Lecture 6 - Eating Disorders Flashcards
What does normal eating look like?
Regular, balanced, and flexible
What is disordered eating?
- Food choices strongly influenced by desire to maintain a certain
weight or body type - Often feel guilt around eating certain foods
- Some avoidance of or difficulty with eating in social situations
What is an eating disorder?
- Food choices influenced by goals of restricting, losing weight, binging/purging
- Feel guilt and shame
around food most of
the time - Frequent avoidance of
eating or attending
social situations involving food
What are different types of EDs?
- Binge Eating Disorder (BED)
- Bulimia Nervosa (BN)
- Anorexia Nervosa (AN)
What is the transdiagnostic approach?
People can go from having no eating disorders to transferring to others. They can go back round in a circle.
EDs are more of a spectrum which you can slide across.
What is the genetic influence of eating disorders?
- Genetic components
- Familial risk
- Twin studies
- Interaction of genetic dispositions and individual experiences
Bulik et al, 2000
What are neurobiological factors of eating disorders?
- Brain & serotonin function > changes in appetite, mood and impulse control in EDs
- Trytophan depletion
What is the influence of peers on body image and eating disorders?
- Weight related teasing
- Fat talk
- Friends who are on diet
- People who do not overly value appearance or dieting
What impact foes the diet industry and media have?
- Weight related teasing
- Fat talk
- Friends who are on diet
- People who do not overly value appearance or dieting
What is weight stigma?
The idea that fat is bad and thin is good -> severe body dissatisfaction -> restriction and dieting -> prolonged disturbance to eating behaviours
What are psychological and dispositional factors?
- Perfectionism
- Shyness
- Neuroticism
- Low self-esteem
- High introspective awareness (awareness of bodily sensations)
- Negative or depressed affect
- Dependence and non-assertiveness
What are special issues for men according to nagata et al, 2019
- Drive for muscularity vs thinness
- Eating differently to bulk up, steroid use
- Exercise, bradycardia (low heart rate
What is the prevalences in the UK?
Community study in UK (Solmi et al., 2016):
- EDs 4.4 %
- BED 3.6%
- BN 0.8%
Age:
- BN 16–24
- BED 44–65
What is the comorbidity to EDs?
- Anxiety (up to 62%) and mood disorders (up to 54%) -> across EDs
- Impulsivity (e.g. substance use disorders (27%), borderline personality disorder (29%-11%) → BN
- OCD → more common in AN (19%) than BN (13%)
What treatment is best for anorexia nervosa?
- Young adult: family therapy / talking therapy (CBT-ED, MANTRA) + weight restoration. This can include inpatient stays and nasal refeeding
(NG). Aim to restore BMI to around 20 ideally - Adult: talking therapy (CBT-ED, MANTRA) + weight restoration. Can again lead to inpatient stay.
- Psychoeducation
What treatment is best for bulimia nervosa?
- Guided self help, e.g. cognitive behavioural self-help materials
- CBT-ED
- YA: may have Family Therapy
- IF low weight, inpatient treatment can be used to restore weight, including NG
- Psychoeducation
What treatment is best for binge eating disorder?
- Guided self-help, e.g. cognitive behavioural self-help materials
- CBT-ED
- No difference between YA/Adults
- Psychoeducation
What is CBT-ED?
- Goal focused talking therapy (NICE)
- Addresses the way our thoughts influence our behaviours, which in turn makes us feel certain ways
- Time limited - waitlist, on NHS you only get 12 session
- Homework
What are the limitations of CBT?
- Long-term effectiveness?
- Suitability?
- Co-morbidites
- Complex trauma
- Continuity of care?
- Service delivery?
- Lack of focus on interpersonal relationships
- Dietary restraint?
