Chapter 9 Eating

Question 1

What are the three main types of eating disorders discussed?

Answer 1

Bulimia nervosa, anorexia nervosa, binge-eating disorder

These are classified according to their key features as outlined in the DSM-5-TR.

Question 2

What demographic suffers most with eating disorders?

Answer 2

Young females in socially competitive environments

Question 3

What is bulimia nervosa characterized by?

Answer 3

Binging (out-of-control) eating episodes followed by self-induced vomiting or chronic exercise

It includes methods of purging such as vomiting, laxatives, diuretics, excessive exercise, or fasting.

Question 4

What are the medical consequences of bulimia nervosa?

Answer 4

Enlargement of salivary glands, erosion of dental enamel, electrolyte imbalance, disrupted heartbeat, kidney failure, intestinal problems, marked calluses on fingers or back of hand

These physical effects can result from repeated purging behaviors.

Question 5

What psychological disorders are commonly associated with bulimia nervosa?

Answer 5

Anxiety and mood disorders, depression, borderline personality disorder, impulsivity

Impulsivity may manifest in behaviors such as compulsive shoplifting.

Question 6

What distinguishes anorexia nervosa from bulimia nervosa in terms of self-perception?

Answer 6

Anorexics are proud of their diets and do not see themselves as ill, while bulimics are ashamed of their problem and lack of control

This difference in self-perception affects their willingness to seek help.

Question 7

True or false: many individuals with bulimia have a history of anorexia

Answer 7

True

Question 8

What is characteristic of anorexia nervosa?

Answer 8

People with anorexia have an intense fear of obesity and relentlessly pursue thinness

Question 9

What are the two subtypes of anorexia nervosa specified in the DSM-5-TR?

Answer 9

Restricting type, binge eating/purging type

Each subtype has distinct behaviors regarding food intake and weight control.

Question 10

What is the typical body mass index (BMI) when treatment for anorexia is sought?

Answer 10

Close to 16

This indicates severe underweight status.

Question 11

What are the medical consequences of anorexia nervosa?

Answer 11

Cessation of menstruation (amenorrhea), dry skin, brittle hair or nails, sensitivity to cold, lanugo, cardiovascular problems, electrolyte imbalance

These symptoms reflect the severe impact of starvation on the body.

Question 12

What are some commonly associated psychological disorders for those with anorexia?

Answer 12

-Anxiety
-Mood disorders
-OCD
-Substance abuse
-Suicide

Question 13

What is binge eating disorder?

Answer 13

Individuals who experience marked distress from binge eating but do not engage in extreme compensatory behaviours and therefore cannot be diagnosed with bulimia.

Question 14

What is binge-eating disorder associated with?

Answer 14

Obesity, later age of onset, prevalence in males

Binge-eating disorder may lead to cross-over into bulimia.

Question 15

What percentage of bulimics are women?

Answer 15

90%–95%

The remaining percentage includes predominantly minority sexual orientation males.

Question 16

What is the age of onset for bulimia?

Answer 16

16-19 years

Question 17

How many Canadians are struggling with eating disorders currently?

Answer 17

1 million

Question 18

How does the prevalence of eating disorders differ between white people and other ethnic groups?

Answer 18

White individuals, especially college students, report more eating disturbances than other groups.

Question 19

What happens to immigrants moving to Western countries regarding eating disorders?

Answer 19

They often develop eating disorders after exposure to Western cultural ideals.

Question 20

How do puberty-related changes contribute to eating disorders?

Answer 20

After puberty, boys develop muscle while girls gain fat tissue, which moves boys closer to the Western ideal and girls further from it, increasing eating disorder risk.

Question 21

Can eating disorders occur in childhood?

Answer 21

Yes, though rare, anorexia can develop in children under 11, with some even restricting fluid intake, which is particularly dangerous.

Question 22

What is ARFID, and how does it differ from anorexia or bulimia?

Answer 22

ARFID is an eating disorder without body image concerns, involving a lack of interest in food, extreme sensitivity to food, or fear of eating consequences (e.g., choking).

Question 23

Who is most affected by ARFID?

Answer 23

It is usually detected in infants and children, but it can persist into adulthood. Unlike anorexia, it affects a higher proportion of males.

Question 24

What sociocultural pressures contribute to the development of eating disorders?

Answer 24

Magazines and beauty pageants glorifying slenderness, societal competition

These pressures can create unrealistic body image expectations.

Question 25

How have beauty standards for women changed over time?

Answer 25

Studies of beauty pageants and Playboy centrefolds show that since the 1960s, the ideal female body has become significantly thinner, with most winners since the 1970s classified as undernourished.

Question 26

What did Fallon & Rozin (1985) find about male and female body image perceptions?

Answer 26

Men see their body size accurately, but women think they are heavier than their ideal and what men find attractive.

Question 27

How does dieting paradoxically contribute to weight gain?

Answer 27

Restrictive dieting causes stress, leading to binge-eating and weight regain.

Question 28

Why are ballet dancers and female athletes at higher risk for eating disorders?

Answer 28

They face intense pressure to maintain a thin body for their sport or profession.

Question 29

How do family dynamics contribute to eating disorders?

Answer 29

Families of individuals with anorexia often emphasize success, appearances, and harmony while ignoring internal conflicts.

