Feeding & Eating Disorders Flashcards
Feeding & Eating Disorders
characterized by “a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning”
Includes pica, anorexia nervosa, bulimia nervosa, and binge-eating disorder
Pica
involves persistent eating of non-nutritive, non-food substances for at least one month; must be developmentally inappropriate and not part of culturally sanctioned practice; most common during childhood
Anorexia Nervosa
a) a restriction of energy intake that leads to a significantly low body weight for the person’s age, gender, developmental trajectory, and physical health
b) an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain
c) a disturbance in the way the person experiences his or her body weight or shape or a persistent lack of recognition of the seriousness of his or her low body weight
Associated Features of Anorexia
over half of individuals with anorexia meet the diagnostic criteria for an anxiety disorder at some point during their life, with the onset of anxiety disorder usually preceding the onset of anorexia; depression is also common but may begin either before or after the onset of anorexia
most commonly occurs in adolescence or young adulthood and is often associated with a stressful life event; over 90% are females
Etiology of Anorexia
Biological factors- a strong genetic contribution is supported by studies finding higher concordance rates among monozygotic than dizygotic twins and an increased risk for the disorder among first-degree relatives
has been linked to neurotransmitter abnormalities; one theory is that people with this disorder have a higher-than-normal level of serotonin that causes restlessness, anxiety, and obsessive thinking and that food restriction lowers serotonin levels, which in turn, alleviates these unpleasant feelings
a drug that increases serotonin levels is not useful for people with anorexia when they are still underweight and restricting their food intake, although it may help prevent relapse once the person has reached normal weight
some studies link anorexia to high levels of family conflict, parents who are overprotective, rigid, and excessively concerned with thinness, mothers who are depressed or domineering, and fathers who are physically or emotionally absent
Treatment of Anorexia
- establishing a positive therapeutic alliance and enhancing the client’s motivation
- normalizing the client’s eating patterns and body weight
- identifying, evaluating, and modifying the client’s beliefs about weight and food using Socratic questioning, decatastrophizing, and other cognitive techniques
- preparing the client for termination of therapy and identifying ways for preventing relapse
family therapy is effective
evidence that a high level of expressed emotion among family members is associated with an increased risk for relapse
family therapy therapy is more effective when families with high expressed emotion receive separated family therapy rather than conjoint family therapy
Bulimia Nervosa
characterized by
a) recurrent episodes of binge eating that are accompanied by a sense of a lack of control
b) inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, or diuretics, fasting, or excessive exercise
c) self-evaluation that is unduly influenced by body shape and weight
binge eating and compensatory habits must occur at least once a week for 3 months
Associated Features of Bulimia
associated with anxiety and depression; anxiety may play an etiological role; depression may occur before or after onset of bulimia and is most common comorbid condition
medical complications: fluid and electrolyte disturbances, metabolic alkalosis (from vomiting), metabolic acidosis (from laxative use), dental problems, and menstrual abnormalities; if electrolyte imbalances are sufficiently severe to cause cardiac arrhythmia
onset of bulimia is often during or after a period of dieting
Etiology of bulimia
linked to low levels of endrogenous opioid beta-endorphin and neurotransmitter abnormalities, especially low levels of serotonin
Treatment of Bulimia
include helping the individual gain control over his/her eating and modifying dysfunctional beliefs about eating, shape and weight; usually incorporate nutritional counseling and cognitive behavioral techniques such as self-monitoring, cognitive restructuring, problem-solving, and self-distraction during periods of high-risk for binge eating
imipramine and fluoxetine have been found effective for reducing binge eating and purging and improving dysphoria
lower CBT associated with lower relapse and treatment dropout rates
Binge Eating Disorder
requires recurrent episodes of binge eating that involves a sense of lack of control over eating, the presence of at least three characteristic symptoms (eating more rapidly than usual, eating until feeling uncomfortably full, eating alone due to feeling embarrassed about the amount of food consumed, and the presence of marked distress about binge eating;
binges must occur, on average, at least once a week for three months
