Chapter 9
How much do Americans spend yearly on weight-reduction foods, products and services?
$68 billion
WHat is the prefrontal cortex?
A structure in the anxiety-related, obsessive-compulsive-related and depression-related circuits
What is the orbitofrontal cortex?
A structure in the obsessive-compulsive-related circuit
What is the striatum?
A structure in the obsessive-compulsive-related circuit
What is interpersonal psychotherapy?
A treatment used to help improve interpersonal functioning.
What is the cognitive side of treatment for anorexia nervosa?
CLients are taught to identify their core pathology and are taught alternative ways of coping with stress and of solving problems
What is the behavioral side of treatment for anorexia nervosa?
CLients are typically required to monitor their feelings, hunger levels, and food intake and the ties between these variables.
How are lasting changes achieved?
CLinical researchers have found that people with anorexia nervosa must overcome their underlying psychological problems in order to create lasting improvement.
When are people least likely to eat junk food?
when they feel confident
Is drug therapy better than psychotherapy?
No, but the combination of the two is more effective than either form alone.
Are the deaths of anorexia nervosa rising?
No. The death rate is falling and the deaths that do occur are from suicide, starvation, infection, gastrointestinal problems, or electrolyte imbalance.
How many people with anorexia nervosa receive treatment?
About a third of them.
What is amenorrhea?
Absence of menstruation.
What does core pathology contribute to?
According to cognitive-behavioral theorists it contributes to all other aspects of the disorders including the repeated efforts to lose weight and the preoccupation with shape, weight, and eating.
What does Hilde Bruch say effective parents do?
Accurately attend to their children's biological and emotional needs, giving them food when they are crying from hunger and comfort when they are crying out of fear.
What poses a problem for enmeshed families according to Salvador Minuchin?
Adolescence. THe teenager's normal push for independence threatens the family's apparent harmony and closeness. In response the family may subtly force the child to take on a "sick" role- to develop an eating disorder or other illness.
What did the survey by Essence find out about African American women?
65% reported dieting, 39% said that food controlled their lives, 19% avoided eating when hungry, 17% used laxatives, and 4% vomited to lose weight.
Who is Hilde Bruch?
A pioneer in the study and treatment of eating disorders who developed a largely psychodynamic theory of eating disorders.
What percentage of teens skin breakfast, skip lunch, have less than 3 dinners with family every week, eat food from fast-food restaurants every day, eat some snacks each day, eat snacks throughout the day, and have poor knowledge of nutrition needs?
50%; 17%; 42%; 24%; 61%; 23%; 67%
What is the outcome of anorexia nervosa?
Although most people recover, as many as 6% become so seriously ill that they die, usually from medical problems brought about by suicide or from suicide.
What is the difference in weightloss methods between men and women?
Men tend to exercise whereas women diet more often.
How many anorexia nervosa cases are in women?
90%
What is the one-year prevalence of anorexia nervosa, bulimia nervosa, or binge-eating disorder?
0.6-4%; 0.5-5%; 2-7%
How people with anorexia or bulimia nervosa are males?
10%
What are the negative outcomes of anorexia nervosa post treatment?
25% of people remain seriously troubled for years. At least 1/3 of patients have recurrences of anorexic behavior, usually triggered by new stresses, such as marriage, pregnancy, or major relocation. They still have concerns about their weight and appearance years later, some still restrict their diets, some feel anxious when they eat with others, some hold distorted ideas about food, eating, and weight.
What percent of all students report periodic binge eating or self-induced vomiting?
25-50%
How many people with bulimia nervosa relapse after recovery?
28% relapse within six months. It is more likely among people who had longer histories of bulimia before treatment, had vomited more frequently during the disorder, continued to vomit at the end of treatment, had histories of substance abuse, and continue to be lonely or to distrust others after treatment.
What is muscle dysmorphia?
An eating disorder where individuals consider themselves scrawny and small and strive for the perfect body through excessive weight lifting and abuse of steroids.
What is binge?
An episode of uncontrollable eating during which a person ingests a very large quantity of food. This usually lasts for two hours.
What are the results of frequent binges?
Around half of people with binge-eating disorder become overweight or obese.
What are people with anorexia nervosa afraid of?
Becoming obese, giving in to their desire to eat and of losing control over the size and shape of their bodies.
How many females in Western countries develop anorexia nervosa in their lifetime?
Between 0.6 and 4%. More of them display at least some of the symptoms
How many binge episodes do people with bulimia nervosa have weekly?
