W6 - Eating Disorders

Question 1

Definition of Eating Disorders?

Answer 1

1. Complex - stems from their personality / childhood problems
2. Potentially life-threatening
3. Usually occurs due to deeper issues that they cannot deal with like self-identity, self-esteem, guilt, self-blame
4. Food & weight are usually symptoms / coping mechanisms

Question 2

Types of Eating Disorders? (4)

Answer 2

1. Anorexia
2. Bulimia
3. Binge-eating
4. Eating disorder NOS (not otherwise specified - has symptoms of different types)

Question 3

Whats the diagnostic criteria for Anorexia? (5)

Answer 3

1. Refusal to maintain normal weight at/above min BMI < 17.5
2. Disturbed by body appearance
3. Intense fear of gaining weight/becoming fat even though they are underweight
4. Amenorrhoea (No period at least 3 cycles)
5. Restricting food/ Binge-purging

Question 4

Whats the diagnostic criteria for Bulimia? (5)

Answer 4

1. Recurrent episodes of binge-eating / purging / excessive exercise
2. At least once a week for 3 months
3. Self-evaluation of weight & body shape
4. Either purging/non-purging type

Question 5

Causes of eating disorders? (5)

Answer 5

1. Genetic
2. Physical: Period started earlier, obesity
3. Psychological: Fear of lack of control
4. Personality: OCD/Perfectionism - high expectations of themselves
5. Socio-cultural: Culture of dieting, exposure to images of skinny people, teased for their weight/looks

Question 6

Individual causes of eating disorders? (3)

Answer 6

1. Low self-esteem, poor body image -> extreme need for approval
2. Perfectionism, high expectations of themselves
3. Constant anxiety/sadness

Question 7

Family factors of eating disorders? (3)

Answer 7

1. Avoid conflict
2. Family has unrealistically high expectations on them & places excessive emphasis on their appearance
3. Overly dependent on their family -> lack of personal autonomy -> turn to food: can control their intake

Question 8

Treatment for EDs? (6)

Answer 8

1. Medical
   - stabilise electrolytes, cardiac condition, hormones, metabolic fxns

Medicines:
A. 2nd gen antipsychotics:
- stabilise mood
- reduce anxiety around food and distorted body image
- olanzapine, quetiapine

B. SSRIs
- reduce binge-purge cycles
- improves mood regulation

C. Anti-anxiety agents
- reduce anxiety around meals

2. Nutritional
   - gradually increase food intake
   - restore normal & healthy eating habits
   - nurses can eat w patients -> foster healthy eating habits -> alleviate stress, anxiety, self-guilt associated with eating
3. Weight restoration
   - Min healthy weight: BMI > 18.5
   - Period return normally
   - Resume normal growth & dev
   - Aim to gain 1kg/wk
4. Psychosocial
   - address underlying problems
   - supportive therapy
   - psychoeducation
   - CBT, grp therapy
   - family therapy, esp for adolescents
5. Multidisciplinary team
   - nurses, doctors, psychiatrists

Question 9

More areas to focus on for people with EDs? (4)

Answer 9

1. Cognitive behavioural therapy by psychologists to reframe body image issues
2. Recommend exercises to maintain muscle mass
3. Learn effective coping skills
4. Prevent & overcome urge to binge, purge