Eating Disorders* Flashcards
Perception that a person has of their physical self and the thoughts and feelings as a result
Influenced by individual and environmental factors
body image
What factors make up body image?
perception “how we see ourselves”
affective “how we feel about how we look”
cognitive “our thoughts and beliefs about our body” behavioral “what we do in relation to how we look”
Chronic negative perception of one’s body is strongly tied to ____
body dissatisfaction
developed countris emphasize thin body type for females, lean/muscular types for men
Bigger issue in high-income countries: US, european countries, australia/new zealand
What makes body dissatisfaction different from an eating disorder?
Morbid fear of weight gain
Idea that one cannot be too thin that overrides all other interests and affairs
What are risk factors for body dissatisfaction (10)?
Age (late childhood/adolescence)
Female
Low self esteem
Perfectionism, high achiever, anxiety, black and white world views
Appearance teasing
Activities with emphasis on thinness (ballet, modeling, athletics)
Frequent dieting for weight loss or high body image concerns expressed around patient
Larger body size
Homosexuality in males
Acculturation in Western Society
What are biological risk factors for body dissatisfaction?
Possible genetic link
Anorexia = disturbances in serotonin, dopamine, and norepinephrine
bulimia = differences in serotonin
difficulty recognizing hunger and satiety
what are commonly associated psychological problems with body dissatisfaction (7)
obsessive-compulsive
anxiety/social anxiety disorder
depression
low self-esteem
phobias
body dissatifaction
body dysmorphic disorder
what are family factors involved in body dissatisfaction (5)?
enmeshed parenting
conflict-avoidant families
inflexibility
push for success
family members with body dissatisfaction or poor eating habits
rigid, controlling, organized family typically fits with which eating disorder
Anorexic
chaotic, critical, conflicted family fits with which disorder
bulimic/BED
what are sociocultural risk factors for body dissatisfaction?
western society ideals
Social feedback based on physical traits–> positive or negative adjustment of self-image
How are eating disorders related to parenting other than modeling?
Ineffective parents don’t respond appropriately to child’s needs ie feeding during anxiety vs hunger which interferes with self-ability to accurately identify hunger vs emotions
Eventually causes abnormal eating habits
what are cognitive risk factors for eating disorders?
- thought that only thing that matters is body image
- feelings that if not thin reflects on personal traits
- mistrust for comparisons of appearance
- often ignore or have difficulty accepting objective evidence of body state
How do you determine normal vs abnormal eating?
Patient’s weight
Health status
Body perception
Up to 80% of the population is dieting at any given time
40% of 9 year old girls have dieted
What are screening tools for eating disorders?
SCOFF questionnaire, ESP questionnaire, EAT form, PHQ form
When does avoidant/restrictive food intake disorder typically begin?
Infancy or early childhood and may persist into adulthood
Classic presentation of avoidant/restrictive food intake disorder?
Underweight child (average BMI-16)
decreased bone mineral density
comorbid anxiety (60%)
comorbid general medical disorder (50%)
What criteria must a patient have in order to be diagnosed with avoidant/restrictive food intake disorder?
Avoiding or restricting food intake
* due to lack of interest or sensory characteristics, or aversive experience
Persistent failure to meet nutritional or energy needs, as manifested by at least 1 of the following:
* clinical significant weight loss, poor growth or failure to achieve expected weight gain
* Nutritional deficiency
* oral supplements or enteral feeding required to achieve adequate nutrition
* impaired psychosocial functioning
Not due to lack of food or culturally restrictive practice, not due to general medical condition
What is epidemiology of anorexia nervosa?
Lifetime .6%
More common in women
Bimodal peak onset: early adolescence (12-15)
Late adolescence/early adulthood (17-21)
Average age at onset 18 y/o
Classic patient: adolescent white female
What are clinical findings of anorexia nervosa?
- Restricted energy intake –> low body weight
- Intense fear of weight gain, or persistent behavior preventing weight gain
- Distorted perception of weight, undue influence of weight on self-worth, or denial of the medical seriousness of low weight
- Abnormal food behaviors
- Behavioral disturbances