Lecture 8: Eating Disorders Flashcards
What is the main characteristic of energy intake in Anorexia Nervosa?
Restriction of energy intake leading to significantly low body weight based on age, sex, development, and physical health.
What fear is commonly associated with Anorexia Nervosa?
Intense fear of gaining weight or becoming fat, or behavior that interferes with weight gain.
How is self-perception affected in Anorexia Nervosa?
Disturbed perception of body weight/shape, self-worth overly influenced by it, or denial of the seriousness of low body weight.
What menstrual-related criterion was removed in DSM-5 for diagnosing Anorexia Nervosa?
Absence of 3 consecutive menstrual cycles.
What defines the Restricting Type of Anorexia Nervosa?
No regular binge-eating or purging in the past 3 months.
What defines the Binge-eating/Purging Type of Anorexia Nervosa?
Regular binge-eating or purging in the past 3 months.
What is Bulimia Nervosa?
An eating disorder involving binge eating followed by purging or other methods to avoid weight gain.
What behaviors are common in Bulimia Nervosa?
Self-induced vomiting, excessive exercise, and other inappropriate weight control behaviors.
How is Bulimia Nervosa clinically similar to another disorder?
It resembles the binge-eating/purging type of Anorexia Nervosa.
How does body weight differ between Bulimia and Anorexia binge/purge subtype?
Bulimia: normal/slightly above normal weight; Anorexia: severely underweight.
What are the two key signs of a binge eating episode in Bulimia Nervosa?
Eating an unusually large amount in 2 hours + feeling a loss of control over eating.
What are examples of inappropriate compensatory behaviors in Bulimia Nervosa?
Self-induced vomiting, misuse of laxatives, diuretics, fasting, or excessive exercise.
How often must binge eating and purging occur for a Bulimia Nervosa diagnosis?
At least once a week for 3 months.
How is self-evaluation affected in Bulimia Nervosa?
It’s overly influenced by body shape and weight.
When can Bulimia Nervosa not be diagnosed?
If the behavior occurs only during episodes of Anorexia Nervosa.
What emotions are commonly experienced by those with bulimia nervosa?
Shame, guilt, self-deprecation, and a desire to hide their behavior.
What is the main difference between BED and bulimia nervosa?
BED involves binge eating without compensatory behaviors like vomiting or fasting.
What is dietary restraint like in BED?
There is much less dietary restraint in BED compared to other eating disorders.
What is BED commonly associated with?
Being overweight or obese.
How to diagnose BED symptomatically?
At least 3 or more from the symptom list.
- Eating too quickly
- Eating when not hungry
- Eating alone due to shame
- Eating until painfully full
- Feeling guilt, disgust, or depression after eating
What emotional symptom is required for a BED diagnosis?
Marked distress about binge eating.
What is the DSM-5 frequency/duration requirement for BED?
Binge eating at least 1 day/week for 3 months.
At what age does anorexia nervosa commonly develop?
Between 16 and 20 years old.
Which group is most at risk for bulimia nervosa?
Women aged 21 to 24.
What is the typical age range for binge-eating disorder?
Between 30 and 50 years old.
What is the gender ratio for eating disorders?
About 3 females for every 1 male.
What is a known risk factor for eating disorders in men?
Homosexuality.
What is the most common eating disorder?
Binge-Eating Disorder (BED).
How has the risk of developing anorexia nervosa changed over time?
It increased during the 20th century.
What trend has been observed in bulimia prevalence recently?
It has decreased in recent decades.
How much higher is the mortality rate for people with anorexia compared to young women generally?
More than five times higher.
What are some effects of malnutrition from anorexia?
Thinning hair, dry skin, downy hair, cold sensitivity, tiredness, weakness.
What can thiamin deficiency in anorexia cause?
Depression and cognitive (thinking) problems.
What can electrolyte imbalances from anorexia lead to?
Heart arrhythmias and possible death.
What are the risks of laxative abuse in eating disorders?
Dehydration, electrolyte imbalance, kidney disease, and GI tract damage.
How does the mortality rate of bulimia nervosa compare to the general population?
It is twice as high.
What can electrolyte imbalances and low potassium cause in bulimia?
Heart abnormalities.
What dangerous substance is sometimes used in bulimia to induce vomiting?
Ipecac syrup, which can damage the heart.
What physical signs appear from self-induced vomiting?
Calluses on hands, throat tears, and red dots around the eyes.
How does frequent vomiting affect the teeth?
Stomach acid erodes teeth, causing ulcers and cavities.
What causes the “puffy cheeks” look in bulimia?
Swollen salivary glands (parotid glands) from vomiting.
How much more likely are anorexic individuals to die by suicide compared to peers?
18 times more likely.
What is the long-term prognosis for bulimia and binge-eating disorder?
Generally good, with high rates of remission.
What is diagnostic crossover in eating disorders?
When someone with one eating disorder is later diagnosed with another.
Which crossover is especially common?
Between the two subtypes of anorexia nervosa.
What proportion of anorexia patients develop bulimia?
About one-third.
What anxiety-related disorder is common in anorexia and bulimia?
Obsessive-Compulsive Disorder (OCD).
What proportion of people with eating disorders engage in self-harm?
More than a third.
What early personality traits are common in people with anorexia?
Rigidity and perfectionism, even in childhood.
Which disorder is culture-bound: anorexia or bulimia?
Bulimia is linked to Western ideals; anorexia is not culture-bound.
What percentage of eating disorder patients are first-born or only children?
56.3%.
How long do the eating disorders usually go untreated?
26 to 43 months.
Which type of anorexia nervosa is more common, and in whom?
Restrictive-type (65.1%), especially in early-onset cases.
Which eating disorder is most commonly presented in clinics in Singapore?
Anorexia Nervosa (41.6%).
How do AN clients differ from BN clients in terms of age and illness duration?
AN clients are younger and have shorter untreated illness.
What characterizes BN clients compared to AN clients?
Higher rates of suicide/self-harm, more co-occurring disorders, but better prognosis
How much greater is the risk of anorexia for relatives compared to controls?
11.4 times greater.
What is the increased risk of bulimia in relatives compared to healthy controls?
3.7 times higher.
Are anorexia and bulimia considered heritable disorders?
Yes.
What did Anne Becker’s Fiji study find after TV was introduced?
Women began dieting and worrying about weight, unlike before.
Where are social pressures to be thin strongest?
In higher socioeconomic status backgrounds.
Who is more likely to develop binge-eating disorder?
Males.
Is perfectionism more common in men or women?
Women.
Can perfectionism be genetic?
Yes, it may have a genetic basis.
What is a common attitude of anorexia patients toward recovery?
They are often pessimistic and view the disorder as chronic.
What is the immediate treatment goal for anorexia nervosa?
Restore weight to a non-life-threatening level.
Why can aggressive treatment for anorexia backfire?
It may overwhelm patients and reduce compliance.
Are antidepressants effective for treating anorexia?
No clear evidence they are effective.
What is the best treatment option for adolescents with eating disorders?
Family therapy, especially the Maudsley model.
How long does a typical Maudsley model program last?
10–20 sessions over 6–12 months.
What role do parents play in family therapy?
Act as a support team to improve relationships.
Which disorder is CBT most effective for?
Bulimia nervosa. Only limited success for anorexia nervosa.
What is the most effective treatment for bulimia?
Cognitive-behavioral therapy (CBT).
What does the behavioral part of CBT for bulimia focus on?
Meal planning, nutritional education, and stopping binge-purge cycles.
What does the cognitive part of CBT address?
Thoughts and behaviors that lead to bingeing.
