week 12 Flashcards

1
Q

What messages are given about weight in our culture

A

You can never be too thin or buff enough
Weight is a moral issue
Implicit association test → weight discrimination
Just eat more (toxic food environment)

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2
Q

How important is genetics in determining out weight

A

50% of variability in weight is associated with genes

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3
Q

What is anorexia nervosa

A

Significantly low body weight in the context of age, sex, developmental trajectory, and physical health
Intense fear of gaining weight and persistence in not gaining weight
Disturbance in experience of weight or shape, undue influence of weight or shape on self-evaluation, persistent lack of recognition of the seriousness of the current low body weight
Restricting type: weight loss is accomplished primarily through dieting, fasting and or excessive exercise
Binge eating/purging type: recurrent episodes of binge eating or purging behavior (
Anorexic range less than 18.5 (ICD-11)

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4
Q

Bulimia Nervosa

A

Recurrent episodes of binge eating
Eating in a discrete period of time, an amount of food that is larger than what most individuals would eat in a similar period of time under similar circumstances
A sense of lack of control over eating during the episode
Recurrent inappropriate compensatory behaviors like self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting or excessive exercise
Must occur at least once a week for 3 months
Self-evaluation is unduly influenced by body shape and weight
The disturbance does not occur exclusively during episodes of anorexia nervosa

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5
Q

Binge-Eating Disorder

A

Recurrent episodes of binge eating
Episode of binge eating is characterized by:
Eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
A sense of lack of control over eating during the episode
The binge-eating episodes are associated with three or more of the following
Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of feeling embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or very guilty afterward
At least once a week for 3 months

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6
Q

Obesity

A

Excess of weight associated with health problems
Chronic medical condition
Different groups are more affected
Non-hispanic black and hispanic adults
Lower education
Intersection of race and education
Also consider age

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7
Q

Which is the most frequently occurring eating disorder

A

Binge eating

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8
Q

Which of these disorders also affects men significantly

A

Binge eating

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9
Q

What proportion of individuals with Binge-Eating Disorder are overweight

A

36-42%

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10
Q

What is the age of onset for these different eating disorders

A

AN → peak onset 13-18 years peaking at 18
BN → age of onset 16-17 years old
Binge eating → late teens to early 20s

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11
Q

What are co-occuring disorders with anorexia nervosa and bulimia nervosa

A

Major Depression (50-70%)
Anxiety disorders (13-60%)
Drug and Alcohol and BN (25%)
Personality disorder (25%)
BPD → BN
OCPD → AN

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12
Q

What are medical comorbidities associated with anorexia

A

Heart attacks
Renal and metabolic complications ex hypothermia sensitivity to cold and heat, disturbed electrolytes due to vomiting
Hematological problems
Dermatological complications (dry skin, head hair loss, hair growing)
Neurological- fatigue, dizziness, hyperactivity
Mortality

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13
Q

What are medical comorbidities associated with bulimia nervosa

A

Fluid and electrolyte damage from purging
Gasto-intestinal complaints
Cardiovascular problems due to electrolyte problems
Russell’s sign
Headaches, poor problem solving
Irregular periods
Renal problems
Dental decay from vomiting
Mortality

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14
Q

What are medical comorbidities associated with obesity

A

Hypertension
Cardiovascular disease
Type II diabetes
Some cancers
Respiratory problems like sleep apnea
Osteoarthritis

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15
Q

What is an objective binge

A

Experiencing a loss of control over eating while eating an unusually large amount of food in one sitting

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16
Q

What are secondary psychological problems associated with anorexia and bulimia

A

Preoccupation with food, weight and shape
Depression, mood swings
Loss of concentration
Preoccupation and Anxiety of food
Social withdrawal
Low self esteem
Obsessiveness
Perfectionism
Poor sleep
Odd eating patterns

17
Q

How are the courses of anorexia and bulimia similar or different

A

AN
Highest Psychiatric mortality rate → 16% after 21 years
Death ½ suicide and ½ physical complications
After 21 years, 51% fully recovered; 21% partially recovered; 10% not recovered and 16% dead
BN
Onset late adolescent to early 20s
30% shift from AN to BN
Waxing and Waning course
6 mths to 10 years outcome 50% fully recovered, 20% meet full criteria for BN and 30% relapse
11-12 year outcome 70% remission
Mortality approximately 0.3%

18
Q

Which eating disorders have multiple evidence based treatments

A

AN
Family Based Therapy
Phase 1: parents take charge of weight restoration
Phase 2: clients regain control of eating
Phase 3: developmental issues
Principle features
Theoretical view of the cause of AN
Empowerment of parents
Separation of the illness from the client
CBT- Enhanced
All eating disorders
2 forms
Focused
Broad: includes additional modules (mood intolerance, clinical perfectionism, and major interpersonal problems
Focused on to stop dieting

19
Q

What are evidence based treatments for bulimia nervosa

A

CBT
19 sessions x 4.5 month individual tx
3 stages, sessions staggered
1. Behavioral strategies → self monitoring, regular eating, alternative behaviors, stimulus control, problem solving
2. Cognitive restructuring → body image
3. Relapse prevention
Psychotherapy
Pharmacotherapy

20
Q

What are evidence based treatments for binge-eating disorder

A

Pharmacological
CBT
Interpersonal psychotherapy
Behavioral weight loss
Self-help
Surgery