Eating Disorders Flashcards
What is an eating disorder?
Severe disturbances in eating behaviour that negatively affect physical or mental health
What are the 3 major subtypes of eating disorder that the DSM recognizes?
1) Anorexia Nervosa
2) Bulimia Nervosa
3) Binge Eating Disorder
What are some of the “other specified eating and feeding disorders?”
Pica, rumination disorder, avoidant, restricted food intake disease, night eating syndrome, purging disorder
What is pica?
When children are unsupervised and eat non food items. Can be chronic in kids and adults with medical deficiencies. Relates to extensive neglect
What is rumination disorder?
Regurgitation of food. Chewing already chewed foods
What is avoidant restrictant food intake disorder?
People who are chronically picky eaters. Eat only certain things and not others. Accompanied by the false impression in adults that they have allergies, intolerances, Chron’s etc. Eating becomes restricted, do not want to hear that they don’t have food allergies. Can become thin and develop osteoparosis.
What are some of the symptoms and clinical features with anorexia nervosa?
Restriction of food intake, leading to significantly low weight as determined by BMI (17 and below). Intense fear of gaining weight and becoming fat. Disturbance in evaluation of weight and body shape, preoccupation with food (fantasizing, calory counting). Depression accompanies.
What percentage of people with anorexia die of starvation, suicide or medical complications?
10%. Highly morbid disease.
What are the 2 subtypes of anorexia?
Restricting and Binge eating/purging
What is the restricting subtype of anorexia?
Will restrict what they eat whenever they can
What is the binge eating/purging subtype of anorexia?
Restrict food, but slip up sometimes and will purge. Leads to digestive issues and tooth breakdown.
What is the difference between the binge eating/purging type of anorexia and bulimia?
Bulimics have a normal BMI and don’t have a distorted bodily view.
What are some of the physical changes and medical complications associated with anorexia?
Lanugo, Russells Sign, decreased fertility, osteoporosis, lethargy, dry hair and dry skin, hair loss, heightened sensitivity to cold, impaired renal function, cardiac arrhythmias.
What is Russell’s sign?
Redness of hands from sticking fingers down throat.
How can a struggle for control manifest in anorexia?
Teenagers have no control in life. Restricting eating is a form of control (between parents and child).
What are some of the disorders that are comorbid with anorexia?
OCD, personality disorders (OCPD), depression.
What is an objective versus a subjective binge?
Objective: actually eating a bunch of food
Subjective: having one chocolate bar and considering that a binge.
What is characteristic of the binge eating done by patients with bulimia?
Either planned or spontaneous. Secretive. Quick eating until uncomfortably full. Lack of control over eating. Triggered by negative moods. Objective binges a home.
What are negative moods associated with bulimia?
Depression, anxiety, fear, and shame triggered by stressful life events.
What kinds of inappropriate compensatory behaviour do people with bulimia participate in?
Purging: self induced vomiting, laxatives, dieuretics, enemas
Excessive exercise and rigid fasting
What is a person with bulimias self esteem and daily routine focused on?
Weight and appearance
What types of disorders are normally comorbid with bulimia?
Depression, anxiety, borderline personality disorder, substance abuse.
What are some medical complications that can accompany bulimia?
Dental problems (important issue, frequent vomiting is harmful to teeth), excess gag reflex, enlarged salivary glands, electrolyte imbalance.
What differentiates bulimia and anorexia?
Bulimia has no bodily misconceptions and they have a normal BMI
What substance do binges often include?
Alcohol.
What are the 2 types of bulimia?
Purging type and non-purging type
What is the purging type of bulimia?
When the binge is followed by self-induced vomiting OR misuse of laxatives or diuretics
What is the non-purging type of bulimia?
Binge is followed by excessive exercising or fasting
What is binge eating disorder?
Recurrent, binge eating like bulimia, but without compensatory behaviours. Eating very rapidly, eating large amounts even if not hungry, eating alone. Sense of lack of control over binge followed by feelings of embarrassment and guilt.
What is not a criterion of binge eating disorder?
Obesity.
What eating disorder has the highest mortality rate of all mental disorders?
Anorexia
What percentage of the population has anorexia and bulimia?
Anorexia: 5% of adolescent and young adult females
Bulim- 1-3% of the same population
How much more common are eating disorders in women?
10 times
What fields of work/activity are eating disorders more commonly found in?
Fields that emphasize weight, appearance, and high athletic performance. Ex: Gymnastics, figure skating, weight lifting, modeling, acting, anchoring etc.
What kinds of women are eating disorders more common in?
- If they have greater media exposure
- Middle-upper class white females
- Arab and asian females living in N. America versus their native countries.
Why does the western world report more problems with eating disorders?
Poverty and food availability makes eating disorders less common. Emphasis on appearance and weight is more common in western and developed Asian countries.
How can family systems affect eating disorders?
Struggles for control in adolescence, influence of peers over family, web, social media, unsupervised by parents
What type of therapy is important in the treatment of adolescent girls?
Family therapy
What are some of the psychological problems associated with eating disorders?
Struggle for control, depression, low-self esteem, escape from self awareness, negative body image, dietary restraint leading to binges, personality.
What is “escape from self-awareness”
Idea that one becomes aware of a problem, and it is overwhelming. Distress causes more eating issus.
What are some personality factors that affect eating disorders?
Perfectionism, obsessiveness, compliance (to dietary norms), lack of awareness of inner feelings, negative self-concept.
What are the personality factors related to?
Management of body image and negative emotional states
What are the biological factors that contribute to eating disorders?
Maturational issues, genetics, dysfunctional neurotransmitter activity
What is delay of maturation?
The fear of developing secondary sex characteristics due to societal pressures and increased body mass. Upsetting comments from men on bodies. Eating very little and losing lots of weight delays the maturational process.
How can perfectionist tendencies relate to eating disorders?
One can never be perfect, therefore there are constant negative emotions.
If you have a relative with anorexia, how much more likely are you to also get anorexia?
4.5X
How does serotonin play into anorexia and bulimia?
Reduced serotonin activity. Serotonin system is associated with feeding and satiety.
What gene contributes to BN patients with a lower BMI?
Serotonin 1B receptor
What are the goals of anorexia treatment?
Weight gain, adressing difficulties that cause/maintain the problem
What are some of the strategies used in the treatment of anorexia?
Family therapy, cognitive therapy, hospitalization, coercive methods (behavioural interventions, forced feedings)
What are behavioural interventions?
When a person gets privileges taken away and has to slowly gain them back by eating
When would forced feeding happen?
When the person is close to death.
Are medications helpful with the treatment of anorexia?
No
Is treatment generally successful with anorexia?
No
What are some of the ways we attempt to treat bulimia?
Antidepressants, cognitive therapy including education, behavioural strategies, challenging dysfunctional beliefs, relapse prevention, interpersonal psychotherapy.
What type of treatment has proved to be quite effective with bulimia?
Cognitive Behavioural
What makes treatment of bulimia more difficult?
When it is comorbid with BPD
