Eating disorders COMPLETE Flashcards by Roba Elsaigh

What does anorexia translate to
And why is it controversial

Absence of appetite
Which is also a side effect to many other medical diseases like the flu
The name is not really realistic to describe the actual disorder

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What are the DSM criteria for Anorexia

Restriction of the required energy intakes for their body, ie age/sex/height, leading to low body weight
Intense fear of weight gain or exercising behaviour that intervenes with weight gain even tho they are under weight
Distorted self image

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How do you calculate BMI?

Weight in kilograms divided by height in meters squared

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In relation to the severity of anorexia, say what BMi would be considered:
1. Mild
2. Moderate
3. Severe
4. Extreme

Mild: above 17
Mederate: 16-16.99
Severe: 15-15.99
Extreme: Below 15

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What is Binging- purging

vomititng/exercising/ laxatives after eating to limit calorie intake, when person is already under weight.

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what is restricting

Dieting to limit calorie intake

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What test is used to measure body image distortions?
What was found

Estimating how big their thigh is.

Healthy subjects over estimate by only 8 percent but eating disorder patients overestimated by 30 percent

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What are the statistics of prevalence in regards to anorexia

It has a lifetime prevalence of 1 percent
10 times more common in females
Will most likely begin in adolescence
more common in western nations

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Talk about the consequences of anorexia

It has the highest mortality rate of any psychiatric disorder
Person risks:
Anemia
Hair loss
Infertility
Kidney problems

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What does bulimia translate to

Ox Hunger

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What is the DSM criteria for Bulimia

Recurring episodes of binge eating,ie. eating large quantities of food with a lack of control

Recurrent compensatory behaviour, ie. taking laxatives, vomiting, exercise

Must occur at least once a week for 3 months

Influenced by body shape/weight

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What’s the key difference between anorexia/ binge eating purging type and bulimia

For anorexia and Binge eating purging, there’s extreme weight loss

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What’s the prevalence of bulimia

1-2% lifetime prevalence
90 percent of patients are females
occurs in adolescence
most patents are normal weight or overweight
75 percent recover

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What are some consequences of bulimia

Erosion of dental enamel
Kidney failure
permanent colon damage
intestine problems

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What is the DSM criteria for binge disorder

recurrent behaviour of binge eating
Binge eating associated with 3 or more of the following:
A. Eating rapidly
B. eating until uncomfortably full
C. eating large amounts when not hungry
D. Eating alone due to embarrassment
E. feeling disgusted/depressed/guilty after over eating
Distress due to the binge eating
Absence of compensatory behaviours like purging

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What is the prevalence of binge eating disorder

Has a life time prevalence of up to 4.7 %
More common in females(but not drastically)
Occurs in adolescence
Most patients are obese- have a BMI over 30

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What are the consequences of binge eating disorder

Obesity
Diabetes
Back pain

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What are some stigmas surrounding binge eating disorder?

That they are vain
Irresponsible
Lack self -care
give in to temptation

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What are the statistics in regards to variability and genetics in both anorexia and bulimia

28-74 percent of the variability in anorexia due to genetic factors
54-83 for bullimia

What is the main finding of strober et al in regards to genetic factors and anorexia and bullimia patients

A person has a higher risk of anorexia/bullimia if one of their first degree relatives have it

What metabolites are decreased due to anorexia/bullimia

Dopamine- patients dopamine system doesn’t respond normally to rewards like food
serotonin

however.research lacks insight on malnutrition and acute starvation

What’s the effect of weight restoration

The metabolites are no longer low as the carbohydrates increase extracellular serotonin through complex metabolic effects on tryptophan

What other endorphin does starvation trigger

Opioids

What is the effect of opioids

They reduce pain, enhance mood and produce a high, which may reinforce not eating

What was the finding of opioids and bullimia and binge eating

Low levels of endogenous opioids

In regards to brain structure/functioning, what was found in regards to anorexia

Have reduced grey matter effects are mostly reversible once weight is restored

In regards to brain structure/functioning, what was found in regards to binge eating disorder

Reduced volume in caudate and orbifrontal cortex

what does reduced volume in caudate and orbifrontal cortex cause

failure in goal directed control the patient is very habit prone and is easily triggered to act

What are the predisposing factors for anorexia

Negative emotion Drive for thinness These straights are heritable and not related to body weight

What are the predisposing factors for binge eating disorder and bulimia

Momentary stress mood Impulsivity The stress triggers habitat behaviour and the lack of goal-directed control makes them consistent

Comment on eating disorders over the years

The rates have drastically increased No longer just derives from the intense fear of becoming fat Social media has had a great effect- pro Ana websites, thinspo etc.

What are some positives in contemporary society in relation to eating disorder

Different body types are being shown in advertising Anti diet culture emerging Magazines stopping photoshopping

`What is the treatment for anorexia

Weight restoration Long term maintenance off weight gain- psychoeducation/ family based therapy

What's the rationale behind family based therapy?

Extreme interdependence and intensity in the family contributes to the eating disorder issues The adolescent doesn't learn to be independent

What is the maudsley method

Family based therapy Focuses on weight gain under parents direction Teaches them about referring and identifies the problem separates the illness and patient to reduce blame dynamic plan to adapt to family age appropriate independence around food choices and weight

Is Family based therapy effective?

More effective in early onset patients- before 19 with a shorter anorexia history of less than 3 months. 90 percent of them were symptom free after 5 years

What is the treatment for bulimia

CBT- develop healthy eating patterns psychoeducation- teaching them that no need to extremely restrict to be at a normal weight

Is medication useful to treat eating disorders

Not effective for anorexia Antidepressants effective in bulimia and binge eating but CBT more effective Anti epileptic med may be useful to decrease appetite

What new disorders were recently introduced by DSM 5 and what are eating disorders now called

Feeding and eating disorders Pica Rumination Avoidant/restrictibe food intake disorder all used to be childhood disorders

What is pica

Persistent eating of non food items like paper, chalk Diagnosis only occurs when person gains medical problems, seen mostly where ppl have intellectual disabilities or brain damage Sometimes there's a compulsive quality

What is rumination disorder?

Regurgitation of food, but not to lose weight

What is ARFID

limited consumption of food because of appearance/taste/ smell do not match eating disorder diagnosis but clinically significant distress linked to old and autism

Side effects of anorexia

1 Anemia 2 Bone and muscle loss 3 Hair loss 4. Lanugo- hair growth in areas that don’t normally have hair 5 infertility/ aménorrhée 6 Kidney problems 7. Electrolyte imbalance 8. Arrhythmia- sudden death 9 suicide

Side effects of bullimia

• Erosion of dental enamel: vomit regularly • Electrolyte imbalance • Kidney failure • Cardiac arrhythmia • Seizures • Intestinal problems • Permanent colon damage

Side effects of bED

• Obesity • Type 2 Diabetes • Cardiovascular problems • Back pain • Joint issues • Sleep-related breathing issues • Anxiety • Irritable bowel syndrome