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BS - Gastrointestinal System pt.1 > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What does the DSM-5 mention as the 4 primary categories of eating disorder?

A
  1. anorexia nervosa
  2. bulimia nervosa
  3. binge eating disorder
  4. OSFED - other specified feeding and eating disorders
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2
Q

Why is the language used to talk about eating disorders so crucial?

A

You should never comment about the body of a patient with an eating disorder

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3
Q

What are the 2 main features of anorexia nervosa?

A
  1. active maintenance of low body weight

2. extreme shape and weight concern

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4
Q

What is the weight and BMI like of someone with anorexia nervosa?

A

In adolescents and children, weight is less than 85% of their expected weight

Or they will have a BMI of 17 or less

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5
Q

What is restricting anorexia?

A

This involves eating very little on a daily basis

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6
Q

What are the 2 types of binge in binge/purging anorexia?

A

Objective binges - this would be recognised as a binge by a healthy person

Subjective binge - involves an anorexic person eating something they hadn’t planned

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7
Q

What is the main age of onset of anorexia nervosa?

What percentage of people this age present with it?

A

Age of onset peaks at 15 and 18 years

0.5% of girls aged 15-18 present with anorexia nervosa

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8
Q

What percentage of anorexia nervosa cases are seen in females?

A

95%

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9
Q

What are the severe physiological and psychological effects underlying anorexia nervosa?

A
  1. starvation affects all organ systems and organs begin to shrink
  2. cognitive impairment may occur due to shrinkage of the brain
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10
Q

What are the behavioural signs of anorexia relating to body image and behaviour?

A
  1. obsessive behaviour
  2. not being truthful about how much weight they have lost
  3. underestimate the severity of the problem
  4. pre-occupation with body weight
  5. distorted perception of body shape/weight
  6. fear of fatness or pursuit of thinness
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11
Q

What are the psychological behavioural signs of anorexia nervosa?

A
  1. rigidity in thinking
  2. setting high standards and being a perfectionist
  3. social withdrawal and isolation
  4. depression and anxiety
  5. compromise of educational and employment plans
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12
Q

What are the behavioural signs of anorexia nervosa relating to food and diet?

A
  1. strict dieting
  2. excessive calorie counting
  3. hiding food
  4. eating only low calorie food
  5. missing meals
  6. avoid eating with others
  7. cutting food into tiny pieces to make it less obvious they have eaten little
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13
Q

What are the other behavioural signs of anorexia nervosa?

A
  1. vomiting or misusing laxatives (purging)
  2. taking appetite suppressants (diet pills)
  3. telling lies about what they have eaten, pretending they have already eaten
  4. finding it difficult to think of anything other than food
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14
Q

Why is is difficult to diagnose an eating disorder?

A

Normally a few of the behavioural signs are observed, but it is very difficult to actually identify an eating disorder

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15
Q

What is the affect of anorexia nervosa on the stomach?

A

The stomach shrinks due to starvation

It begins to physically hurt after only eating a small amount

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16
Q

What are the physical signs of anorexia nervosa that affect mood?

A
  1. getting irritable and moody
  2. difficulty concentrating
  3. difficulty sleeping and tiredness
  4. feeling dizzy
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17
Q

What are the physical signs or anorexia nervosa that can be visibly noticed?

A
  1. severe weight loss
  2. constipation and bloating
  3. growth of downy hair on the body
  4. hair falls out
  5. swelling of the feet, hands or face
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18
Q

What are the physical signs of anorexia nervosa that cannot be visibly noticed?

A
  1. stomach pains
  2. feeling cold/having a low body temperature
  3. low blood pressure
  4. periods stop or are irregular
  5. weakness/loss of muscle strength
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19
Q

What was the Minnesota experiment?

A

The calorific intake of men was halved, and they had no previous experience of eating disorders

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20
Q

What behaviour was shown by the men in the Minnesota experiment?

A

They became preoccupied with food

Some developed bulimic responses, some would hide food and eat secretly and some would take hours to eat meals

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21
Q

What happened to the men in the Minnesota experiment, once they had access to food?

