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Eating disorders > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

Up to …. of people die of anorexia nervosa

A

20%, with slightly more than 5% dying within 10 years

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2
Q

….has the highest mortality rate of any psychological disorder reviewed in this text, including depression.

A

Anorexia nervosa

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3
Q

from …% to …% of anorexia-relate deaths are suicides…

A

20% to 30%, which is 50 times higher than the risk of death from suicide in the general population

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4
Q

Suicide occur in …% of patients with eating disorders

A

30% to 40%

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5
Q

Earlier or later years of onset for eating disorders?

A

Earlier.

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6
Q

Has prevalence leveled off?

A

If it has, it is very recent (yes)

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7
Q

Death rates among EDs compared to normal population

A

6 times.

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8
Q

Are eating disorders found in developing countries?

A

nope.

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9
Q

Are eating disorders going global?

A

yes.

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10
Q

What percentage are females?

A

90%

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11
Q

Just as important as the amount of food eaten is that the eating is experienced as…

A

out of control (in Bulimia), a criterion that is an integral part of the definition of binge eating.

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12
Q

Another important criterion is…

A

compensatory behaviours (such as purging or exercise)

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13
Q

Vomiting reduces approximately …% of calories just consumed (less if delayed at all)

A

50%

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14
Q

How effective are laxatives for weightloss?

A

barely at all.

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15
Q

What are the consequences of purging?

A

salivary gland enlargement (chubby cheeks), eroding dental enamel, sodium and potassium levels can drop (electrolyte imbalance), cardiac arrythmia, seizures, renal (kidney) failure (some of which can be fatal). Callouses on backs of knuckles or fingers from purging.

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16
Q

Do people with bulimia develop more or less body fat than age and weight matched controls?

A

MORE. that sucks.

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17
Q

Associated disorders

A

80% have anxiety disorder, 66% of adolescents with bulimia presented with anxiety disorder (people with anxiety do not have elevated comorbidity with bulimia btw)

20% have depression when interviewed, between 50-70% at some point during course of the disorder.

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18
Q

Any other disorders?

A

about a third are substance abusers when interviewed. Traits of instability and novelty seeking may account for comorbidity.

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19
Q

Are Anorexics proud of their control and weightloss?

A

yes. People with Bulimia however, are ashamed of both their eating issues and their lack of control.

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20
Q

People with anorexia have an intense fear of…

A

obesity and relentlessly pursue thinness.

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21
Q

When does it begin?

A

In adolescents who are overweight or who perceive themselves to be.

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22
Q

Two types of anorexia

A

Binging type and restricting type

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23
Q

How many engage in binge eating and purging?

A

approximately half.

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24
Q

Is subtyping useful?

A

May not be in predicting future course of the disorder but rather may reflect a certain phase or stage of anorexia, (a finding confirmed.)

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25
Q

within the DMS5, subtyping only refers to the past…

A

3 months.

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26
Q

DSM5 criteria specifies “significantly low body weight” at which percentage?

A

15%

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27
Q

Another key criterion of anorexia is…

A

marked disturbance in body image

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28
Q

What often leads to initial visit?

A

pressure from a loved one

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29
Q

Some anorexics will show increased interest in cooking and food. Why?

A

A demonstration of absolute control over their eating.

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30
Q

Medical signs

A

some have cessation of menstruation, dry skin, brittle hair or nails, sensitivity to or intolerance of cold temperatures, lanugo (downy hair on limbs and cheeks), cardio problems, chronically low blood pressure and heart rate.

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31
Q

Rates of depression among anorexics..

A

can be up to 70%

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32
Q

Other disorders associated with anorexia?

A

OCD - obsessions with gaining weight

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33
Q

Difference between binge-eating disorder and Bulimia?

A

Binge-eaters do not compensate for their binges.

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34
Q

The same patterns of herritability as other eating disorders?

A

No, they’re different for binge eating disorder.

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35
Q

Same male/female ratio as bulimia or anorexia?

