
Q

What is the cause of the high mortality rate associated with ED?

A

organ failure

suicide

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9
Q

What is NSSI?

A

non-suicidal self-injury

deliberate and direct injury or damage of body tissue

usually intended without suicidal ideation

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10
Q

Why do individuals self harm?

A

relieve and regulate internal emotions/memories

punish oneself in response to feeling guilt/shame

gain a sense of control

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11
Q

Describe the self-destructive cycle of an eating disorder?

A 
anxiety/dissatisfaction/emotional pain
->
coping (disordered eating)
->
immense guilt
->
coping (self-harm)
->
anxiety/dissatisfaction/emotional pain
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12
Q

What are the 2 features common to EDs?

A

extreme concern for weight and shape
- immense fear of being fat, exaggerated desire for thinness

extreme practices of weight control

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13
Q

What different factors play into the fear of being overweight?

A

social - culture of thinness

psychological - determines self-worth, self-acceptance, and perceived acceptance

neurobiological - biochemical differences create vulnerabilities, impact on perceptual processes leading to perceptual distortions

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14
Q

What are the most common areas of body dissatisfaction?

A

butt
thighs
abs

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15
Q

What did Nichter and Vuckovic discover about the way girls in middle school talked about their body?

A

self-abasing and apologetic

obsessed with body talk

coined the term “fat talk”

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16
Q

When does body dissatisfaction start?

A

early!

42% of grade 1-3 students want to be thinner

81% of 10 year olds afraid of being fat

40-60% of 6-12 year old girls are concerned about their weight or becoming too fat

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17
Q

What is fat talk?

A

tendency for friends, particularly female, to take turns disparaging their bodies to each other

common and expected for women to self-degrade

normative discontent

young people seen as more likeable if they engage in fat talk

believe in provides reassurance but creates back and forth comparison that are never ending

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18
Q

What are some negative effects associated with fat talk?

A 
body dissatisfaction
negative affect
depression
anxiety
ED symptoms or full on disordered eating
more frequent checks of ones body

also creates body dissatisfaction in others

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19
Q

What is meant by distortions in body view?

A

dissatisfactions with weight and shape regardless of actual weight/shape

distorted view of the self

very common

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20
Q

What are some of the extreme practices used to lose weight?

A 
self-induced vomiting
amphetamines
laxative and diuretic abuse
fasting
excessive exercise
enemas
diet pills
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21
Q

What is anorexia nervosa?

A

term defined means chronic lack of appetite/desire for food, but this is inaccurate

become preoccupied with food

self-imposed starvation

avoiding food even when hungry

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22
Q

What is the DSM-5 criteria for AN?

A

a) restriction of food/energy intake leading to significantly low body weight
b) intense fear of gaining weight or persistent behaviour that interferes with weight gain
c) disturbance in the way body weight or shape is experienced

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23
Q

What are the 3 different ways in which disturbance of body weight/shape can be experienced?

A

distorted body view

undue influence of body weight/shape on self-evaluation

persistent lack of recognition of the seriousness of current low weight

24
Q

What are the 2 subtypes of AN?

