Lecture 7 Flashcards
Eating Disorders and Obesity (40 cards)
What are some potential signs of an eating disorder
- excessive exercise
- preoccupation with feeling fat
- abnormal electrolyte levels
- intense fear of gaining weight
- unusually large intake of food
- anxiety around or avoidance of eating
What are the feeding and eating disorders
- Pica
- Rumination Disorder
- Avoidant/Restrictive Food Intake Disorder
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
What are the ABC Characteristics of Bulimia Nervosa
A) Recurrent episodes of binge eating. An episode is characterised by:
1. Eating a much larger amount of food than most people would in similar time and situation
2. A sense of lack of control over eating during the episode
B) Recurrent inappropriate compensatory behavior to prevent weight gain
C) The binge eating and inappropriate behaviors both
occur on average at least once a week for 3 months
D) Self-evaluation is influenced by body shape and weight
E) Disturbance does not occur exclusively during anorexia
**also need to specify if in partial remission or full remission, and also specify the severity (mild, moderate, severe, extreme)
What is the prevalence of Bulimia Nervosa
1% overal
1.5% for women
0.5% for men
What are some comorbid psychological disorders with Bulimia Nervosa
- 50%-70% have met criteria for a mood disorder at
some point - 80% have met criteria for an anxiety disorder at some
point, commonly PTSD, Social Phobia, or OCD - 25-30% attempt suicide, but rate of suicide is not
higher than the general population
What are key features of Bulimia Nervosa (not how its characterised, but more so things associated with the type of food consumed etc.)
- Binges may involve up to 4,800 calories
- Foods consumed are often high in sugar, fat, or
carbohydrates - Most individuals are within 10% of normal body weight
- Compensatory behaviors – designed to “make up for”
binge eating including purging (self induced vomiting, diuretics, laxatives) or non-purging (Excessive exercise, fasting or food restriction)
What are feelings commonly experienced among those with Bulimia Nervosa
Most are overly concerned with body shape, fear of gaining weight
- feelings of guilt, shame or regret are prevalent
What can be some consequences of Bulimia Nervosa
- Less lethal than anorexia nervosa BUT twice the
mortality rate found in comparably aged peers without
BN
Medical problems can arive from purging, including:
- Erosion of dental enamel, mouth ulcers
- Swollen salivary glands that lead to a puffy face
- Electrolyte imbalance
- Kidney failure, cardiac arrhythmia, seizures,
intestinal problems, permanent colon damage
What are the ABC Characteristics of Anorexia Nervosa
A) Restriction of energy intake resulting in weight that is less than minimally normal (adults) or expected (children) in the context of age, sex, developmental trajectory and physical health
B) Intense fear of weight gain or becoming fat OR behavior that
interferes with weight gain when weight gain is needed
C) Disturbance in how weight/shape is experienced, undue influence of weight/shape in self-evaluation, or denial of seriousness
What are the specifiers for Anorexia Nervosa
- specify whether: restricting subtype OR binge-purge subtype
- specify if: in partial remission, in full remission
- specify if: mild, moderate, severe, extreme
what is bmi
bmi = body mass index
- weight(kg) divided by height (m2)
What is the prevalence for anorexia nervosa in men vs women
1% for women
0.3% for men
Common among ballet performers (20%)
Age of onset generally between 16-20 yrs - mostly female, white and from middle to upper middle class
What are some common comorbid disorders with Anorexia Nervosa
- depression (70% experience at some point)
- sexual dysfunction
- OCD and substance abuse (purging type) (higher than average rated)
- suicide is very prevalent (18x more likely then same aged peers)
What are some key features of Anorexia Nervosa
- Often begins with dieting
- Disturbance in how one’s weight or body shape is experienced
- Avoid eating in front of others
- Many deny having a problem
What can be some consequences of Anorexia Nervosa
- Mortality rate is 5x higher than the mortality rate for
similarly aged females - Starving body borrows energy from internal organs,
leading to organ damage including cardiac damage >
can cause heart attack - Electrolyte imbalance
- Amenorrhea
- Sensitivity to cold temps
- Lanugo
- Dry skin, brittle hair and nails
What are changes involved with anorexia nervosa/starvation syndrome
- Personality/mood changes: Apathy, depression, tiredness,
irritability, moodiness; poor concentration; narrowing of
interests; loss of sexual interest; less spontaneity - Social changes: Deterioration in group spirit; reluctance to
make group decisions or plan activities; social interaction
became stilted; loss of interest in education/career
activities - Food preoccupation: Preoccupation with food; food planning; food rituals
increase in smoking, nail-biting
What are the ABC Characteristics of Binge Eating Disorder
A) Recurrent episodes of binge eating. An episode is characterized by:
1. Eating, in a discrete period of time, an amount of food that is larger than average
2. A sense of lack of control over eating during the episode
B) Binge eating is associated with 3 or more:
1. Rapid eating
2. Eating until uncomfortably full
3. Eating when not physically hungry
4. Eating alone due to embarrassment
5. Feelings of disgust, guilt, or depression afterwards
C) Marked distress regarding the binge eating
D) Binge eating occurs on average at least 1 day/week for 3 months
E) No AN or BN or inappropriate compensatory behavior
What are the specifiers for Binge Eating Disorder
Specifiers: in partial remission, in full remission
Specify severity: mild, moderate, severe, extreme (based on # of binges)
What is the prevalence of Binge Eating Disorder
men: 2%
women: 3.5%
Higher rates in obese sample (6.5%-8%)
What is Binge Eating Disorder commonly comorbid with
High comorbidity with
- anxiety disorders (65%)
- mood disorders (46-70%)
- substance use disorders (23%)
What are some key features of Binge Eating Disorder
They have more concern about their weight or shape
than overweight/obese pts without BED
- A typical binge involves around 1,900 calories
- Associated with being overweight or obese
What are some consequences of Binge Eating Disorder
- Physical discomfort and gastrointestinal distress
- Shame, self-hatred, anxiety, and depression
- Weight gain, obesity
- Cardiovascular disease
- High blood pressure
- High cholesterol
- Adult-onset diabetes
- Gout
What are some common diagnostic crossovers for eating disorders
** What is striking is diagnostic crossover AND the
similarity between the disorders
- Anorexia Nervosa, restricting
<—> Anorexia Nervosa, binge-eating/purging - Anorexia Nervosa, binge-eating/purging <—> Bulimia Nervosa
- Bulimia Nervosa <—> Binge Eating Disorder
List the causes of eating disorders
- Biological influences
- Sociocultural influences
- Family influences
- Psychological and behavioural influences
