Test 2 Flashcards
First written account of binge purge behaviours dates back to 4 BC to AD 65
Noted in Ancient Rome
Religious roots – fasting
Historical context of Eating Disorders
Society and culture influence prevalence of eating disorders
In North America and Western Europe – rates have increased since ______’s
1920
Unrestricted eating
Watchful eating
Increasing weight and shape preoccupation
Clinical eating disorders
Continuum of Eating Experiences
eating to the occasion and being spontaneous…. not restricting before or after
Unrestricted eating
Paying attention to what is being eaten (mindful kind of?)
Possibly a diet
Watchful eating
refers to when individuals spend excessive time thinking about their weight/shape and this interferes with their functioning (e.g., being distracted while engaged conversation because thinking about weight/shape)
Preoccupation with weight/shape
An eating disorder is a serious, complex, mental health issue that affects one’s emotional and physical health.
An unhealthy relationships with food, their weight or appearance.
e.g. anorexia, bulimia and binge eating disorder
Clinical eating disorders
Pica
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Other Specified
Unspecified
DSM 5- Feeding and Eating Disorders
An eating disorder in which a person eats things not usually considered food.
Young kids often put non-food items (like grass or toys) in their mouths because they’re curious about the world around them.
Pica
a rare behavioral disorder in which food is brought back up from the stomach. It is either rechewed, reswallowed, or spit out.
Rumination Disorder
extremely selective eaters and sometimes have little interest in eating food. They may eat a limited variety of preferred foods, which can lead to poor growth and poor nutrition.
(occurs in children frequently?)
Avoidant/Restrictive Food Intake Disorder (ARFID)
a psychiatric disease in which patients restrict their food intake relative to their energy requirements through eating less, exercising more, and/or purging food through laxatives and vomiting. Despite being severely underweight, they do not recognize it and have distorted body images.
Anorexia Nervosa
It is characterized by uncontrolled episodes of overeating (called bingeing). This is followed by purging by self-induced vomiting, misuse of laxatives, and other methods.
Bulimia Nervosa
regularly eat much more food than most people. They often eat quickly, eat when they are stressed or upset (instead of just when they’re hungry), and feel like they can’t stop eating, even when they’re uncomfortably full. They also binge at least once a week for several months.
Binge Eating Disorder
have symptoms that are similar to one or more eating disorders, but may not meet all the criteria for these conditions.
Other Specified
where behaviours cause clinically significant distress or impairment of functioning, but do not meet the full criteria of any of the feeding or eating disorder criteria.
Unspecified
Pica
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
These three are more common in ________ and individuals with intellectual disabilities.
children
Criteria A
Restriction of intake leading to significantly low body weight
Criteria B
Intense fear of weight gain and persisting behaviour even if actually losing weight
Criteria C
Distorted body image (weight, shape, self-evaluation) or lack of recognition of the seriousness of current low weight
Mild – BMI 17 or greater
Moderate – BMI 16-16.99
Severe - BMI 15-15.99
Extreme – BMI less than 15
DSM Anorexia Nervosa
U
N
D
E
R
Underweight
Nervous about weight
Distorted perception
Excessive exercise
Restricting calories
(Anorexia DSM)
Can be:
Restricting type
Binge/purge type
Anorexia
OCD brain patterns
“I need to lose weight/purge”
“I am fat”
Anorexia
During the last 3 months, person has not engaged in episodes of binge eating or purge behaviours
Restricting type (Anorexia)
During the last 3 months, the person has engaged in episodes of binge purge behaviours
Binge-eating/Purging type (Anorexia)
After full criteria met, Criteria A is still and B or C
In Partial Remission (Anorexia)
After full criteria met, no criteria has applied for a substantial period of time
In Full Remission (Anorexia)
Abnormal lab findings may lag behind damaging effects
Anemia, leukopenia
Amenorrhea
Dehydration
High cholesterol
Decreased liver function
Vitamin & mineral deficiencies
Physiological effects of Anorexia
Decreased thyroid functioning
Damage to heart & kidneys
Decreased energy, lethargy
Constipation
Abdominal pain
Cold intolerance
Low BP & pulse
Dry, cold skin
Lanugo
Peripheral edema
Dental erosion
Osteoporosis
Decreased concentration
Physiological effects of Anorexia
Can be fatal:
Starvation, suicide, heart attacks, electrolyte imbalance
Hospitalization may be necessary
Anorexia
Temperamental – Persons who develop anxiety disorder or obsessive compulsive disorder in childhood are at increased risk of developing anorexia nervosa
Temperamental Risk Factors (Anorexia)
Associated with cultural settings in which thinness is valued
Environmental Risk Factors (Anorexia)
Increased risk if there is a history among 1st degree relatives
Genetic and Physiological Risk Factors (Anorexia)
Feelings of ineffectiveness
Strong need to control environment
Inflexible thinking
Limited social spontaneity, restrained initiative & emotional expression
Perfectionism is strongly associated
Increased prevalence in some sports – ballet and wrestling
Associated Traits of Anorexia
Criteria A: Recurrent episodes of binging characterized by:
Eating in a short period of time (usually 2 hours) much more than people normally consume
A sense of overeating and lack of control over the binge behavior
Criteria B: Recurrent use of means to prevent weight gain (inappropriate compensatory behaviours)
Criteria C: Frequency at least twice once a week for 3 months
Criteria D: Excessive concern with body shape & weight
Criteria E: Behaviour does not occur solely with Anorexia Nervosa
DSM Bulimia Nervosa
Full criteria previously met, now some but not all criteria met
In partial remission - DSM Bulimia Nervosa Specifiers
Full criteria previously met, now no longer present for a substantial period of time
In full remission - DSM Bulimia Nervosa Specifiers
Mild 1-3 episodes per week
Moderate 4-7/week
Severe 8-13/week
Extreme 14+/week
Severity - DSM Bulimia Nervosa Specifiers
Serious cardiac events and skeletal myopathies are associated with use of syrup of ipecac
Gastrointestinal problems and rectal prolapse have been reported
Health concerns (Bulimia)
Fatalities associated with:
Cardiac arrhythmias
Gastric ruptures
Suicide
Bulimia
Weight concerns, low self-esteem, depression, anxiety in childhood increase risk
Temperamental Risk Factors (Bulimia)
Associated with cultural settings in which thinness is valued.
Associated with childhood abuse
Environmental Risk Factors (Bulimia)
Associated with childhood obesity
Increased risk if there is a history among 1st degree relatives
Genetic and Physiological Risk Factors (Bulimia)
B
O
W
L
Binge eating
Offsetting behaviours
Weekly (2x wk for 3 months)
Linked to self esteem
Weight loss
Limited intake
Proud of weight loss
Anorexia Nervosa
Typically normal weight or slightly overweight
Characterized by binge eating
Ashamed of problem
Bulimia Nervosa