Week 9 - Eating Disorders Flashcards
Categories of Eating Disorders
Anorexia Nervosa AN
Bulimia Nervosa BN
Binge Eating Disorder BED
Other Specified Disorders OSFED
Anorexia Nervosa
Onset at any age – usually 14-24 years
Refusal to maintain body weight (15% below expected weight)
Intense fear of gaining weight
Undue influence of body weight on self-evaluation
IN females - 3 months or longer loss of menstrual cycle
SPECIFIC TYPES
Restricting – not engaged in bingeing or purging
Binge eating/purging type – engaging in bingeing and purging
Bulimia Nervosa
Recurrent episodes of binge eating – larger amounts/limited time/lack of control
Recurrent compensatory behaviour – vomiting, laxatives, diuretics, exercise
Binge/compensation occur 2x weekly for 3 months
Self evaluation is influenced by body weight/shape
SPECIFIC TYPES
Purging type
Non-purging type – fasting, exercise as compensatory behaviours
Binge Eating Disorder
Binging behaviour without compensatory behaviour
Distress and lack of control around binging
Extreme feeling of guilt and shame
High Risk Populations
Adolescents – females Age – adolescence (as young as 6) Competitive occupations – athletes, dancers, models Women – key transition periods Trauma sufferers Low self esteem, anxiety depression Perfectionist or compulsive personality traits Family history of eating disorders Weight loss or dieting behaviours
Assessment of Eating Disorders
Physical – blood chemistry, urinalysis, ECG. Exclude other weight loss reasons
Psychiatric – confirm diagnosis and co-morbidities
Body Image assessment – ask simple questions
Nutritional assessment – current intake, rituals, behaviours
Family assessment – relationships, history
Treatment of eating disorders
Medical stabilisation
Safety, vital signs, re-feeding, monitor emotional status
Re-feeding syndrome – electrolyte/fluid disturbances (drop in phosphate levels – cardia, neurological, haematological complications
Restoration of weight/nutritional intake
Psychotherapy
Family based therapy (young women with AN)
CBT (AN)
Interpersonal psychotherapy (BN)
Dialectical behaviour therapy
Supportive recovery in the community
Pharmacology – limited evidence in AN – usually treating co-morbidity; SSRI’s in BN; anti-psychotic’s in AN
Recovery of eating disorders
It is different for different people Medically Diagnosis – doesn’t meet criteria Behaviour – no longer engaging Physical Health – healthy weight Psychological – positive attitude to feed, body, self Practical – improved quality of life
Adults: 50/30/20
Adolescents: 70/20/10
Cause of Eating Disorders
Genetic Vulnerability
50-70% of heritability across genes related to appetite, metabolism, mood etc
Strong family history with mothers and daughters
Sociocultural Factors
Internalisation of the ‘thin/muscular ideal’
Occupation ideals
Individual Factors
A number of personality traits including perfectionism, impulsivity, OC
Low self esteem
Physical/sexual abuse
