Eating disorders

Question 1

How common are eating disorders? And who is usually affected?

Answer 1

90% female
5 to 10 million girls and women
Anorexia Nervosa .5-1% of females 13-35
Bulimia Nervosa 2-5% of females 13-35
Industrialized countries

Question 2

Characteristics of anorexia nervosa

Answer 2

Low body weight (

Question 3

Characteristics of bulimia nervosa

Answer 3

Recurrent binge-eating:
Unusually large amount offood (by social comparison) in a short amount of time
Feeling out of control

Compensatory behavior:
Vomiting
Laxative abuse
Excessive exercise
Fasting

Extreme focus on shape/weight

Question 4

What psych disorder has the highest mortality rate?

Answer 4

Anorexia

High risk of suicide (30% of deaths), dying from anorexia itself (19% of deaths), cancer (11%)

Question 5

When do 90% of women with an eating disorder develop it?

Answer 5

12-25

Question 6

Biological predisposing factors for an eating disorder

Answer 6

Family history of eating disorders orchemical dependency

Mood disorder, anxiety or depression

Traits/Temperament

Increased BMI prior to onset

Early onset puberty

Cognitive lags—set shifting/integrating complexity

Question 7

Predisposing environmental factors for an eating disorder

Answer 7

Go fast, highly competitive academic/social environment

Dieting culture—war on obesity

High risk sports/industry

Family history of severe dieting/exercise

Family constellation—enmeshed/disengaged

Question 8

What are common precipitants to an eating disorder?

Answer 8

Almost always an internal or external experience of being out of control:

Onset of puberty between the ages of 11-14, i.e. four years the average young women gains 40 pounds with a disproportionate fat ratio

Major transitions—separation/individuation/identity

Traumatic events—abuse/rejection/failure

Family difficulty—divorce /disengagement

Onset of co-morbid illness—anxiety/depression

Innocent weight loss—increased exercise/performance enhancement

Question 9

Genes and eating disorders

Answer 9

NOT a disease of choice!

Gene – environment interaction

EDs are familial illnesses
–12 x risk for AN and 4 x for BN

Heritability estimates:
–50-80% genetic influence
–Unique experiences but not shared experiences

What is inherited?
–Temperamental traits
–Co-morbid anxiety, depression, OC tendencies

Question 10

Temperament in anorexia nervosa

Answer 10

Harm avoidant

Neurotic

Obsessional

Anxious

Reward dependent

Perfectionistic

Low novelty seeking

Abysmal self-esteem

Question 11

Temperament in bulimia nervosa

Answer 11

Harm Avoidant

Neurotic

Obsessional

Perfectionistic

Anxious

Low self-esteem

Higher novelty seeking

Impulsive

Affective dysregulation