A

They ate continuously but continued to binge even after they reached their optimal weight

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22
Q

How does an individual with bulimia nervosa feel about their condition?

A

They feel very out of control of their condition

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23
Q

What behaviour is observed in bulimia nervosa?

A
  1. recurrent binge eating, where large amounts of food are eaten very quickly
  2. compensatory behaviour (e.g. vomiting, fasting)
  3. there is an extreme shape and weight concern
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24
Q

What must the binge frequency be for someone to have bulimia nervosa?

A

At least once a week for 3 months

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25
Q

What is the normal age of onset for bulimia nervosa?

What % of people this age are affected?

A

The age of onset tends to be late adolescence to young adulthood

It affects 1-3% of girls aged 18-25 years old

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26
Q

What percentage of people with bulimia nervosa are female?

Why might this figure not be accurate?

A

95% of people with bulimia nervosa are female

Men are less likely to prevent with symptoms

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27
Q

What is the major risk associated with purging and why does it occur

A

high risk of cardiac arrest

potassium is lost through purging, which helps muscles to work including heart muscle

28
Q

What are the behavioural signs of bulimia nervosa related to how the person feels?

A
  1. mood swings
  2. associated with depression, low self-esteem, misuse of alcohol and self-harm
  3. feeling anxious and tense
  4. feeling a loss of control over eating
  5. feelings of guilt after binging and purging
29
Q

What are the behavioural signs of bulimia nervosa relating to binging?

A
  1. they disappear soon after eating
  2. they purge after binging using vomiting, laxatives, diuretics, over-exercising or fasting
  3. they are preoccupied with thoughts of food, and organise their life around eating and purging
30
Q

What are the other behavioural signs of bulimia nervosa?

A
  1. distorted perception of body shape or weight

2. being secretive about their bulimic episodes

31
Q

How may people with anorexia nervosa and bulimia nervosa look different in appearance?

A

Someone with bulimia nervosa tends to be more of a healthy body weight

32
Q

Why should doctors be careful to prescribe laxatives to bulimic patients?

A

The bowel becomes sluggish in a state of famine, leading to constipation

There is a risk that patients may abuse them

33
Q

What is the typical pattern of food behaviour in someone with bulimia nervosa?

A

There tends to be periods of restriction

These are followed by periods of binging and compensatory behaviours

34
Q

What are the physical signs of bulimia nervosa that are visibly noticeable?

A
  1. swelling of hands and feet
  2. amenorrhea (periods stop or are irregular)
  3. regular changes in weight
  4. bloating and constipation
  5. excessive exercising
  6. enlarged salivary glands
35
Q

What are the physical signs of bulimia nervosa that are not visibly noticeable?

A
  1. electrolyte abnormalities/imbalance
  2. gastric problems
  3. stomach pain
  4. fatigue and lethargy
36
Q

What are the physical signs of bulimia nervosa that are only visible to the patient?

A
  1. vomiting

2. misuse of laxatives and diuretics

37
Q

What is binge eating disorder?

A

Recurrent binge eating without the compensatory behaviour

Large amounts of food are eaten very quickly, showing a loss of self-control

38
Q

What is the binge frequency in binge eating disorder?

A

It is usually once a week for at least 3 months

39
Q

What 3 factors do all eating disorders have in common?

A
  1. behaviour is always centred around food
  2. there are core beliefs and associated concerns about body weight and shape
  3. high levels of distress
40
Q

What is meant by the transdiagnostic view of eating disorders?

A

There are shared clinical features of eating disorders, and patients tend to move over into another disorder over time

41
Q

Why is the transdiagnostic view used?

A

There is a lot of variation within the behaviour of eating disorder patients, where they exhibit the behaviour of another eating disorder

42
Q

What 4 domains must be treated in order for someone with an eating disorder to recover?

A
  1. severe (clinical) perfectionism
  2. low self-esteem
  3. intense mood states that are very irregular
  4. interpersonal difficulties (e.g. avoidance of social situations due to social anxiety)
43
Q

What are the 2 stages of disordered eating?

