Eating disorders Flashcards
How many calories does the brain need to keep going?
500
Why is it important to heat up anorexics?
Because being cold —> shiver —> lose more weight
What is anorexia nervosa often comorbid with?
Severe depression, OCD, OCPD, anxiety
AN causes _________ of the brain
pseudoatrophy
In the metabolic system, AN can cause __________ and ____________
hypothermia, dehydration
AN can make your __________ irregular
heartbeat
AN can suppress __________ development, causing you to become very ___________
red blood cells, tired
AN causes your ________ to crash, which means…
white blood cells, you’re not protected from bacterial infections
What are olanzopine and seroquel used for in anorexic patients?
To quell anxiety when they are given food, not specifically for AN
According to biggest study on EDs: In the early years after onset, the odds of recovering from ___ were greater than ___ but over time the probabilities of recovery shifted to favour ___.
AN, BN, BN
BN group had _____ the rate of recovery at 10-14 years than the AN group
three times
If you don’t recover from AN as an adolescent, you are risking…
permanent changes to your brain
What is refeeding syndrome?
potentially fatal shift of fluids and electrolytes that occurs when refeeding a malnourished patient.
Phosphate is needed to keep your heart going, when starved your phosphates become depleted. But if you eat too much too quickly your phosphate levels can get too high and you can die
What happens to anorexic’s brain if you give them a Krispy Kreme doughnut?
Their amygdala and hippocampus will light up > extreme fear response
How does the anorexic’s brain react when looking at others vs looking at themselves?
Their brain lights up normally when looking at someone else, but there is no activation when they are looking at themselves - the thought of looking at themselves is so terrifying that the brain shuts down
We think AN is related to an area of the brain called the __________. Anorexics’ _______ underperform
insula
Weak central coherence refers to…
the cognitive style where is a bias towards local or detail-focused processing accompanied by difficulties in the integrative processing of information
- ass. with autism spectrum disorders
AN patients have difficulty with set-shifting. What is it?
the ability to move back and forth between multiple tasks, operations and mental sets
- anorexics cannot change their strategy
The average duration of AN is…
7 years
Binge eating episodes are characterised by a _________ over eating
lack of control
Compensatory behaviours in BN include…
self-induced vomiting, misuse of laxatives, diuretics, fasting, excessive exercise
For BN: The binge eating and inappropriate compensatory behaviours occur on average at least ___________ for ___ months
once a week, 3
The severity specifiers for BN are based on _____.
frequency of inappropriate compensatory behaviours Mild = 1-3 Moderate = 4-7 Severe = 8-13 Extreme = 14+
BN is much easier to treat without comorbidity. What is BN often comorbid with?
Substance abuse, depression, personality disorders esp. BPD, anxiety disorders
The gold standard for assessing EDs is the…
Eating Disorders Examination (EDE)
The EDE includes 4 subscales:
Restraint
Weight concern
Shape concern
Eating concern
CBT-E (CBT for BN) usually lasts for ___ and is conducted in __ stages
20 weeks, 3 stages
What are the aims of Stage 1 of CBT-E?
- establish a sound therapeutic relationship
- educate patient about cognitive view of BN, explain need for both behaviour and cognitive change
- establish regular weekly weighing
- educate patient on body weight regulation, dieting adverse effects, physical consequences of binge eating, vomiting and laxative misuse
- reduce frequency of binging behaviour by introducing a pattern of regular eating and alternative behaviour
- reduce secrecy and enlist cooperation of friends and family
What are the aims of Stage 2 of CBT-E?
- tackle dieting
- enhance problem-solving skills
- address concerns about shape and weight
- address other cognitive distortions
What happens during Stage 3 of CBT-E?
- 3 interviews at 2-week intervals - ensure progress is maintained
- relapse prevention
- awareness of vulnerability factors
- how to deal with setbacks
It’s important to include _________ food into meal plans so that it doesn’t trigger binging
forbidden
The Keys study / the Minnesota starvation study showed that..
If you starve humans for too long, you lose control over food intake
The most important part of treatment for bulimia is …
the Daily Food Record