Question 30

Do eating disorders have a genetic component?

Answer 30

Yes, relatives of people with eating disorders are 4-5 times more likely to develop them.

Question 31

What is the heritability estimate for eating disorders?

Answer 31

0.56 ## Footnote This suggests a significant genetic component to the development of eating disorders.

Question 32

What personality traits might contribute to eating disorders?

Answer 32

Emotional instability, poor impulse control, perfectionism, and negative affect.

Question 33

What brain region is linked to eating disorders?

Answer 33

The hypothalamus, which regulates eating behavior and interacts with neurotransmitter systems.

Question 34

Which neurotransmitter is most associated with eating disorders?

Answer 34

Serotonin; low levels are linked to impulsivity and binge eating.

Question 35

How do hormones influence binge eating?

Answer 35

High ovarian hormone levels can increase emotional eating and binge eating, especially post-ovulation.

Question 36

What is "activity anorexia"?

Answer 36

Excessive exercise leading to a loss of appetite, observed in both humans and animals.

Question 37

What research suggests eating disorders can develop without cultural influences?

Answer 37

Studies on rats show excessive exercise combined with food restriction can cause anorexia-like symptoms.

Question 38

What psychological dimensions are often found in young women with eating disorders?

Answer 38

Diminished sense of personal control, lack of confidence, perfectionist attitudes, low self-esteem, intense negative emotional reactions, distorted body image ## Footnote These factors can exacerbate the severity of the disorder.

Question 39

How does perfectionism contribute to eating disorders?

Answer 39

It only plays a role if individuals already have low self-esteem and believe they are overweight.

Question 40

What is mood intolerance, and how does it relate to eating disorders?

Answer 40

It's the inability to tolerate negative emotions, leading to bingeing, purging, or excessive exercise to cope.

Question 41

What role do food restriction and negative body image play in eating disorders?

Answer 41

Restriction can trigger bingeing and purging cycles due to fear of weight gain and emotional distress.

Question 42

Why doesn't dieting alone explain eating disorders?

Answer 42

Many people diet, but only a minority develop eating disorders, suggesting additional factors like perfectionism, peer influence, and family attitudes about body image.

Question 43

How do personality traits influence different eating disorders?

Answer 43

Overcontrolling tendencies may lead to anorexia, while impulsivity may lead to bulimia.

Question 44

Why do some individuals with eating disorders lose extreme weight while others binge and purge?

Answer 44

This may be influenced by genetics, physiology, or personality traits like control versus impulsivity.

Question 45

What are common drug treatments for eating disorders?

Answer 45

Antidepressants, Prozac ## Footnote These medications may help alleviate symptoms associated with eating disorders. For bulimia not anorexia.

Question 46

Are drugs alone suggested as treatment for eating disorder?

Answer 46

No, current expert opinions suggest that medications are likely most useful in conjunction with psychological treatments.

Question 47

What is the most effective treatment for Bulimia Nervosa?

Answer 47

Cognitive-Behavioral Therapy-Enhanced (CBT-E), which includes: - Teaching physical consequences of bingeing/purging -Educating on ineffectiveness of vomiting/laxatives for weight control -Establishing structured eating patterns (5-6 meals/day) - Modifying dysfunctional thoughts about body shape, weight, and eating - Developing coping strategies to resist bingeing/purging

Question 48

How does Interpersonal Psychotherapy (IPT) treat Bulimia Nervosa?

Answer 48

-Focuses on improving interpersonal functioning rather than eating behaviors -Has comparable long-term efficacy to CBT

Question 49

What are key components of psychosocial treatments for bulimia nervosa?

Answer 49

CBT-E, IPT, traditional CBT, behavior therapy, family therapy ## Footnote These therapies aim to change dysfunctional thoughts and improve interpersonal functioning.

Question 50

What is the role of Family Therapy in treating Bulimia Nervosa?

Answer 50

Addresses conflicts within families, particularly for adolescents with eating disorders

Question 51

What is a common treatment approach for binge-eating disorder?

Answer 51

CBT, weight-loss programs, self-help procedures ## Footnote Treatment should specifically address binge eating behaviors.

Question 52

What is the primary treatment for Binge-Eating Disorder (BED)?

Answer 52

-CBT (adapted from Bulimia treatment) -Targets binge-eating behavior and weight-related attitudes -Leads to significant binge reduction and modest weight loss ## Footnote IPT can be used if patient does not respond to CBT

Question 53

How does CBT-E help with Anorexia Nervosa?

Answer 53

-Targets anxiety about obesity and fear of losing control over eating -Challenges overvaluation of thinness -Prevents relapse after weight restoration

Question 54

What is the purpose of Motivational Enhancement Therapy (MET) in Anorexia treatment?

Answer 54

Assesses and increases readiness for change ## Footnote Readiness linked to better treatment outcomes

Question 55

How does Family-Based Therapy (FBT) help in Anorexia treatment?

Answer 55

Restructures family dynamics around food and eating ## Footnote Especially effective for adolescents with short illness duration

Question 56

What preventive measures can help reduce the incidence of eating disorders?

Answer 56

Eliminating exaggerated focus on body shape, educating about food and eating habits, promoting a healthy body image, countering media portrayals of thinness ## Footnote These strategies aim to foster a healthier relationship with food and body image.