Eating Disorders Flashcards
What are the diagnostic features of anorexia nervosa?
- Active maintenance of low body weight (<85% of expected weight or BMI = <17)
- Extreme shape and weight concern
What are the physical signs of anorexia?
- Low BP
- Dizziness
- Stomach pains
- Hair falls out
- Feeling cold/low body temperature
- Swelling in feet, hands or face
- Difficulty sleeping
How are mental disorders diagnosed?
Using Diagnostic and Statistical Manual of Mental Disorders
What was a new category to eating disorders diagnosis in DSM-5?
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder (new)
- OSFED (Other Specified Feeding and Eating Disorders) (new)
- AFRID (Avoidant Restrictive Food Intake Disorder)
What are the 2 types of anorexia nervosa?
- Restricting
2. Binge/purge
What is the sex ratio of anorexia?
95% female
What is the peak age of anorexia onset?
Between 15-18
What are the signs of anorexia?
- Behavioural (avoiding food they think is fattening, excessive exercising, lies)
- Psychological (depression, anxiety, social withdrawal)
- Cognitive and social (obsessive, pre-occupation with weight, thinking they are overweight)
What is an objective/subjective binge?
Objective - eating amount of food considered larger by ‘normal’ people
‘Subjective’ - eating amount of food considered larger by person with anorexia
Physical signs of anorexia?
- Low bp
- Growth of downy hair all over body
- Hair falls out
- Swelling in feet, hands, face
- Stomach pains
- Difficulty concentrating
What is the Minnesota starvation experiment?
Put normal people on starvation diet for 24 weeks (lost 25% of body weight)
Interested in different refeeding diets
Symptoms of starvation very similar to those of anorexia
What is bulimia nervosa?
- Recurrent binge eating (large amounts quickly, loss of control
- Compensatory behaviour (vomiting, fasting, exercise, laxatives)
- Extreme shape and weight concern
Binge frequency at least 1/week for 3 months
When is the peak onset of bulimia nervosa?
Late adolescence, young adult
What is the sex ratio of bulimia nervosa?
95% female
What are the impairments of bulimia nervosa?
- Complications of purging (e.g. tooth decay, oesophageal tears)
- Psychological
What are the physical signs of bulimia nervosa?
- Electrolyte abnormalities (lack of magnesium, sodium)
- Swelling of hands and feet
- Enlarged salivary glands
- Constipation
- Lethargy
- Amenorrhea
- Gastric problems – feeling bloated
How does a ‘binge eating disorder’ differ?
- Recurrent binge eating – large amounts quickly, loss of control
- Marked distress regarding binge eating
BUT - No compensatory behaviour
Often seen in obesity and weight management services
What terms are used for those who don’t meet the threshold for anorexia/bulimia etc?
Disordered eating, eating difficulties
What are the risk factors for the development of eating disorders?
Perfectionism Family history Mental health problems History significant dieting Being part of sport/activity where there is emphasis on appearance
What is the main pathway to ED?
Dieting
Moderate dieting at 15 = 5x more likely to develop ED
Severe dieting at 15 = 18x more likely
What are the specific risk factors of ED?
Body dissatisfaction risk factors –> negative body image, weight preoccupation, dieting –> ED
What are the non-specific risk factors of ED?
Self-regualtory risk factors –> trauma, parental psychopathology/insensitivity –> low self-esteem, insecure attachment, affective dysregulation –> non-eating disordered psychopathy –> ED
What can influence EDs in adolescences?
- Peer impression management (conforming, socially normative dieting)
- Food autonomy from parents (refusing parental control)
How are food and mood regulation connected?
- Mood lifted by consumption of good tasting, high energy food
- +ve (-ve?) reinforcement
- cravings triggered by –ve mood
What can drive stopping eating?
When external events feel outside personal control e.g. response to an argument
- to influence others e.g. to show feelings of distress, defiance, or anger
What can drive binge eating and purging?
- Regulate negative emotional states
- Escape from aversive self-awareness
reinforcing and self-maintaining
What are the stages of treatment?
- Weight management
- Psychological therapies e.g CBT-e (Cognitive Behavioural Therapy), Guided Self Help
- Relapse prevention
What is the main approach for children and young people?
FBT - Family Based Therapy
What is the course of disordered eating?
- Single, short crisis (recovery more likely)
- Chronic, intractable disorder
Essential things to remember
- Eating disorders may not be the primary problem but develop as a way of managing the problem
- ‘you look healthy’ = you look fat
