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Flashcards in 1229 Exam 6 Eating Disorders Deck (43):

Anorexia nervosa:

an eating disorder marked by weight loss, emaciation, a disturbance in body image, and fear of gaining weight.


Bulimia Nervosa:

A disorder marked by recurrent episodes of binge eating, self induced vomiting and diarrhea, excessive excercise, strict dieting or fasting, and an exaggerated concern about body shape and weight.


Binge Eating:

a form of compulsive overeating with episodes of binge eating occur. SOme authorities do not consider it a spearate form of compulsive eating disorder.


Not Otherwise Specified (NOS)-

an eating disorder that contains some, but not all, of the criteria to meet a specific disorder.


Four theory types of eating disorders:




more and more evidence is stacking up in favor of a biological cause for some eating disorders-- specifically Bulimia and Anorexia. Several hormones are getting attention from researchers but findings are still unclear. But one neurotransmitter, Serotonin, is becoming a more and more likely suspect in the cause of most eating disorders, especially anorexia and bulimia. The bottom line is that the evidence is moving toward, and not away, for at least a partial neurobiological cause in eating disorders.

**Eating disorders are not considered specific disease but are syndromes. (A group of symptoms)


Psychological theories--

Once the strongest these models now represnet some of the weakest based on study results, theroires about eating disorder. one theory that confiction about sexual roles played a part in eating disorders has never been proven.
The currently accepted psychopathology in eating disorders is low self esteem and doubts about self worth.
*Bottom line is that these theories are expected to play a significant role but currently are not proven.


Sociocultural Theories:

The idea in the western world that the thinner a woman is the more desirable she is has been around for decades, not centuries.
Thin is in.
Leslie Hornby or "Twiggy" started this.
Prior to this, Marilyn Monroe was the ideal woman.
In cultures where the pressures to be thin do not exist, eating disorders are very rare.
**Culture has played a large role in the increase of eating disorders in the US and Western countries since the 60s


Genetic Theories:

At one time a genetic link to eating disorders was considered unlikely. now the evidence is clear that there is a strong link in all eating disorders.
studies on twins and studies on families of anorexics and bulimics have revealed strong genetic links to these disorders
The most study is done on genetic links to eating disorders the stronger the evidence becomes that genetics plays a major role.


Characteristics of Anorexia and Bulimia:

fear of weight gain
both have body image distortions
low self esteem issures
both have high incidence of depression
both are more prevalent in metro areas than rural areas
both affect about the same percentage of females vs males.(9-1 female)


S&S of Anorexia:

extreme weight loss
thin appearance abnormal blood counts (anemia and leukopenia)
dizziness or fainting
blue discoloration of fingers
brittle nails (decrease protein intake)
hair that thins, breaks or falls out
soft, downy hiar covering the body (lanugo)
absence of menstration
dry skin
intolerance of cold
irregular heart rhythms (electrolytes)
low blood pressure
swelling of arms/legs (decreased albumin)


Bulimia Nervosa S&S:

feeling that you cant control eating behavior
eating until the point of discomfort/pain
eating much more food in a binge episode than normal meal.
self induced vomiting after eating
exercising excessively
misuse of laxatives, diuretics, or enemas
being preoccupied w body shape & weight
going to BR after eating or during meals
abnormal bowel funcitoning
damaged teeth andgums
sores in throat and mouth
irregular heartbeat
sores, scars or calluses on the knuckles or hands
menstrual irregularitites or loss of menstraution
depression and anxiety.


Bulimia is categorized in two ways:

purging and non purging


Purging bulimia:

regularly engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas to compensate for binges.


Non purging bulimia:

use other methods to rid yourself of calories and prevent weight gain, such as fasting or over exercising.


Milieu Therapy for anorexia and bulimia:

with interdisciplinary approach is the best approachfor bulimics and anorexics.
milieu means controlled or inpatient environment with a team of HCPs that usually include psychiatrist, psychologist, or therapist, nutritionist, nurses, and possibly other therapists.
best that the client is treated in a unit or clinic specializing in eating disorders



fear eating
co morbidity w clinical depression
increased among teenage girls and have been for 5 decades.
increased males in the past 2-3 decades
drug therapy alone is not effective
therapy is postponed in clients in clinical crisis until IBW (ideal body weight) is reached a certain minimum.



Don't fear eating the enjoy it, but panic if they cannot purge.
co morbidity w clinical depression
increased among teenage girls and have been for 5 decades.
increased males in the past 2-3 decades
drug therapy alone is not effective
therapy is postponed in clients in clinical crisis until IBW (ideal body weight) is reached a certain minimum.