A
  1. it may be a single, short crisis

2. this may then develop into a chronic, intractable disorder

44
Q

What group of people tend to recover from a single, short crisis?

What is required for recovery?

A

Recovery is more likely in adolescents who are offered appropriate help quickly

There is little evidence of spontaneous recovery

45
Q

Why should disordered eating try to be stopped in the ‘single, short crisis’ stage?

A

If it develops into a chronic disorder, this is much more difficult to treat and takes much longer

46
Q

What is the definition of behaviour relating to disordered eating?

A

It is the way in which people cope with stresses in their life

47
Q

Why might someone stop eating?

A
  1. when external events feel outside of personal control
    e. g. after an argument
  2. to influence others
    e. g. showing feelings of distress, defiance, anger
48
Q

Why might someone begin binge eating and purging?

A

To regulate negative emotional states

49
Q

What 5 factors make a young person more likely to develop an eating disorder?

A
  1. mental health problems
  2. family history
  3. perfectionism
  4. history of significant dieting
  5. being part of a sport or activity where there is an emphasis on appearance
50
Q

What are the 2 types of risk factors that contribute to developing an eating disorder?

A
  1. Body dissatisfaction risk factors (specific)

2. Self-regulatory risk factors (non-specific)

51
Q

What are 3 categories of specific risk factors?

What do they result in?

A

Contextual, physical, developmental

They lead to:

  1. negative body image
  2. weight preoccupation
  3. dieting
52
Q

What are 3 categories of non-specific risk factors?

What do they result in?

A

parental psychopathology/insensitivity, trauma, temperamental/biological predispositions

They lead to:

  1. low self-esteem
  2. affective dysregulation
  3. insecure attachment
53
Q

What is an example of a physical aspect that influences disordered eating?

A

Coming from a family with larger/smaller BMIs means that you are more likely to follow this trend

54
Q

What did Patton’s cohort study show about how dieting is linked to eating disorders?

A

Dieting is a predictive factor for eating disorders

It is linked, even though it is not causative

55
Q

How does cult of image affect eating disorder prevalence?

A

Magazine media invites and exploits social comparisons in relation to appearance

56
Q

Why are adolescents often vulnerable to eating disorders?

A

During adolescence, there is a focus on developing your own identity

Identity becomes bound to external appearance

57
Q

What are food behaviours like in adolescents?

A

There are high levels of shape/weight concern, especially in girls

This is acted out through food - dieting, skipping meals, vegetarianism, etc.

58
Q

How does peer impression management influence food behaviours in adolescents?

A

Peer impression management involves socially normative dieting and conforming to social norms

59
Q

How does mood tend to improve in patients with anorexia?

A

Their mood improves as their weight increases

During day-to-day eating, mood is improved by eating good tasting, high energy food

60
Q

How are cravings triggered in someone with an eating disorder?

A

Cravings tend to be triggered by a negative mood

usually particular food groups are completely cut out of the diet by someone with an eating disorder

61
Q

How is behaviour affected by consumption of regular meals?

A

There is an improvement of mood when regular meals are consumed

62
Q

What other factors can trigger the behaviour related with eating disorders?

A

Many external events

e.g. binging and restricting is used to manage negative emotional states

63
Q

What is the first step in getting someone to manage their eating disorder behaviours?

A

Getting people to understand their emotions and why they are feeling a particular way

If they can manage their emotions, they are more likely to be able to manage their behaviour

64
Q

What are the 3 stages involved in treatment of an eating disorder?

A
  1. weight management
  2. psychological therapies
  3. relapse prevention
65
Q

What is the initial focus of eating disorder treatment during the weight management stage?

A

Not usually weight gain, but ensuring that the patient doesn’t lose anymore weight

66
Q

What are examples of psychological therapies that are used to treat eating disorders?

A
  1. family based therapy (used for children)
  2. Cognitive behavioural therapy
  3. Guided self help
67
Q

When is guided self help often used as a treatment?

A

It is the most effective treatment for bulimia nervosa and binge eating disorder

BS - Gastrointestinal System pt.1 (22 decks)

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