eating disorders Flashcards
gender differences (EDs)
occur primarily in women – estimates 3 females for every male has an ED
- gender bias in DSM = men less likely to recognize they have an ED & often misdiagnosed
diagnostic crossover (EDs)
very likely for someone with one ED to be later diagnosed with another
- bidirectional transitions between 2 subtypes of anorexia
- shifts from ana to bul also common – but no direct transition from RA to bul
- also no crossover from RA to BED, but bul to BED occurs
comorbidity of EDs
depression (all eds)
OCD - ana & bul
substance abuse - BPA, bul & BED
self-harming
anxious-avoidant personality disorders - RA
anorexia nervosa
= an intense fear of gaining weight or becoming fat + behaviors that results in significantly low body weight
- many deny having a problem & deny the seriousness – become fulfilled by weight loss but make efforts to conceal thinness
2 subtypes: restricting anorexia & binge/purge anorexia
anorexia age of onset
most likely to develop between ages 15 – 19
anorexia prevalence
0.9% in women, 0.3% in men
bulimia nervosa
= uncontrollable binge eating followed by efforts to prevent weight gain by using inappropriate behaviors (purging)
- difference between bulimia & BPA is weight – person with bulimia is not severely underweight
bulimia age of onset
20-24 years
bulimia prevalence
worldwide: 1%
US prevalence: 1.5% women, 0.5% men
binge eating disorder
important difference from bulimia: after a binge a person with BED does not engage in in any form of inappropriate compensatory behavior
- much less dietary restraint
- associated with being over-weight
- age of onset: 30-50
- lifetime prevalence worldwide: 2%
- US prevalence: 3.5% women, 2% men
- physical consequences: obesity & the problems that come with it
risk/causal factors - homosexuality (ED)
in men
gay & bi men have higher rates – bcuz they want to be attractive to men & they know men seek attractiveness in partners = more body dissatisfaction
risk/causal factors - genetics (ED)
- tendency to develop ED runs in family
- both ana & bul are heritable disorders
- evidence for a gene on chromosome 1 being linked to RA
- Eds linked to regulation of serotonin
genetic factors may influence some of the traits that make people more likely to respond to pressures with disturbed eating
risk/causal factors - brain abnormalities (ED)
- damage to frontal & temporal cortex linked to development of ana & bul
- temporal cortex involved in body image perception & parts of frontal cortex involved in monitoring pleasantness of smell & taste
risk/causal factors - serotonin (ED)
modulates appetite & feeding behavior
- many ED patients respond well to antidepressants
- serotonin made from amino acid called tryptophan – only obtained from food & converted to serotonin
medication in treating anorexia
antidepressants are sometimes used
olanzapine: an antipsychotic medication - provide benefits in the treatment of anorexia
- a desirable side effect is weight gain
family therapy in treating anorexia
best treatment for adolescents - 10-20 sessions over 6-12 months, 3 phases
1. refeeding phase - therapist works w parents and supports efforts to help their child to eat healthily. family meals observed by the therapist
2. relationships phase - patient begins to gain weight, new patterns of relationships are made + family issues and problems addressed
3. termination phase - focus is on the development of more healthy relationships between patient and parents
CBT in treating anorexia
- proven to be effective in treating bul - ana & bul share many features = often used to treat anorexia
- recommended length of treatment is 1-2 years
- major focus involves modifying distorted beliefs concerning weight and food + distorted beliefs about the self that may have contributed to the disorder
medication in treating bulimia
antidepressants :
- patients taking antidepressants did better than patients given placebo
- usually a response within the first 3 weeks
- do not show early improvement = unlikely to benefit from further treatment on the same medication
- decrease the frequency of binges + improve patients’ mood and preoccupation with weight and shape
CBT in treating bulimia
leading treatment for bulimia
- behavioral component = focuses on normalising eating patterns
- cognitive component = aimed at changing the cognitions and behaviours that initiate or perpetuate a binge cycle
medication in treating BED
antidepressants, appetite suppressants, anticonvulsant medications
- high level of comorbidity between BED & depression = antidepressants sometimes used
interpersonal therapy in treating BED
therapy sessions focusing on how interpersonal problems may cause binges (grief, interpersonal roles, interpersonal deficits)
