Eating Disorders Flashcards
Type of person most likely to develop an eating disorder
Upper middle class white females
Which is more culture-bound: bulimia or anorexia?
Bulimia, essentially does not exist outside western culture and is growing in places where western ideals are on the rise
Bulimia nervosa
Recurrent episodes of binge eating, recurrent inappropriate compensatory behaviors in order to prevent weight gain, self evaluation is unduly influenced by body weight and shape
Mild-Extreme bulimia scale
Mild: 1-3 compensations
Moderate: 4-7
Severe: 8-13
Extreme: 14+
Key feature of a binge
Feels out of control
Amount consumed is less important
Purging methods
Self induced vomiting, laxative, diuretic, enema abuse, excessive exercise
All generally ineffective
Medical consequences of bulimia
Enlargement of the salivary glands, facial swelling, erosion of dental enamel, tearing of esophagus, damage to fingers and hands, electrolyte imbalance, damage to colon, severe constipation
Bulimia stats
1-1.5% in a given year
90-95% are female
Only 66% reach remission
Comorbidities with bulimia
Anxiety disorders, mood disorders (which typically present after), substance abuse
Risk of suicide is elevated
Anorexia nervosa
Restriction of energy intake leading to a significantly low body weight, intense fear of gaining weight, disturbance in the way ones body shape is experienced, may be restricting or purging subtype
Anorexia severity scale
Mild: BMI>17
Moderate: 16-16.99
Severe: 15-15.99
Extreme: <15
Anorexia vs. bulimia
Difference between the diagnoses is the body wight criteria
Characteristics of anorexia
Relentless pursuit of thinness, weight loss typically achieved via strict caloric intake, obsessions with food, begins in adolescence
Medical consequences of anorexia
Amenorrhea, cardiovascular complications, low blood pressure, low heart rate, heart attacks, dry skin, brittle bones, intolerance to cold, lanugo
Anorexia stats
0.4% in a given year
33% achieve remission
10:1 female to male
Comorbidities with anorexia
Mood disorders (OCD in particular), substance abuse, suicide
Number one cause of death in anorexia
Suicide
Ancel Keys study
Effects of dietary restriction: develop distress, depression, self harm, lack of sexual interest, withdrawal, cognitive decline, significant preoccupation with food
Implications for treatment due to Minnesota Starvation Study
Focus on achieving a normal body weight and restoring health before working on any of the cognitive
Binge eating disorder
Recurrent episodes of binge eating associated with eating more rapidly than normal, until feeling uncomfortably full, large amounts when not hungry, alone due to embarrassment, feeling disgusted
Binge eating disorder characteristics
Responds better to treatment
Body shape concerns
Many overweight, but happens across all body types
Dieting before binging vs. binging before dieting
Binging first is associated with more Comorbidities and a poorer prognosis
BED to regulate negative affect
Poorer prognosis for those who binge eat to regulate emotions
This is the case for 30% of patients
Binge eating stats
1.6% in females in a given year
0.8% in males
Similar across all ethnicities
Social factors for eating disorders
Women are expected to be thin, dieting pulls everywhere, transmission through peer groups
Role of the family in eating disorders
Families tend to be very successful, concerned about external appearances, have high expectations, not deal well with negative emotion or conflict
Mothers and eating disorders
Tend to be perfectionistic, communicate a desire for their child to be thin and attractive
Biological factors in eating disorders
Run in families 4-5x as likely
May be a genetic component
Psychological factors for an eating disorder
Lack of sense of control, lack of self confidence, low self esteem, difficulty tolerating negative emotions, highly perfectionistic
Treatment for bulimia
CBT is most effective, focus on psychoeducation and then a shift to eating regimens, distortions
Drugs have little to no effect
Treatment for anorexia
Immediate goal of medical stability, then CBT but is very difficult to treat
Refeeding syndrome
As patients begin to eat the body adapted to malnourishment does not react well to sudden food intake
Can be fatal due to cardiac arrhythmia
Treatment for binge eating
CBT and IPT both effective
Medications not so much
