Module 13: Eating Disorders Flashcards
define disordered eating
- range of eating disorders and behaviors
- spanning from less severe behaviors to more severe diagnoses
examples of clinically diagnosed diseases of disordered eating
- anorexia nervosa
- bulimia nervosa
is anorexia nervosa and clinical anorexia the same thing
no
define clinical anorexia
- absence of hunger cues or loss of appetite
- physiological reason (when you’re sick)
examples of behaviors of disordered eating
- unhealthy eating patterns
- compensatory habits
what are some examples of compensatory habits
- extreme dieting
- extreme exercise
- elimination: purging, laxative use, etc
describe the continuum of disordered eating
- disordered eating is on a broad spectrum
- ranges from healthy eating with a good body image to pre-occupation with weight to distorted body image to clinically diagnosed conditions
who can make an eating disorder diagnosis
physician or psychologist after an assessment of a patient
where would you find the criteria to diagnose an eating disorder
diagnostic and statistical manual, fifth edition (DSM-V)
what eating disorders are define in the DSM-V
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
- other specified feeding or eating disorder (OSFED)
- unspecified feeding or eating disorder (UFED)
define anorexia nervosa
refusal to maintain body weight at or above a minimally normal weight for age and height (BMI less than 18.5)
common characterizations of anorexia nervosa
- intense fear of gaining weight
- generally underweight
- poor body image
- amenorrhea may occur in females
what are the two subtypes of anorexia nervosa
- restricting type
- binge-eating/purging type
define the restricting type of anorexia nervosa
restricting food intake
define the binge-eating/purging type of anorexia nervosa
eating a large amount of food in a short amount of time and then purging
how is bulimia nervosa different from the binge-eating/purging subtype of anorexia nervosa
- anorexia nervosa binge- eating patients are below a normal weight/BMI
- bulimia nervosa patients are usually of normal weight/BMI
define bulimia nervosa
- binging: eating large quantities of food in a short period of time
- followed by compensatory behavior: purging, laxative use, dieting, excessive exercise
what is a common feeling/driver of many eating disorders
- feelings of loss of control
- disordered eating to regain feeling of control
what are the two subtypes of bulimia nervosa
- purging bulimia
- non-purging bulimia
define the purging bulimia nervosa subtype
purging after binging by means of laxatives, diuretics, or vomiting
define the non-purging bulimia nervosa subtype
engaging in compensatory behaviors besides purging after binging such as excessive exercise or dieting
what protein causes binge eating to provide temporary escape from negative feelings and why
- neuropeptide y
- decreases anxiety and pain; increases hunger
define binge eating disorder
- recurrent episodes of binge eating
- lack of compensatory behaviors to control weight (no dieting, exercise, purging)
describe the prevalence of binge eating disorder in the general population
- 1-2% - probably much higher
- often goes unreported
- may be higher among obese individuals
define other specified feeding or eating disorder (OSFED)
- disordered eating patterns and behaviors that do not meet specific criteria for other eating disorder diagnoses
- interfere with normal daily life
what are two ways that eating disorders often interfere with normal daily life
- reduced ability to engage in social interactions
- inability to perform work at expected level
examples of other specified feeding or eating disorder (OSFED)
- atypical anorexia nervosa
- bulimia nervosa (of low frequency and/or limited duration)
- binge eating disorder (of low frequency and/or limited duration)
- purging disorder
- night eating syndrome
define atypical anorexia nervosa
- OSFED
- weight is at or above the normal range (BMI over 18.5)
- still have manifestations of anorexia nervosa
define bulimia nervosa (of low frequency and/or limited duration)
- OSFED
- same symptoms of bulimia nervosa
- frequency less than 1 episode per week
- duration less than 3 months
define bing eating disorder (of low frequency and/or limited duration)
- OSFED
- same symptoms of binge eating disorder
- frequency less than 1 episode per week
- duration less than 3 months
define purging disorder
- OSFED
- recurrent purging to influence weight in absence of binging
define night eating syndrome
- OSFED
- recurrent episodes of night eating: eating after waking or excessive food intake after evening meal
define unspecified feeding or eating disorder (UFED)
- eating disorders that do not meet specific criteria for eating disorder or when there is not enough information to classify something as an eating disorder
- results in clinically significant distress or impaired social and occupational engagement
what is the difference between OSFED and UFED
- OSFED: conditions that don’t meet the specific criteria for other eating disorders
- UFED: there is insufficient information about a particular eating disorder
examples of unspecified feeding or eating disorders (UFED)
- orthorexia
- avoidance restrictive food intake disorder (ARFID)
- pica
- rumination/purging disorder
define orthorexia
- UFED
- fixation on righteous eating
- obsession with eating only foods considered pure and of high quality (organic, low-fat, sugar-free, grass-fed beef, no GMOs/antibiotics)
