Lecture 9-Eating disorders and body image disturbance

Question 1

Pathological Dieting

Answer 1

unhealthy dieting

Weight control behaviors

Question 2

Social Determinants

Answer 2

Weight-teasing

Parent and peer weight norms

Parenting practices

Question 3

Environmental Deteminants

Answer 3

Perceived media pressure to be thin

Exposure to weight-loss magazine articles

Question 4

Anorexia Nervosa

Answer 4

Persistent restriction of intake to maintain a significantly low body weight

85% lower than what would be expected for height

Intense fear of gaining weight or becoming fat

Distorted physical self-image (body image distortion)

/failure to recognize seriousness of condition

/heightened influence of weight

/shape on self-evaluation

Question 5

Anorexia: Subtypes

Answer 5

Restricting Type – During current AN episode, not regularly engaging in binge-eating or purging behaviour

Binge-Eating/Purging Type – During current AN episode, regularly engaged in binge-eating or purging behaviour (vomiting/laxatives)

Question 6

Bulimia Nervosa

Answer 6

Recurrent episodes of binge eating in a discrete period of time; consuming amount larger than most would eat; compensatory behaviours

Regular binge-purge cycle occurring once a week for 3 months

Sense of lack of control over eating

Question 7

Bulimia Nervosa

Answer 7

Purging:

Self-induced vomiting/emetic use or laxatives, diuretics

Non purging:

strict dieting/excessive exercise

Question 8

Bulimia- Health consequences

Answer 8

Fatigue, dehydration, and electrolyte imbalances

Cardiac arrhythmias, urinary problems, gastrointestinal complications, epileptic seizures

Increased body temperature during vomiting due to ineffective thermoregulation

Increased risk of heat related illnesses

Poor concentration

Question 9

Binge eating disorder (BED)

Answer 9

Characterized by binge eating behavior; large amount of food in short periods of time

Association with obesity

Formal inclusion as diagnosis in DSM V

Frequency/duration – weekly, for 3 months

Question 10

Night eating syndrome (NES)

Answer 10

Evening hyperphagia and insomnia, nocturnal eating, ‘morning anorexia’, onset – stressful events

Emotional eating which continues throughout night, unlike a binging episode

Question 11

Transdiagnostic -meaning?

Answer 11

Those that apply the same underlying. treatment principles across mental disorders

Question 12

Transdiagnostic Symptoms

Answer 12

Body checking -maintain disorders

Compulsive Exercise

Question 13

Epidemiology

Answer 13

The study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations.

Question 14

Epidemiology of Anorexia

Answer 14

1-2% of female populations in Westernised countries

Age of onset usually between 15 and 19

Question 15

Epidemiology of Bulimia

Answer 15

Prevalence rate around1-2 %

Age of onset usually between 15 and 19

Question 16

Epidemiology of BED

Answer 16

1.5% of population affected, according to World Health Organization

Females at greater risk

Average duration is around 4 years

Question 17

3 STAGE THEORY

Answer 17

1. Birth and Predisposing factors
2. Precipitating factors
3. Maintaining factors

Question 18

Predisposing (vulnerability) factors

Answer 18

Genes, epigenetic effects, obstetric complications, season of birth

Question 19

Precipitating factors

Answer 19

(Perception of) overweight, others’ comments on weight/shape

Question 20

Perpetuating (maintaining) factors

Answer 20

Physiological effects of starvation/bingeing, anxiety, depression

Question 21

What connects all three disorders?

Answer 21

Precipitating factor: Severe Dieting

Question 22

Levine et al., 1994

Answer 22

Puberty, internalisation of the thin ideal, body dissatisfaction, peer and parent weight concerns/dieting

Adolescence more likely to become more dissatisfied through acknowledgement of media influences; this is the idea that dieting is inevitable

Question 23

Compulsive behaviour

Answer 23

Imbalance between habit system (putamen) and goal-directed system (caudate & prefrontal cortex) = dominance of habit system

Habits developed through repetition of behavior

Question 24

Prevention efforts

Answer 24

Cognitive Behavioural Therapy (CBT)

Generally, efforts are designed to target body image concerns and dieting