Eating Disorders Part 1 Flashcards
Why is early intervention in eating disorders recommended?
Has better prognosis
Why is intervention is general for eating disorders recommended?
- Eating disorders have a high mortality rate
- 80% of ED patients will reach remission
What increases in severity as time goes on?
ED’s, there is often lots of pre-contemplation prior to seeking treatment; they go through denial, have lack of insight
Which type of ED has the highest mortality rate?
Anorexia Nervosa
What kind of treatments to ED patients seek prior to ED help?
-Weight loss
-Bariatric surgery
Counterintuitive to the root of the problem
Describe the three key features of AN
1) Restriction of energy intake leading to a significant weight-loss
2) Intense fear of gaining weight or becoming fat
3) Disturbances in self-body image, lack of recognition of the seriousness of their body weight
(T/F) To have anorexia, patients must have a significantly low weight
F, they must have experienced significant weight-loss, which doesn’t necessarily mean they are at a low weight (i.e. going form BMI of 30-22)
When does someone recovering from and ED begin to see their lack of recognition in the own seriousness of their ED?
Once they stat re-gaining weight, sometimes their cognitive rigidity begins to soften
What are the two sub-types of AN?
- Restricting type
- Binge-eating/purging type
BMI 17 + AN=
Mild
BMI 16-16.99 AN =
Moderate
BMI 15-15.99 AN =
Severe
BMI <15 AN +
Extreme
In the prognosis of AN, ___ of patients will normalize weight
2/3
In prognosis of AN, patients with illness before 17 y/o achieve a ___ outcome than adult onset
better
(T/F) There is a higher rate of full recovery and lower mortality in adults compared to adolescents
F, in adolescents
(T/F) AN is a more difficult course in those with the disease prior to puberty
True
List key characteristics of AN (8)
- Excessive concerns about weight, shape, health
- Excessive perfectionism
- Social rigidity
- Self-denial
- Social withdrawal
- Extreme focus on job, schoolwork
- Anxiety
What is cognitive rigidity?
Those with AN have an “amazing” ability to restrict food intake due to their strong beliefs. We need to break down this belief system.
What is a major positive prognosis factor for those with AN? Why?
Those with a supportive social network. Once a patient leave the program, they need social support to succeed
(T/F) Orthorexia is officially recognized as an ED
F, but some patients after recovering from an ED may showcase some orthorexia like behaviours
What are 5 commonly observed dietary patterns in AN? (GG-RR-L)
- Gradual decrease in food intake
- Gradual decrease in portion size
- Removal of high-energy food
- Rigid schedule of eating
- Limited to bulky, nutrient-poor foods
What are the other 5 commonly observed dietary patterns in AN? (L-FFF-V)
- Limited food choices/amount of calories
- Fat avoidance
- Food avoidance, related to digestive symptoms
- Fluid avoidance, or excessive fluid intake
- Vegetarianism or veganism
What are the 4 key diagnoses for Bulimia nervosa?
1) Recurrent episodes of binge eating following by BOTH eating a large amount of food in a discrete amount of time, with a sense of lack of control
2) Compensatory behaviour to avoid weight-gain, which is recurrent
3) Distorted body image, shape and weight
4) Occurs at least once a week for the last 3 months
What are some compensatory mechanisms following a binge?
-Fasting, strict deprivation, use of laxatives/diuretics, excessive exercise, omitting insulin
What is the key difference between AN binge/purge and bulimia?
There is no significant weight loss in bulimia
What are the two main questions those with ED’s ask?
1) WIll my body re-gain weight after recovering from an ED?
2) What is a normal portion size
How do attitudes differ between those with AN and BN?
In someone with AN, their beliefs are so strong that they don’t think chocolate cake is good. In BN, they agree that chocolate cake is good, but feel shameful after having it - thus resort to compensatory mechanisms.
(T/F) Eating a regular size meal then purging is classified as BN
F, is OFSED
What are the 8 key characteristics of BN? (BILE-CIAO)
- Body weight fluctuations
- Inability to accurately express/identify feelings
- Labile mood
- Excessive concerns about weight/shape
- Chaotic relationships and interaction
- Impulsivity
- Anxiety
- Obsessive thoughts focused on restricting and bulimia
How is the severity of BN slotted?
Based on the average number of compensatory behaviours per week
Mild BN?
1-3
Moderate BN?
4-7
Severe BN?
8-13
Extreme BN?
14 or more
What is the diagnostic criteria for BED?
Recurrent episodes of binge eating, where the episodes are characterized on:
1) 3 or more factors
2) No compensatory behaviour
3) At least once a week, for three months
What are the 5 factors, where three are required in BED diagnosis?
- Eating rapidly
- Eating until uncomfortably full
- Not feeling physically hungry
- Eating alone
- Feeling disgusted with oneself, depressed or very guilty afterwards
(T/F) All people with BED feel out of control
F, some people feel as it is something normal, or something that they must do
How is the severity of BED slotted?
Based on the average amount of binge-eating episodes per week
Mild BED?
1-3
Moderate BED?
4-7
Severe BED?
8-13