Eating Disorders Flashcards
What are some examples of normal eating
- going into meal hungry, eating until satisfied
- overeating or undereating at times
- giving some thought to nutrition but without missing out on enjoyable foods
- giving yourself permission to eat sometimes bc you are happy, sad, bored
- responding to and respecting humger
- aim for enjoyment
Describe feature of disordered eating
Persistent thoughts:
- preoccupation over calories, grams, portions
- preoccupation over weight loss, or control of food
Negative emotions:
- guilt, shame, disgust are attached to food
Maladaptive behaviors:
- consistently eating for reasons other than hunger or true cravings
self-concept:
- believing one’s own identity and self-worth is based on size, weight, or what one eats
Describe Anorexia Nervosa
- fear of obesity/drive for thinness
- extreme dietary restriction/compensatory behaviors like purging/extreme exercise
- fear of being obese
Describe - Bulimia Nervosa
- fear of obesity/ drive for thinness
- binge eating followed by purging
- note the diff = binges and purging
Describe - Binge Eating Disorder
- similar body image concerns to BN/AN
- using food to self-soothe; anxiety, stress, weight concerns
- binge eating without compensatory behavior -> can lead to obesity
- use food as an emotion regulation method
- binge but no purge
Note the table in the textbook about prevalence and genders
- not just women affected
- all
Are ED’s increasing over time?
Yes, the point of prevalence doubled btwn 2000 and 2018
- is it bc of social media, or is it bc we are more aware?
What age/gender has the highest incidence?
adolescent girls
Which mental disorder has the highest mortality rate?
Eating disorder have the highest mortality rate of all mental disorders
- 7.6% mortality rate
- 23% deaths were suicide
Over 10 years, what % of people with an ED will show improvements?
over 10 years, half with ED will show improvement
What is the DSM for Anorexia Nervosa
A. Restriction of energy intake leading to low body weight
- restriction of energy intake relative to requirements, leading to significantly low body weight
B. Fear of gaining weight
- intense fear of gaining weight, becoming fat
C. Weight or shape concerns
- disturbances in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight
D. Specifiers
- Restricting type: during the last 3 months
*******go back andn finsih
Describe the criteria for Bulimia Nervosa ** back to leture
Describe the criteria for binge eating disorder ** fill in form lectire
Bulimia vs Anorexia
Body Image
BU: self-influenced by body wight and shape
AN: distorted perception of self and the hazards of extremely low weight
Personality Diatheses
BU: impulsivity
AN: strict control
Common comorbid mental disorders
BU: anxiety, MDD, Borderline PD. substance use, impulse control
AN: OCD, substance abuse/impulsivity with binge-purge type
Body weight
AN: maintains a significantly low weight
What comorbidities are common with ED’s
- depression
- anxiety
- stress
- low self-esteem
- high need for control
- inflexible thinking
- difficulty managing emotions
- beliefs of inadequacy
Name some of the medical complications of - Anorexia Nervosa
- significantly low weight
- amenorrhea
- dehydration and electrolyte imbalance
- bradycardia and arrhythmias
- postural hypotension
- hypothermia
- dental problems
- osterpenia
- delayed gastric emptying
- irritability
- mortality
- suicide
What are medical complications of - Bulimia Nervosa
- electrolyte imbalance
-hypokalemia ( low blood potassium) - GI distress
- delayed gastric emptying
- menstrual irregularities
- postural hypotension
- esophageal tears/ruptures
- arrhythmias
- dental problems
- metabolic alkalosis
- parotids gland swelling
- weight fluctuations
- chronic renal failure
Name some physical symptoms of eating disorders
- sores around mouth: vomiting
- calluses/scars on knuckles: inducing vomiting
- lanugo hair: AN
- dry, flaky skin
- cold sensitivity
- constipation
- edema
- stress fractures - related to bone loss
What are some behavioral symptoms of eating disorders
- meal skipping
- eating then quickly going to bathroom
- small portions
- only nonfat foods
- “vegetarianism”
- frequent weighing
- frequent dieting
- time/energy cooking for others
What are some cognitive symptoms of eating disorders
Core assumptions/schemas:
- personal worth = appearance and attractiveness
- femininity = beauty
- masculinity = muscular and ‘cut’
- perfectionism
- i must be thin/fit; can’t allow self to be overweight
personalization
- others focus on weight/appearance
- belief that others are focused on my weight
overgeneralization
- thin = control/self discipline
- being thing is a demonstration of how self disciplined you are
dichotomous thinking
- fat/thin = ugly/pretty = out of control/in control
superstitious thinking/misconceptions
- food fats are dangerous
- being thin/fit brings love and attention
Describe body image disturbance
- cognitive distortion – overestimate actual size
describe the experiment about body image disturbance
- asked to indicate on a demension their ideal body, what do they thing is attractive, where would they currently rank self
- people with ED have way more spread
- other attractive rating was what men would say was most attractive
How did they use computers for an experiement about body distorted perception
- took person and 3d scanned
- adjusted the body weight
- found that people with anorexia thought they were way bigger than they are
- found that people with anorexia wanted a BMI than healthy
Name a factor about ED that leads to distress
- the distress over perceived discrepancy btwn what they think they look like vs what they want to look like
Ethiology - Describe the cognitive behavioral model for AN
over evaluated belief about shape/weight lead to:
biased info processing
- interpret neutral events as relating to size/shape and self worth
- implications of body shape, weight, and maintaining control
leads to stereotypic eating and elimination
- dietary restriction, food avoidance
- negatively reinforced - removed aversive stimulus - self at higher weight
reinforce of weight control
- evidence of self-worth and self-control
Describe the Binge-Purge-Cycle
drive for thinness vvv
- inadequate coping -> negative affect -> escape from self-awareness -> negative affect -> extreme dieting -> hunger
- binge
- guilt
- purge
- anxiety reduction
- guilt/depression
- inadequate coping -> negative affect -> escape from self-awareness -> negative affect -> extreme dieting -> hunger
*** negatively reinfoced - binged reinforce the negative affect and hunger bc goes away when binge, the purge is neg inforced bc takes away the fear about gaining weight
There are 5 levels of treatment with varying intensity - describe
Level 1: Outpatient
- scheduled appointments with multi-disciplinary team: Medical provider, therapist, dietitian
Level 2: Intensive Outpatien
- 2-3 days per week outpatient treatment
- indiv, group, and nutrition therapy
- support meals
Level 3: Day program
- 5 days per week, 8 hours per day
- same techniques as level 2 but more intensive
Level 4: Residential
- residential hospital
- long-term care: 34 h a day treatment facility
Level 5: Hospital
- in-patient stay
- short-term crisis stabilization
Describe CBT for EDs
Nutrition intervention:
- meal planning
- weekly goals
- hydration
Psychoeducation:
- food pyramid
- truth about purging
Cognitive restructuring
- examine the kinds of thinking errors
Body image intervention:
- no weighing or checking
- in vivo body exposure (look at body, evaluate, and experience the appraisals and evaluations then learn to cope)
In vivo food exposure (fear foods)
- or binge purge = eat then don’t let them purge/exercise
Exposure with response prevention
Relapse in prevention
