Feeding & EaƟng / Wake-Sleep Disorders Flashcards
(32 cards)
What are the main diagnostic features of Anorexia Nervosa?
Significantly low body weight
Intense fear of gaining weight
Distorted body image or denial of seriousness
Subtypes: Restricting type or binge-eating/purging type
What are the main diagnostic features of Bulimia Nervosa?
Recurrent binge eating
Compensatory behaviours (e.g., vomiting, laxatives)
Occurs at least once/week for 3 months
Self-worth overly tied to body weight/shape
Not during episodes of anorexia nervosa
What are the two subtypes of Anorexia Nervosa?
Restricting Type – Weight loss through diet, fasting, or exercise; no regular bingeing/purging.
Binge-Eating/Purging Type – Regular binge eating or purging while maintaining significantly low body weight.
What key questions should you ask to differentiate between Anorexia Nervosa and Bulimia Nervosa?
Ask about body weight, binge eating frequency, purging behaviours, food restriction, body image, and fear of weight gain.
Anorexia involves low body weight, Bulimia involves recurrent binge/purge episodes at normal weight.
What is Body Mass Index (BMI) and how is it calculated?
BMI is a measure of body fat based on a person’s weight in kilograms divided by height in meters squared. It’s used to classify underweight, normal, overweight, and obesity.
Formula: BMI = weight (kg) ÷ height (m²)
What are some major medical complications of Anorexia Nervosa?
Amenorrhea
Caused by low estrogen levels, often due to significant weight loss and hormonal disruption.
Osteoporosis
Results from inadequate dietary calcium and hormonal imbalances.
Leads to increased risk of fractures.
Kidney Damage
Due to dehydration and laxative abuse, especially in the binge-purge subtype.
Heart Arrhythmias
Irregular heart rhythms, often due to electrolyte imbalances (like low potassium).
Hypotension
Low blood pressure is common with starvation and dehydration.
Anemia
A result of nutritional deficiencies, especially iron.
Death (Approx. 15% of patients)
Often from severe malnutrition or suicide, making it one of the most fatal psychiatric disorders.
How do you differentiate between Bulimia Nervosa and Binge-Eating Disorder?
Bulimia includes binge eating + compensatory behaviours (e.g., vomiting).
BED involves binge eating only, with no purging or compensatory behaviours.
Bulimia often occurs at normal weight; BED is more often linked to obesity.
Both involve distress and loss of control, but body image concerns are more severe in bulimia.
What are some medical and behavioral complications of Bulimia Nervosa?
Medical:
Tooth erosion, salivary duct blockage, pancreatitis
Potassium loss → weakness, heart arrhythmias
Esophageal rupture, stomach distress, irregular periods
Behavioral:
Substance abuse (30–70%)
Impulsive behaviours: promiscuity, self-harm, theft
What is Cyclic Vomiting Disorder, and how does it differ from Bulimia Nervosa?
CVS involves repeated, sudden bouts of vomiting separated by normal periods, often with no psychological cause. It differs from bulimia in that vomiting is not self-induced and there are no body image disturbances or binge episodes.
What sociocultural, biological, and psychosocial risk factors contribute to the onset of anorexia nervosa?
Sociocultural: Thin-ideal pressure, media influence, family focus on appearance
Biological: Genetic predisposition, anxiety traits, perfectionism
Psychosocial: Low self-esteem, need for control, stress, emotional conflict (e.g., family issues)
What are the main treatment options for Anorexia and Bulimia Nervosa, and how do you determine the level of care needed?
Treatment options: Outpatient therapy (CBT, FBT), IOP, residential treatment, inpatient hospitalization.
Level of care depends on: Medical stability, psychiatric risk, motivation, support system, and severity of disordered behaviours. Medical crisis or suicidality requires inpatient care; stable but struggling patients may benefit from IOP or residential support.
How do you differentiate between Pica and Prader-Willi Syndrome?
Pica: Eating non-food items (e.g., dirt, hair), not related to hunger, no genetic basis.
Prader-Willi Syndrome: Genetic disorder causing insatiable hunger, food hoarding, obesity, and developmental issues.
Pica involves non-nutritive consumption; PWS involves compulsive overeating due to lack of satiety.
What is Anorexia Athletica?
A condition involving compulsive exercise and dietary restriction to improve athletic performance or appearance; may lead to health risks and overlaps with anorexia nervosa.
What is Muscle Dysphoria?
A form of body dysmorphic disorder where individuals, often males, obsess about being too small or under-muscled, leading to excessive workouts and dietary control.
What is Orthorexia Nervosa?
An unhealthy obsession with eating only “pure” or “healthy” foods, often causing malnutrition, rigidity, and social avoidance. Not primarily about weight loss.
What are the potential consequences of poor or insufficient sleep?
Cognitive: Memory problems, poor focus, slower reactions
Emotional: Increased anxiety, irritability, and depression risk
Physical: Weakened immunity, heart disease, weight gain, insulin resistance
Functional: Accidents, impaired performance, disrupted circadian rhythm
What features do all dyssomnias have in common?
All dyssomnias involve problems with sleep quantity, quality, or timing, cause distress or impairment, and are not due to another condition. They include difficulty falling asleep, excessive sleepiness, or irregular sleep schedules.
What does the word apnea mean, and in which sleep disorder is it present?
Apnea means temporary cessation of breathing, and it is the key feature of sleep apnea disorders, especially Obstructive Sleep Apnea (OSA) and Central Sleep Apnea.
What is the typical order of sleep stages during a normal sleep cycle?
N1 → N2 → N3 (deep sleep) → REM, then the cycle repeats (usually 4–6 times per night).
What happens during each sleep stage?
N1: Lightest sleep; easy to wake.
N2: Light sleep with body temperature drop and sleep spindles.
N3: Deep (slow-wave) sleep; physical recovery, immune support.
REM: Active brain, vivid dreams, emotional and memory processing
Which sleep disorders are associated with weight issues, and how do they affect sleep stages?
Obstructive Sleep Apnea (OSA): Linked to obesity; disrupts N3 and REM with repeated awakenings and poor rest.
Night Eating Syndrome (NES): Seen in overweight individuals; leads to fragmented sleep with more N1 and N2, and less N3.
Insomnia (from obesity/dieting): May cause difficulty falling asleep, frequent awakenings, especially during REM.
Hypersomnolence Disorder: Sometimes co-occurs with obesity; involves excessive time in N2 and N3, but sleep feels non-refreshing.
What is cataplexy and why does it occur in narcolepsy?
Cataplexy is a sudden loss of muscle tone while awake, often triggered by emotion. It occurs in narcolepsy due to REM sleep paralysis mechanisms intruding into wakefulness, causing muscle atonia even though the person is conscious.
What is a circadian rhythm, and how long does it last?
A circadian rhythm is the body’s internal 24-hour clock that regulates sleep, hormones, and body temperature. It naturally runs slightly longer than 24 hours and is reset daily by light.
What can disrupt circadian rhythms?
Light exposure at night, shift work, jet lag, sleep disorders, substance use, and irregular sleep schedules.
