Eating Disorders Flashcards
What is a purge?
Use of vomiting, laxatives, diuretics or enemas to eliminate calories
What is a. Binge?
- Eating a large amount within a discrete period (I.e. an amount “definitely larger than most people would eat under a similar circumstance”)
- eating is out of control during episode
What are the types of eating disorders?
- Anorexia nervosa
- Bulmia nervosa
- Binge-eating disorder
- Unspecified eating disorder
What are the diagnostic criteria of Anorexia Nervosa?
- Restriction of food that leads to a person being significantly underweight
- underweight is defined as having a body mass index under 18.5 kg/m^2 - Intense fear of gaining weight(evidenced by extreme preoccupation, frequent assessment, behaviors that interfere with weight gain etc.
- Body image disturbance(eg.g. Belief of being overweight, denying seriousness of low weight)
Behavior last Over 3 months
What is the normal. BMI range?
18.5 -24.9 kg/m^2
Give the classifications of anorexia nervosa
Mild- BMI range =17-18.49 kg/m^2
Moderate- BMI range= 16-16.99 kg/m^2
Severe- BMI range= 15-15.99
Extreme- under 15
What are the anorexia nervosa subtypes?
Based on recent behavior
- Binge-eating/purging type:
- If the person recurrently binges AND/OR purges
- Restricting type:
- The person does NOT recurrently binge or purge
- Weight loss is maintained through dieting, fasting +/- over exercising
Explain the epidemiology of anorexia nervosa
-over 90% of affected persons are females however, the prevelance data for males is scarce
- Onset: bimodal(average 17 years)
- early adolescence(12-15 years)
- late adolescence and early childhood (15-21 years)
Interests/occupation:
- Modeling, beauty competitions
- Gymnastics
- Ballet dancing
- Wrestling
What are the psychological/social factors of Anorexia Nervosa?
- cultural pressures to be thin
- Difficulty establishing autonomy from parents during adolescence ( a “control” issue)
- Perfectionist trait
- Low self-esteem
- Difficulty resolving conflicts
- Difficulty communicating negative emotions
What are the biological factors of anorexia nervosa?
- Genetic susceptibility to anorexia
- A person may inherit biochemical alterations that leads to obsessiveness
- Cultural pressures may direct the obsessiveness to body image
What are the eating rituals of someone with anorexia nervosa?
- complain of distaste for food
- Fear of eating in public
- Obsessed with food —> hoard food, collect recipes, involved in elaborate food perpetration, food related professions (waitress, cook, dietician, nutritionist)
What are the physical consequences of anorexia nervosa?
- Amenorrhea, loss of sex drive,bconstioation
- low heart rate, low blood pressure and low temperature
- hair loss
- Lanugo
- dry skin, brittle nails
Many possible medical complications: (hormone deficiency, organ failure, brain changes) with approximately 20% mortality rate
How is anorexia nervosa treatment usually initiated?
A patient is usually not self-refferred, since anorexia tends not to distress patient
Treatments is typically family initiated
How can anorexia nervosa be treated by in-patient hospitalization:
- weight gain is the immediate goal for in-patient care
- Combined with behavioral principles (e.g. operant conditioning) to encourage weight gain
- An attendant often supervises the patient to thwart attempts to lose weight
How can CBT be used to treat anorexia nervosa?
- In patient or out patient
- it is an essential component of treatment
- used to change the patient’s attitude about food and weight and learn how to break destructive eating habits
How can Pharmological therapy be used in treatment of anorexia nervosa?
-No FDA approved drug for treating anorexia
-Common off labeled drugs prescribed are:
Antidepressants (SSRI)
Appetite stimulants
-They are usually ineffective
What is the general outcome of anorexia nervosa?
- There is good short term response to in-patient treatment in a controlled environment
- Although short-term treatment may be effective, long term prognosis tends to be poor after patients are released home
What are the diagnostic criteria of bulimia nervosa?
- Recurrent binge eating
- Recurrent inappropriate compensatory behavior for binge
- purging(e.g. vomiting, laxatives, diuretics, enemas)
- Non-purging (fasting and/or excessive exercise
- The binge/inappropriate compensatory behaviors must occur more than 1 time per week fir 3 months
- Self-evaluation is unduly influenced by body shape and weight
What are the Bulimia Nervosa clarifications?
Mild- 1-3 (number of compensatory behaviors per week)
Moderate- 4-7 (number of compensatory behaviors /week
Severe- 8-13(number of compensatory behaviors/week)
Extreme- 14 or more (number of compensatory/week)
What are the features of bulimia nervosa?
There are no subtypes go bulimia nervosa
Persons typically have a BMI in the normal range or are slightly overweight
Normal BMI= 18.5 - 24.99
Give the epidemiology of Bulimia Nervosa
-More than 90% of persons with bulimia nervosa are women
Onset:
- average age of onset: 19-20 years
- After failed dieting attempts
Occupations:
- Modelling, beauty competition
- gymnastics
- ballet dancing
- wrestling
What are the psychological/social contributing factors of bulimia nervosa?
- societal pressures to bd thin +/- a means to improve self-esteem
- Strict dieting results in a broken diet and impulsivity, “all or none” eating (I.e. binging )
- fear of weight gain after binge leads to inappropriate compensatory behavior
What are the biological contributing factors of bulimia nervosa?
A person may inherit biochemical changes(low serotonin) that leads to impulse control problems
What are the physical consequences of bulimia nervosa?
- electrolyte imbalance
- irregularity in heartbeat
- consequences of excessive vomiting
