Eating and sleep Wake disorders Flashcards
1
Q
Eating Disorders Overview
A
- Three major types: anorexia nervosa, Bulimia, binge eating disorder
- All involve severe disruptions in eating behavior
- AN and BN involve extreme preoccupation w weight
- BED involves less distortions about weight
2
Q
Bulimia Nervosa
A
- Binge eating: hallmark of bulimia
- Eating excessive amounts in a discrete period of time
- Eating is perceived as uncontrollable
- may be associated w guilt shame or regret
- may hide behavior from family members
- foods consumed often in fat sugar or carbs
- Compensatory behavior to prevent weight gain
- Purging: use of diuretics, laxatives, self-induced vomiting– most common
- Excessive exercise
- Fasting or food restriction (must coincide w binging)
- Once a week for at least 3 months
- Self-evaluation influenced by body shape and weight
3
Q
Bulimia Associated features (medical, psychological)
A
- Medical
- most are within 10% of normal body weight
- purging can result in severe medical problems
- Erosion of dental enamel, electrolyte imbalance (laxatives), kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage
- psychological features
- Concern w body weight
- Most are comorbid w psychological disorders
4
Q
Anorexia Nervosa: Overview
A
- Extreme weight loss- hallmark of anorexia
- intense fear of weight gain
- often begins w dieting
- restriction of calorie intake below energy requirements
- sometimes 15% below expected weight
- Self control and pride with weight loss as opposed to feeling out of control and trying to hide it (as occurs in bulimia)
5
Q
DSM V Criteria Anorexia nervosa
A
- Restriction of aloric intake that lead to significantly low body weight
- Intense fear of gaining weight
- Overemphasis on body weight or shape in self-evaluations or denial of current low weight
- Subtypes
- Restricting
- Binge-eating-purging:
- Not binging as much as bulimia purging more
- Severely underweight in anorexia not bulimia
6
Q
Anorexia Nervosa: associated features (medical and psychological)
A
- Medical
- Most deadly mental disorder
- 20% may die as a result
- starving body borrows energy from organs leading to damage
- Also leads to loss of periods, dry/brittle hair and nails, electrolyte imbalance, decreased cognitive functioning, electrolyte imbalance
- Most deadly mental disorder
- Psychological features
- Disturbance in body image
- Most have comorbid psychological disorders
- 70% depression at some point
- higher than average substance abuse and OCD
7
Q
Binge eating overview
A
- Binge eating without compensatory features
- Associated with distress or functional impairment
- Excessive concern with weight not present
- More often in men
- Better response to treatment than other EDs
8
Q
Binge Eating DSM criteria
A
- Recurrent binge eating:
- eating large amount than is typical for others in that situation
- Lack of control
- At least three of the following
- Eating more rapidly than normal
- Eating until uncomfortably full
- eating alone due to embarassment about large amounts of food
- Feeling disgusted with oneself or guilty after eating
- Distress
- At least 1x per week on average for 3 weeks
9
Q
Associated Features Binge eating
Medical psychological
A
- Medical
- Often overweight or obese
- Psychological
- May or may not have concerns about body weight and shape
- Emotional or night eating e.g. eating when depressed or bored
- More psychopathology than non-binging obese individuals
- Some transition to bulimia
10
Q
Bulimia and Anorexia Facts and Statistics
A
Bulimia:
- Most common eating disorder
- More prevalent in women than men (but men rising)
- Chronic if untreated especially if lifetime preoccupation with body (can be family induced)
- Common in college-age women (5-8%)
- onset 16-19 years old
Anorexia
- Majority female and white
- Middle and upper-middle-class families
- More chronic resistant to treatment than bulimia
- age of onset around 13
11
Q
Demographic differences Anorexia and Bulimia
A
- Gender differences
- Bodily concerns primarily thinnes women & muscle for men
- Men most common subgroups
- Gay/bi men
- Sports concerned with weight class
- Ethnic considerations
- Older research showed less prevalence in African American women but the disparity is decreasing (idea that African American men liked larger women in the past)
- Cross cultural factors
- mostly in western world
- non-western women may develop after moving to western countries
- Strong socio-cultural origins for ED
12
Q
Media and cultural considerations
A
- Media and cultural considerations
- Thinness associated with success
- Cultural emphasis on dieting
- Standards of ideal body size
- Thinnes is not possible for many, society still puts value in “thin ideal”
- Standard leads to low self-esteem and burden for overweight and obese individuals
13
Q
Family influences Eating disorders (social and biological)
A
- Parents with distorted perception of food intake may restrict childrens intakes too
- Families of anorexic individuals
- High achieving
- Concerned with external appearances
- Overly motivated to maintain harmony (anorexia form of coping if there is no open communication in family)
- Disordered eating also causes family strains: parental guilt and frustration which leads to poorer outcomes
- Some genetic components
- More likely to develop if family has
- Could be due to inherited personality traits like emotional instability or impulsivity
- Some evidence of NT and Hormone dysregulation in eating disorders
14
Q
ED psychological dimensions
A
- Low sense of personal control and self confidence
- Socially competitive environment
- Perfectionistic attitudes
- Distorted body image
- preoccupation with food
- Extreme self-focus– especially in performing arts (e.g. dancing where looking at self in the mirror constantly)
- Distress intolerance: using compensatory behavior to feel better regulated mood
15
Q
Treatments Psychosocial Bulimia and binge eating
A
CBT
- Address maladaptive beliefs (e.g. “I’m overweight so no one will love me)
- Psychoeducation (health consequences; awareness of hunger and satiation cues)
- food logs (but could lead to obsession, should be for informational purposes)
- Treat comorbid anxiety/depression
- Binge eating: including weight loss strategies
Medication
Andidepressants
- SSRIs can help reduce binging and purging behaviors
- Not efficacious long run
