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EXCI 445 > Chapter 15- Eating Disorders > Flashcards

Chapter 15- Eating Disorders Flashcards

1
Q

what is the main problem in eating disorders in athletes ?

A

low energy availability (low diet- exercise expenditure)

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2
Q

what is normal eating ?

A

normal eating is flexible, it varies in response to your hunger, schedule, proximity to food, and feelings

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3
Q

what is the hunger-fullness scale? where should we be on it ?

A

famished, hungry, neutral, full, over-stuffed

we should always be between hungry and full

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4
Q

how do we feel when we are on either extremes of the hunger-fullness scale ?

A

when we are famished or over-stuffed : low energy, lethargic, etc

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5
Q

which foods promote satiety ?

A

protein and fiber

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6
Q

what is the success rate of diets ?

A

5%

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7
Q

is dieting normal adolescent behavior ?

A

NO

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8
Q

what is the connection between dieting and eating disorder ?

A

teens who diet are a lot more likely to develop an eating disorder

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9
Q

what is the connection between dieting and being overweight ?

A

dieting at a young age leads to being heavier later in life

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10
Q

when was the Ancel Keyes starvation study conducted and on who ?

A

in 1944-45 on conscientious objectors

wanted to study what would happen in concentration camps

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11
Q

what were the main findings of the Ancel Keyes starvation study ?

A

6 month semi starvation diet (lose 25% BW) leads to obsession w food, unusual eating habits (40 gums a day), binge eating, physical changes

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12
Q

what are 4 ways of purging ?

A

vomiting
misuse of laxatives
diuretics
diet pills

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13
Q

what does purging mean ?

A

ridding body of unwanted food

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14
Q

what was the main modification of the DSM 5

A

added other diseases than BN and AN

such as : binge eating disorder
nocturnal eating syndrome
avoidant/restrictive food intake disorder

etc

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15
Q

what is the lifetime risk of anorexia nervosa ?

A
  1. 9% for women

0. 3% for men

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16
Q

what is the lifetime risk of bulimia nervosa ?

A
  1. 5% women

0. 5% men

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17
Q

which is more prevalent: BN or AN ?

A

BN

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18
Q

what is the lifetime risk of binge eating disorder ?

A

3.5% women

2% men

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19
Q

what is the lifetime risk of OSFED ? (other specified feeding or eating disorder)

A

3-10%

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20
Q

what is the proportion of men and women who have eating disorders ? `

A

10% men

90% women

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21
Q

what percentage of ED start in adolescence ?

A

85%

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22
Q

how is body image a risk factor to ED ?

A

when body image becomes central to self-worth, incidence of ED increases

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23
Q

how does the prevalence of ED in athletes compare to ED in non-athletes ?

A

athletes suffer twice as much from eating disorders as non-athletes

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24
Q

what is the prevalence of ED in athletes ?

A

6-45% women

0-19% men

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25
Q

what are three categories of sports with higher rates of ED?

A

endurance
aesthetic
weight category

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26
Q

which are more likely to encourage ED: coaches or parents ?

A

coaches

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27
Q

does lower BW improve performance ?

A

no

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28
Q

what is the focus in sports which encourage ED ?

A

focus on the individual (gymnastics) and/or endurance (swimming)

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29
Q

what is the BMI at which you are more likely to have an ED ?

A

no such thing

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30
Q

what did the DSM-5 change in the diagnosis of anorexia nervosa ?

A

got rid of amenorrhea since men also have AN and menopausal women can have AN

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31
Q

what are the 3 diagnostic criteria (DSM5) for anorexia ?

A

restriction of intake leading to severely low BW (adults BMI <17=mild, <15= extreme)

intense fear of gaining weight

disturbed perception of body size/ shape

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32
Q

what are the two types of anorexia nervosa ?

A

restrictive

binge eating/purging

33
Q

how long do the symptoms need to persist in AN to be diagnosed ?

A

3 months

34
Q

what is the recovery key in AN ?

A

early recognition & treatment

35
Q

what is a main symptom of anorexia due to macronutrient deficiency ?

A

hypothermia

36
Q

what does low body temperature in anorexia manifest itself (4)

A

experience a lower body temp
lower BMR
lower RMR
LANUGO

37
Q

what is lanugo ?

A

soft downy hair on face, back, and arms as a protective mechanism built into the body to help keep a person warm in starvation (anorexia)

38
Q

lanugo is associated with which ED ?

A

anorexia

39
Q

what mental health issue has the highest mortality rate

A

anorexia

40
Q

what happens to the AN body after a few months?

A

cardiovascular issues: protein energy malnutrition similar to marasmus

leads to heart failure

41
Q

what happens to the heart in AN

A

heart muscles become weak and thin due to protein breakdown

chambers decrease in size, blood pressure decreases, pulse decreases, leading to heart failure

42
Q

what is the main cause of death in AN ?

A

heart failure due to electrolyte imbalance (esp Ca, Na, K, P) which are critical to maintain electric currents necessary for normal heart beat

43
Q

which state increases risk of death in AN ?