A

No, higher prevalence of males for binge eating disorder.

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36
Q

Likelihood of remission the same as bulimia or anorexia?

A

GREATER likelihood of remission and better response to treatment in BED than other EDs.

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37
Q

Is obesity and BED caused by the same things?

A

No, BED is caused by separate factors and is more associated with more severe obesity.

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38
Q

20% of obese individuals in weight loss programs engage in binge eating, and how many who are up for bariatric surgery?

A

50%.

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39
Q

What is the prognosis for BED?

A

18% retain full diagnostic criteria for BED at a 5 year followup.

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40
Q

Those who are obese with BED, however…

A

can cross over to bulimia.

41
Q

about half try … before bingeing, and half….

A

start with bingeing and try dieting.

42
Q

Who is more severely affected by BED and more likely to have additional disorders? Dieters or Bingers?

A

Bingers.

43
Q

What distinguishes obese people with BED from individuals who are obese without BED?

A

They have the same concerns about shape and weight as people with anorexia and bulimia.

44
Q

Approximately… % binge to alleviate bad mood or negative affect.

A

33%.

45
Q

What percentage that present for treatment are women with bulimia?

A

90-95% are women.

46
Q

What about the men?

A

They’re slightly older and slightly more gay, and there’s more and more of them.

47
Q

Was the gender imabalance always there with bulimia?

A

Nope. The vast majority of recorded cases were male.

48
Q

Who is most at risk for bulimia?

A

adolescent girls.

49
Q

By the time they hit 20, how many have experiecned some form of eating disorder?

A

13%

50
Q

Which are more prevalent (lifetime)?

A

Binge-eating disorder (2.8%), Subthresh BED (1.2%), Bulimia (1%), Anorexia (0.6%) -although anorexia could be underrepresented.

51
Q

Median age of onset for all eating-related disorders occurs typically between…

A

18 and 21.

52
Q

Anorexia can begin closer to…. while Bulimia can start..

A

Anorexia - 15, Bulimia - 10.

53
Q

Strongest predictors of persistent bulimia are…

A

a history of childhood obesity and a continuing overemphasis on the importance of being thin. In addition, individuals tend to retain their bulimic symptoms instead of shifting to symptoms of other eating disorders.

54
Q

negative attitude toward being overweight can appear as early as…

A

3 years old.

55
Q

More than half girls of ages … to … would like to be thinner.

A

6 to 8.

56
Q

By 9, …% of girls are trying to lose weight, and by 14, …%

A

20% by 9, 40% by 14.

57
Q

Both Bulimia and anorexia can occur in later years, particularly after the age of …

A

55.

58
Q

Generally, concerns about body image…. with age.

A

decrease.

59
Q

The most dramatic factors that cause eating disorders are…

A

social and cultural.

60
Q

Are Anorexia and Bulimia the most culturally specific disorders identified?

A

Yes!

61
Q

Do friendship cliques cause problematic attitudes or disordered eating that follows?

A

No. They may share these concerns, but girls are probably just picking friends with common interests.

62
Q

Do mothers with anorexia restrict food to their children?

A

yes, they can do.

63
Q

Adolescent girls who dieted were … times more likely to develop an eating disorder than those who weren’t.

A

8 times.

64
Q

What effect is most likely when adolescent girls try to lose weight?

A

they typically GAIN weight.

65
Q

Girls who attempted dieting faced more than …% greater risk of obesity than those who did not diet.

A

300

66
Q

Repeated cycles of dieting produce…

A

stress-related withdrawal symptoms, much like other addictive substances, resulting in more eating than would have occurred without dieting.

67
Q

The typical family of someone with anorexia is..

A

successful, hard-driving, concerned about external appearances, and eager to maintain harmony.

68
Q

Recent evidence… the role of parents in development of EDs.

A

DOWNPLAYS (let mum off the hook a little)

69
Q

Relatives of patients have a… times higher likelihood of developing an ED.

