eating disorders

Question 1

what are the officially recognized eating disorders?

Answer 1

• anorexia nervosa
• bulimia nervosa
• binge eating disorder
• avoidant/restrictive food intake disorder
• pica
• rumination disorder
• NOT OBESITY

Question 2

what are key traits of anorexia nervosa?

Answer 2

•	Key Diagnostic Features
o	Relentless pursuit of thinness
o	Fear of becoming fat
o	Significantly underweight
•	Associated Features
o	Behavioral: Food obsession, peculiar eating, depression, increased physical activity
o	Physiological: Hypothermia, Anemia, Low estrogen, Decreased brain mass
•	Risk Factors
o	Females, Adolescence, Middle/upper class, Caucasian
o	Prevalence – about 0.5% of women
•	Long-Term Outcome:
o	Full recovery: 1/3 to ½
o	Death: 5% per decade of follow-up
o	Alive but not well: the rest
o	Obesity? Rare

Question 3

what are key traits of bulimia nervosa?

Answer 3

• Key Diagnostic Features
o Recurrent episodes of binge eating
o Recurrent inappropriate compensatory behavior (vomiting/laxatives)
• Definition of a binge
o Eating an amount of food much larger than most people would eat in a similar period of time under similar circumstances (about 2000 calories)
o A sense of “lack of control” during the episode
• Associated Physical Features
o Irregular menses, Dental erosion, Enlarged salivary glands, Laxative dependence
• Risk Factors
o Females, normal weight
o Prevalence – about 1-2% of women

Question 4

what is the theory of development of eating disorder?

Answer 4

• Predisposing Factors – i.e. Female, genes, environment, societal emphasis on thinness
o Trend in BMI of Miss America Pageant winners goes down from 1922 to 1999
• Precipitating Factors – i.e. stresses of adolescence
• Perpetuating Factors – i.e. dieting to binge eating to dieting

Question 5

what are key traits of binge eating disorder?

Answer 5

•	Key diagnostic features
o	Recurrent binge eating
o	No compensatory behavior
o	Marked distress about the behavior
•	Clinical Features
o	Middle aged
o	Mostly male
o	Most are overweight or obese
o	Low levels of mood and anxiety disturbance are common

Question 6

what are treatments for anorexia?

Answer 6

• Anorexia Nervosa
o Weight Gain – intensive and structured nursing usually successful, IVs rarely needed
o Psychotherapy – (family treatment for younger patients)
o Medication – No evidence for specific utility (placebos act the same)

Question 7

what are treatments for bulimia?

Answer 7

• Bulimia Nervosa
o Psychotherapy – cognitive Behavior therapy
o Medication – antidepressants
o Controlled psychotherapy/antidepressant treatment studies shown to work

Question 8

what are treatments for binge eating disorder?

Answer 8

o Goals
• Normalize eating patterns and cease binge eating
• Manage obesity
• Reduce distress (psychological)
o Treatment
• Range of treatments improve mood disturbance (psychological, AD medication)
• But high rate of placebo effectiveness