Eating Disorders Flashcards
1
Q
Eating disorders
A
- Persistent disturbance in eating behavior.
2
Q
Anorexia nervosa
A
- Lack of appetite induced by nervousness.
- Intense fear of gaining weight combined with behaviors that result in a significantly low body weight.
- Purging vs restrictive type = the way they maintain their very low weight.
3
Q
Anorexia nervosa: Restricting type
A
- Efforts to limit the quantity of food consumed. Calorie intake controlled, avoidance of eating in front of others, eating excessively slow or cut their food into small pieces/dispose their food.
4
Q
Anorexia nervosa: Purging/binge-eating type
A
- Either binge, purge, or binge and purge.
- Binge: out-of-control consumption of food, might be followed by activities that remove the food eaten.
- Purge: ways to remove food from the body, self-induced vomiting, laxatives etc. Exercise/fasting is not purging.
5
Q
Bulimia nervosa
A
- Uncontrollable binge eating and efforts to prevent resulting in weight gain by using purging techniques.
- Normal weight or slight overweight.
- Begins with restricted eating motivated by desire to be slim. Then, gradually erodes and starts eating ‘forbidden foods’. This is followed by purging.
- Average binge is 4800 calories.
6
Q
Binge eating disorder
A
- After a binge, the person does not engage in any form of inappropriate behaviors.
- Less dietary restrain.
-Associated with being overweight or even obese.
7
Q
Age of onset
A
- Anorexia: starts at 7 but usually develops at 15-19 years.
- Bulimia: 20-24 years.
- Binge eating: 30-50 years.
8
Q
Gender differences
A
- 3:1 women vs men.
- Gender bias in the DSM-5.
- Homosexual men have higher rates of eating disorders than heterosexual men.
9
Q
Prevalence
A
- Anorexia: 1%
- Bulimia: 0.9%
- Binge-eating: 2%
10
Q
Medical complication: Anorexia
A
- Highest mortality rate.
- 3% die from the consequences of self-imposed starvation.
Body complications: - Hair thinks and brittles
- Blood: anemia and others
- Muscles and joints: weak muscles, swollen joints, fractures, osteoporosis.
- Kidney stones and failure.
- Low potassium, magnesium and sodium
- Constipation, bloating.
- Bruise easily, dry skin, growth of fine hair, cold easily, yellow skin, nails brittle.
- Low blood pressure, slow heart rate, heart failure.
- Period stops, bone loss, trouble getting pregnant, miscarriage, post partum depression.
- Brain and nerves: bad memory, fainting, changed brain chemistry, cant think straight etc.
11
Q
Medical complications: Bulimia
A
- Less lethal
Body effects: - Electrolyte imbalances and low potassium from purging = risk for heart abnormalities.
- Damage to the heart muscles may be due to using ipecac syrup (vomiting)
- Tears to the throat may occur or calluses on the hands due to self vomiting.
- Teeth damage also occurs damage the contents of the stomach is acidic (brushing after is worse).
- Swollen parotid (saliva) glands caused by vomiting
- Small red dots around your eyes due to pressure of vomiting.
12
Q
Course and outcomes
A
- Suicide
- Recovery is still possible: 52.1% for anorexia, 70% for bulimia, and high rates for binge-eating.
13
Q
Diagnostic crossover
A
- Bidirectional transition between the two types of anorexia is common.
- Binge/purge anorexia and bulimia is common
- Binge eating and bulimia is common
- No cases of binge eating and anorexia
14
Q
Comorbidity
A
- Depression: 68% anorexia, 63% bulimia, 50% binge eating.
- OCD found with bulimia and anorexia.
- Substance use with bulimia, anorexia (not restricting type)
- Personality disorders are also co-morbid. Restrictive type = anxious-avoidant, binge/purge = borderline personality disorder.
15
Q
Culture
A
- Anorexia = all over the world.
- Culture influences disorder’s clinical manifestation.
- Bulimia = people with exposure to western ideals about thinness, access to large amounts of food and who can purge in private.
16
Q
Biological factors
A
- Abnormality in the hypothalamus - VMH for satiety, LH for hunger
- Damage to frontal/temporal = anorexia/bulimia
- Temporal - body image
- Frontal - monitoring pleasantness of smells and taste.
- Set point theories: hunger impulse to get back to set point in bulimia and binge.
- Serotonin: low levels (modulate appetite and feeding behavior)
17
Q
Sociocultural factors
A
- Magazines, social media
18
Q
Family influences
A
- Dysfunction/poor communication
- Desired thinness from family
19
Q
Individual risk factors
A
20
Q
Treatment: Anorexia nervosa
A
- Chronic and pessimistic about recovery. High dropout rate from therepy, reluctant to treatment.
- Immediate concern: restore body weight, successful short term.
21
Q
Treatment (anorexia): Medication
A
- Antidepressants: no evidence of effectiveness.
- Antipsychotic drugs: olanzapine might be beneficial, helps with distorted thinking and side effect is weight gain.
22
Q
Treatment (anorexia): Family therapy
A
- Preferred treatment
- Does not blame child/parents = maudsley model
- 10-20 sessions spaced over 6-12 months and has 3 phases:
1. Re-feeding
2. New patterns of relationships with food: once weight has gained
3. Termination phase: relationship with patient and parents. - Effective for those not suffering from anorexia for more than 3 years.
23
Q
Treatment for bulimia: medication
A
- Antidepressants
- Positive response seen within 3 weeks.
- If no early improvements - no further benefit from medication.
24
Q
Treatment for bulimia: CBT
A
- Leading treatment
- Focus (behavioral): normalizing eating patterns, meal plan, nutritional education, ending purging/binging.
- Focus (cognitive): changing congitions/behaviors that initiate binge cycle, challenging dysfunctional thought patterns.
- Effective for 30-50% of cases.
25
Treatment for binge-eating:
- Antidepressants
- Appetite supprants: suppresses hunger + stabilizes mood
- Anticonvulsants: reduces seizures + appetite and hunger.
- Sibutramine: inhibits re-uptake of serotonin and norepinephrine, reduces frequency of binges and associated with weight loss.
- Intrapersonal psychotherapy: effective, drop out rate 7%
- CBT: self-help books, drop out rates 30%.
26
Article: selective visual attention for ugly and beautiful body parts in eating disorders
Background:
- Body exposure to treat bad body feelings.
- Little known about the cognitive effects of body exposure.
Aim + method:
- Eye movement registration (electroculography) as index of visual attention while eating.
- Exposed to their own body and to control bodies.
Results:
- Low focus on their ‘beautiful’ body parts whereas their ‘ugly’ body parts was given priority in the symptomatic pp.
- Self-serving cognitive bias found in normal pp: focus on own beauty parts and less on ugly parts.
- When viewing other bodies, opposite was found: symptomatic = beauty parts, normals = ugly parts.
