Lecture 19 Flashcards
Obsessive-compulsive disorder affects ___ of the population in the US
1-3%
Explain the photo and excerpt at the opening of the chapter of ED
- describes ED symptoms (body image: doubt, anger, disgust)
- interconnection between body and mind (somatic and mental components in relation to eating disorders
- voice: people experiencing ED differently - these are her own words about how she felt
- treatment and recovery often involves reclaiming one’s body and voice by correcting ideas about eating, body image and self-perception (including self narrative
How are EDs chracterized?
- by different kinds of preoccupations with food and weight
When is the time of life with the highest prevalence of ED
- mid-to late adolescence
What has the highest mortality rate of ANY mental illness
- anorexia nervosa
- 10% of those diangosed die within 10 years of onset
People with anorexia nervosa have about how years reduction in life expectancy
- about 20-25 year reduction in life
*it may be helpful to think of ED and their symptoms as existing along a continuum of severity, rather than as binary (ill or not)
— a person can experience ED symptoms at levels that do not meet diagnostic criteria
What are the features that the DSM-5 shows as being core to the experience of ED
- persistent disturbance of eating or eating related-behaviour, resulting in alterations in consumption or absorption of food
- changed eating behaviour which significantly impacts health or functioning
What are the key diagnoses in the DSM-5?
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
What does the Anorexia nervosa diagnostic criteria include?
Over a period of at least 3 months:
a) persistent behaviours such as food restriction, purging, misuse of medications (ex. laxatives), or over-exercising, which interfere with maintaining an adequate weight for health
b) Powerful fear of weight gain/becoming overweight (“fat”)
c) Overestimation of body size (inaccurate perception)
d) Denial of the seriousness of the condition and its impact
◦ Potentially life-threatening, high mortality rate stemming from cardiac arrest, suicidality and other causes
What does the Bulimia Nervosa diagnostic criteria include?
- Repeated food restriction then binging, and then purging (to prevent weight gain)
- Above cycle of behaviours occurs at least once a week over a period of at least three months
- Negative evaluation of body weight/shape
- People with bulimia often experience extreme feelings of shame regarding bingeing/purging and hide these behaviours (may lead to more guilt)
- People with bulimia are often average weight but may experience fluctuations
◦ Loved ones may not recognize this eating disorder as a result - Bulimia is associated with depression, self-harm, suicidality
define binging
- consumption of an unusually large amount of food over a short period of time with lack of control over type/amount of food
What does the diagnostic criteria of binge eating disorder include?
- new disorder introduced in DSM-5
- Consumption of an unusually large amount of food over a short period of time
◦ Different from overeating, which is very common - Produces psychological distress
- Person feels out of control about what they are eating, how much they are eating, and when they are able to stop
- Does not feature compensating behaviours (e.g., purging, medication misuse, etc.)
- Considered a disorder when it occurs at least once a week for at least three months
What is the prevalence of key eating disorders
Anorexia nervosa: Women 0.9%, Men 0.3%
Bulimia nervosa: Women 1.5%, Men 0.5%
Binge eating disorder: Women 3.5%, Men 2.0%
What patterns are evident in the prevalence of key eating disorders
- women tend to be more affected
How does binge eating disorder (BED_ differ from “overeating”?
- foods might just be food for overeating
- its a physiological thing for BED
How is BED different from bulimia nervosa
- anorexia and bulimia is when you have problem maintaining weight
Explain ARFID
Avoidant Restrictive Food Intake Disorder (ARFID)
- Usually starts in infancy/childhood, may stem from traumatic experience involving food (like becoming ill)
- Involves unusual avoidance of particular types/textures/colours of foods
- Severe enough to impair adequate nutrition
- Not stemming from inadequate access to food or other medical condition (allergies, intolerance)
- Does not feature body dissatisfaction or preoccupations with weight/shape
- If untreated, can lead to anorexia nervosa or bulimia nervosa in adolescence or adulthood
What is rumination disorder
- consistent (effortless) regurgiatation of chewed and/or partially digested food over a period of at least one month
- may be a symptom of anorexia or bulimia
- unintentional
What is pica
- persistent consumption of non-food items over a period of at least one month (ex. paper, dirt, hair, chalk)
- normal during childhood
- term used to describe presence in other life stages
Why is it called “pica”>
- latin for magpie
— bird that eats almost anything
Explain OSFED
Other Specified Feeding or Eating Disorder (OSFED):
* Examples include: atypical anorexia nervosa, bulimia nervosa of low frequency and/or limited duration, purging disorder, night eating syndrome
- These disorders relate to AN, BN, and BED (the 3 primary diagnoses discussed) with minor differences in diagnostic criteria
Explain unspecified feeding or eating disorders
- symptoms do not meet criteria for full diagnosis (of AN, BnN, BED, OSFED, or ARFID), but cause distress and impaired functioning
explain anorexia athletica (“compulsive exercising”)
- Over-exercise to the point of neglecting other priorities in life
- Exercise used to control body shape and weight
- Exercise used provide a sense of power, control, self-respect
- not in DSM
What are the potential controversies of anorexia athletica
- Would be very common among professional athletes
- And recreational athletes (typifies “no days off” ethic)
- Our culture could be seen as actively promoting this type of disorder- we often commend and celebrate this type of relentless dedication to behaviours viewed positively (like “work addiction”)
- We may simultaneously glamourize AND pathologize this potential disorder (this critique could be made in relation to many eating disorders)
explain Orthorexia
- Not recognized in DSM-5
- A cluster of food and weight related symptoms, involving obsessive focus on food
- Eating only foods perceived to be “healthy”
- Relying only on “natural remedies” for illness
- Finding more pleasure in following food rules than in the experience of the food itself, feelings of despair when failing to follow food rules
- May result in social isolation and ill health
explain Body Dysmorphic DIsorder
- Classified in DSM-5 under “obsessive-compulsive and related disorders” (not categorized as an eating disorder, but may be comorbid with an eating disorder)
- Involves preoccupation with appearance – focussing on nonexistent or minor flaws in physical appearance
- Often includes repetitive mirror checking, excessive grooming rituals, skin picking, changing clothes, and other behaviours
- Preoccupation impairs daily functioning
- Subtypes have been proposed (muscle dysmorphia: concerns about being insufficiently muscular)