Medical care for eating disorder clients in crisis:

first focus is the clients physical well being.
suicide precautions are routine on admission.
*remove shoelaces, nothing sharp, no meds in room.
resoting weiht to a more normal level is a first priority.


Complications to watch for during medical care phase of treatment.

observe for signs and symptoms of electrolyte imbalances
heart arrhythmias
low BP
check if cold. provide extra blankets
re-feeding syndrome- a rare but serious complication seen in victims of starvation when they start to feed


Re feeding syndrome:

rare in clinical settings. occurs in clients who are starved or severely malnourished.
usually occurs in four days or less from starting of feeding.



severe bradycardia

due to electrolyte monitoring and carefully regimented feeding, this syndrome is extremely rare in the clinical setting


Read med complications!

box 17-1 p 304
box 17-2 criteria for admission of clients with eating disorders
review 17-1 pp. 302-303


Binge eating (Compulsive overeating):

The main difference in binge eating disorder whis is now classified as a NOS, and anorexia and bulimia is the binge eater attempts no compensating measures such as purging, laxatives, or excessive exercising.


Characteristics of binge eating:

frequent episodes of uncontrollable binge eating
feeling extremely distressed or upset during or after bingeing
no regular attmepts to "make up" for the binges through vomiting, fasting, or over-exercising


Binge eating treatment:

cognitive behavioral therapy
interpersonal psychotherapy
dialectical behavior therapy


cognitive behavioral therapy-

focuses on the dysfuncitonal thoughts and behaviors involved in binge eating. One of the main goals to become more self aware of how food is used to deal w emotions. your therapist may ask you to keep a food diary or a journal of your thoughts about eating, weight, and food.


interpersonal psychotherapy-

focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. your therapist will also help you improve your communication skills and develop healthier relationships with family members and friends.


dialectical behavior therapy-

combines cognitive behavioral techniques with meditation. The emphasis is on teaching binge eaters how to accept themselves, tolerate stress better, and regulate their emotions. your therapist will also address unhealthy attitudes you may have about eating, shape, and weight.


Drugs used in treatment of binge eating disorder:

*Drugs must be in conjunction with therapy. As in other disorders they ineffective alone.
useful in treating the depression associated with binge eating disorder
best effective treatment is combined medical and psychological regimen.
effective meds include Paxil, Prozac, and Zoloft.
with proper therapy a high percentage recover.


Signs of emotional eating:

using food to:
fill a void in your life
feel better or cheer yourself up
calm down or soothe your nerves
escape from problems
cope with stress and worries
reward yourself


causes of binge eating and compulsive overeating:

social and cultural



researchers have also found a genetic mutation that appears to cause food addiction. There is evidence that low levels of the brain chemical serotonin play a role in compulsive eating


social and cultural-

some parentsunwittingly set the stage for binge eating by using food to comfort or reward their children. children exposed to frequent critical comments about their bodies and weight are also vulnerable. sexual abuse in childhood has been linked to some cases.



depression and binge eating are strongly linked. There is evidence that low self-esteem, loneliness, and body dissatisfaction are involved in compulsive overeating.


Eating disorder not otherwise specifed (NOS)

simply a method to classify an eating disorder that does not meet the full criteria for a spevific disorder.
read 306--book gives six examples. ignore number six... it is unclear.


physical effects of long term binge eating and obesity.

type two diabetes*
gallbladder disease
high cholesterol
high blood pressure*
heart disease*
certain types of cancer
joint and muscle pain
gastrointestinal probs
sleep apnea



refers to body weight that is at least 10 percent over the recommended weight for a certain individual. BMI over 25***
Obesity is generally defined as a BMI >30


cause of ovesity:

simple obesity comes from consuming more calories than the body needs. THe cause is usually a sedentary life style or eating a diet high in fats and calories or both.


Treatments for obesity:

medication-- currently there are two broad classifications of medications for obesity. long and short term.


Long term--

lipase inhibitors--prevent fat breakdown by inhibiting lipase production.

Orlistat generic form which is marketed as Xenical.


short term medicaitons--

there are several.
OTC-many are available. many contain ephedrine.
Ephedrine is not proven safe for the treatment of obesity.*
Important to note that there are serious side effects associated with this weight loss treatment.*



Obesity surgery is recommended as an option in the treatment of obesity onely for patients with eithera BMI of more than 40 or BMI of 35-39.9 when other serious obesity related conditions are present.
death rate from obesity surgery is 1-200
clients with severe obesity need a medical work up from an endocrinologist.