Eating Disorders Flashcards
Anorexia nervosa key points
restriction of energy intake leads to significantly low weight that is minimally normal for young people. With an intense fear of gaining weight or becoming fat. Often co-morbid with depression
Bulimia nervosa
Recurring episodes of binge eating, easting in a set time a larger amount than what most people would eat in that amount of time in similar circumstances. A sense of lack of control during that eating period, with recurrent behaviours such as vomiting or excessive exercise. Binge eating and compensatory behaviours must last 3 months
Binge eating disorder
Recurring episodes of binge eating, eating in a set period of time an amount of food that is larger that what most people would eat in that period, a sense of lack of control in that period. Also have 3 or more of the following: eating more rapidly than normal, eating till too full, eating larger amounts when no longer hungry, eating alone due to shame, feel disgusted or guilty after eating. Once a week for 3 months
Avoidant/Restrictive Food Intake Disorder (ARFID)
Eating disturbance such as lack of interest in eating food, avoidance based on sensory aspects of food or concern about adverse consequences of eating. Significant weight loss, not meeting growth or nutritional gains, dependence on supplements, marked interference with psychological functioning
Orthorexia Nervosa: Criteria A
Obsessive focus on ‘healthy’ eating defined by dietary theory or set of beliefs which may lead to unhealthy weight loss. Restrictive diet as optimally healthy, violation of self imposed rules cause exaggerated fears.
Orthorexia Nervosa: Criteria B
Compulsive behaviour begins to result in malnutrition and weight loss. Intrapersonal distress and weight loss. Intrapersonal distress and reduced social/personal functioning due to beliefs about a healthy diet.
Key statistics on prevalence of eating disorders, NICE 2020
Estimates 725,000 people in the UK have an eating disorder. Western countries between 5.5% and 18% of young females but depended on accessibility of seeing a GP. Between 2015/16 and 2020/21 hospital admissions for eating disorders increased by 84%. Binge eating disorder among the most common
Genetic risk factors
Strong genetic risk for AN, BN, BED. If have a parent with history of ED makes someone 2x as likely. 11x
more likely to develop AN if have a relative with the disorder. 9.6x more likely to develop BN if have a relative with the disorder and 2.2x more likely to develop BED of have a relative with the disorder.
Gut health risk factors
Endocrines produces in the gastrointestinal (GI) tract communicate with the brain to regulate functions of appetite and satiety. Dysregulation of the gut microbiome may be responsible for ED pathology. In C sections babies will be swiped with the endocrines instead as may not get the needed endocrines
Early childhood and adolescence risk factors
High in-utero exposure to cortisol through maternal stress is associated with ED. Pre term infants living in an incubator are at risk due to different feeding experiences and structural brain alterations linked to under development. Rules such as the need to clear their plate. If the parent displays characteristics associated with an ED e.g. drive for thinness. Attachment need to make our bodies look good to be accepted. Associating food as a reward.
Childhood weight risk factors
Higher weight in childhood leads to increased risk, especially among culturally and linguistically diverse individuals and males. As well as parental perception of their child being overweight.
Abuse and Trauma risk factors
Emotional abuse is a significant preditor of purge/binge eating in women, whilst sexual abuse and physical neglect were associated with symptoms in men.
Socioeconomic status risk factors
Occurs at similar rates across all income levels. High educated parents increase the risk due to the perfectionism. Not set meal times mean dangerous eating choices can continue. US studies found low food security a preditor for ED behaviours.
Body image and social influence risk
Endorsement of thin ideals and drive for thinness are exacerbated in response to exposure to messages which are stigmatising towards individuals who are overweight or obese. Meta-analysis of labatory-based experimental studies found viewing idealised images can result in small increases in body dissatisfaction, but a greater impact on groups with high risk of ED.
Elite sports, female athlete triad and excessive exercise.
Engaging in activities that promote strict dieting and low body fat could contribute to ED and maintenance of symptoms. Among 224 athletes 22.8% prevalence of ED symptoms. In non-elite populations recognising excessive exercise among women is important in the risk assessment of ED as they are 2.5x more likely to have an ED diagnosis.
