Disordered eating workshop Flashcards
What is the definition of obesity?
- abnormal or excessive fat accumulation that may impair health
- BMI greater than or equal to 25 is overweight
- BMI greater than or equal to 30 is obesity
What are the criticisms of using BMI as an idicator of obesity?
BMI doesn’t take into account
- age
- gender
- body frame
*
What should we also consider in addition to BMI?
- waist circumference
- ratio of hip to waist
- fat deposited around abdomen
What is the bahavioural perspective on obesity?
interaction between nature and nurture
- sedentary behavior
- lack of physical activity
- overeating
- eating the wrong foods
- eating for the wrong reasons (bored, annoyed, stressed)
- mobility disorders
- medical side effects
what is an “obesogenic” environment?
level of fat across population too high relative to average activity levels
What factors contribute to the obesogenic environment?
- lack of school facilities for play
- few cycling paths
- genetic predisposition
- parent’s health knowledge/cooking skills
- high energy foods promoted via advertising
- more eating out
- less education about lifestyle/nutrition/cooking
- media messages about body image
What are some of the mental health implications of obesity?
- contemporary cultural obsession with thinness
- stigma
- aversion to fat reported by both adults and children
- attribution of blame for obesity to the person
- promote poor self-image, low self-esteem, fatigue, embarrassment, and higher rates of depression
what are some of the physical implicaitons of obesity?
- cardiovascular disease
- hypertension
- T2 diabetes
- joint trauma
- mobility
- DVT
- Hernia
- some cancers (colon_
- mortality
myth or fact?
breast feeding is protective against obesity?
myth
Myth or fact?
regardless of body weight, and increased level of exercise increases health?
Fact
Myth or fact?
regularly eating breakfast is protective against obesity?
Myth
myth or fact?
early childhood is the period in which we learn exercise and eating habits that influence our weight throughout life?
myth
Myth or fact?
Snacking contributes to weight gain and obesity?
myth
What is DSM5? what are its four broad categories of eating disorders?
DSM5= diagnositc and statistical manual of mental disorders 5th edition
four categories =
- anorexia nervosa 55%
- bulimia nervosa 8%
- binge eating disorder
- avoidant/restrictive food intake disorder 12%
What are the typical defining characteristics of anorexia nervosa?
- restriction of energy intake relative to requirements leading to a significantly low body weight (less than minimally normal/expected)
- intense fear of gaining weight or becoming fat - persistant behaviour that interferes with weight gain, even though at a significantly low weight
- disturbance in the way in which ones own body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or persitent lack of recognition of the seriousness of the current low body weight.
What is Atypical anorexia nervosa?
All of the criteria for anorexia nervosa are met, except that, despite significant weight loss, the individual’s weight is within or above the normal range
What are some of the warning signs of anorexia nervosa?
What are some of the health complications associated with anorexia nervosa?
- Amenorrhea (cessation of menstrual cycle)
- abnormally slow heartbeat
- low blood pressure
- anaemia
- poor circulation in hands and feet
- muscle loss / weakness including heart
- dehydration / kidney failure
- edema/swelling
- memory loss/disorientation
- chronic constipation
- growth of lanugo hair
- bone density loss/osteoporosis
What are the characteristics of Bulimia nervosa according to the DSM 5 criteria?
- recurrent episodes of binge eating - (eating in a small amount of time large periods of food, sense of lack of control over eating during an episode)
- recurrent inappropriate compensatory behaviour in order to prevent weight gain (purging) - including vomiting, laxative misuse, fasting, excessive exercise, insulin misuse
- binge eating and compensatory behaviours both occur, on average, at least once a week for three months
- self evaluation is unduly influenced by body shape and weight
- the disturbance does not occur exclusively during episodes of anorexia nervosa
*1,2,4 are essential for diagnosis, and 3 is the scaling of severity*
What are the warning signs for bulemia nervosa?
describe the treatment of Anorexia nervosa and bulemia nervosa
1) restore the person to a healthy weight
2) treat the psychological issues related to the disorder
3) reduce or eliminate behaviours or thoughts that lead to disordered eating and prevent relapse
Describe the “SCOFF” questionaire
To identify eating disorders
- Do you make yourself SICK because you feel uncomfortably full?
- do yo uworry you have lost CONTROL over how much you eat?
- Have you recently lost more than ONE Stone (14 pounds) in a three month period?
- do you believe yourself to be FAT when others say you are too thin?
- would you say that FOOD dominates your life?
* a score of 2 indicates possible anorexia or bulimia*
What is the most accurate way to measure percent body fat?
Dual energy X-ray absorption
What is more important? weight or exercise?
Stable fitness in studies reduced all-cause and CVD mortality
1 metabolic equivalent gain in fitness associated with 15% reduction in all - cause mortality
BMI change had no effect on mortality when controlled for fitness
What is metabolic syndrome?
a muliple risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function - it is a risk factor for coronary heart disease as well as for diabetes, fatty liver disease, and several cancers.
risk factors for this condition include obesity (especially abdominal obesity), physical inactivit, and atherogenic diet, cigarette smoking, hypertension, elevated LDL cholesterol, family history of premature CVD, aging etc.
Is high adiposity strongly associated with increased mortality?
Not necessarily
- ABDOMINAL adiposity is strongly associated with increased mortality - b/c abdominal fat is associated with visceral fat (hormonally acitve) and associated with Type 2 diabetes
What is marasmus?
muscle wasting and depletion of body fat due to inadequate intake of all nutrients and total calories - common in starvation situations
What is kwashiorkor?
Muscle atrophy, normal body fat, due to inadequate protein but adequate calories - clinical presentation is anorexia, normal weight and height, severe generalised oedema, rounded cheeks, dry peeling skin, distended abdomen, hypopigmented hair (flat sign in hair)
What is ‘re-feeding syndrome in anorexia?”
characterised by
- hypophosphatemia (primary cause)
- hypokalemia
- hypomagnesemia
- vitamin and trace mineral deficiencies
- volume overload
- edema
- *risk factors= extent of weight loss, rapidity of weight gain*
What is the feeding strategy for extemely malnourished patients?
- correct electrolyte imbalance
- begin with calorie intake to reflect energy expenditure
- increase calories 300-400 kcal every 3-4 days
- weight gain should be around 1kg/week
