Eating Disorders Flashcards
What is the historical difference between Anorexia and Bulimia?
Anorexia was established in the 1800s while Bulimia is a relatively new diagnosis.
DSM-V Criteria for Anorexia
1) Marked self-induced weight loss or failure to make expected weight gains during growth
2) Intense fear of weight gain regardless of actual size
3) Fundamental disturbance or distortion of weight perception
4) Amenorrhea (loss of menstrual cycle) or lack os sexual interest, violence, or potency
DSM-V for Bulimia
1) Recurrent episodes of binge eating followed by…
2) Repeated compensatory behaviors to counteract weight
- vomiting
- laxatives
- fasting
- excessive exercise
3) One’s self-evaluation is overly influence by body weight and shape
What are the two sub-types of Anorexia?
1) Restricting type = fasting
2) Bulimic/Bingeing/Purging type
Anorexia vs. Bulimia
1) Anorexics deny abnormal eating behavior while Bulimics recognize it
2) Anorexics are introverted while Bulimics are extroverted
3) Anorexics turn away food in order to cope while Bulimics turn towards food to cope
4) Anorexics have a preoccupation with losing weight while Bulimics have a preoccupation with an ideal, unrealistic weight
What is the mortality rate of patients with Anorexia?
50%
highest rate in psychiatry
Methods of purging are:
- self-induced vomiting
- excessive exercise
- laxatives
- diuretics
Possible etiologies of Anorexia and Bulimia
- conforming to cultural ideals
- avoidance of maturational challenges (trying to remain young)
- control
- genetics (familial… twin studies show relationship between AN & BN)
- increased levels of CRF in the hypothalamus that reduces desire for food intake and increases desire to groom
- low levels of Leptin hormones associated with amenorrhea and starvation
Health consequences of Anorexia
- hypothermia
- impaired renal function
- hypotension
- cardiac arrythmias
- lanugo hair
- osteoporosis
- brain atrophy
- hormonal abnormalities
- constipation
- abdominal pain
- cold intolerance
- lethargy
- excessive energy
- brittle hair and nails
Health consequences of Bulimia
- calluses on hands
- biting or clamping jaws
- dental problems and erosion
- esophogial erosion
- “chipmunk face”
- cardiac arrythmias
- lanugoR hair
- low potassium, chloride, and calcium
- electrolyte disturbances
Risk factors of an eating disorder
- transitioning
- puberty
- dieting
- perfectionist personality
- anxiety or mood disorders
- life events
- athletes, actors, models
Good Prognosis Indicators of Anorexia
- age of onset between 12-17 (too young is bad habit and too old cannot have parent mandated treatment)
- lowest weight achieved
- social functioning
- # of hospitalizations
- “restricting” better than “purging”
- responding to treatment
Good Prognosis Indicators of Bulimia
- higher SES
- younger age of onset
Definition of obesity.
20% over ideal body weight or BMI > 30
Obesity in America
By that definition, 1 in 3 Americans is obese and 17% of all adolescents are obese.