describe avoidance restrictive food intake disorder (ARFID)
- UFED
- person is at or above a normal BMI
- avoid certain foods usually because of sensation of food (taste, sight, smell, texture)
- do not have poor body image
define pica
- UFED
- craving or consumption of non-food items (paint chips, chalk, hair)
- may be experienced with pregnancy
- idiopathic
define rumination/purging disorder
- UFED
- purging of food without poor self-image
- no physiological impairment causing purges
- idiopathic
examples of eating disorders not associated with poor self-image
- ARFID
- pica
- rumination/purging disorder
when do disordered eating behaviors often become most obvious
during adolescence
what ages do eating disorders affect
all ages
how early can signs of eating disorders be observed
7
why do women over 40 often develop eating disorders
response to traumatic event (death, assault, divorce)
what percent of reported cases of eating disorders are men
- 10%
- many go unreported though
what are the most common eating disorders among men
- binge eating disorder
- OSFED
what is a common reason for male eating disorders
men feeling pressured to emulate the ideal male physique
risk factors for disordered eating behavior
- body dissatisfaction
- poor self-esteem
- puberty
- teasing
- family
- athletics
- dieting
- cultural pressure
what are harmful psychological consequences of eating disorders
- anxiety
- depression
- low self-esteem
- disturbed body image
- amenorrhea (in women)
what are harmful nutritional consequences of eating disorders
- impaired growth and development in children and teens
- osteoporosis
- impaired immune system function
- infertility
how does cultural pressure often cause eating disorders
- portrayal of female body in media
- advertising
define body image
- how individual pictures their body
- how we feel about how we look
what is often the starting point for developing disordered eating behaviors
poor body image/body dissatisfaction
define body dysmorphic disorder (BDD)
preoccupied with the thought that the appearance is unattractive or deformed
define muscle dysmorphia
- type of body dysmorphic disorder (BDD)
- individuals focus on their muscularity and believe they are never muscular enough
- aka bigorexia
teasing by who can cause disordered eating habits
- peers
- family members
what is a common characteristic between people with anorexia and those with bulimia
- low self-esteem
- highly self-critical
- perceive self as inadequate
who is at highest risk for poor body image in relation to puberty
those who mature early or late
is puberty often more traumatic for girls or boys
girls
are family problems often the primary cause of eating disorders
no
characteristics of families of people with anorexia nervosa
- not accepting individuality
- overprotectiveness
- inflexible rules
- inadequate boundaries
- inability to effectively communicate
what are the 3 health problems associated with female athletes
- disordered eating
- amenorrhea
- osteoporosis
medical complications of anorexia nervosa
- heart failure
- kidney failure
- multiple organ failure
- illness such as pneumonia
what percent of anorexia nervosa patients die
5-20%
why is illness such as pneumonia a complication of anorexia nervosa
- poor immune response
- don’t have adequate proteins to make antibodies
why is heart failure a complication of anorexia nervosa
heart muscle being broken down into amino acids to be made into glucose for energy
why is kidney failure a complication of anorexia nervosa
amino acids being broken down for energy create ammonia which can be toxic to the kidneys
medical complications of bulimia nervosa
- stomach rupture
- heart failure
- irregular menstrual cycles
- diminished libido
- addictions and/or compulsive behavior
- depression, anxiety, suicide
why is heart failure a complication for bulimia nervosa
purging causes loss of electrolytes and other minerals needed for heart contraction and relaxation
medical complications of binge eating disorder
- associated with obesity
- high blood pressure
- high cholesterol
- CVD
- type 2 diabetes
- gallbladder disease
- joint problems
- depression
what do people with muscle dysmorphia engage in
- increased training intensity and frequency
- steroid use
what type of steroids are generally used by people with muscle dysmorphia
anabolic-androgenic steroids (AAS)
describe anabolic-androgenic steroids (AAS)
- manufactured hormones related to natural male sex hormones (testosterone)
- developed in 1930s for medical purposes
- illegal to possess without prescription
- banned in most competitive sports
what are negative side effects of AAS
- reduced testicular size and enlarged breasts
- acne
- increased blood pressure
- increased LDL cholesterol
- decreased HDL cholesterol
- liver cancer
- aggressive behavior
- hepatitis B and C viruses
- HIV
why does AAS use cause testicular atrophy
- artificially increasing testosterone levels
- cells in testes that naturally make testosterone don’t need to anymore so they shrink
why does AAS use cause gynecomastia (enlarged breasts)
- AAS increase testosterone
- excess testosterone converted to estrogen which causes enlarged breasts
is aggression a primary or secondary emotion
secondary
describe the treatment of eating disorders
- established on individual basis
- use multidisciplinary treatment approach
- different types of therapy, nutrition counseling
is physical appearance reliable for determining whether someone has an eating disorder
no
