Eating Disorders Flashcards
What are the 7 eating disorders?
- Anorexia
- Bulimia
- Pica
- Rumination
- Binge-eating disorder
- OSFED
- AFRID
What are the characteristics of anorexia?
- Restriction of energy intake leading to significant weight loss
- Intense fear of gaining weight/getting fat
- Lack of recognition of the seriousness of the current low body weight
- not always visible (someone could have a normal BMI but have lost a lot of weight…considered anorexia)
What are the 2 types of anorexia?
- restricting (no binge eating or purging)
2. binge eating/purging
What is the severity of anorexia based on BMI?
17+ = mild 16-16.99 = moderate 15-15.99 = severe 15- = extreme
What is another indication of the severity of anorexia other than BMI?
Compulsive exercise
What is the prognosis of anorexia?
- 2/3 of patients normalize weight
- patients with illness onset before 17y achieve a better outcome than adult onset
- relapsing happens
- time of remission is 5-6 years for adults
What are some common dietary patterns in anorexia?
gradual decrease of food intake removal of high energy foods gradual decrease in portion sizes rigid schedule of eating limited food choices fat avoidance
What are the two questions most people will ask?
- will my body revenge and want to gain weight and I will become fat?
- What is the normal serving?
What is bulimia and its characteristics?
Recurrent episodes of binge eating characterized by BOTH the following:
- eating large amounts of food in a discrete amount of time
- sense of lack of control over eating during an episode
There is also recurrent inappropriate compensatory behaviour in order to prevent weight gain (fasting, strict deprivation, compulsive exercise, use of laxatives, meds)
What is the severity of bulimia based on the average number of compensatory behaviour episodes per week?
mild = 1-3 moderate = 4-7 severe = 8-13 extreme = 14+
What is one of the main differences between anorexia and bulimia (indicator)?
Anorexia usually has really low weight, whereas bulimia has normal weight
What is binge eating?
Recurrent episodes of binge eating characterized by 3 or more of the following:
- eating much more rapidly
- until feeling uncomfortably full
- not feeling physically hungry
- eating alone
- feeling disgusted with one-self, very guilty afterwards
What is the main difference between binge eating and anorexia/bulimia?
BED is not associated with the recurrent use of inappropriate compensatory behaviour
What is the severity of BED based on average number of binge-eating episodes per week?
mild = 1-3 moderate = 4-7 severe = 8-13 extreme = 14+
What is OSFED?
Other specified feeding or eating disorder
- atypical anorexia (weight within or above the average range)
- bulimia nervosa of low frequency and/or limited duration
- binge-eating disorder of low frequency and/or limited duration
- purging disorder
- night eating syndrome
What is ARFID?
Avoidant restrictive food intake disorder
more commonly seen in childhood
not characterized by concern about body weight or size
What is the prevalence of EDs?
AN: 0.5-1% BN: 1-3% BED: -women: 3% -men: 2% -overweight people: 5-30% - bariatric surgery patients: 40%
What are the 2 things that cause eating disorders?
- genetic predisposition
2. environmental factors
What are some signs of extreme concerns with weight and body image?
frequent weighing
measuring
body checking
comparing themselves to others
What are the 4 negative consequences of vomiting?
- dehydration
- digestive resistance (gets more and more difficult to vomit)
- recurrent binge eating
- long term weight gain
What percentage of people with ED do compulsive exercising?
75%
What are some signs of eating disorder among athletes?
- frequent and prolonged visit to the gym
- frequent weighing
- km and calories monitoring
- weight fluctuations
- mood swings
- social withdrawal
- extreme concerns towards weight and food
What is the SCOFF questionnaire?
- do you make yourself sick because you feel uncomfortably full?
- do you worry that you have lost control over how much you eat?
- have you recently lost more than one stone (14lbs) in a 3 month period?
- do you believe yourself to be fat when others say you are too thin?
- would you say the food dominates your life?
What is the worst body system to be affected when there are complications related to ED?
cardiovascular
What is motivational interviewing?
A communication style to help resolve ambivalence
What is the psychological intervention of adolescents?
Family-based treatment: the parents are in charge of the refeeding of their child - slowly pass on the control to the child
What are the 3 psychological interventions used for BN and BED?
- cognitive behavioural therapy: questioning beliefs, distorted cognition, prescribing the proper behaviour
- dialectal behavioural therapy: especially for people with emotion regular, different personality disorders
- interpersonal therapy: long-term effectiveness
What is the sequential model of care?
Day program: 24h a week for 12-16 weeks
Day hospital: 40h a week
Hospitalization: 6 bed unit for 3 months
What is the weight gain goal per week once the person is hospitalized? in the day program?
1 kg/week
500g/week if BMI <20
What should be a pattern of eating (how many meals per day?)
5-6
What is the treatment goal for anorexia?
weight gain
