eating disorder causes + maintenance

Question 1

define eating disorders

Answer 1

persistent disturbance of eating behaviour intended to control weight

Question 2

how are they diagnosed?

Answer 2

• ICD follows DSM

- BMI (weight/height2) - healthy generally 19-25 h/e athletes are usually heavier bc muscle mass/ethnicity/age/gender

Question 3

anorexia nervosa diagnosis

Answer 3

• persistent restriction of energy intake–>low body weight
• intense fear of/behaviours to prevent gaining weight
• disturbance in way body weight/shape experienced
• subtypes: restricting, binge-eating/purging
• ballerinas sanctioned to be underweight
• <17.5 BMI

Question 4

bulimia nervosa

Answer 4

• recurrent episodes of binge eating, lack of control
• recurrent inappropriate compensatory behaviour to prevent weight gain (vomiting/laxatives/diuretics/excessive exercise)
• self-evaluation influenced by body shape/weight
• doesn’t occur exclusively during anorexic episodes

Question 5

binge-eating disorder

Answer 5

• recurrent episodes of binge eating, lack of control
• eating til uncomfortably full, large amounts, eating alone, feeling depressed after
• bingeing at least once a week for 3 months
• no compensatory behaviours
• trouble accessing services

Question 6

other specified feeding and eating disorders (OSFED)

Answer 6

• many symptoms of other disorders but don’t meet full criteria for diagnosis
• atypical anorexia: despite sig weight loss, weight still in ‘normal’ range
• atypical bulimia: low freq/limited duration
• atypical binge-eating: low freq/limited duration
• purging disorder
• night eating syndrome

Question 7

avoidant/restrictive food intake disorder

Answer 7

-children/young people
-disturbance in eating/feeding - nutritional deficiency, dependence on supplements, weight gain/loss
-‘fussy eaters’
-treatments are behavioural- focus on anxiety
3 types:
-sensory-based avoidance: refuse based on smell/texture/colour/presentation
-lack of interest: in consuming food
-food associated with fear-evoking stimuli

Question 8

are diagnoses needed?

Answer 8

• fairburn et al 2003: diagnosis of specific eating disorders doesn’t do what it should: 40-50% cases don’t fit diagnoses, atypical group are largest, doesn’t indicate best treatment
• shift to transdiagnostic model

Question 9

co-morbid psychological problems

Answer 9

• anxiety: OCD, social anxiety
• depressed mood: low serotonin
• personality disorder: anxiety + impulsivity based
• alcohol + substance use

Question 10

complications from eating disorders

Answer 10

• cardiac
• muscular weakness
• osteoporosis
• liver damage
• oseophageal tearing
• fainting

Question 11

epidemiology

Answer 11

the study/analysis of distribution, patterns and determinants of health and disease conditions in population

Question 12

incidence

Answer 12

number of new cases in set window of time, number of people at risk of it

Question 13

prevalence

Answer 13

number of current cases/number of people who have had problem in the past in a certain time period

Question 14

what are the prevalence rates for ED?

Answer 14

-750,000 cases in UK
-1% of pop
-generally young, female (14-30 years)
in young female population:
-anorexia - 0.3%
-bulimia - 1%
-other cases - 2-3%

Question 15

why can’t just medical records be used to know prevalence rates?

Answer 15

• GPs aren’t perfect at spotting cases
• more awareness is causing higher rates
• westernisation is related to increasing identification
• curaco study: more cases among non-whites in recent years
• fiji study: clear link to intro of western media, TV and social network based exposure

Question 16

theories of causation

Answer 16

-sociocultural + neurobiological: abuse, parental mood/eating etc
h/e evidence weak, lack longitudinal data
neurobiological factors unclear e.g. genetics, hypothalamic damage preventing hunger?

Question 17

what are the theories of maintenance?

Answer 17

• cognitive patterns
• safety behaviours
• emotional factors
• perceptual factors
• social factors

Question 18

cognitive patterns

Answer 18

low self-esteem, perfectionism have self-maintaining cycle e.g. low self-esteem don’t look for positive things about self
2 central beliefs:
-broken cog link between eating and weight
-overvaluation: appearance and weight as defining ourselves as being acceptable to people

Question 19

safety behaviours

Answer 19

• behaviours that calm us temporarily

- long-term consequence makes us feel worse so we do it again to calm down

Question 20

emotional factors

Answer 20

• anxiety biggest emotional maintaining and triggering emotion for eating problems
• depression is consequence
• impact from anger/loneliness/boredom

Question 21

perceptual factors

Answer 21

• perceptual distortions
• see themselves 25-30% larger than they are
• misperceive weight

Question 22

social factors

Answer 22

• social pressure to be thin/muscly in western culture

- fashion mags/social media

Question 23

how are behaviours formulated?

Answer 23

• done with individual to normalise what they do- identifies risk
• triggers
• setting conditions

Question 24

how are cases formulated?

Answer 24

• a way of understanding the functions
• ABC model: antecedents, behaviours and consequences, focus on feedback loops that maintain problem
• fairburn et al 2003 model is complex and evidence is weak
• useful models e.g. slade 1982
• central role of control
• stress on maintenance elements