Eating Disorders Flashcards
What is anorexia nervosa?
Low weight obsessively achieved because of fear of fatness. 2 subtypes AN-R and AN-BN
What is bulimia nervosa?
Attempted weight loss by starvation leads to vicious cycle of restriction/binge/purge at normal weight
What is binge eating disorder?
Binges and periods of attempted restriction but without other compensatory behaviours- often overweight
What is the screening tool used to check for eating disorders?
SCOFF
Do you ever make yourself Sick because you feel uncomfortably full?
Do you worry you have lost Control over how much you eat?
Have you recently lost more than One stone in a three month period?
Do you believe yourself to be Fat when others say you are too thin?
Would you say that Food dominates your life?
What are the causes of anorexia nervosa?
Life events - transitions, conflicts, losses, stresses
Genetic predispositions - OCD, anxiety disorders, perfectionisms
Perinatal factors
Perpetuating consequences of starvation and of avoidance
What are the causes of bulimia?
Predisposing genetic factors
Life events
Food restriction
What are some methods of food avoidance used by patients?
Diets – becoming vegetarian, vegan
Not touching food or grease
Developing dislikes, pickiness, even ‘allergies’
Interpreting all symptoms as allergy or indigestion
Eating very slowly, only eating at certain times
Avoiding parties and social occasions
Spoiling or messing of food, bizarre combinations
Refusing to eat more than the person who eats least, rules about always finishing last etc
Medication abuse - Appetite suppressants – including gum, cigarettes - alternative, OTC & www medications
What are some of the methods of getting rid of calories used by patients?
Self-induced vomiting
Chewing & spitting out
Overexercise
Overactivity – obsessive housework, fidgeting, twitching, never sitting down, fetching one item at a time, carrying heavy loads
Cooling – inadequate dress, open windows
Blood letting
Deliberate self harm when anorexic rules are broken
Medication abuse – alternative, over the counter, internet medications, excessive caffeine and stimulant consumption
Failing to take prescribed medication that can cause weight gain – insulin, steroids, anticonvulsnats – or overdosing on prescribed medicines that cause weight loss - thyroxine
What are the psychological consequences of eating disorders?
Malnourished brains experience depression, anxiety, obsessionality, loss of concentration on anything but food
Extreme overvaluation of low weight and thin/lean shape
Obsessive weight-losing feels like a solution, not a problem
Cognitive style shows reduced central coherence and narrowed focus of interest
Depression at low weight rarely responds to medication
What are the social consequences of eating disorders?
Encourages lying and cheating
Withdrawal from friendships, lose interest in sexual relationships
How does excessive exercise cause psychosocial harm?
Compulsive exercise/activity distracts from other thoughts, leaves sense of obligation to be active
Competitive exercise may lead to circumscribed conditional measures of self-esteem & sees others as rivals not friends
Sacrifice of social occasions to exercise programmes
competitive exercise may interfere with friendliness to others
solitary exercise makes people loners
Inability to stay still or even sit down interferes with social life, travel, school, studying, work, therapy
What are the physical consequences of eating disorders?
Heart damage Poor repair and resistance Reduced immunity to infections Anaemia Bone loss Fertility problems Seizures Arrhythmias
How can excessive exercise cause physical harm?
Using up too much energy Fatigue Amenorrhoea, infertility Osteoporosis Heat stroke dehydration Injury (fractures, soft tissue, arthritis)
What are the guidelines for treatment of eating disorders?
CBT for normal weight bulimia nervosa or alternatively IPT or fluoxetine 60mg daily
Specialised family work for anorexia nervosa
Olanzapine (low dose)
What increases the chance of relapse in eating disorders?
Continuing to be overactive, especially to do solitary overexercise (running, gym)
Drinking calorie-free fluids, eg diet cola
Following a restrictive diet eg vegan, ‘clean eating’
Purging behaviours
Isolation and secrecy
Having a baby (50% relapse rate)
Weight-losing illness eg diabetes
