Eating Disorders Flashcards
Anorexia Nervosa
Obsessive desire to lose weight/ be thin by restricting food
Weight of anorexic patients
BMI under 18
Symptoms of AN
Low body weight
Fear of weight gain
Body image disturbance
Restrictions in AN
Amount of food
Type of food
Other ways AN patients may try to lose weight
Purging
Excessive exercise
Subjective binges
Reported binge but food intake was small
Objective binges
Large amount of food in a small period of time
What type of binges may occur in AN
Subjective binges
Disturbance in body image
Dissatisfaction with
Certain body part
Overall weight
Shape of body
Associated features of AN
Social withdrawal
Irritability
Preoccupation with food
Depression
Subtypes of AN
Binge/purging
Restricting
Bulimia Nervosa
Binge eating followed by compensating
Compensatory behaviours
Fasting
Excessive exercise
Purging
What types of binges take place in BN
Objective binges
How often must the cycle occur and for how long for a BN diagnosis
atleast 1/week for 3 months
Symptoms of BN
Objective binges followed by compensatory behaviours
Undue influence of body image and weight on self esteem
BN weight
normal weight or slightly overweight
Binge eating Disorder
Recurrent objective binges + distress
of symptoms needed for a BED diagnosis
atleast 3
BED symptoms
Eating rapidly
Eating until uncomfortably full
Eating large amounts of food when not hungry
Eating alone due to embarrassment about amount of food being eaten
Feeling disgusted, guilty or depressed after binge
Are compensatory behaviours used in BED
No, not regularly
Avoidant/Restrictive Food Intake Disorder
Difficulty in eating, results in lack of nutrition and energy consumption
Is that lack of food intake in AFID due to body image disturbances
No it is not
Eating disorders are more common in which gender
Female, 2-3 times more common
Most common eating disorder
Binge -eating Disorder
Second most common eating disorder
Bulimia Nervosa
Rarest eating disorder
Anorexia Nervosa
Which disorder shows the most gender differences
Anorexia Nervosa
Which disorder shows the least gender differences
Binge-eating disorder
What eating behaviours do men participate in the most
Binge-eating and excessive exercise
Which male group reports the highest level of symptoms
Middle age men
Age of onset of AN
19
Age of onset of BN
20
Age of onset of BED
25
Which disorder has the highest mortality rate
AN
Recovery rate for BN
50% no symptoms
20% show no change in symptoms
What is an effective assessment tool for eating disorders
Interviews
better than self reports
How many ED diagnosis can you have at one time
Only one at a time
Etiology of Eating Disorders
Genetics
Neurotransmitter deregulation
Pre-existing obesity
Psychosocial factors
Biological factors of EDs
Genetics (50%) Neurotransmitter deregulation (Dysfunctional serotonin activity)
What must be ruled put to make a eating -disorder diagnosis
Must rule out medical reasons for symptoms and MDD
What differentiations must be made to diagnosis
Is it BN or binge-eating/purging AN?
Is it BED or BN? Are compensations excessive and inappropriate?
Psychosocial factors of EDs
Physical/ sexual abuse
Personality characteristics
Personality characteristics that influence development of EDs
Perfectionism Neuroticism Punishment avoidance Sensitivity to social rewards Negative urgency Low extraversion Level of Impulsivity
Neuroticism
personality trait characterized by anxiety, fear, moodiness, worry, envy, frustration, jealousy, and loneliness.
Negative urgency
Tendency to act rashly when distressed
Extraversion
Measure of outgoingness and social ability of a person
Family factors
Family history of EDs
High parental expectations
Transmission of pathological values (value on weight and attractiveness)
Miscommunication (Mothers can give false/ inaccurate info)
Family relationships
Sociocultural Factors
Thin ideal
Thin ideal > increased body dissatisfaction > increased risk of disorder
How does the media portray eating disorders
Young White females
Rarely discuss bad aspects
Never see biological/genetic reasons for the disorder
Treatment of Anorexia Nervosa
Family based treatments (Most Effective) CBT for relapse prevention Focal psychoanalytical therapy Motivational interviewing Specialist supported clinical management
Family based treatment
3 phases involving family
- Weight restoration
- Return of eating control
- Promote normal development (Non-weight based identity)
Who is family based treatment effective for
Teens
Treatment for Bulimia Nervosa
CBT (Most Effective) Interpersonal therapy Family-based treatment Motivational enhancement Dialectical behaviour treatment
CBT for Bulimia Nervosa
Reduce dysfunctional dieting
Develop skills to deal with high risk situations
Modify thoughts and feelings about shape and weight
How does CBT reduce dysfunctional dieting
Promote moderation
Nothing is completely good food or bad food
Theory behind CBT for BN
Dietary restriction + negative emotions = binge-eating/purging
Treatment for Binge Eating Disorder
CBT Interpersonal therapy Behavioural weight loss Dialectical Behaviour Therapy (Most Effective) Motivational interviewing
What is the most effective treatment for BED
Dialectical behaviour Therapy
Behavioural Weight loss
There is a good and bad foods list
Evidence based treatment
What is Dialectical Behaviour Therapy effective for
Useful for any illness with strong negative emotions including BN and BED
Most effective most BED
Dialectical Behaviour Therapy
Emotion regulation
3 Components
Components of DBT
Group Skills Training
Individual Therapy
Telephone Coaching
Goals of DBT in BED
Mindfulness
Distress Tolerance
Emotion Regulation
Interpersonal Effectiveness
What is Mindfullness (DBT)
Learn that negative emotions are brief states
Distress Tolerance (DBT)
Learn skills to help yourself through a crisis
Emotion Regulation (DBT)
Reduce vulnerability to negative emotions
Interpersonal Effectiveness (DBT)
Develop relationship skills
Levels of Prevention
Universal
Selected
Indicated
Universal Prevention
Targets cultural attitudes and practices
Main focus are public institutions and public policies
Selected Prevention
Targets high risk groups
Indicated Prevention
Targets people showing early warning signs
Girls with high weight/shape concerns
Dissonance-based Prevention programs
Have people critique the thin ideal
Reduce discrepancy between beliefs and actions
CBT- based prevention
Read material and discuss online
How effective are prevention programs
Small to moderate effect
What levels of prevention are most effective
Indicated and Selected
Which group benefits the most from prevention programs
Adolecents
Are interactive or presentation(didatic) based prevention more effective
Interactive
Should prevention focus on teaching about EDs
More effective when they are focused on body acceptance