Chapter 8 Eating disorders

Question 1

2 Major Types of Eating Disorders

Answer 1

Anorexia Nervosa

Bulimia Nervosa

Question 2

Binge Eating Disorders

Answer 2

Involves disordered eating behavior but may

involve fewer cognitive distortions about weight and shape

Question 3

Obesity

Answer 3

considered a symptom of some eating disorders but not a disorder in and of itself

Question 4

Bulimia Nervosa

Answer 4

Eating excess amounts of food in a discrete period of time
–Eating is perceived as uncontrollable
–May be associated with guilt, shame or regret
–May hide behavior from family members
–Foods consumed are often high in sugar, fat or carbohydrates

Compensatory behaviors – designed to “make up for” binge eating
–Most common: Purging
•Most common: Self-induced vomiting
•May also include use of diuretics or laxatives
–Excessive exercise
–Fasting or food restriction

Question 5

Bulimia Nervosa Associated features

Answer 5

–Most are within 10% of normal body weight
–Purging methods can result in severe medical problems
•Erosion of dental enamel, electrolyte imbalance
•Kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage

–Most are overly concerned with body shape –Fear of gaining weight –Most have comorbid psychological disorders

Question 6

Anorexia Nervosa: Defining features

Answer 6

Extreme weight loss – hallmark of anorexia
–Restriction of calorie intake below energy
requirements
–May also involve binging and purging
–Defined as 15% below expected weight
–Intense fear of weight gain and losing control over eating
–People suffering from anorexia show a relentless pursuit of thinness
–Often begins with dieting

Question 7

Anorexia Nervosa: Associated Features

Answer 7

Most show marked disturbance in body image
–Most are have comorbid other psychological disorders
–AN is the most deadly mental disorder
•Starving body borrows energy from internal organs,
leading to organ damage
•Most serious consequence is cardiac damage which can lead to heart attack and death

Question 8

Binge Eating Disorder

Answer 8

New disorder in DSM-5
–Binge eating without associated compensatory behaviors
–Associated with distress and/or functional impairment (e.g., health risk, feelings of guilt)

Question 9

Binge Eating Disorder: Associated Features

Answer 9

Many persons with binge-eating disorder are obese
–Some, but not all, have conerns about shape and weight
–Often older than bulimics and anorexics
–More psychopathology vs. non-binging obese people

Question 10

Bulimia Facts and Stats

Answer 10

–Majority are female – 90%+
–Onset typically in adolescence –Lifetime prevalence is about 1.1% for females, 0.1% for males
–6-7% of college women suffer from bulimia at some point
–Tends to be chronic if left untreated

Question 11

Anorexia Facts and stats

Answer 11

–Majority are female and white
–From middle- to upper-middle-class families –Usually develops around early adolescence –More chronic and resistant than bulimia
•Lifetime prevalence approximately 1% •Cross-cultural factors
–Develop in non-Western women after moving to Western countries
–Rare in African-American women

Question 12

Causes for Anorexia and Bulimia

Answer 12

Media and cultural considerations
–Media portrayals: thinness linked to success, happiness
–Cultural emphasis on dieting –Standards of ideal body size
•Change as much as fashion •Difficult or impossible to achieve
•Biological considerations
–Partial genetic component
–Deficits in serotonin may contribute to bingeing

Psychological and behavioral considerations
–Low sense of personal control and self-confidence
–Perfectionistic attitudes –Distorted body image –Preoccupation with food –Mood intolerance

Question 13

Anorexia and Bulimia Treatment

Answer 13

Psychosocial treatments
–Cognitive-behavioral therapy (CBT)
•Treatment of choice
•Basic components of CBT: Identifying maladaptive thinking patterns and behavioral habits, then gradual practice of new habits
•Medical and drug treatments
–Antidepressants
•Can help reduce binging and purging behavior •Usually not efficacious in the long-term

Question 14

Goals for Anorexia and Bulimia

Answer 14

General goals and strategies
–Weight restoration
•First and easiest goal to achieve
–Psychoeducation –Behavioral and cognitive interventions
•Target food, weight, body image, thought and emotion
–Treatment often involves the family
–Long-term prognosis for anorexia is poorer than for bulimia
•Preventing eating disorders

Question 15

Obesity

Answer 15

Considered BMI of 30+ •Not DSM disorder, but may be a consequence •Statistics
–In 2008, 33.8% of adults in the United States were
obese; 37.5% in 2010 –Mortality rates
•Are close to those associated with smoking
–Increasing more rapidly in children/teens
–Obesity also growing rapidly in developing countries

Question 16

Obesity and night eating syndrome

Answer 16

Obesity and night eating syndrome
–Occurs in 7-19% of treatment seekers
–Occurs in 55% of individuals seeking bariatric surgery
–Features
•Consume 1/3+ of daily caloric intake after dinner
•Get up during the night to eat
•Patients are wide awake and do not binge eat
•Often not hungry, skip breakfast the next morning

Question 17

Causes for Obesity and Disordered eating

Answer 17

–Obesity is related to technological advancement
–Genetics account for about 30% of obesity cases
–Biological and psychosocial factors contribute as
well

Question 18

Obesity treatment

Answer 18

Efficacy
–Moderate success with adults –Greater success with children and adolescents
•Treatment progression – from least to most intrusive options

First step
–Self-directed weight loss programs
•Second step
–Commercial self-help programs
•Third step
–Behavior modification programs
•Last step
–Bariatric surgery