Eating Disorders Flashcards
Of all the eating disorders, which is the least common?
1 - anorexia nervosa
2 - binge eating disorder
3 - bulimia nervosa
4 - Avoidant restrictive food intake disorder
5 - none of the above
1 - anorexia nervosa
- BUT has one of the highest mortality rates of all mental health conditions, caused by physical and physiological difficulties, as well as suicide
Of all the eating disorders, which is the most common?
1 - anorexia nervosa
2 - binge eating disorder
3 - bulimia nervosa
4 - Avoidant restrictive food intake disorder
5 - none of the above
2 - binge eating disorder
Of all the eating disorders, which is the most common in men?
1 - anorexia nervosa
2 - binge eating disorder
3 - bulimia nervosa
4 - Avoidant restrictive food intake disorder
5 - none of the above
2 - binge eating disorder
What age group are most commonly affected by anorexia nervosa?
1 - 15-19y/o
2 - 15-30y/o
3 - 30-45y/o
4 - >55y/o
1 - 15-19y/o
Anorexia nervosa (AN) is characterised by which of the following?
1 - significantly low body weight for the individual’s height, age, developmental stage or weight history
2 - BMI <18.5 in adults, and BMI-for-age <5th percentile in children
3 - rapid weight loss (>20% of total body weight within 6 months)
4 - all of the above
4 - all of the above
Patients with anorexia nervosa (AN) typically have an altered view of themselves. Patients typically have all or some of the following EXCEPT which one?
1 - think they are overweight when underweight
2 - able to gain weight easily
3 - reduce weight through fasting, choosing low calorie options or excessively slow eating
4 - purging behaviours such as self-induced vomiting, use of laxatives or diuretics
5 - increased energy expenditure
6- excessive preoccupation with weight, body shape and food
7 - overvalued ideation with reference to weight and shape
8 - intense desire for thinness which is central to their self-worth, confidence and self-esteem
2 - able to gain weight easily
- they typically have an intense fear of gaining weight.
Do all patients with anorexia nervosa have insight into their condition?
- no
- often family and friends notice the weight loss
There are 2 subtypes of anorexia nervosa:
- Restricting pattern
- Binge-purge pattern
Which of these matches the following:
- weight loss and maintenance of low weight is accomplished primarily through restriction alone or combined with increasing energy expenditure.
- Restricting pattern
There are 2 subtypes of anorexia nervosa:
- Restricting pattern
- Binge-purge pattern
Which of these matches the following:
- engages in binge eating or purging or both (purging is making themselves vomit following binging)
- Binge-purge pattern
- similar to bulimia nervosa, but in AN the patient has a very low weight
- diagnosis can change to bulimia nervosa in cases where the individual continues to engage in binging and/or purging behaviours after regaining a more normal weight, and maintaining this for a year.
Which of the following do NICE recommend when treating an adult patient with anorexia nervosa?
1 - individual cognitive behavioural therapy focused on eating disorders (CBT-ED)
2 - maudsley anorexia nervosa treatment for Adults (MANTRA)
3 - specialist supportive clinical management (SSCM)
4 - focal psychodynamic therapy (FPT) focused on eating disorders
5 - all of the above
5 - all of the above
- MANTRA = intensive outpatient treatment. Parents are integrated as an active and positive role to incorporate and encourage participation in their child’s recovery journey
- FPT = long term management on what symptoms means to patient and their affects
Which of the following do NICE recommend when treating a child patient with anorexia nervosa?
1 - individual cognitive behavioural therapy focused on eating disorders (CBT-ED)
2 - family therapy focused on anorexia nervosa (FT-AN).
3 - maudsley anorexia nervosa treatment for Adults (MANTRA)
4 - specialist supportive clinical management (SSCM)
5 - focal psychodynamic therapy (FPT) focused on eating disorders
6 - all of the above
2 - family therapy focused on anorexia nervosa (FT-AN).
- if unsuitable then can try CBT-ED
Which of the following best describes Bulimia nervosa?
1 - binge eating following by purging, whilst being underweight
2 - restricting food and increasing activity to maintain low weight
3 - recurrent binge eating, followed by behaviours to avoid weight gain over >1month but not underweight
4 - all of the above
3 - recurrent binge eating, followed by behaviours to avoid weight gain over >1month but not underweight
- the not being underweight is what distinguishes this from anorexia nervosa
Bulimia (greek for hunger) nervosa patients typically binge and then use behaviours to avoid weight gain. When these patients do binge, is this a control or a loss of control?
