eating disorders

Question 1

gender differences (EDs)

Answer 1

occur primarily in women – estimates 3 females for every male has an ED
- gender bias in DSM = men less likely to recognize they have an ED & often misdiagnosed

Question 2

diagnostic crossover (EDs)

Answer 2

very likely for someone with one ED to be later diagnosed with another
- bidirectional transitions between 2 subtypes of anorexia
- shifts from ana to bul also common – but no direct transition from RA to bul
- also no crossover from RA to BED, but bul to BED occurs

Question 3

comorbidity of EDs

Answer 3

depression (all eds)
OCD - ana & bul
substance abuse - BPA, bul & BED
self-harming
anxious-avoidant personality disorders - RA

Question 4

anorexia nervosa

Answer 4

= an intense fear of gaining weight or becoming fat + behaviors that results in significantly low body weight
- many deny having a problem & deny the seriousness – become fulfilled by weight loss but make efforts to conceal thinness
2 subtypes: restricting anorexia & binge/purge anorexia

Question 5

anorexia age of onset

Answer 5

most likely to develop between ages 15 – 19

Question 6

anorexia prevalence

Answer 6

0.9% in women, 0.3% in men

Question 7

bulimia nervosa

Answer 7

= uncontrollable binge eating followed by efforts to prevent weight gain by using inappropriate behaviors (purging)
- difference between bulimia & BPA is weight – person with bulimia is not severely underweight

Question 8

bulimia age of onset

Answer 8

20-24 years

Question 9

bulimia prevalence

Answer 9

worldwide: 1%
US prevalence: 1.5% women, 0.5% men

Question 10

binge eating disorder

Answer 10

important difference from bulimia: after a binge a person with BED does not engage in in any form of inappropriate compensatory behavior
- much less dietary restraint
- associated with being over-weight
- age of onset: 30-50
- lifetime prevalence worldwide: 2%
- US prevalence: 3.5% women, 2% men
- physical consequences: obesity & the problems that come with it

Question 11

risk/causal factors - homosexuality (ED)

Answer 11

in men
gay & bi men have higher rates – bcuz they want to be attractive to men & they know men seek attractiveness in partners = more body dissatisfaction

Question 12

risk/causal factors - genetics (ED)

Answer 12

• tendency to develop ED runs in family
• both ana & bul are heritable disorders
• evidence for a gene on chromosome 1 being linked to RA
• Eds linked to regulation of serotonin

genetic factors may influence some of the traits that make people more likely to respond to pressures with disturbed eating

Question 13

risk/causal factors - brain abnormalities (ED)

Answer 13

• damage to frontal & temporal cortex linked to development of ana & bul
• temporal cortex involved in body image perception & parts of frontal cortex involved in monitoring pleasantness of smell & taste

Question 14

risk/causal factors - serotonin (ED)

Answer 14

modulates appetite & feeding behavior
- many ED patients respond well to antidepressants
- serotonin made from amino acid called tryptophan – only obtained from food & converted to serotonin

Question 15

medication in treating anorexia

Answer 15

antidepressants are sometimes used
olanzapine: an antipsychotic medication - provide benefits in the treatment of anorexia
- a desirable side effect is weight gain

Question 16

family therapy in treating anorexia

Answer 16

best treatment for adolescents - 10-20 sessions over 6-12 months, 3 phases
1. refeeding phase - therapist works w parents and supports efforts to help their child to eat healthily. family meals observed by the therapist
2. relationships phase - patient begins to gain weight, new patterns of relationships are made + family issues and problems addressed
3. termination phase - focus is on the development of more healthy relationships between patient and parents

Question 17

CBT in treating anorexia

Answer 17

• proven to be effective in treating bul - ana & bul share many features = often used to treat anorexia
• recommended length of treatment is 1-2 years
• major focus involves modifying distorted beliefs concerning weight and food + distorted beliefs about the self that may have contributed to the disorder

Question 18

medication in treating bulimia

Answer 18

antidepressants :
- patients taking antidepressants did better than patients given placebo
- usually a response within the first 3 weeks
- do not show early improvement = unlikely to benefit from further treatment on the same medication
- decrease the frequency of binges + improve patients’ mood and preoccupation with weight and shape

Question 19

CBT in treating bulimia

Answer 19

leading treatment for bulimia
- behavioral component = focuses on normalising eating patterns
- cognitive component = aimed at changing the cognitions and behaviours that initiate or perpetuate a binge cycle

Question 20

medication in treating BED

Answer 20

antidepressants, appetite suppressants, anticonvulsant medications

• high level of comorbidity between BED & depression = antidepressants sometimes used

Question 21

interpersonal therapy in treating BED

Answer 21

therapy sessions focusing on how interpersonal problems may cause binges (grief, interpersonal roles, interpersonal deficits)