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eating disorders and obesity Flashcards

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1
Q

what is the role of media in obsessions with food and body shape?

A

media

  • bombards us with a ‘standard of beauty’
  • makes us believe that all women should be thin
  • associate beautiful people with happy lives and high moral standards

-promotes body dimension of female models, actresses, cultural icon
->became thinner over the years
10x more articles on dieting /weight management for woman rather than men

-active social media -> maintaining factor for body/eating concerns
indv w body related /eating concern , more drawn to appearance related activities -> engagement in appearance ->persistent body/eating concern
=>bidirectional , mutual reinforcement

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2
Q

what is aneroxia nervosa?

A

(an= without, orexis= appetite)
-> not always true

fear of gaining weight / becoming fat
pursuit of thinness that can be deadly
refuse to maintain normal weight

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3
Q

two types of aneroxia nervosa?

A

1) restricting type

2) binge eating /purging type

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4
Q

what are the psychological symptoms of aneroxia nervosa?? (7)

A 
fear of gaining weight/fatness
irritability and anxiety 
low self esteem
preoccupation w food /weight /size
impaired memory/attention/concentration 
denial
distorted thinking styles /body image 
->see things as black and white 
->overgeneralisation
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5
Q

what are the behavioural symptoms of aneroxia nervosa?

A

avoidance of eating
excessive exercising
ritualistic behaviour
deceptive behaviour (storing /hiding food)
excessive fluid consumption
frequent toilet visit (laxative / vomiting)

when starved, body turn to itself to produce energy
fat burns-> muscle burns-> organs destroyed to find fuel

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6
Q

what is bulimia nervosa ?

A 
(boux: ox, limes: hunger)
characterised by:
frequent binge eating
lack of control over eating
recurrent inappropriate behavior to preven weight gain

->modern disease

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7
Q

types of bulimia nervosa?

A

purging type:
vomiting
laxatives
diuretic (water pill)

non-purgin:
fasting
exercising

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8
Q

what is binge eating disorder?

A

characteristics:
episodes of binge eating
typically overweight or obese
no compensatory weight loss behaviour

->mental disorder

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9
Q

what type of treatment are there for anorexia nervosa?

A

antidepressant or other medication
family therapy
CBT
emergency, restore weight procedure

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10
Q

how does eating disorder in men look like?

A 
sociocultural pressure to have toned muscular bodies
body dissatisfaction (wanting a muscular upper torso)- excessive exercising
underdiagnosed: stereotype for female disorders
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11
Q

eating disorder and it’s association with other psychopathology??

A
  • clinical depression
  • OCD
  • personality disorders: impulsivity, anxiety,social isolation, depression
  • ASD
  • substance abuse disorder
  • > increase self harm/suicide
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12
Q

guidelines for emergency procedure ED

A

person health risk due to ED, don’t consent

  • only treat in inpatient setting
  • compulsory treatment

child/young person at serious risk, do not consent

  • ask parent or caregiver
  • legal framework for compulsory treatment

-> high calcium diet (oral feeding, tube), stop exercising, bed rest

goals:
counter physio effect of starvation
weight gain

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13
Q

what is the target for CBT?

A
  • encourage healthy eating/ reaching healthy body weight
  • personalised treatment plan on processes that maintain eating problem
  • monitoring dietary intake and association with thoughts and feelings
  • cognitive restructuring includes: body image concerns, mood regulation, social skills, self-esteem, relapse
  • enhance self-efficacy
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14
Q

model of aneroxia nervosa?

A

over-evaluation of weight/shape/eating

  • > strict weight control
  • > increased checking weight/body shape/food
  • > decrease rate of weight loss
  • > perceive as failure to loss weight
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15
Q

treatment for bulimia nervosa?

A

common:
antidepressant or other medication
CBT

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16
Q

factor in eating disorder

A

multi-determined:
-ED runs in families (genetic factors mixed)- susceptibility to ED inherited

  • set point theory : our bodies try to maintain weight within preferred range that is genetically determined
  • brain abnormalities and neurotransmitters
17
Q

what is the genetic contribution for aneroxia nervosa?

A

strober (2002). 3 times more common among relative of aneroxia and bulimia
-> element of familial transmissibility

more closely related genetically related= more likely to have AN
MZ twin 29/50 (58%)
DZ twins 2/42 (5%)
-> strong genetic contribution, consistent with increased susceptibility

18
Q

what are the neurotransmitter dysfunction in AN?