Self-induced vomiting is most reported, however all compensatory behaviours cause distress to the individual
have conditions relating to teeth, oesophagus, gastro-intestinal, low potassium
hide their condition due to shame
have body image disturbance
- typically a loss of control
- BUT then use compensatory behaviours to avoid weight gain
Bulimia (greek for hunger) nervosa patients typically binge and then use behaviours to avoid weight gain. Do all patients with Bulimia nervosa use self-induced vomiting?
- common
- BUT not all patients use it
- compensatory behaviours cause significant stress to the patient, such as teeth, oesophagus, gastro-intestinal, low K+, but they ALL hide their condition due to shame
have body image disturbance
Which of the following symptoms do patients with Bulimia nervosa NOT typically present with?
1 - eat in a discrete period of time (<2 hours), a larger than usual amount of food
2 - taking control during the binge
3 - recurrent inappropriate compensatory behaviour to prevent weight gain (exercise, no insulin etc.)
4 - self-evaluation is unduly influenced by body shape and weight
5 - bingeing or purging does not occur exclusively during episodes of behaviour that would be common in those with anorexia nervosa
2 - taking control during the binge
- patients describe losing control during a binge and feeling unable to stop
- typically patients describe it as an uncontrollable impulsive urge
In patients with Bulimia nervosa, binging is often triggered by something. Which 2 of the following are commonly reported?
1 - emotional/difficult situation
2 - new medications
3 - period of food restriction
4 - meeting other patients with Bulimia nervosa
1 - emotional/difficult situation
3 - period of food restriction
In patients with Bulimia nervosa, when these patients binge, is this on healthy food or foods that they try to avoid?
- foods that they try to avoid
- in extreme cases binge foods may include flour, dried pasta, partially defrosted or discarded foods
In patients with Bulimia nervosa, which of the following is NOT true?
1 - eat much more rapidly and with a loss of control
eat until uncomfortably full and eat large quantities when not physically hungry
3 - eat when others can see them eating
4 - patients often experience negative emotions at how much they have eaten such as shame, guilt or disgust
3 - eat when others can see them eating
- this is incorrect, patients typically eat alone or in secret
- binging is typically cyclical
In bulimia nervosa, what are the NICE guidelines for treatment in adults and children?
1 - group cognitive behavioural therapy focused on eating disorders (CBT-ED)
2 - family therapy focused on anorexia nervosa (FT-AN).
3 - maudsley anorexia nervosa treatment for Adults (MANTRA)
4 - specialist supportive clinical management (SSCM)
5 - focussed guided self help programme
6 - all of the above
5 - focussed guided self help programme
If this does not work then can use group or individual CBT-ED
- in children FT-AN should be offered
In patients with binge eating disorder, patients are characterised by regular episodes of binge eating. However, do these patients engage in compensatory behaviours following the binges in an attempt to reduce any weight gain?
- no
- binge eating disorder = NO compensatory behaviours
- bulimia nervosa = YES to compensatory behaviours
In patients with binge eating disorder, patients are characterised by regular episodes of binge eating without compensatory behaviours following the binges in an attempt to reduce any weight gain. During the binges do patients feel in control or a loss of control?
- experience a loss of control
- typically eat more, or different foods than they normally would
- typically eat, even if not hungry
In patients with binge eating disorder, patients are characterised by regular episodes of binge eating, where they feel a loss of control, without compensatory behaviours following the binges in an attempt to reduce any weight gain. Following the binge, how do patients typically feel?
1 - relief from emotional distress
2 - delayed feeling of guilt and self loathe
3 - patients may have binge eating disorder with anorexia or bulimia nervosa
4 - patients often make self promises to be different following binges
5 - all of the above
5 - all of the above
In order to be diagnosed with a binge eating disorder, do patients typically have to be overweight?
- no
In binge eating disorders, what are the NICE guidelines for treatment in adults and children?
1 - group cognitive behavioural therapy focused on eating disorders (CBT-ED)
2 - family therapy focused on anorexia nervosa (FT-AN).
3 - maudsley anorexia nervosa treatment for Adults (MANTRA)
4 - specialist supportive clinical management (SSCM)
5 - focussed guided self help programme
6 - all of the above
5 - focussed guided self help programme
If this does not work then can use group or individual cognitive behavioural therapy focused on eating disorders (CBT-ED)