Lecture 8: Eating Disorders

Question 1

What is the main characteristic of energy intake in Anorexia Nervosa?

Answer 1

Restriction of energy intake leading to significantly low body weight based on age, sex, development, and physical health.

Question 2

What fear is commonly associated with Anorexia Nervosa?

Answer 2

Intense fear of gaining weight or becoming fat, or behavior that interferes with weight gain.

Question 3

How is self-perception affected in Anorexia Nervosa?

Answer 3

Disturbed perception of body weight/shape, self-worth overly influenced by it, or denial of the seriousness of low body weight.

Question 4

What menstrual-related criterion was removed in DSM-5 for diagnosing Anorexia Nervosa?

Answer 4

Absence of 3 consecutive menstrual cycles.

Question 5

What defines the Restricting Type of Anorexia Nervosa?

Answer 5

No regular binge-eating or purging in the past 3 months.

Question 6

What defines the Binge-eating/Purging Type of Anorexia Nervosa?

Answer 6

Regular binge-eating or purging in the past 3 months.

Question 7

What is Bulimia Nervosa?

Answer 7

An eating disorder involving binge eating followed by purging or other methods to avoid weight gain.

Question 8

What behaviors are common in Bulimia Nervosa?

Answer 8

Self-induced vomiting, excessive exercise, and other inappropriate weight control behaviors.

Question 9

How is Bulimia Nervosa clinically similar to another disorder?

Answer 9

It resembles the binge-eating/purging type of Anorexia Nervosa.

Question 10

How does body weight differ between Bulimia and Anorexia binge/purge subtype?

Answer 10

Bulimia: normal/slightly above normal weight; Anorexia: severely underweight.

Question 11

What are the two key signs of a binge eating episode in Bulimia Nervosa?

Answer 11

Eating an unusually large amount in 2 hours + feeling a loss of control over eating.

Question 12

What are examples of inappropriate compensatory behaviors in Bulimia Nervosa?

Answer 12

Self-induced vomiting, misuse of laxatives, diuretics, fasting, or excessive exercise.

Question 13

How often must binge eating and purging occur for a Bulimia Nervosa diagnosis?

Answer 13

At least once a week for 3 months.

Question 14

How is self-evaluation affected in Bulimia Nervosa?

Answer 14

It’s overly influenced by body shape and weight.

Question 15

When can Bulimia Nervosa not be diagnosed?

Answer 15

If the behavior occurs only during episodes of Anorexia Nervosa.

Question 16

What emotions are commonly experienced by those with bulimia nervosa?

Answer 16

Shame, guilt, self-deprecation, and a desire to hide their behavior.

Question 17

What is the main difference between BED and bulimia nervosa?

Answer 17

BED involves binge eating without compensatory behaviors like vomiting or fasting.

Question 18

What is dietary restraint like in BED?

Answer 18

There is much less dietary restraint in BED compared to other eating disorders.

Question 19

What is BED commonly associated with?

Answer 19

Being overweight or obese.

Question 20

How to diagnose BED symptomatically?

Answer 20

At least 3 or more from the symptom list.
- Eating too quickly
- Eating when not hungry
- Eating alone due to shame
- Eating until painfully full
- Feeling guilt, disgust, or depression after eating

Question 21

What emotional symptom is required for a BED diagnosis?

Answer 21

Marked distress about binge eating.

Question 22

What is the DSM-5 frequency/duration requirement for BED?

Answer 22

Binge eating at least 1 day/week for 3 months.

Question 23

At what age does anorexia nervosa commonly develop?

Answer 23

Between 16 and 20 years old.

Question 24

Which group is most at risk for bulimia nervosa?

Answer 24

Women aged 21 to 24.

Question 25

What is the typical age range for binge-eating disorder?

Answer 25

Between 30 and 50 years old.

Question 26

What is the gender ratio for eating disorders?

Answer 26

About 3 females for every 1 male.

Question 27

What is a known risk factor for eating disorders in men?

Answer 27

Homosexuality.

Question 28

What is the most common eating disorder?

Answer 28

Binge-Eating Disorder (BED).

Question 29

How has the risk of developing anorexia nervosa changed over time?

Answer 29

It increased during the 20th century.

Question 30

What trend has been observed in bulimia prevalence recently?

Answer 30

It has decreased in recent decades.

Question 31

How much higher is the mortality rate for people with anorexia compared to young women generally?

Answer 31

More than five times higher.

Question 32

What are some effects of malnutrition from anorexia?

Answer 32

Thinning hair, dry skin, downy hair, cold sensitivity, tiredness, weakness.

Question 33

What can thiamin deficiency in anorexia cause?

Answer 33

Depression and cognitive (thinking) problems.

Question 34

What can electrolyte imbalances from anorexia lead to?

Answer 34

Heart arrhythmias and possible death.

Question 35

What are the risks of laxative abuse in eating disorders?

