Eating Disorders: Anorexia

Question 1

What does Anorexia Nervosa (coined in 1874 by Sir William Gull) translate to?

Answer 1

A nervous loss of appetite, which was originally believed to be the source of starvation, much like depression.
However, it is not - the label is incorrect! It is starving yourself, even when you desperately want to eat.

Question 2

What is Pica ED

Answer 2

Eating non-nutritional, nonfood substances

Question 3

What is Rumination ED

Answer 3

Chewing and regurgitating repeated - like a cow

Question 4

Avoidant?restrictive Food Intake Disorder

Answer 4

Avoidance of the sensory aspects of food eg. taste, texture and smell

Question 5

What are the two main sub-categories of Anorexia Nervosa

Answer 5

Restricting Type:
> During the last 3 months the patient has not engaged in episodes of binge eating or purging behaviour.
> Weight loss through extreme dieting, fasting and/or excessive exercise

Binge-eating/purging type:
> During the last 3 months the patient has engaged in recurrent binge-eating and purging behaviour

Question 6

What is considered partial remission?

Answer 6

After full criteria for anorexia nervosa previously met, Criterion A (low body weight) has not been met for a sustained period, but either Criterion B or C is still being met

Question 7

What is considered full remission?

Answer 7

After full criteria for anorexia nervosa previously met, none of the criteria have been met for a sustained period of time

Question 8

What are the three (A,B, & C) criteria for anorexia nervosa?

Answer 8

Criterion A: Restriction of energy intake leading to significantly low body weight (behavioural)

Criterion B: intense fear of gaining weight or becoming fat, or persistent behaviour that prohibits weight gain, even though at a significantly low weight (cognitive)

Criterion C: Disturbance in the way which one’s body weight or shape is experienced (cognitive)

Question 9

What is the BMI level for the severity classification? (mild, moderate, severe, extreme)

Answer 9

Mild: >= 17kg/m^2
Moderate: 16 - 16.99kg/m^2
Severe: 15 - 15.99kg/m^2
Extreme:

Question 10

What does the ‘literature’ suggest about the male/female %

Answer 10

Male:

Question 11

What are the common characteristics of a patient with anorexia nervosa?

Answer 11

> obsessive
> perfectionist
> low self-esteem
> highly anxious
> high achievers

Question 12

What are some of the symptoms of anorexia nervosa?

Answer 12

> linugo hair - most likely a evolutionary adaption to keep warm
ceasing of menstruation
loss of calcium from the bones
low hormone levels
heat produced through metabolism no longer exists -> get very cold
severe bacterial infections; their immune system has switched off

Question 13

Can drug treatment help?

Answer 13

> No - sadly, there is no drug which can help, even antidepressant drugs can’t help their depressive symptoms
However, medication for anti-psychotic drugs (for schizophrenia) is being used to treat the anxiety associated.

Question 14

Why must you do extensive medical testing when assessing someone with anorexia nervosa?

Answer 14

The extent of the medical implications may not be overt; they may be just around the corner

Question 15

What did the study by Keys et al. (1950) show about anorexia nervosa?

Answer 15

> The study recruited young men and starved them
After 3 months, the experiment had to be abandoned
It showed that many of the symptoms of anorexia nervosa are symptoms of starvation - unhealthy focus on food, low body temperature.

Question 16

What is refeeding syndrome

Answer 16

> When you are significantly underweight, many of the essential salts that your body needs are so depleted
These salts are needed to keep the heart going; they are also used in digestion - esp phosphate
When given massive meals, all the phosphate was used to digest the meal, leaving none left for the heart
Died from cardiovascular disease

Question 17

What is cognitive dissonance in their perception of themselves?

Answer 17

Difference between how they know they look and how they FEEL they look

Question 18

What happens when a AN patient looks at themselves?

Answer 18

Control person:
self vs non-self images =
> there is greater activation in the insula (deep in the cerebral cortex - deals with perception, self-awareness, cognitive function)

AN patients:
self vs non-self images =
> engage the attentional and self-referencing, but suppression fo the perceptional processing
> their brain freezes

Question 19

How does AN affect your cognitive functioning?

Answer 19

> AN patients focus on minute detail - eg. all the different animals which compile to make a face.
Can’t see global picture - coherence
Much faster and more accurate in detail focused search tasks
Great trouble shifting back and forth between multiple tasks - eg. become so focus on original set of rules or strategies

Question 20

What is the average duration of AN

Answer 20

7 years

Question 21

Is AN genetically linked?

Answer 21

It is highly heritable, but will not find a single gene - most likely to find linked to anxiety and perfectionism etc.