🤯Psychiatry🤯 - Eating disorders Flashcards
What is the 5:2 diet?
Intermittent caloric restriction method
5 days of normal eating, 2 days of calorie restriction (500-600kcal)
What is the difference between binge eating and bulimia?
Binge eating is where you consume an excessive amount of food - no compensation - most common eating disorder especially in higher weight individuals
Bulimia is consuming an excessive amount of food - followed by compensation (e.g. purging/excessive caloric restriction)
Why are men statistically less likely to be advised to lose weight?
Doesn’t experience same levels of distress or shame/guilt
Less internalised stigma
What is the definition of an eating disorder?
A persistent disturbance of eating behaviour or behaviour intended to control weight, which significantly impairs physical health or psychosocial functioning
Driven by “fear of fatness” or extreme distress about eating
What categories can disturbances of eating behaviour be sorted into?
Binge eating
Restricted eating
-Quantity
-Range
What are some common weight controlling behaviours?
Restricted eating (fasting)
Self induced vomiting
Excessive exercise - element of compulsion, distressed when unable to
Laxative, diuretic and other energy burning or appetite suppressing medications (e.g. caffeine, smoking)
What physical health impairments can result from out of control eating disorders?
Impacts growth and development
Stop periods
Effects on the brain
Results in osteoporosis
High mortality
What psychosocial consequences can out of control eating disorders result in?
Functional impairment
-Impacts work
-Relationships (family, peers, intimate)
-Daily living
Distress
List the main eating disorders
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Other Specified Feeding and Eating Disorders (OSFED)
Avoidant/Restrictive Food Intake Disorder (ARFID)
Rumination Disorder/Syndrome
Pica
What is the most common eating disorder?
Anorexia nervosa
Always top differential if showing signs of malnutrition
What is pica?
Eating non-nutritious substances
Which 2 eating disorders are generally not seen in routine clinical practice?
Rumination disorder/syndrome
Pica
What is anorexia nervosa?
Restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory and physical health
Intense fear of gaining weight or becoming fat, or persistent behaviour that interferes with weight gain
Often body dysmorphia
Restricting – exercising is main weight management strategy
What is bulimia nervosa?
Over eating episodes:
Large amount of food in discrete time period - sense of lack of control
Inappropriate compensatory mechanisms
Body image disturbance
Occur at least 1x week for 4 weeks or more
What is binge eating disorder?
Episodes of over eating at least once a week for 4 weeks or more
No or minimal compensation
Hence, frequently overweight
Briefly outline anorexia, bulimia and binge eating in terms of the key characteristics
What is purging disorder?
Defined by recurrent purging behaviour to influence weight or shape (e.g., self-induced vomiting, misuse of laxatives, diuretics, or other medications including insulin) in the absence of binge eating.
Weight is in the normal range
What is ARFID?
Replaces and extends Feeding Disorders of Infancy and Early Childhood (FdoIEC)
Feeding/Eating disturbance:
-significant weight loss
-significant nutritional deficiency
-dependence on enteral -feeding/nutritional supplements
-marked interference with psychosocial functioning
No weight/shape concerns
What are the subtypes of ARFID?
Three main subtypes and a mixed group:
Individuals who do not eat enough/show little interest in feeding (25.1%)
Individuals who only accept a limited diet in relation to sensory features (29.5%)
Individuals whose food refusal is related to aversive experience (7.2%)
Combined subtype (38.2%)
Give a more brief definition of ARFID
Umbrella term to describe eating behaviours that weren’t driven by weight and shape concerns
Has to be clinically significant
What are the key epidemiological points for eating disorders?
ED are relatively common in childhood and adolescence
-around 40% of adolescent girls show ED behaviours by age 16, 11% diagnosable
Incidence of AN and BN are stable – around 1-2% of adolescents
Incidence of OSFED & BED may be increasing – lifetime prev. around 2.3%
AN is still most common disorder in ED clinics
What acts as the strongest predictor of EDs?
EDs run in families
What are the psychosocial risk factors for EDs?
Psychological:
Temperament/personality
Neurocognition
Self-esteem
Psychopathology
Behaviour
Sociocultural:
Family
School/peers
Wider social influences
General:
Life events
Trauma
Life events/trauma - a risk factor for any mental disorder
What personality traits have a correlation with ED development?
Perfectionism (especially fasting and purging)
High self esteem - protective for AN; low self esteem - risk factor for bulimic and compulsive eating
Which psychological conditions can increase the risk of an ED?
anxiety disorders (i.e. OCD) - increased risk of AN
externalising disorders (i.e. ADHD), history of depression - increased risk of BN,
Which trauma/life events leave people more susceptible to certain EDs?
Sexual abuse (binge-purge type disorders)
Life events (non-specific)
What sociocultural factors put someone at risk of developing an ED?
Some evidence of increase in developing countries of incidence/prevalence (mass media exposure)
Bullying, teasing by peers, social pressure to be thin
Exposure to social network media
