Eating Disorders

Question 1

What are the DSM-V criteria of Anorexia Nervosa, and the two types of AN

Answer 1

1. intense fear or distress in gaining weight
2. Strict limitation on energy intake due to the distress whenever gaining weight
3. Distorted perceptions on weight/shape, usually not aware of their weight endangered, weight/shape being a large part of their self-identity
   restrictive and binge eating/purging

Question 2

What are psychological factors and clinical presentations of anorexia nervosa

Answer 2

psychological factor
> perfectionism
> danger avoidance
> feelings of ineffectiveness
> socially inhibited
> cannot think flexibly due to the low energy in the frontal cortex
> emotion restrains
> common autistic features

clinical presentations
> gradually eliminating food
> food rituals
> preoccupation of food
> ignoring hunger cues
> wearing baggy clothes to hide their body

Question 3

Health implications and cognitive changes

Answer 3

health implications
> comorbidity high with other diseases such as cardiac and endocrine
> common hospitalisation
> high death rate
> high comorbidity with depression, anxiety, and OCD

cognitive change
> impairing cognitive functions (therefore first step of intervention = weight restoration so that later interventions are more effective)

Question 4

What are the diagnostic criteria of bulimia nervosa

Answer 4

reoccurrence of binge eating episodes
once per week in three months
unhealthy way to compensate on binge eating
weight/shaping being a huge factor of self-identity
happens exclusively with AN

Question 5

psychological factors, clinical presentations, and comorbidity of bulimia nervosa

Answer 5

psychological factors
impulsivity
low self-esteem

clinical presentations
the binge eating cycle
weight fluctuates but within the average range
recognises the issue
preoccupation of food

high comorbidity with anxiety and depression and substance use

Question 6

What are the diagnostic criteria of binge eating disorder

Answer 6

Recurrent binge eating
more than once in three months
three out of the followings
> continues to eat even when full
> eating more rapidly than normal
> eating alone because of shame and guilt
> distress of binge eating after
> eating large amount of food even when not hungry
marked distress
no use of unhealthy interventions for compensation (vs AN, BN)

Question 7

what is atypical anorexia nervosa

Answer 7

meeting all criteria for anorexia nervosa, just without significant weight lost
this can be due to social norms and medical norms

Question 8

What are the models of eating disorder

Answer 8

dual-pathway model for BN
(social expectation of thin + internalising the value) > body dissatisfaction > (negative affect + dietary restraints, which eventually leads to binge eating) > BN

categorical model
there are overlap of symptoms across different EDs
A transdiagnostic model seems to best capture since symptoms transit from one to another gradually (diagnostic instability)

transdiagnostic model
three main components
low self-esteem: holding a universal negative perception of self > making the interventions less effective
life adversities: symptoms of ED (e.g., binge eating) are treated as a coping method for life adversities
mood intolerance: the symptoms are used as mood modulating strategies

Question 9

What are the aetiologies of ED (risk factors, genes, environments etc)

Answer 9

risk factors
dieting
certain personality traits or temperaments
body dissatisfaction
genes: looking at the serotonin transporter gene
environment also plays a huge role (supported by twin studies and gene x environment interaction studies)

Question 10

What are treatments of ED

Answer 10

types of treatment
family-based for younger patients
CBT/CBT-E
the earlier the treatment is = the more effective it is

barriers to treatment
secrecy
not aware of the seriousness of the symptoms
egosyntonic
fearful of change