A

serotonin: involved in mood, obsessions, appetite regulation, impulse control
- AN have low level of 5TH metabodies
- abnormalities

dopamine: reward system
hyper sensitivity of dopamine system ->AN pathology

19
Q

what is the set point theory of ED

A

leptin (safety hormone): reduces food intake ‘fat controller’
perturbed in AN, increased sensitivity, hypoleptinaemia is an indictor of severity of disorder

obsese poeple have increased amount of leptin-> decreased sensitivity: inability to detect brain does not respond to leptin (thus keep eating)

grehlon (hunger hormone): increase food intake, appetite stimulator

eating-> fat increase-> leptin arise-> signal body reduce intake of food
fat low-> leptin level low

20
Q

what is the activity based anorexia model ??

A

robert : low calorie intake, limited food in combination w exercice

  • > loco-motor activity increase
  • > hyperactive, run more compare to animals with less food
21
Q

what about the hyperactivity in AN?

A

40-80% show excessive activity or motor restlessness
-> difficult to control and jeopardise weight recovery

-deliberate calorie burning /weight reduction strategy
-coping strategy to suppress negative states: exercices -> anxiolytic & emotion regulation effect
- thermo-regulatory behaviour: exercice to counter hypothermia (due to restricted feeding and subsequent weight loss)
keeping patient warm: beneficial for treatment

22
Q

risk factors fr anorexia nervosa

A

negative body shape & internalisation of thin ideal in women; rate body as heavier than ideal/ what’s attractive

23
Q

what are the neurocognitive impairments in AN?

A

associated with OCD, perfectionism,social communicative , emotional difficulties

poor set shift (inflexible), weak central coherence, poorer global ntegration

24
Q

social and emotional processes in ED?

A

emotional, social, communicative interpersonal difficulties (amplified with acute stress)
disordered eating= maladaptative strategy to regulate emotion, (avoidance ) reinforced when temporary reduction in anxiety

twin studies demonstrate:

  • difficulty w emotion recognition
  • stronger attentional bias to social threat
  • positive association between social / facial threat and duration of binging ,vomiting, laxative
  • emotion recognition and social attention stronger in Mz (genetic bias)

emotional and attentional bias modification training -> treatment

25
Q

what are the socio cultural influences on AN

A

fashion magazines, media (tv) i family, peers

->idealises extreme thinnness

26
Q

what are the family characteristics of AN patients?

A
  • limited tolerance on psychological tension; poor social conflict skills
  • emphasis on property/rule mindedness
  • parental over direction, discouragement of autonomous
  • preoccupability in desirability of thinness, dieting, physical appearance

johnson et al .2002
->low parental affection/ communication/time spent =eating and overweight problems

27
Q

socio cultural risk factors for eating disorders?

A

westerns cultures associated ED
-thin portrayed as desirable, sign strength of character, self control, success etc…
more common in high-income asian societies

28
Q

what happens in the experience exposure to televison??

A

look at fijan ado girls
-> attitude on body chnage drastically w tv (1995)
-> within 3 years girls that vomited to control weight from 0%-6-11%
causal link between tv/ media exposure and ED

29
Q

explain how ED is culturally bound?

A

keel and kump (2003)
bulimia nervosa ; culturally bound (influenced by media)
anorexia nervosa ; more genetic

30
Q

what is cognitive interpersonal maintenance model of anorexia nervosa?

A

-> cognitive, socio-emotional and interpersonal elements act together to cause and maintain

premorbid trait: OC trait, vulnerability factor, contribute to maintenance, with AN beliefs /behavior

cognitive processing style (rigidity, poor set shift, weak central coherence)underpin threats

socio-emotional impairment, difficulties in social cognition, attentional bias
family traits: high expressed emotions, criticism, hostility, overprotection=>accentuate/perpetuats problem

31
Q

what is obesity?

A 
defined by BMI (balance between heght and weight)
public heath concern: 
-high cholesterol 
-hypertension
-diabetes
-heart disease
-cancer
-arthitis

not considered as eating or brain disorder
-> habit of over-eating ‘food addiction’
brain areas involved in motivation to eat, reward, inhibitory control (serotonin/dopamine) play part

32
Q

what are the risk and causal factors for obesity?

A

risk factors:

  • runs in families
  • neurotransmitters& hormones (leptin=insensitive, grehlin)
  • socio-cultural influences
  • stress and comfort food
  • > associate watching smt pleasant and eating
  • > attending parties; element of food
  • > becoming anxious angry or bored
  • family influences:
  • > behaviour: *high fat/calorie diet *overfeeding * ‘social contagiousness’ * attenuate distress
experience on rats:
give access to high fat/sugar foods
-> gained weight quickly
->decrease brain reward circuit
->food less rewarding=> dev. compulsive eating
33
Q

treatment methods for obesity??

A

lifestyle modification (prevention)
medication
bariatric surgery

clinical psych and mental health (6 decks)

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