Eating Disorders

Question 1

What are the 7 eating disorders?

Answer 1

1. Anorexia
2. Bulimia
3. Pica
4. Rumination
5. Binge-eating disorder
6. OSFED
7. AFRID

Question 2

What are the characteristics of anorexia?

Answer 2

• 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)

Question 3

What are the 2 types of anorexia?

Answer 3

1. restricting (no binge eating or purging)

2. binge eating/purging

Question 4

What is the severity of anorexia based on BMI?

Answer 4

17+ = mild
16-16.99 = moderate
15-15.99 = severe
15- = extreme

Question 5

What is another indication of the severity of anorexia other than BMI?

Answer 5

Compulsive exercise

Question 6

What is the prognosis of anorexia?

Answer 6

• 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

Question 7

What are some common dietary patterns in anorexia?

Answer 7

gradual decrease of food intake
removal of high energy foods
gradual decrease in portion sizes
rigid schedule of eating
limited food choices
fat avoidance

Question 8

What are the two questions most people will ask?

Answer 8

1. will my body revenge and want to gain weight and I will become fat?
2. What is the normal serving?

Question 9

What is bulimia and its characteristics?

Answer 9

Recurrent episodes of binge eating characterized by BOTH the following:

1. eating large amounts of food in a discrete amount of time
2. 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)

Question 10

What is the severity of bulimia based on the average number of compensatory behaviour episodes per week?

Answer 10

mild = 1-3
moderate = 4-7
severe = 8-13
extreme = 14+

Question 11

What is one of the main differences between anorexia and bulimia (indicator)?

Answer 11

Anorexia usually has really low weight, whereas bulimia has normal weight

Question 12

What is binge eating?

Answer 12

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

Question 13

What is the main difference between binge eating and anorexia/bulimia?

Answer 13

BED is not associated with the recurrent use of inappropriate compensatory behaviour

Question 14

What is the severity of BED based on average number of binge-eating episodes per week?

Answer 14

mild = 1-3
moderate = 4-7
severe = 8-13
extreme = 14+

Question 15

What is OSFED?

Answer 15

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

Question 16

What is ARFID?

Answer 16

Avoidant restrictive food intake disorder
more commonly seen in childhood
not characterized by concern about body weight or size

Question 17

What is the prevalence of EDs?

Answer 17

AN: 0.5-1%
BN: 1-3%
BED:
-women: 3% 
-men: 2% 
-overweight people: 5-30%
- bariatric surgery patients: 40%

Question 18

What are the 2 things that cause eating disorders?

Answer 18

1. genetic predisposition

2. environmental factors

Question 19

What are some signs of extreme concerns with weight and body image?

Answer 19

frequent weighing
measuring
body checking
comparing themselves to others

Question 20

What are the 4 negative consequences of vomiting?

Answer 20

• dehydration
• digestive resistance (gets more and more difficult to vomit)
• recurrent binge eating
• long term weight gain

Question 21

What percentage of people with ED do compulsive exercising?

Answer 21

75%

Question 22

What are some signs of eating disorder among athletes?

Answer 22

• 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

Question 23

What is the SCOFF questionnaire?

Answer 23

• 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?

Question 24

What is the worst body system to be affected when there are complications related to ED?

Answer 24

cardiovascular

Question 25

What is motivational interviewing?

Answer 25

A communication style to help resolve ambivalence

Question 26

What is the psychological intervention of adolescents?

Answer 26

Family-based treatment: the parents are in charge of the refeeding of their child - slowly pass on the control to the child

Question 27

What are the 3 psychological interventions used for BN and BED?

Answer 27

1. cognitive behavioural therapy: questioning beliefs, distorted cognition, prescribing the proper behaviour
2. dialectal behavioural therapy: especially for people with emotion regular, different personality disorders
3. interpersonal therapy: long-term effectiveness

Question 28

What is the sequential model of care?

Answer 28

Day program: 24h a week for 12-16 weeks
Day hospital: 40h a week
Hospitalization: 6 bed unit for 3 months

Question 29

What is the weight gain goal per week once the person is hospitalized? in the day program?

Answer 29

1 kg/week

500g/week if BMI <20

Question 30

What should be a pattern of eating (how many meals per day?)

Answer 30

5-6

Question 31

What is the treatment goal for anorexia?

Answer 31

weight gain