A

4 to 5 times.

70
Q

…% of identical twins had bulimia, compared with …% of fraternal.

A

23% of identical twins, 9% of fraternal.

71
Q

General consensus is that genetic makeup is about ….. the equation

A

half.

72
Q

What is inherited?

A

non-specific personality traits (impulsivity, emotional instability, perfectionistic traits, negative affect).

73
Q

What brain bits are involved?

A

hypothalamus might play an important role (and the neurotransmitters flowing through it).

74
Q

and neurotransmitters?

A

serotonin, the system most often associated with eating disorders (hence impulsivity and binge eating).

75
Q

Most drugs under study for EDs target ….

A

serotonin.

76
Q

What is the connection between binge eating and hormones?

A

High levels of post-ovulatory phase hormones accounted for emotinal eating behaviour.

77
Q

Perfectionism is only weakly associated with eating disorders, but when combined with…

A

distorted perception of body image, a powerful enginge to drive eating disorder behaviour is in place.

78
Q

women with bulimia, when hungry, had more intense …. emotoinal responses when viewing pictures of food, and subsequently ate … at a buffet, presumably to … their ….

A

negative emotional responses, they ate more at a buffer to reduce their anxiety.

79
Q

Drug and psychological treatments with proven effectiveness for … disorders are also the treatment of choice for eating disorders.

A

anxiety.

80
Q

A small minority of indiviuals are successful at controlling their intake through …. (anorexia), whereas the majority are unsuccessful and compensate in a cycle of …. and ….

A

dietary constraint, compensate in cycle of binging and purging.

81
Q

Have drug treatments found to be effective in treating eating disorders?

A

not for anorexia but may be useful for bulimia during binge/purge cycles (SSRIs, Prozac), although drugs alone do not have substantial long-lasting effects.

82
Q

What do short-term CBT target?

A

problem eating behaviour and associated attitudes about the overriding importance and significance of body weight and shape.

83
Q

Are treatments now transdiagnostic?

A

yes.

84
Q

What is the first stage CBT-E?

A

teaching the patient the physical consequence of binge eating and purging, as well as the ineffectiveness of vomiting and laxative abuse for weight control.

85
Q

What else is taught in CBT-E

A

altering dysfunctional thoughts and attitudes about body shape, weight, and eating. Coping strategies for resisting the impulse to binge and/or purge are also developed, including arranging activities so that the individual will not spend time alone after eating during the early stages of treatment.

86
Q

What is seen as the treatment of choice?

A

CBT-E

87
Q

A problem with CBT-E?

A

trained therapists are not always available

88
Q

Treatment for binge eating?

A

ITP is just as effective as CBT (60% response)

89
Q

Are self-help procedures useful for BED?

A

They can be.

90
Q

CBT guided self-help treatment showed what kind of response?

A

70% reduction in binge eating by week 4.

91
Q

What is the most important goal for treatment of anorexia?

A

restoring weight to a point that is at least within the low-normal range.

92
Q

If bodyweight is below … the average healthy body weight, inpatient treatment is recommended.

A

75%

93
Q

How many are able to gain weight and what is the motivation?

A

85% can regain weight and knowing they can leave the hospital when they hit this goal.

94
Q

Is initial weight gain an indicator of long-term treatment outcome?

A

unfortunately, no.

95
Q

The focus must shift, after gaining weight to…

A

anxiety over becoming obese and losing control of eating, as well as emphasis on thinness as a determinant of self-worth, happiness and success.

96
Q

Is outpatient CBT more or less effective as nutritional counseling?

A

Yes, much more successful.

97
Q

At discharge, what predicts increase in anorexia psychopathology over the following year?

A

emotional regulation.

98
Q

What treatment has the most support for treating adolescents with anorexia?

A

Family-based Treatment.

99
Q

What is effective at preventing disorders?

A

Focusing on eliminating an exaggerated focus on body shape or weight and encouraging acceptance of one’s body.

Eating disorders (1 decks)

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