Eating Disorders Flashcards

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1
Q

Eating Disorders in DSM-5: As a theme

A

Involve restrictive or excessive eating, issues of control and other underlying psychological processes, and can result in very serious medical consequences, including hospitalization or death

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2
Q

Eating Disorders

A

Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder

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3
Q

The most common eating diagnosis

A

“Other Specified Eating Disorder” since 1) disordered eating can take many forms and 2) patterns can change over time

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4
Q

Anorexia Nervosa: Defining Characteristics

A

Extreme weight loss and thinness, seriously under “expected” body weight (Women may show amenorrhea as a sign of this, Many lack insight into how serious the problem is); Fueled by intense fear of obesity or fear of losing control over eating; Body image disturbance underlies this relentless pursuit of thinness, which often begins with “normal” dieting

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5
Q

Anorexia Nervosa really stands for…

A

“Nervous loss of appetite” Refusal to eat or intake calories

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6
Q

Amenorrhea

A

Menstrual Cycle stops

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7
Q

Intense fear of obesity or fear of losing control over eating is similar to…

A

The fear seen in phobias but with food

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8
Q

3 main distinctions of Anorexia Nervosa

A

1) Severally low body weight, 2) Denial of problem, 3) Significant amount of fear

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9
Q

Anorexia Nervosa Subtypes

A

Restricting subtype, Binge-eating/purging subtype; 50/50 btw the two
(We’ll discuss how this differs from bulimia shortly…)

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10
Q

Restricting Subtype

A

Drastically limit caloric intake via dieting and fasting (Not eating as much as normally would or should

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11
Q

Binge-eating/purging Subtype

A

Involves binging on food and then purging it

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12
Q

Purging

A

Get rid of food ingestion somehow (Diuretics, Laxatives, Throwing up) Self induced

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13
Q

To determine if one has Anorexia Nervosa…

A

Consider last 3 months. If person has binged/purged in that time, it’s that subtype. If not, it’s restricting.

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14
Q

Anorexia: Facts and Statistics

A

Mortality rate is 6x general population due to starvation, suicide, and sometimes substance use problems (Other serious medical complications occur as well); 10% with anorexia are male (and prevalence is higher in gay males); Many show OCD tendencies (and BDD specifically); Usually develops in teenage years; More chronic, serious, and resistant to treatment than bulimia

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15
Q

Why are the 10% of males with anorexia predominantly gay males?

A

Because gay men focus on body image more often

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16
Q

BDD shown in Anorexia

A

Body Dysmorphic Disorder; Imagine self as hideous

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17
Q

Anorexia is more…

A

Chronic, serious, and resistant to treatment than bulimia

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18
Q

Bulimia Nervosa: Defining Characteristics

A

Binge eating is the “hallmark” of bulimia and involves consuming excessive amounts of food in one sitting; Must happen at least once a week for three months; During a binge, eating is perceived as uncontrollable and may continue until there is physical pain (due to fullness) and/or high levels of guilt/shame

19
Q

In bulimia nervosa binge eating is…

A

Required, unlike in anorexia; Far exceed what a typical person would eat

20
Q

Bulimia Nervosa causes individuals to feel uncomfortable…

A

Physically (too full) and Psychologically (shame or guilt about how much they ate); Feel unable to control

21
Q

Bulimia Nervosa may be comorbid with…

A

Substance abuse, Mood disorder; Used as coping mechanism

22
Q

Bulimia Nervosa also includes compensatory behaviors such as…

A

Purging (eliminating food) through self-induced vomiting, diuretics, or laxatives; How does this differ from B/P subtype of AN? Exercising excessively is also common, Could even include fasting between binges

23
Q

Compensatory Behaviors (Bulimia Nervosa)

A

Behaviors that “undo” the binging (does not have to be purging but may be)

24
Q

Bulimia Nervosa: Facts & Statistics

A

Much more common than anorexia; Weight loss is much less severe in bulimia (most are within 10% of target body weight); Binges are often impulsive and triggered by emotional distress; Purging methods can result in severe physical complications

