Eating Disorders Flashcards
1
Q
Perspectives
A
HISTORICAL - religious orders CROSS-CULTURAL - Western "thin = attractive" ideal - ie. British TV in Fiji causing eating disorder outbreak and change of concept of "beauty"
2
Q
Eating Disorder Types
A
ANOREXIA NERVOSA (AN) BULIMIA NERVOSA (BN) EATING DISORDER NOT OTHERWISE SPECIFIED (EDNOS) BINGE EATING DISORDER (BED) OBESITY (?)
3
Q
EDT: Anorexia Nervosa
A
- refusal to maintain body weight (self-starvation)
- restricting VS binging/purging
- at least 15% below “normal” weight
- intense weight gain fear
- disturbance of body image
- amenorrhoea (menstruation absence)
4
Q
EDT: Bulimic Nervosa
A
- loss of control over eating
- “normal” weight
- binging/purging cycles (ie. vomiting/laxative misuse)
- over-exercising
5
Q
Management Issues
A
- major dilemma for clinicians
- respecting patient choice/autonomy
- patient refusing insight into self-harm caused
- enabling patient to reduce health risks
- treatments vary in invasiveness
- insufficient contextual/effectiveness research
6
Q
Common Pathways to Eating Disorders
A
- many w/AN may develop BN
- ECKERT et al (1995); some develop BN w/o first having AN
- both usually develop in adolescence
- x10 more likely in women than men
- AN = 1% late adolescent women
- BN = 1-3% prevalence
- both probably estimates
7
Q
Risks
A
- malnutrition effects (ie. lesser metabolism of vitamins/minerals); brittle bones (bone density reduction))
- joint disorders
- dental erosion (particularly in BN via vomit acid)
- cerebral atrophy (extreme AN)
- cognitive problems (extreme AN)
- hypothalamic function abnormalities via neurological differences/weight loss/emotional disturbance in AN
8
Q
Theories
A
- adolescent disorder
- extreme end of “continuum of weight control issues” (60-70% of women on diets)
- may always be range of factors to various degrees
9
Q
Causes
A
- risk factors over time include:
BIRTH/INFANCY
CHILDHOOD
ADOLESCENCE
10
Q
C: Birth/Infancy Factors
A
- gender
- genetics
- obstetric complications
- early feeding difficulties
- high concern parenting
- neurobiology via impairments to cortical/sub-cortical structures (self-knowledge/reward/food pathways)
11
Q
C: Childhood Factors
A
- childhood obesity
- childhood anxiety disorders
- sexual abuse/neglect
- adverse life events
- OCPD
12
Q
C: Adolescent Factors
A
- adolescence in of itself
- body dysmorphic disorder
- high exercise levels
- dieting!!
- OCD/perfectionism
- negative self-evaluation
13
Q
Cognitive/Behavioural Development
A
- “source of control” in life suggests function to EDs
- conflict between independence/fear of maturity
- co-existing/pre-cursive depression magnifies cognitive errors ie. guilt/shame (22-88%)
- lack of alternative control through transitions; intensified/entrenched via external food control
- deflects attention from other family issues
- media’s “aspiration for slimness” (especially AN)
- dissatisfaction w/body shape/size
- weight phobia via distorted body image
14
Q
Body Image Distortion: Self VS Others
A
- TOVEE (2000); 204 women; 1/6 AN/BN; 5/6 healthy
- estimate body mass index; shown photos to do the same
- ED overestimated photos BMI (but control did same, just less); AN were worst
- ED rated slim photos attractive
- ED overrated own BMI
- vicious feedback loop; losing weight = downward shift in attraction perception
15
Q
Compulsive Exercise
A
- historical; tenacious drive for physical activity
- prominent characteristic in AN, even facing severe emaciation
- BEUMON et al (1994); precedes ED onset
- CRISP et al (1980); one of last symptoms to pass
- associated w/
LENGTHIER HOSPITALISATION
HIGHER RELAPSE RISK
POOR LONG-TERM OUTCOME
