Eating Disorders Chapter 11

Examples of Psychological Factors Leading to Eating Disorders

- Abuse issues - Undetected comorbidities including depression, anxiety, identity issues, etc. that have not been properly dealt with.

Examples of Biological Factors Leading to Eating Disorders

- Genetics - Abnormalities in the thalamus - Problems with feeling full -> diet may never leave one feeling saturated. - Yo-yo dieting, which causes the body to hold onto fat - Methamphetamine abuse

Bulimia Nervosa - DSM Check list

- Psychologically motivated hunger. - Recurrent episodes of binge eating with experience of loss of control. - Recurrent purging behavior. - Both occur at least once a week for at least three months. - Poor self-image based on body shape and weight.

DSM Checklist Anorexia Nervosa

- Psychologically motivated hunger. - Weight is at least 15% below normal. - There is an intense fear of gaining weight or becoming fat - Disturbance of body perception, i.e. there is high comorbidity with body dysmorphia. - Sometimes excessive exercise.

Binge Eating Disorder

- Repeated episodes of compulsive overeating in a short time period. - Occurs at least once a week for at least three months. - Occurs without really feeling hungry and to the point of feeling uncomfortably full. - Is often done in secret and is followed by feelings of guilt and disgust.

Which medications are helpful in anorexia and bulimia?

- SSRI's & Prozac - Help with the OCD component of anorexia. - Help with impulse control and depression in bulimia.

Examples of Social Factors Leading to Eating Disorders

- The pressure to be thin - Cultural factors

Binge Eating Disorder: Onset

- Wider age range - Person usually has a long history of weight struggles.

Anorexia Nervosa: Lifetime Prevalence

1 - 2%

Treatments of Eating Disorders (4)

1) Medication 2) CBT 3) Family Therapy 4) Treating comorbid conditions

Anorexia Nervosa tends to have high comorbidity with which two personality disorders?

1) OCD: in terms of mental calculations of calories, etc. 2) Narcissism: in terms of perfectionism and having a hypomanic presentation of the self.

Types of Eating Disorders (4)

1) Pica 2) Anorexia Nervosa 3) Bulimia Nervosa 4) Binge Eating Disorder

2 Types of Purging Behavior

1) Vomiting 2) Using laxatives

Bulimia Nervosa: Lifetime Prevalence

3%

Binge Eating Disorder: Gender

50% - 60% are female.

Bulimia Nervosa: Gender

80% are females.

Anorexia Nervosa: Gender

90% of those struggling are female.

Binge-

An episode of uncontrollable eating during which a person ingests a very large quantity of food.

Binge Eating Disorder: Lifetime Prevalence

At least 5%

The Course for: Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder

Chronic and progressive without treatment.

Bulimia Nervosa: Onset

Mid-teens to early 20's *Generally later than anorexia*

Pica

Recurrent, compulsive consumption of non-nutritive items. - This disorder is commonly seen in those with previous abuse issues.

Anorexia Nervosa-

Refusal to maintain body weight above a minimally normal weight for age and height Intense fear of gaining weight, even though underweight Disturbed body perception, undue influence of weight or shape on self-evaluation, or denial of the seriousness of the current low weight. In postmenarcheal females, amenorrhea.

Amenorrhea-

The cessation of menstrual cycles.

What is the main difference between bulimia nervosa and binge eating disorder?

There is no purging behavior in binge eating disorder.

Anorexia Nervosa: Onset

Usually starts in early teens.

Ventromedial hypothalamus (VMH) A brain region that

depresses hunger when activated.

Lateral hypothalamus (LH) A brain region that

produces hunger when activated.