Eating Disorders

Question 1

What kind of eating disorders are there?

Answer 1

Anorexia Nervosa (AN)
Bulimia Nervosa (BN)
Binge-Eating Disorder (BED)
Other Specified Feeding or Eating Disorder (OSFED)
Orthorexia

Question 2

What are the cultural issues of ED?

Answer 2

The eating disorders are very tied to culture, and understanding this is critical in appreciating their complexity. Weight stigma/shame plays a big role in perpetuating EDs.

Question 3

What is typically used for body weight?

Answer 3

BMI after 19, children follow a curve.

Question 4

What is BMI?

Answer 4

Weight (lb) divided by height (inches) ; adjusted for age/sex

Question 5

Prevalence of ED?

Answer 5

-1% of cis men have a diagnosed ED
-9% of cis women
-18% of trans/gender non-conforming

Question 6

What is the core feature of anorexia nervosa?

Answer 6

The core feature of Anorexia nervosa (AN) is dramatic, dangerous levels of weight loss that are not explainable by a particular medical condition.

Question 7

Prevalence of AN?

Answer 7

The prevalence of AN is could be as low as 0.3%.

Question 8

How to patients with anorexia eat?

Answer 8

They chose odd food combinations (cabbage and ketchup, for example), and eat in a highly ritualized manner.

Question 9

What is mortality rate of AN?

Answer 9

Anorexia has very high mortality rate (10x earlier than expected death expectation and relapse rate)

Question 10

WHat is number one personality trait of anorexia?

Answer 10

Perfectionism number one personality trait that comes with anorexia

Question 11

What happens when there is a lack of nutrients?

Answer 11

Development of depressive feelings.

Question 12

What are some of the symptoms of Anorexia?

Answer 12

Dry skin, brittle hair or nails, sensitivity to cold temperatures, osteoporosis, and lanugo – the growth of downy hair on the limbs and cheeks.

Question 13

How does anorexia stop menstrual cycle?

Answer 13

Leptin levels crash so it signals to the brain that the body is at low fat which the brain signals to stop ovulation/period.

Question 14

What happens in the brain (AN)?

Answer 14

Certain regions of the parietal lobe seem to be involved in body image. Low levels of activation in the brain but the insula (involved in disgust) is highly activated when looking at oneself.

Question 15

What is ghrelin?

Answer 15

Ghrelin is a hormone that is associated with hunger.

Question 16

How does ghrelin affect patients with anorexia?

Answer 16

Circulating ghrelin levels are very high in patients with AN. This is an expected consequence of their perpetual state of starvation, but individuals with AN appear to be ghrelin-resistant.

Question 17

What are the hallmarks of bulimia?

Answer 17

-Eating a larger amount of food than most people would typically consume under similar circumstances (binging).
-Attempting to compensate for excess food intake either through purging or exercise.

Question 18

What are the subtypes of bulimia?

Answer 18

-Purging (vomiting)
-Non-purging (exercise)

Question 19

What is a sign of bulimia?

Answer 19

Russels sign.

Question 20

Methods of purging?

Answer 20

1. Vomitting
2. Laxatives and diuretics
3. Prescription thyroid hormone (raise metabolism)

Question 21

Neurobiology of BED?

Answer 21

Very similar to addiction. heavy involvement in the endorphin system.

Question 22

Treatment of BED?

Answer 22

Contrave is used for treatment for BED. Anti-depressants are added to the drug since the levels of pleasure are lowered.

Question 23

Treatment of EDs?

Answer 23

1. Re-feeding and/or weight gain important
2. Behavior-based (Dialectical Behaviour Therapy)
3. Pharmacotherapy to treat concurrent disorders