Eating disorders 1 Flashcards

1
Q

balance between hunger and satiety =

A

homeostasis

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2
Q

what are the internal causes of hunger and satiety?

A

genetics
learning
social learning

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3
Q

what are the external causes of hunger and satiety?

A

social pressures
food industry
toxic environment

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4
Q

a persistent disturbance of eating behaviour or behaviour intended to control weight, which significantly impairs physical health/psychological functioning =

A

eating disorder

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5
Q

only ___% of cases are underweight as majority of people with eating disorders are not identifiable by being skinny

A

15

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6
Q

BMI =

A

weight (Kg) / Height in m2

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7
Q

what is the healthy range of BMI?

A

19-25 (varies with factors such as ethnicity)

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8
Q

why is BMI not a very meaningful measure for young people?

A

young people are growing over time so we use expected weight for height and this is adjusted for age

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9
Q

what is the BMI of someone overweight?

A

over 25

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10
Q

what is the BMI for an obese person?

A

over 30

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11
Q

why do athletes have a higher BMI?

A

muscle weighs more than fat

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12
Q

persistent restriction of energy intake leading to significantly low body weight, intense fear of gaining weight, disturbance in body experience =

A

anorexia nervosa

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13
Q

what are the subtypes of anorexia?

A

restricting

binge-eating/purging

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14
Q

which is the worst subtype of anorexia?

A

binge-eating > more worried about suicide

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15
Q

explain the critical thoughts of why weight is not a definite indicator of anorexia

A

some people have naturally low BMI and don’t put on weight easily despite eating lots, ballerinas encouraged to be underweight (social sanctioning), lots of variation, BMI needs to be adjusted for specific ethnic groups, most cases won’t show extreme weight loss at the start, might be starvation for other reasons

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16
Q

recurrent episodes of binge eating of eating more in a short period than people would normally in a similar period =

A

Bulimia nervosa

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17
Q

what are some of the recurrent inappropriate behaviours in order to prevent weight gain (bulimia)?

A
self induced vomiting
misuse of laxatives
diuretics
other medications
fasting
excessive exercise
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18
Q

how many times does binges and behaviours have to occur for the diagnostic criteria of bulimia?

A

1 x a week for 3 months = DSM-5

DSM-4 = 2 x a week

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19
Q

recurrent episodes of over eating, sense of lack of control, eat more rapidly and large amounts when not hungry, eating alone, feelings of disgust/depression/guilt =

A

binge eating disorder

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20
Q

does binge eating disorder have any purging or compensatory behaviours?

A

no

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21
Q

which disorder is the most common?

A

binge eating disorder

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22
Q

how often does binge eating disorder have to occur in the diagnostic criteria?

A

1 x a week for 3 months

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23
Q

what does OSFED stand for?

A

other specified feeding and eating disorders

24
Q

present with many symptoms of other eating disorders but don’t meet full criteria for diagnosis =

A

atypical cases

25
Q

why were OSFEDs introduced?

A

lots of people don’t fit neatly into diagnosis with eating disorders but would still benefit from help

26
Q

what are some disorders that fit under OSFED?

A
atypical anorexia nervosa
atypical bulimia nervosa
atypical binge eating disorder
purging disorder
night eating syndrome
27
Q

despite significant weight loss, the individuals weight is within or above the normal range =

A

atypical anorexia nervosa

28
Q

what makes bulimia nervosa and binge eating disorder atypical?

A

lower frequency and/or duration

29
Q

what does ARFID stand for?

A

Avoidant/Restrictive Food Intake Disorder

30
Q

who is mainly affected by ARFID?

A

children and young people

31
Q

what are some of the signs of ARFID?

A
disturbance in eating
substantial weight loss
nutritional deficiency
dependence on supplements
absence of typical food beliefs
anxiety induced
fussy eating
32
Q

what are the 3 subtypes of ARFID?

A
  1. sensory based avoidance
  2. food associated with fear evoking stimuli
  3. lack of interest (in consuming or tolerating nearby)
33
Q

refuses food intake based on smell, colour, texture, presentation = which subtype of ARFID?

A

sensory based avoidance

34
Q

Fairburn et al (2003) found that __-__% of cases don’t fit neatly into diagnosis and _______ cases are the largest single group

A

40-50, atypical

35
Q

what are some problems with diagnosis of eating disorders?

A

many fail to stay in 1 diagnosis e.g. patients with anorexia develop bulimia, doesn’t indicate best treatment
(consequently there is a shift from rigid diagnoses = trans diagnostic model)

36
Q

what do the underlying biological causes and consequences of eating disorders means we have to consider?

A

comorbid psychological problems

37
Q

what are some comorbid psychological problems that arise with eating disorders?

A

anxiety disorders
depressed mood
personality disorder
alcohol/substance use

38
Q

why is alcohol use a higher risk and used more over substance use?

A

has a higher nutritional load so can replace food and keep you going throughout the day

39
Q

what are problems arise that lead to higher mortality rates?

A
cardiac complications
muscular failure
osteoporosis
liver damage
oesophageal tearing
fainting
40
Q

number of new cases in a period of time =

A

incidence

41
Q

number of current cases =

A

point prevalence

42
Q

number of cases who have had the problem over the past year =

A

annual prevalence

43
Q

what factors make it hard to calculate incidence so we focus on prevalence instead?

A

slow onset
secrecy
slow diagnosis

44
Q

which disorder gets the most attention despite having the lowest prevalence rate?

A

anorexia (0.3%) then bulimia (1%) then other cases (2-3%)

45
Q

when looking at more vulnerable groups prevalence rate _______

A

increases

46
Q

what are the proposed sociocultural and neurobiological factors as causes of eating disorders?

A
early parenting
abuse
bullying
emotional invalidation
childhood obesity
parental mood/eating
childhood anxiety
47
Q

what are some of the limitations with studies and causal evidence for eating disorders?

A

aren’t many cases in population and need a large sample size

lack of longitudinal data

selective sampling

risk of selective memory

risk of misinterpreting associations

doesn’t infer causation

48
Q

what are cognitive patterns that maintain an eating disorder? (theories of maintenance)

A

low self esteem
negative self attribution
perfectionism

(each of these have a self maintaining cycle)

49
Q

what are the 2 central belief systems?

A

broken cognitive link between eating and weight, overevaluation

50
Q

explain the ‘broken cognitive link’ theory

A

most of us believe our eating and weight will balance out naturally whereas people with eating disorders have broken cognition believing whatever they eat will cause weight to shoot up. this drives restriction > bingeing > gaining weight > restricting

51
Q

explain overvaluation as theory of maintenance

A

believe appearance and weight define them as being acceptable people, only good enough if in control of body (especially women)

52
Q

what are the safety behaviours that calm patients down when feeling anxious?

A
binge eating
restricting
body avoidance/checking
exercise
purging
53
Q

what is the long term consequence of safety behaviours?

A

feel worse so do behaviour again to calm us > forms vicious cycle

54
Q

what is the biggest maintaining and triggering emotion for eating problems?

A

anxiety (particularly in relation to safety behaviours)

55
Q

how do perceptual factors play a part in eating disorders?

A

perceive themselves 25-30% larger than they are, overestimate size

56
Q

what is thought shape fusion?

A

when we see food we already feel larger in size before eating it

57
Q

what are the steps a clinician would use to formulate an eating disorder by increasing the chances of a binge?

A

starve a person for period of time > make them feel distressed > expose them to lots of food > disinhibit (get person drunk)