Lec 4: Eating Disorders

Question 1

Eating Disorders

Answer 1

typically involve clinical features associated with disturbances in body image and food intake

Question 2

Diagnostic Criteria for Anorexia Nervosa

Answer 2

refusal to maintain normal body weight, intense fear of gaining weight and being fat, distorted body image; BMI used to specify severity

Question 3

Anorexia Nervosa Onset

Answer 3

early or middle teen years; usually triggered by dieting and stress; women ten times as likely to develop; dieting early in life are at risk

Question 4

Anorexia Nervosa Comorbidity

Answer 4

depression, OCD, phobias, panic disorder

in men: substance dependence, mood disorders, schizophrenia

Question 5

Anorexia Nervosa Suicide Rates

Answer 5

20% attempting

5% completing

Question 6

Anorexia Nervosa Physical Changes

Answer 6

low blood pressure, heart rate decrease, kidney and gastrointestinal problems, loss of bone mass, brittle nails, dry skin, hair loss, lanugo (soft downy body hair), depletion of electrolytes

Question 7

Bulimia Nervosa Diagnostic Criteria

Answer 7

uncontrollable eating binges (occurring at least twice a week for 3 months) followed by compensatory behavior (self-induced vomiting, misuse of laxatives, fasting, excessive exercise); severity by frequency of compensatory behavior

Question 8

Binge

Answer 8

an excessive amount of food consumed in under two hours; often triggered by stress and negative emotions; typically easily consumed, high calorie foods; typically loss of control, dissociation; shame and remorse often follow

Question 9

Bulimia Nervosa Onset

Answer 9

late adolescence or early adulthood; 90% women

Question 10

Bulimia Nervosa Comorbidity

Answer 10

depression, personality disorders, anxiety, substance abuse, conduct disorder

Question 11

Bulimia Nervosa Suicide Rates

Answer 11

suicide attempts and completions higher than general population but lower than anorexia

Question 12

Bulimia Nervosa Physical Changes

Answer 12

menstrual irregularities, potassium depletion from purging, laxative use depletes electrolytes (cardiac irregularities), loss of dental enamel from vomiting

Question 13

Eating Disorder Prognosis

Answer 13

70% recover
early intervention has better outcomes
poorer when comorbid with depression and substances abuse
difficult to modify distorted view of self within culture that values thinness
Anorexia: 10x higher death rates than normal population

Question 14

Pica

Answer 14

consumption of nonnutritive nonfood substances; spike in childhoood

Question 15

Rumination Disorder

Answer 15

repeated regurgitation of food

Question 16

Genetic Etiology

Answer 16

family/twin studies support genetic link
heritable traits: weight dissatisfaction, desire for thinness, binge eating, and weight preoccupation (chromosome 1q)
association with serotonin and opioid receptor issues

Question 17

Neurobiological Etiology

Answer 17

hypothalamus uninvolved
alterations in the brain during the ill state (mood, cognition, impulse control)
low levels of endogenous opioids (which reduce pain enhance mood, and suppress appetite) thought to promote craving and reinforce binging

Question 18

Psychodynamic Etiology

Answer 18

disturbed parent child relationship: over controlling parent, conflicted mother-daughter relationship
personality characteristics: body dissatisfaction, lack of interoceptive awareness, and negative emotions, perfectionism

Question 19

Sociocultural Etiology

Answer 19

society values thinness; dieting more prevalent; unrealistic media portrayals causes shame

Question 20

Cross-Cultural Etiology

Answer 20

anorexia found in many cultures, may not include fear of getting fat
bulimia more likely in western cultures
body images and preoccupation with thinness also culturally influences
syndrome reminiscent of anorexia present in late 17th century, suggests factors beyond culture may play a role (neurobiology?)

Question 21

Eating Disorder Treatment

Answer 21

most don’t receive treatment
antidepressants (SSRI) more effective for bulimia, but drop out and relapse rates are high
CBT for bulimia challenges social ideals and beliefs about weight, more effective than medication