A

restricting type
- weight loss through extreme methods of weight control

binge-eating purging type

  • exhibit AN but also engage in binge eating or 1+ purging behaviour
  • typically those who binge eat purge, but some don’t binge and still purge
25
When is AN most likely to develop?
early to mid teens often after an episode of dieting and exposure to life stress co-occurs with substance use disorder
26
What is drunkorexia?
restricted eating or purging used to control weight gain from binge drinking common in college/university females
27
What are the health consequences of AN?
body starved of essential nutrients needed for function body processes slowed to conserve energy results in serious medical consequences - malnutrition - low BP - heart damage - osteoporosis - brain dysfunction - infections eventually death
28
Why do adolescents deny or downplay the problem?
cognitive factors underdeveloped ability to see future consequences personal fable better arguers - more easily rationalize or provide explanations for behaviour
29
What are the outcomes of AN?
of 5 AN deaths, 4 are from health complications and 1 is from suicide males at higher risk of death - diagnosed later, tend not to seek treatment 70% recover - slow and difficult - relapse is common and frequent
30
What is bulimia nervosa?
episodes of binge eating followed by anxiety and disgust over possible weight gain and desire to be rid of food
31
What are the diagnostic criteria for BN?
a) recurrent episodes of binge eating - eating more than most people would, feeling lack of control over it b) repeated compensatory behaviours to prevent weight gain c) at least once a week over 3 months d) self-evaluation unduly influenced by body shape/weight e) if separate from AN: if part of AN, then AN binge-purging type
32
Why can BN go unnoticed?
weight normal to overweight well-hidden, may go on for years
33
What is the binge purge cycle?
``` strict dieting -> diet slips/difficult situations -> binge eating triggered -> purge to avoid weight gain -> feelings of shame/self-hatred -> strict dieting ```
34
What are the health consequences of BN?
binge-purge cycles affect the entire body - digestive problems - electrolyte/chemical imbalances - depressed immune function - dental problems - osteoporosis - cognitive issues - seizures - abdominal pain often in a state of starvation despite normal weight - malnutrition - fainting, weakness, rapid HR, etc. mortality - less common than AN
35
What is binge eating disorder?
recurrent episodes of eating large quantities of food (quickly to the point of discomfort) loss of control during binge feeling shame, distress, or guilt not using compensatory measures to counter the binge most common ED
36
What is the DSM-5 criteria for BED?
a) recurrent episodes of binge eating - lack of control over eating - eating an amount of food definitely larger than standard b) episodes associated with 3+ of: - rapid eating - eating until uncomfortably full - eating a lot when not physically hungry - eating alone due to embarrassment of how much eating - feeling disgusted, depressed, or guilty c) marked distress d) at least once a week for 3 months e) not associated with BN or AN
37
What are the different severity levels for BED?
episodes per week: mild: 1-3 moderate: 4-7 severe: 8-13 extreme: 14+
38
What are some health consequences of BED?
weight gain and obesity - and associated health problems depression
39
What are some sociocultural factors leading to ED?
idealization of thinness media/movie portrayals don't fit the reality of a pubescent body unrealistic expectations
40
What types of social pressures lead to ED in males?
idealized lean, muscular bodies increases body dissatisfaction in males silent epidemic
41
What is the Scarlett O'Hara effect?
eating lightly to project femininity
42
What is the anti-fat bias?
fat-phobic society promoted in the media - in TV, more negative comments given and reinforced by laughter towards heavier females excessive body fat tends to have negative connotations in our society - lazy, unsuccessful
43
What is fat shaming?
point out/nag/embarrass based on weight leads to depression and low self-esteem eating/weight may INCREASE can trigger/exacerbate disordered eating leads to lower levels of PA, negative attitudes towards sports in youth often done by family or friends
44
What is thin shaming?
assumed to be anorexic food and exercise are policed eating/weight may DECREASE can trigger/exacerbate disordered eating
45
What is the issue with dieting?
puts youth at risk for ED far more likely to later engage in ED dieting is increasing among Canadian youth
46
What are some psychological factors contributing to ED?
pressure to succeed competitive domains (gymnastics, dance, modelling, sports) perfectionism painful life situations - food to cope with life stressors issues of control - overly controlled by others, body is the one thing they can control
47
What is the relation between athletic competition and ED?
many D1 and D2 NCAA female athletes had attitudes, symptoms, or actual ED symptoms
48
What biological factors contribute to ED?
genetics - ED runs in families - body dissatisfaction/desire to be thin are heritable brain chemistry - hormones - endogenous opiods - neurotransmitters genetics and brain chemistry create predisposition/vulnerability
49
Describe the eating disorder trap.
predisposition (genetics, brain chemistry) -> environmental factors (sociocultural pressure, negative life situations) -> feeling out of control and unlovable - > feel fat/body dissatisfaction - > weight control - > weight loss/control - > feel relief/accomplishment over weight - > recurrence of fear of weight gain - > restart the cycle
50
What are pro-ana sites?
view ED or diet behaviours as a lifestyle choice offer tips, support, ideas challenges to maintain behaviours
51
What are lifestyle views of ED?
normalize or even glamourize extreme restriction and severe control of the self ignore emotional issues and destructive physical impacts delay acknowledgement/treatment seeking contribute to relapse
52
What are some different treatments for ED?
extremely difficult to get them into treatment, often deny having a problem education - on disorders or nutrition individual therapy - psychotherapy, CBT family therapy drug therapy support groups - can be problematic, pick up tips hospitalization/private treatment centres best approach is multidimensional and multi-professional
53
What can we do to reduce ED behaviour?
stop talking about dieting don't engage in fat talk resist negative advertising assess personal/family attitudes towards weight and avoid negative interactions power of modelling! - mothers especially ensure areas of independence - decision making and control outside ones own body emphasize many ways to succeed/many parts in the self model good eating don't weigh yourself!
54
What is the message of the 34x25x36 video?
"there are no perfect bodies, we make the perfect bodies" mannequin industry replicates what the "perfect girl" is for the times, dictated by fashion companies make the buyer think that they could look like that
55
What were some interesting new points provided in the "Recovering: Anorexia Nervosa and Bulimia Nervosa" video?
lose your friends, they get sick of your games lot of stigma around people with ED many triggers cognitive effects - feel like a zombie, a shell of a person feel a gap in their life once they get rid of the time commitment of their eating disorder feel unique and like no one can help them
56
What is basal metabolic rate?
minimal amount of energy used by the body during a resting state drops to about 15% during puberty - on top of fat-muscle ratio increasing markedly during puberty -> weight gain
57
Why is obesity an adolescent issue?
eating high calorie, low fibre foods physically inactive excessive screen time not enough sleep

PS276 (12 decks)

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