Eating disorders Flashcards
What are the named eating disorders?
Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Avoidant restrictive food intake disorder (ARFID)
Other specified feeding or eating disorder (OSFED)
Rumination-regurgitation disorder
Pica
What are the characteristics of anorexia nervosa?
- Significantly lo body weight BMI <18.5
- Or rapid weight loss 20% in 6 months or failure to gain weight if child
- Distorted view of themselves/weight
- Fear of gaining weight (reducing or maintaining low weight, purging behaviours, increasing energy expenditure
- Excessive preoccupation with weight, body shape and food
- Desire for thinness is central to self worth
What is the relative mortality of anorexia nervosa?
Has one of the highest mortality rates of all mental health conditions
Usually recognised by surrounding people, not the patient
Denial can be a problem
What are the two subtypes of anorexia nervosa?
RESTRICTING PATTERN
- Weight loss etc accomplished mainly by restriction alone and increased energy expenditure
BINGE EATING PATTERN
- Low weight and binging or purging or both
- Varies from bulimia nervosa due to lower weight
What is bulimia nervosa?
Recurrent binge eating followed by compensatory behaviours to avoid weight gain - once a week or over a month
What is bulimia nervosa characterised by?
- Eating a larger amount of food in a discreet period of time
- Lack of control during episode
- Recurrent inappropriate compensatory behaviour to prevent weight gain (vomiting, diuretics, laxatives, enemas etc)
- Self worth unduly influenced by weight and shape
What is a binge in bulimia nervosa?
Large quanitities of food that may normally be avoided e.g. high calorie/cheap food
Sometimes flour, dry pasta, partially defrosted/discarded foods
Used to block out difficult emotions and thoughts
Release tension after a trigger
Followed by guilt, shame and disgust
May eat in secret or alone
Eat until uncomfortably full
What may be a trigger in bulimia nervosa?
Emotional or difficult situation
Shame and guilt from previous diet period impacts self esteem and body image concerns
What is a purge in bulimia nervosa?
Compensatory behaviour after a binge
Rids calories, avoids weight gain, manages feelings of guilt, anger, shame of binging
- Self-induced vomiting
- Restriction/diuretics to lose weight
- Laxative/enema to prevent absorption
- refusing to take insulin if diabetic
- Excessive energy expenditure
What are the characteristics of binge eating disorder?
- Recurrent binging without compensatory behaviours like in BN (once a week or over a month)
- Loss of control over eating behaviours, notably more or different than before
- More in men than any other eating disorder
- Temporary emotional relief, later shame, guilt and self loathing
- Often leads to period of restriction ‘tomorrow will be different’
- May previously had anorexia or bulimia
Weight in binge eating disorder
Can result in weight gain, but not directly associated with weight
Do not have to be overweight to have the disorder
Weight bias and discrimination are common
Emotions in binge eating disorder
Used as a coping mechanism to manage emotional stress
Often describe as zoning out - unaware of magnitude of food consumed, lack ability to stop eating
Followed by emotional distress - guilt and shame
Affects attention concentration, relationships and isolation
What is the presentation of binge eating disorder?
Eating very rapidly
Eating beyond the point of feeling full
Eating when not hungry
Loss of control over eating
Eating alone or in secret
What is OFSED?
Abnormal eating behaviours that do not meet full criteria of any other disorder
What are the signs of OFSED?
Difficulty eating in front of others
Preoccupation with food
Low confidence and self esteem
Negative body image
Irritability and mood swings
Tiredness and difficulty concentration
Social withdrawal
Feelings of shame, guilt and anxiety
Secretive behaviour around food
What are examples of OFSED?
Atypical anorexia: anorexic symptoms, but are in normal weight range
Bulimia nervosa: bulimic symptoms, but cycles are not as frequent
Binge eating disorder: symptoms, but episodes are less frequent
Purging disorder: someone purges but not as part of binge/purge cycles
Night eating syndrome: eating after waking or eating alot after evening meal
What is ARFID?
Avoidant restrictive food intake disorder behaviours are not motivated by weight or bodily perceptions or any other medical condition
Avoid certain foods can lead to significant weight loss, lack of nutrients, dependence on nutritional supplements, physical health issues.
Can have concerns about weight etc. but does not necessarily lead to avoiding weight gain
What are the signs of ARFID?
-Lack of appetite/interest in food, impaired hunger cues, consume far less than required
- Heightened emotional arousal or distraction leads to reduced food intake
- Sensitivity to sensory characteristics of food
- Concerns about the consequences of eating
- Avoiding social events with food
- Needing to take supplements for nutritional needs
- Delays in development esp with malnutrition
- Can happen in all ages
What is pica?
Eating non-food substances
Ingestion of non-food items is persistent or severe enough to require clinical attention.
Symptoms are not a manifestation of another medical condition
What is rumination-regurgitation disorder?
Repetitive habitual bringing up of swallowed food that may be partly digested (regurgitation)
May be re-chewed and re-swallowed (rumination) or spat out
Regurgitation is frequent (at least several times a week) and sustained over several weeks
May sense a lack of anxiety from the behaviour
Regurgitation not from a condition that causes it or nausea
Often done in secret and feel shame
What is the cycle of trying to break eating disorder habits and beahviours?
Pre-contemplation: denial of a problem, resistance likely.
Contemplation: understands there is a problem. Partly resistant, not doing as they say etc.
Preparation: decided and make plans to change, realise costs of staying this way outweigh benefits
Action: make necessary steps to get help, trying alternative coping mechanisms.
Maintenance: resisting relapse
What are characteristics of anorexia in children?
BMI under fifth percentile in children and adolescents
Prepubertal onset - pubertal events delayed or arrested
What are characteristics of anorexia in men?
Loss of sexual interest or potency
Differences in idealised body shape - muscular shape, definition, physical fitness
What does bigorexia refer to?
Non-medical term
Muscle dysphoria
Preoccupation with the idea that your body is too small or not muscular enough
