Week 5 Flashcards
How many diagnoses are there for EDs in the DSM
8, with Anorecia nervosa, Bullimia nervosa, and binge eating disorder being the top 3
5 things we KNOW about all Ed’s
Charicterised by disturbances to thoughts, behaviours, and attitudes to food and eating
Can extend to preoccupation with excercise and body weight/shape
Real, life threatening illnessess, with high fatality.
Typically develop in adolescence.
Biological, psychological and social risk factors
What does the word anorexia nervosa mean?
An-Orexis-Nervosa; nervous absence of appetitite
3 main criteria of AN
A) restriction of energy intkae relevant to requirements, leading to a significantly low body weight for their age, sex, physical health.
B) intense fear of gaining weight or becoming fat, even though underweight.
C) Disturbance in the way in which ones body weight or shape is experienced, nudue influence of body weight or shape on self-evaluation, or denial of seriousness of current low body weight.
2 subcategories of AN
- restricting type: Sbutype that is the classic AN, no binge eating.
- Binge eating: the individual regularly engages in eating and purging behaviours, including vomiting or laxatives.
Course and prevelance of AN
Average age of onset is 16-17 years. Prevelance is below 1% Rarely diagnosed in women over 40. Onset usually comnig with stressful life event. AN can lead to BN
Associated features of AN
depressed mood, social withdrawal, irritability, insomnia, suicidal ideation, obsessive compulsive features prominent.
Concerns of eating in public, need for control over the environment
inflexible thinking, perfectionism, restrained emotional expression.
Many physical issues that come with it *hair growth, cold all the time, hair loss etc
What is the word BN from
Ox Hunger
5 BN criteria
A) Recurrent episodes of binge eating. NOTE; binge eating classification on another slide.
B) recurrent inappropriate compensatory behaviour to prevent weight gain, such as vomiting, misuse of laxatives or other meds, fasting, or excessive excercise.
C)the binge eating and inappropriate compensatory behaviours occur, on average, at least once a week for three months.
D) self-evaluation is induly influenced by body shape and weight
E) binging or purging does not occur exclusively during episodes of behaviour that would be common in those with anorexia nervosa.
NOTE, anorexia ‘beats’ bulemia, as in, if a person meets the crtieria for BOTH bulemia and AN, they’ll get diagnosed with AN binge-eating subtype
What is the crtieria for a binge eating episode in the context of BN and BED
Eating, in a discrete period of time(e.g., within a two-hour period), an amount of food that is definitely largerthan what most people would eat during a similar period of timeand under similar circumstances
–Lack of control over eatingduring the episode (e.g., a feeling that you cannot stop eating, or control what or how much you are eating)
Course and prevelance of BN
Chronic and intermittenet without treatment.
Some argue it will resolve on its own, but this is controversial.
Increasingly common in middle aged men. Average onset is 18 yr
Associated features of BN
High level of comorbidity; esp. with anxiety disorders (70), depression (70-50%) substance abuse (37%)
Complications due to vomiting and purging;
electrolyte distubances causing weakness, tiredness, depression and rarely sudden death, irregular menses, oesophagel rupture. On slide 20 is a diagram of all the fucked stuff that happens to your body.
Binge eating disorder criteria
A) recurrent episodes of binge eating (same criteria as BN binges)
B) these episodes are associated with three or more of the following;
1. eating more rapidly than normal
2. eating until feeling uncomfortably full
3. eating large amounts of food even when not hungry
4. eating alone because feeling embarrased abuot how much they’re eating
5. feeling disgusted with onself, depressed, or very guilty after.
C) marked distress is present
D) the binge eating occurs once a week for 3 months
E) there is NO compensatory behaviour, and the behaviour doesn’t occur alongside AN or BN
Course and prevelance of BED
Most common of all eating disorders; 6%. Higher than AN and BN put together. Equal % of men and women. Latest onset, 25 yrs. Combordities are physical and psychological. Luckily, better response to treatment than other eating disorders.
Social explanations of EDS
Media and cultural, body standards.
EDs and Dieting
Deitary; adolescent dieting linked to 6-18x greater risk of developing an ED. We tend to become obsessed with food when we can’t eat much (that fucked study about when participants were put on a restrictive diet, they started obsessing over food)
Family influence of EDS
Parents with distorted perception of food and eating may restrict children’s intake too
•Families of individuals with anorexia are often:
–High achieving
–Concerned with external appearances
–Overly motivated to maintain harmony > leads to poor communication and denial of problems
•Disordered eating also strains family relationships
AN usually comes from close boundary crossing families
BN comes from chaotic and conflicted families
Biological links to Eds
Not much? There is a genetic element (more likely to get one if parent has one)
4% ⇧risk first-degree relatives -AN
–9.6% ⇧risk first-degree relatives -BN
and low serotonergic activity is often found in EDs.
Psychological explanations
Low self-esteem Perfectionistic attitudes distorted body image preoccupation with food mood intolerance
What is the cost of EDS
leading cause of disease and injury in young women (australia).
Estimated cost against life of EDS is higher than anxiety, depression combined
SO, what the fuck do we do about EDS
Early identifiaction is key. people with BN tend to take 7 years before seeking treatment (!!!). Those who receive treatment early generally recover. Some Drs use the SCOFF questionare to test EDs from people they reckon might be showing signs
Evidenced based-ED treatment.
CBT-ED
Family based treatment
Adolescent focused therapy for ED
and a few more
