Eating Disorders

Question 1

What are the four eating disorders?

Answer 1

1) Anorexia Nervosa
2) Bulimia Nervosa
3) Binge-Eating Disorder
4) Unspecified Eating Disorder

Question 2

What is the diagnostic criteria for anorexia nervosa?

Answer 2

1. Restriction of food that leads to being significantly underweight (based on BMI)
2. Intense fear of weight gain –> preoccupied with body weight
3. Body image disturbance –> belief of being overweight

Question 3

For adults and children what is the BMI number for anorexia?

Answer 3

Adults –> BMI less than 17
although grey zone is between >/= 17 but around 18.5

for children 2-18 y.o –> anorexic if BMI is less than 5th percentile

Question 4

There are two subtypes of Anorexia, name the two

Answer 4

1) Binge-eating/purging type —>binge and/or purge with laxatives or enemas
2) Restricting type –> does not binge or purge (basically starving themselves)

Question 5

When do eating disorders typically start?

Answer 5

Adolescence

Question 6

Which disorder is considered the most deadly mental disorder?

Answer 6

Anorexia Nervosa

again because they are simply not eating

Question 7

What are some indicators of excessive thinness ?

Answer 7

1) Low BMI
2) Amenorrhea and loss of sex drive
3) Constipation
4) Hypothermia and Lanugo (neonatal hair)
5) Hypercholesterolemia (>300)

Question 8

What are some indicators of excessive vomiting?

Answer 8

1) Russell’s Sign –> calloused knuckles due to use for vomiting
2) Dental Enamel Erosion
3) Chipmunk Cheeks –> salivary gland inflammation
4) Subconjunctival hemorrhage (pressure from vomiting)
5) Hypokalemia –> electrolyte imbalance

Question 9

Why does someone become anorexic?

Answer 9

1) Psychological and Social Factors
* Weight loss is reinforced (internally and externally)
* Means of controlling one’s own life
* cultural pressures
2) Biological Factors
* genetic susceptibility (this goes beyond imitating behavior, actually inheriting biochemical alterations for obsessiveness and then environment channels the obsession)

Question 10

What are the treatments for anorexia?

Answer 10

1) In patient hospitalization –> behavioral techniques to encourage weight gain
2) Psychotherapy –> CBT –> changing the way they think and act
3) Pharmacological –> no drug is consistently effective for anorexia

Question 11

The next eating disorder is Bulimia Nervosa, what is the diagnostic criteria?

Answer 11

1. Recurrent binge eating
2. Recurrent inappropriate compensatory behavior for binge –> (purging or non purging)
3. Binge/inappropriate compensatory behaviors must occurs >1/week for 3 months
4. Self-evaluation is unduly influenced by body shape and weight

Question 12

What is the definition of a binge?

Answer 12

Eating a large amount in a discrete period

Eating is out of control during the episode

Question 13

Are there subtypes of Bulimia?

Answer 13

NO

Question 14

So what is the difference between bulimia and anorexia if they both can involve binging and purging??

Answer 14

Weight!
Bulimics typically have normal body weight or slightly overweight
Anorexics are underweight

Question 15

Can an individual be both anorexic and bulimic?

Answer 15

of course not

but usually have it at different times

Question 16

What are the etiology factors for bulimia?

Answer 16

Psychological and Societal Factors

Biological Factors

Question 17

What are treatments for Bulimia?

Answer 17

Patient usually initiates treatment
outpatient based
CBT
Antidepressant medications may be useful in adjunct

Question 18

Do bulimics or anorexics have greater motivation to change?

Answer 18

Bulimics

Question 19

The next eating disorder is Binge Eating Disorder (BED), what is the diagnostic criteria?

Answer 19

1. Binge Eating –> at least 1/week for 3 months
2. Binging is associated with behaviors such as: rapid eating, eating until uncomfortably full
3. No inappropriate compensatory behavior

Question 20

Is BED associated with obesity?

Answer 20

yes (BMI >- 30)

Question 21

What are the treatments for BED?

Answer 21

CBT

Antidepressants

Question 22

What are the SCOFF questions?

Answer 22

S: Sick ( induce vomiting?)
C: Control ( lose control?)
O: (1 stone weight loss in 3 months?) 14.4 lbs or 6.5kg
F: FAT ( believe fat?) 
F: Food ( food dominates?)

yes to >/= 2 of these suggests an eating problem

Question 23

What is an unspecified eating disorder?

Answer 23

subclinical eating problems (ex. normal weight but purging)