Lecture 9.1: Eating Disorders Flashcards

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1
Q

What are Eating Disorders?

A

Eating Disorders are conditions characterised by severe and persistent disturbance in eating behaviours with associated distressing thoughts and emotions

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2
Q

What are the 2 ‘Classical’ Eating Disorders?

A
  • Anorexia Nervosa (AN)
  • Bulimia Nervosa (BN)
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3
Q

What is Anorexia Nervosa?

A
  • Refusal to maintain weight at or above a.
    minimally normal weight according to height
    and age
  • Intense fear of gaining weight or becoming fat
    even though underweight
  • Body image disturbance
  • Amenorrhea (absence of at least 3 consecutive
    menstrual cycles)
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4
Q

What are the 2 Types of Anorexia Nervosa?

A
  • Restricting Type
  • Binge-Eating / Purging Type
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5
Q

What is Bulimia Nervosa?

A
  • Recurrent binge eating (excessive amount of
    food over 2 hrs, sense of lack of control)
  • Inappropriate compensatory behaviour.
    (vomiting, laxatives, excessive exercise)
  • Twice a week for 3 months
  • The binge eating and inappropriate
    compensatory behaviour both occur, on
    average, at least twice a week for 3 months
  • Self-evaluation unduly influenced by body
    shape/weight
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6
Q

What are the 2 Types of Bulimia Nervosa?

A
  • Purging Type
  • Non-Purging Type
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7
Q

What causes an Eating Disorder?: Biological Factors (5)

A
  • Genetic Factors
  • Females: Male is 10:1
  • OCD/Autism-Spectrum Traits
  • Metabolic Vulnerability
  • Environmental influences in perinatal period
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8
Q

What causes an Eating Disorder?: Psychological Factors (9)

A
  • Personality Traits
  • High ability to delay rewards
  • Increased sensitivity to social ranking and
    threat
  • Body Image Disturbance
  • Alexithymia
  • Self-esteem
  • Depression
  • Anxiety
  • Self-harm
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9
Q

What causes an Eating Disorder?: Psychosocial Factors (7)

A
  • Parental Eating Problems
  • Peer Stress
  • Trauma
  • Culture
  • Thin Idealisation
  • Middle-to-High Socioeconomic Status
  • Social Media
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10
Q

What causes an Eating Disorder?: Behavioural Factors (5)

A
  • Over-control of weight and eating
  • Over-concern with BMI
  • Social Isolation
  • Coping by avoidance or perfectionism
  • Impaired physical and mental quality of life
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11
Q

The ‘Need for Self-Control’ is a key component in Eating Disorders, why is this? (4)

A
  • Dieting provides direct and immediate evidence
    of self-control
  • Control of eating has potent effect on others in
    the immediate environment
  • Means of arresting or reversing puberty (threat
    to self-control)
  • Western society emphasis on shape and weight
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12
Q

What/Who are Perfectionists?

A

‘Perfectionists are those whose standards are high beyond reach or reason, people who strain compulsively and unremittingly toward impossible goals and who measure their own worth entirely in terms of productivity and accomplishment’

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13
Q

What is Impulsivity?

A

Acting on the spur of the moment; not
focussing on the task at hand; not
planning and thinking carefully

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14
Q

What is the only approved drug in the UK/USA to treat BN?

A

Fluoxetine hydrochloride

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15
Q

What factors are influenced by Serotonin (5-HT Receptors)?

A
  • Appetite & Satiety
  • Impulsive/Compulsive/Obsessional Behaviour
  • Mood & Emotional Processing
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16
Q

Why is Serotonin (5-HT Receptors) important in EDs?: Anorexia Nervosa

A
  • 5-HT system is inherently unstable and poorly
    modulated
  • 5-HT system fluctuates erratically
  • Dieting causes a reduction of 5-HT signal
    transmission in BN
  • Possibly contributing to low mood
  • Binges used to modulate 5-HT
17
Q

Why is Serotonin (5-HT Receptors) important in EDs?: Bulimia Nervosa

A
  • Premorbid disturbance in 5-HT
    neurotransmission
  • Contributes to anxious, obsession traits which
    tend to predate dev of AN
  • Restricted eating as a means of reducing 5-HT
    functional activity (possibly via TRP availability)
  • Therefore reducing anxiety
18
Q

What is the Effect of Orexin on appetite?

A

Increases Appetite

19
Q

What is the Effect of Peptide YY(3-36) on appetite?

A

Signals from the gut decrease appetite
by inhibiting neurones that that produce
neuropeptide Y and Agouti-related protein

20
Q

What is the Effect of Insulin and Leptin on appetite?

A

Decrease appetite via stimulating melanocortin producing neurones

21
Q

What is the Effect of Ghrelin on appetite?

A

Signals from the gut increase appetite stimulating NPY and AgRP neurones and stimulating Orexin release

22
Q

Enhanced Cognitive Model of EDs (5 Step Cycle)

A

Negative Self-Belief
Negative Thoughts
Emotions/Feeling
Thoughts about Eating
Problematic Eating Behaviours

23
Q

Treatments for Eating Disorders: AN (8)

A
  • Inpatient psychiatric treatment of 2-3 months
  • Followed by close outpatient monitoring and re-
    feeding regimen
  • Nutritional counselling and education
  • Behavioural therapy (rewards to reinforce)
  • Cognitive-Behavioural Therapy
  • Family Treatment
  • Interpersonal Group therapy
  • Medication
24
Q

Treatments for Eating Disorders: BN (6)

A
  • Outpatient Clinics
  • Behavioural Therapy
  • Cognitive Behavioural Therapy
  • Family Treatment
  • Group Therapy
  • Medication
25
Q

What is an SSRI? How do they work?

A
  • Selective serotonin reuptake inhibitor
  • Work by blocking (“inhibiting”) reuptake
  • Meaning more serotonin is available to pass
    further messages between nearby nerve cells
26
Q

What are topics of focus in CBT in EDs? (6)

A
  • Emphasis on self-monitoring of eating and
    weight
  • Psychoeducation about weight, shape and
    eating
  • Establishing regular pattern of eating including
    snacks
  • Involving a significant other (family member,
    partner, friend)
  • Identifying barriers to change
  • Working on maintaining mechanisms