25
Q

Purging methods can result in severe physical complications such as…

A

Erosion of dental enamel, dehydration, electrolyte imbalance, kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage

26
Q

Binge Eating Disorder

A

Involves periods of binge eating that are much like those seen in bulimia (excessive eating, loss of control, shame, guilt etc.); Again, at least once a week for 3 months; However, compensatory behavior is not observed; Females more likely to have this disorder (3.5% versus 2% of men); Medical consequences are also common, but are somewhat different and related to excess weight (Does not have to be obese or overweight)

27
Q

Biological Dimension of Eating Disorders

A

Moderate heritability, Pubertal weight gain, Appetite Neural Circuitry, Dopamine, Ghrelin and Leptin

28
Q

Psychological Dimension of Eating Disorders

A

Body image dissatisfaction, Low self-esteem; Lack of control; Perfectionism or other personality characteristics; Childhood sexual or physical abuse

29
Q

Social Dimension of Eating Disorders

A

Parental attitude and behaviors, Parental comments regarding appearance, Weight concerned mothers, History of being teased about size or weight, Peer pressure regarding weight/eating

30
Q

Sociocultural Dimension of Eating Disorders

A

Social comparison, Media presenting distorted images, Cultural definitions of beauty, Objectification (Female and male bodies evaluated through appearance)

31
Q

Eating Disorders and the Role of Culture

A

Images we see show women thin and men muscular but many are technologically advanced; Family communication and school programs can help children realize that every image they see is not necessarily real or as important to everyday life

32
Q

Primary goal (Treatment of Anorexia Nervosa)

A

Weight restoration and addressing physical complications, which may require hospitalization (May need to be involuntarily admitted to hospital to avoid complications and relapse)

33
Q

Psychotherapy Targets (Treatment of Anorexia Nervosa)

A

Nutrition and compliance with eating (food logging is important, dysfunctional thoughts/attitudes, social functioning, other related problems; CBT has a lot of support here; Family therapy is often helpful as well; Experienced clinician is required (some cases are mild and resting to treatment well, other more serious cases lie to hide severity and result in fatality)

34
Q

Treatment of Bulimia Nervosa also begins with…

A

Addressing physical complications

35
Q

Main goal is to… (Treatment of Bulimia Nervosa)

A

Normalize eating patterns, eliminate the cycle of binging and purging, and address underlying thoughts and feelings (issues with self-esteem); CBT also effective here (ERP is one approach)

36
Q

Medication (Treatment of Bulimia Nervosa)

A

More likely to involve medication than anorexia, esp. SSRI’s (Bc low levels of serotonin can cause impulsivity which is treatable)

37
Q

Treatment of Binge Eating Disorder

A

Usually includes education about/support for healthy approaches to weight loss; 2 primary phases: Identify triggers for binge eating, Learn coping skills to handle the urge to binge; Can be triggered by stress or environmental factors (passing fridge, commercials)

38
Q

Body Weight (Differentiating between Anorexia and Bulimia)

A

AN: Must be underweight; BN: Does not have associated weight criteria

39
Q

Level of Fear (Differentiating between Anorexia and Bulimia)

A

AN: Level of fear is present and clinically significant; BN: Does not have a phobic like obsession with it

40
Q

What binging/ purging looks like (Differentiating between Anorexia and Bulimia)

A

AN: B/P tends to be more planned and controlled than in bulimia

41
Q

CBT for Treatment of Anorexia Nervosa

A

Most often recommended; Change their thinking patterns to be more structured and happy; Food logging is important to change how individuals think of themselves and food

42
Q

Family Therapy for Treatment of Anorexia Nervosa

A

Most common eating disorder to be influenced by family therapy (best option if possible); Weight concerned mothers have the biggest influence; Also many with anorexia experience issues with others because they do not believe is severe or end up being friends with others that show similar thoughts and actions

43
Q

CBT for Treatment of Bulimia Nervosa

A

ERP (Exposure Response Prevention) is one approach in which clinicians 1) Work at level of Vicious Cycle (Eat normal size meal without compensating), 2) Exposure to stressful event without being allowed to eat (Treatment type is also seen in OCD)