A

exercise

44
Q

explain the GI problems in AN

A

deteriorated GI tract, slowed absorption, slowed production of digestive enzymes by pancreas, atrophy of lining of GI

45
Q

why would some athletes that are AN experience an increase in performance ?

A

euphoria
it is short lived
starvation is a physiological stressor and releases NE and E which will evoke a feeling of euphoria and increase VO2max

46
Q

how does AN affect endurance ?

A

deteriorates as liver and muscle glycogen deplete + reduction of strength and power from loss of muscle mass

47
Q

what is a common symptom of AN in sports ?

A

dehydration which decreases plasma volume and the ability to thermoregulate

48
Q

what is the RED-S?

A

screens for relative energy deficiency in sport (better than the athlete triad)

49
Q

how does the DSM-5 define bulimia nervosa

A

cycles of binge eating and inappropriate compensatory behaviors once a week for at least three months

lack of control over binges, followed by purging (vomiting, exercise, laxative, strict dieting)

BMI >18.5

50
Q

what is Binge Eating Disorder ?

A

binging for 1x/week at least for three months

no compensatory behaviors (no purging)

51
Q

what proportion of men and women does binge eating disorder affect ?

A

60% women

40% men

52
Q

what are 4 health risks in binge eating disorder ?

A

acute gastric dilation
post-binge pancreatitis
cardiac risks (htn, cvd, dm, edema)
weight gain

53
Q

does purging help lose weight ?

A

no, only half of what is consumed is rid of

54
Q

what is a skin problem that shows signs of self induced vomiting:

A

Russell’s sign

55
Q

what are the two methods for self induced vomiting ?

A

ipecac: a vomiting pill but usually only used for poisoning; it is cardiotoxic and can lead to heart problems

or fingers down throat

56
Q

what happens to glands in self induced vomiting ?

A

parotid glands are enlarged with elevated amylase

57
Q

what are metabolic complications of self induced vomiting ?

A

hypokalemia, hypochloremia
alkalosis
dehydration

58
Q

what can be a consequence of laxative abuse (4)

A 
electrolyte imbalance (dehydration)
constipation/diarrhea
loss of colon function due to laxative dependence 
rapid weight gain when discontinued
59
Q

what are two consequences of diuretic use

A

electrolyte imbalance and dehydraiton

kidney damage

60
Q

what are 2 side effects of diet pills

A

elevated BP

anxiety

61
Q

what kind of energy are ED ppl prone to

A

stress fractures

62
Q

how does bulimia affect performance in sports

A

weak muscles, lower electrolytes and potassium means more fatigue

dehydration: less thermoregulation

slower recovery from workouts due to lack of vitamins and minerals

osteoporosis

63
Q

what is anorexia athletica ?

A

excessive workouts + restriction

64
Q

what is the main risk factor for anorexia athletica ?

A

pressure to improve performance by diet or exercise

65
Q

what is orthorexia nervosa ?

A

dysfunctional eating patterns, obsessed with eating healthy pure diet

(not a diagnosed eating disorder)

66
Q

what is diabulemia ?

A

when ppl with type I diabetes skip or reduce insulin to lose weight (1/3 women with type I)

nauseated from elevated blood sugars (ketoacidosis), which will make them vomit, weight loss

67
Q

side effects of diabulemia ?

A

nephropathy, CVD, electrolyte imbalance, dehydration, death

68
Q

what is nocturnal eating syndrome ? what are the DSM criteria

A

excessive intake of food at night with distress about it and guilt, with the excess eating not explained by social norms, sleep cycle, etc
need to fit 3/5 symptoms:

lack of morning hunger, urges to eat in evening/night, belief that one must eat in order to fall back to sleep at night, depressed mood, difficulty sleeping

69
Q

which adults are more at risk of nocturnal eating syndrome ?

A

obese people and those seeking bariatric surgery

70
Q

what is muscle dysmorphia? how is it classified ?

A

classified as obsessive compulsive

compulsive exercise, inflexible dieting regimens, anabolic steroid abuse, obsessive thoughts of muscles

71
Q

what is nocturnal eating syndrome classified as ?

A

OSFED (DSM 5)

72
Q

prevalence of muscle dysmorphia ?

A

1/3 men

73
Q

what is the best way to treat an ED ?

A

multidisciplinary treatment

74
Q

most ED patients are outpatient or inpatient ?

A

outpatient

75
Q

when is an ED an inpatient ?

A

when they cant improve as outpatient, concern for safety

76
Q

what is refeeding syndrome ?

A

when you aggressively refeed an ED person, shifts electrolytes from serum, which can lead to thiamin, P, Mg, K deficiency

77
Q

what should be a golden rule when refeeding an ED person?

A

feed conservatively, monitor electrolytes

78
Q

what is avoidant/restrictive food intake disorder ?

A

avoidance of food, failure to meet energy needs, but no body image issues (usually kids)

EXCI 445 (13 decks)

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