Answer 35

Dehydration, electrolyte imbalance, kidney disease, and GI tract damage.

Question 36

How does the mortality rate of bulimia nervosa compare to the general population?

Answer 36

It is twice as high.

Question 37

What can electrolyte imbalances and low potassium cause in bulimia?

Answer 37

Heart abnormalities.

Question 38

What dangerous substance is sometimes used in bulimia to induce vomiting?

Answer 38

Ipecac syrup, which can damage the heart.

Question 39

What physical signs appear from self-induced vomiting?

Answer 39

Calluses on hands, throat tears, and red dots around the eyes.

Question 40

How does frequent vomiting affect the teeth?

Answer 40

Stomach acid erodes teeth, causing ulcers and cavities.

Question 41

What causes the “puffy cheeks” look in bulimia?

Answer 41

Swollen salivary glands (parotid glands) from vomiting.

Question 42

How much more likely are anorexic individuals to die by suicide compared to peers?

Answer 42

18 times more likely.

Question 43

What is the long-term prognosis for bulimia and binge-eating disorder?

Answer 43

Generally good, with high rates of remission.

Question 44

What is diagnostic crossover in eating disorders?

Answer 44

When someone with one eating disorder is later diagnosed with another.

Question 45

Which crossover is especially common?

Answer 45

Between the two subtypes of anorexia nervosa.

Question 46

What proportion of anorexia patients develop bulimia?

Answer 46

About one-third.

Question 47

What anxiety-related disorder is common in anorexia and bulimia?

Answer 47

Obsessive-Compulsive Disorder (OCD).

Question 48

What proportion of people with eating disorders engage in self-harm?

Answer 48

More than a third.

Question 49

What early personality traits are common in people with anorexia?

Answer 49

Rigidity and perfectionism, even in childhood.

Question 50

Which disorder is culture-bound: anorexia or bulimia?

Answer 50

Bulimia is linked to Western ideals; anorexia is not culture-bound.

Question 51

What percentage of eating disorder patients are first-born or only children?

Answer 51

56.3%.

Question 52

How long do the eating disorders usually go untreated?

Answer 52

26 to 43 months.

Question 53

Which type of anorexia nervosa is more common, and in whom?

Answer 53

Restrictive-type (65.1%), especially in early-onset cases.

Question 54

Which eating disorder is most commonly presented in clinics in Singapore?

Answer 54

Anorexia Nervosa (41.6%).

Question 55

How do AN clients differ from BN clients in terms of age and illness duration?

Answer 55

AN clients are younger and have shorter untreated illness.

Question 56

What characterizes BN clients compared to AN clients?

Answer 56

Higher rates of suicide/self-harm, more co-occurring disorders, but better prognosis

Question 57

How much greater is the risk of anorexia for relatives compared to controls?

Answer 57

11.4 times greater.

Question 58

What is the increased risk of bulimia in relatives compared to healthy controls?

Answer 58

3.7 times higher.

Question 59

Are anorexia and bulimia considered heritable disorders?

Answer 59

Yes.

Question 60

What did Anne Becker’s Fiji study find after TV was introduced?

Answer 60

Women began dieting and worrying about weight, unlike before.

Question 61

Where are social pressures to be thin strongest?

Answer 61

In higher socioeconomic status backgrounds.

Question 62

Who is more likely to develop binge-eating disorder?

Answer 62

Males.

Question 63

Is perfectionism more common in men or women?

Answer 63

Women.

Question 64

Can perfectionism be genetic?

Answer 64

Yes, it may have a genetic basis.

Question 65

What is a common attitude of anorexia patients toward recovery?

Answer 65

They are often pessimistic and view the disorder as chronic.

Question 66

What is the immediate treatment goal for anorexia nervosa?

Answer 66

Restore weight to a non-life-threatening level.

Question 67

Why can aggressive treatment for anorexia backfire?

Answer 67

It may overwhelm patients and reduce compliance.

Question 68

Are antidepressants effective for treating anorexia?

Answer 68

No clear evidence they are effective.

Question 69

What is the best treatment option for adolescents with eating disorders?

Answer 69

Family therapy, especially the Maudsley model.

Question 70

How long does a typical Maudsley model program last?

Answer 70

10–20 sessions over 6–12 months.

Question 71

What role do parents play in family therapy?

Answer 71

Act as a support team to improve relationships.

Question 72

Which disorder is CBT most effective for?

Answer 72

Bulimia nervosa. Only limited success for anorexia nervosa.

Question 73

What is the most effective treatment for bulimia?

Answer 73

Cognitive-behavioral therapy (CBT).

Question 74

What does the behavioral part of CBT for bulimia focus on?

Answer 74

Meal planning, nutritional education, and stopping binge-purge cycles.

Question 75

What does the cognitive part of CBT address?

Answer 75

Thoughts and behaviors that lead to bingeing.