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Eating Disorders Flashcards

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1
Q

anorexia nervosa - DSM

A

pretence preoccupation with what is put into their body
restriction of energy intake relative to requirements, leading to significantly low body weight (for age, sex, height)

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2
Q

how is anorexia nervosa assessed

A

using BMI charts

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3
Q

mild anorexia BMI

A

> 17

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4
Q

moderate anorexia BMI

A

16- 17

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5
Q

severe anorexia BMI

A

15-16

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6
Q

extreme anorexia BMI

A

<15

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7
Q

what are the symptoms of anorexia nervosa

A

intense fear of weight gain or becoming overweight
behaviour which interferes with weight gain despite being underweight
distorted self image
lack of recognition of seriousness of the low weight

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8
Q

subtypes of anorexia

A

restricting
binge-purging

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9
Q

anorexia - restricting

A

dieting to limit calorie intake

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10
Q

anorexia - binging/purging

A

purging to limit calorie intake
includes compensatory behaviours (excessive exercises, laxatives etc)

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11
Q

anorexia and body image distortions

A

overestimate their weight more than other people

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12
Q

anorexia and thigh circumference distortion

A

overestimated by 30%

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13
Q

prevalence of anorexia nervosa

A

~1%

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14
Q

anorexia nervosa and sex differences

A

10x more common in females

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15
Q

anorexia nervosa and age of onset

A

adolescence
- critical period for brain development where people are gaining independence

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16
Q

anorexia nervosa and mortality rate

A

highest of any psych disorder

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17
Q

outcomes from restrictive eating

A

anaemia
bone and muscle loss
hair loss
lanugo
infertility (menstrual cycle shuts down)
kidney problem
electrolyte imbalance
arrhythmias
suicide

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18
Q

criteria of bulimia nervosa

A
  • recurrent episodes of binge eating
  • recurrent inappropriate compensatory behaviours to prevent potential weight gain
  • at least 1x a week, for 3 months
  • self evaluation is unduly influenced by body image
  • not better explained by anorexia nervosa
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19
Q

binge eating episodes explained

A

eating amount of food larger than most would eat in similar time-period, and circumstances
sense of lack of control over eating

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20
Q

compensatory behaviours explained

A

vomiting
diuretics/laxatives
fasting
excess exercise

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21
Q

lifetime prevalence of bulimia nervosa

A

~1-2%

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22
Q

bulimia nervosa and sex differences

A

90% of patients are females

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23
Q

bulimia nervosa and age of onset

A

adolescence

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24
Q

bulimia nervosa and weight

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A

most are normal or overweight

25
bulimia nervosa and recovery rate
75% prognosis
26
side effects of bulimia nervosa
erosion of dental enamel electrolyte imbalance kidney failure cardia arrhythmia seizures intestinal problems colon damage
27
binge eating disorder - DSM criteria
recurrent and persistent episodes of binge eating marked distress regarding binge eating absence of compensatory behaviours
28
criteria - 3 feelings which are associated with binge eating episodes
eating much more rapidly than normal eating until feeling uncomfortably full eating large amounts of food when not feeling phsyically hungry eating alone due to being embarassed about amount of food eaten feeling disgusted with self, depressed, guilty after overeating
29
prevalence of binge eating disorders
up to 4.7%
30
binge eating disorder and sex differences
somewhat more common in females
31
binge eating disorder and age of onset
adolescence
32
binge eating disorder and weight
most patients are obese (BMI >30)
33
side effects of binge eating disorder
obesity type 2 diabetes cardiovascular problems back pain joint issues sleep related breathing issues anxiety IBS
34
criticisms of EDs
patients thought to be vain behaviours are thought to be personal choice irresponsible, lack of self care
35
genetic link for anorexia nervosa
28-74% of variance explained
36
first degree relatives relative risk for anorexia
11x
37
genetic link with bulimia nervosa
54-83%
38
first degree relatives risk for bulimia
4.4-9.6x RR
39
shared risk between EDs
high risk of anorexia in first degree relatives of bulimia patients high risk of bulimia in first degree relatives of anorexia
40
brain structure and anorexia nervosa
reduced grey matter but effects are mostly reversible confounded with acute starvation
41
brain structure and binge eating disorder
reduced volume in orbitofrontal cortex and caudate lower volumes in areas linked to failures in goal directed control
42
predisposing cognitive behaviour factors for anorexia
negative emotion perfectionism drive for thinness altered interoceptive awareness obsessive compulsive personality
43
what is altered interoceptive awareness
extent to which you can identify the signals in your own body (e.g. hunger)
44
cognitive behavioural factors with altered interoceptive awareness with binge eating and bulimia
closely linked to momentary stress, mood reactionary to natural fluctuations in stress over time impulsive stimulus response associations
45
social factors and EDs
increased rapidly since the 1970s cultural shifts in the "weight ideal"
46
cultural comparisons of anorexia nervosa
does not always include fear of becoming fat (mostly seen in western cultures)
47
social media and ED behaviours
increases in laxative use 3x, vomiting 3x or higher
48
2 tiered approach for anorexia treatment
weight restoration long term maintenance of weight gain
49
weight restoration - anorexia nervosa treatment
risk of death first resolved food is medicine hospitalisation is common sometimes feeding tubes
50
long term maintenance of weight gain - anorexia nervosa
psychoeducation - understanding not alone, symptoms common, it is a condition behavioural and cognitive interventions family based therapy
51
behavioural and cognitive interventions - anorexia nervosa
body image triggers addressing dietary restraint
52
why does family based therapy work for anorexia nervosa
due to extreme independence and intensity of familial interactions contributing to ED
53
maudsley method - anorexia nervosa
achieving weight gain under parental direction parents coached on re-feeding and identifying problem areas (making demands, anger etc) focus on separating illness and patient - reduces blame and stigma establish age appropriate independence around food choices and weight
54
effectiveness of family based therapy for anorexia
90% of patients symptom free at 5 year followup
55
overall goal of treating bulimia nervosa
develop healthy eating patterns
56
psycho-education for treating bulimia nervosa
normal weight can be achieved without extreme restriction having unplanned snack is not catastrophe unrealistic food restriction can trigger binge challenge societal standard about ideal weight/shape
57
medication and anorexia
antidepressants help with the comorbid depression and anxiety but no medication helps with dieting and restrictions
58
medication and bulimia and BED
- antidepressants are effective - anti-epileptic medication may also be helpful for reducing bingeing and purging (via decreased appetite)

TCD (17 decks)

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