Stress and Eating Disorders Flashcards
What are the four unhealthy eating cues?
-social cues
-situational cues
-negative thoughts
-negative feelings
What are the social cues that affect eating?
-often eating is the primary activity in social settings
-wanting to fit into social settings
-peer pressure
What are the situational cues that affect eating?
-seeking comfort during crisis/loneliness
-avoiding negative feelings
-reward
What are the negative thoughts and feelings that affect eating?
The Cycle of Automatic Eating:
-unpleasant situation
-automatic negative thoughts
-negative feelings
-eat our emotions
What is the prevalence of eating disorders and rate of obesity?
-approximately 5 million Americans have a diagnosable eating disorder
-including: anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified (EDNOS)
-among teenagers the rate of obesity is 17%
What are the risk factors for eating disorders?
-gender [predominantly women due to societal pressures]
-race or ethnicity
-childhood eating and gastrointestinal problems
-elevated shape and weight concerns
-sexual abuse
-negative body image and self-evaluation
-general psychiatric comorbidity
What are the symptoms of Anorexia Nervosa (AN)?
-rapid weight loss
-excessive concern with body shape and weight
-preoccupation with food and calories
-decrease in variety of foods eaten
-skipping meals
-ritualized eating and food preparation
-menstrual irregularities
-excessive exercise
-can result in anemia
What are the core features and onset patterns of Anorexia Nervosa?
-refusal to maintain minimum body weight
-pathological fear of gaining weight
-distorted body image
-weight loss = achievement; weight gain = loss of control
-affects mostly adolescent females
-onset: early to mid-teens, often after life stress or intense dieting
-prevalence: ~0.5% lifetime; 10x more common in females
-rising trend of early onset in girls (ages 8–13)
What are the 2 subtypes and personality traits associated with Anorexia Nervosa?
-Restricting Type: self-starvation without purging
-Binge-Eating/Purging Type: regular purging behaviors
-common traits: obsessiveness; perfectionism; low self-esteem
What is the relationship between stress and Anorexia Nervosa (AN)?
-AN is linked to HPA axis dysregulation
-stress → CRH hypersecretion, a known anorexic agent
-hard to determine if HPA changes are due to AN or starvation
-major affective disorders may also influence HPA abnormalities
-most findings: HPA dysfunction does not correlate with depression, BMI, or body weight
-malnutrition is proposed as a key driver of HPA changes
-no clear direct link between stress and AN
-individuals with AN often ignore hunger cues despite physiological need
What are the symptoms of Bulimia Nervosa (BN)?
-fear of loss of control over eating
-excessive concern with body shape and weight
-feelings of shame and secrecy concerning bulimic behaviours
-consuming large amounts of food at one time (bingeing)
-self-induced vomiting
-abuse of laxatives, diet pills
What are the key features of Bulimia Nervosa (BN), including the 2 subtypes?
-recurrent episodes of binge eating, followed by purging or fasting
-characterized by fear of weight gain and distorted body image
-Purging type: vomiting or misuse of laxatives
-Non-purging type: excessive fasting or exercise
-onset: late adolescence/early adulthood
-90% female, lifetime prevalence ~1–3% in women
-10x more common in females than males
What are behavioral and clinical characteristics of Bulimia Nervosa?
-binges often planned, occur in secret, include easily consumed high-calorie foods
-triggers: depressed mood, interpersonal stress, intense hunger after restriction
-individuals feel loss of control and shame
-physical signs: dental enamel loss, menstrual irregularities
-fewer physical symptoms than AN
-often comorbid with Axis I & II disorders: major depression diagnosed in 36–63% of cases
-more common than anorexia nervosa
How is the HPA axis involved in Bulimia Nervosa (BN)?
-psychological stress and large food intake both activate the HPA axis
-this leads to increased cortisol secretion during bingeing
-purging behavior does not affect cortisol levels
-suggests that HPA activation in BN is mostly due to stress and binge eating, not purging
Do BN patients show abnormal HPA-axis function?
-normal-weight BN patients show similar HPA activity to healthy controls
-bingeing and vomiting do not significantly affect hormonal secretion
-unlike in AN, there is no strong link between BN symptoms and HPA-axis dysfunction
What is the relationship between stress and eating behavior in Bulimia Nervosa?
-stress is linked to the onset of BN
-bulimic women increase food intake significantly after stress compared to controls
-in a study, both BN and healthy women ate more carbs after stress, but bulimics ate more overall
What are the symptoms of binge eating?
-fear of loss of control over eating
-bingeing [recurrent episodes of binge eating without purging or fasting]
-feelings of disgust
-poor self-esteem
-tend to be overweight:
–long history of failed attempts to diet and lose weight
–feelings of lack of control that causes distress
What are key features of Binge Eating Disorder?
-onset: late adolescence or early adulthood
-prevalence: 1–3%
-associated with high levels of depression
-leads to impaired social functioning and body dissatisfaction
-more common in women, but the gender gap is smaller than in other eating disorders (only 1.5x higher in women than men)
How is stress related to binge eating behavior?
-restrained and emotional eaters tend to overeat when stressed
-patients with binge eating disorder are more likely to be emotional eaters
-moderate heritability (≈ 0.5)
-binge eating may act as an escape from negative self-awareness or an attempt to improve mood
How is obesity classified in medical and psychological systems?
-obesity is classified as a condition in the International Classification of Diseases (ICD)
-it is not included in the DSM-IV as a mental disorder
-refers to being significantly overweight, often linked to health complications
How does stress influence obesity and fat distribution?
-BED (Binge Eating Disorder) women show greater cortisol response to stress than normal subjects
-obese women often show HPA axis dysregulation
-increased cortisol is linked to central fat distribution (fat above the waist)
-high cortisol can cause insulin resistance, promoting visceral fat accumulation
What is coping, and how can poor coping impact eating behavior?
-coping refers to the thoughts and behaviors used to manage, tolerate, or reduce internal or external demands.
-poor coping skills can lead to increased stress, which reduces dietary restraint and can result in weight gain or loss, forming a spiral pattern of behavior.
-women are more likely to use food to cope with stress, whereas men may turn to alcohol or smoking.
How do coping styles differ in individuals with eating disorders?
-Women with eating disorders (ED) tend to be: less optimistic; use cognitive avoidance; show self-blame (especially in BN); display less mastery in crises; rely on ineffective coping strategies
-there’s a positive link between eating pathology and avoidant or emotion-focused coping styles.