Between 1 and 30.
What percent of the population have binge-eating disorder?
Between 2 and 7%
How many calories are consumed in a binge episode?
Between 2,000-4,300. Some people consume as many as 10,000.
How many bulimia nervosa cases are in females?
Between 75 and 90%
Is Hilde Bruch's theory supported?
Clinical reports and research have provided some support. Clinicians have observed that the parents of teenagers with eating disorders tend to define their children's needs rather than allow the children to define their own needs. Additionally, research has supported Bruch's belief that people with eating disorders perceive internal cues, including emotional cues, inaccurately. Lastly, research studies support Bruch's argument that people with eating disorders rely excessively on the opinions, wishes, and views of others.
What treatment is used in life-threatening cases?
Clinicians may need to force tube and intravenous feedings on a patient who refuses to eat. This force may cause the client to distrust the clinician.
What is the most successful treatment at preventing relapses when it continues for at least a year beyond a patient's recovery from anorexia nervosa?
Cognitive-behavioral therapy when it is used as maintenance therapy
What happens when a person's weight rises above their weight set point?
The ventromedial hypothalamus and other brain areas are activated, and they try to remove the excess weight by reducing hunger and increasing the body's metabolic rate.
When does a bulimic pattern begin?
During or after a period of intense dieting, often one that has been successful and earned praise from family members and friends.
What is weight set point?
The weight level that a person is predisposed to maintain, controlled in part by the hypothalamus
What is the difference between multidimensional risk perspective and psychopathology perspective?
It is not as specific. But they are similar as they both contend that the risk factors for eating disorders unfold over the course of development, that interactions between these different risk factors and combinations of factors may lead to the same eating disorders.
What do cognitive-behavioral therapists try to help clients with anorexia nervosa change their attitudes about?
Eating and weight. THe therapist may guide the client to identify, challenge, and change maladaptive assumptions ("i must always be perfect") and educate clients about the body distortions typical of anorexia nervosa and help them see that their own assessments of their size are incorrect. Even if the client never judges their body accurately they are able to recognize it is a symptom of their anorexia.
What does cognitive-behavioral therapy do for people with anorexia nervosa?
It helps them restore their weight, overcome their fear of becoming overweight, develop greater self-esteem, correct their body distortions and dissatisfaction, adopt more accurate and adaptive eating attitudes, acquire more appropriate eating and exercise habits, and develop better problem-solving skill.
What is causing the shift in the eating behaviors and eating problems of African American women?
Their acculturation
What does adolescence do to children who cannot rely on internal signals?
It increases their basic desire to establish independence, yet they feel unable to. To overcome their sense of hopelessness they seek excessive control over their body size and shape and over their eating habits.
Describe the prefrontal cortex of a person with an eating disorder
It is abnormal
What do treatment programs for bulimia nervosa emphasize?
Education as much as therapy.
What did Hilde Bruch say were the two types of parenting?
Effective and ineffective
What does influential family theorist Salvador Minuchin believes leads to eating disorderS?
Enmeshed family patterns.
What did a survey of 248 adolescent girls tie together?
It directly tied eating disorders and body dissatisfaction to social networking, internet activity, and television browsing. The respondents who spent more time on Facebook were more likely to display eating disorders, have negative body image, eat in dysfunctional ways, and want to died. Those who spent more time on fashion and music websites and those who viewed more gossip and leisure related television programs showed similar tendendices.
What happens when the lateral hypothalamus of an animal is stimulated electrically?
It eats even if it has been fed recently
What do eating disorders have to do with economic differences?
In the past, women in the upper socioeconomic class expressed more concern about thinness and dieting than women of the lower socioeconomic classes. Eating disorders were more common in higher classes, but it has increased recently in all classes.
What format are cognitive-behavioral, interpersonal and psychodynamic therapy offered in?
Individual or group therapy formats including self-help groups. Group formats are at least somewhat helpful for 75% of people with bulimia nervosa.
What does a teenager taking on a sick role do for an enmeshed family?
It enables the family to maintain its appearance of harmony because a sick child needs their family and family members can rally to protect them.
Describe the insula of people with eating disorders
It is abnormally large and activeA
What is the Dx checklist for anorexia nervosa?
Individual purposely takes in too little nourishment, resulting in body weight that is very low and below that of other people of similar age and gender. Individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain despite low body weight. Individual has a distorted body perception, places inappropriate emphasis on weight or shape in judgments of him or herself, or fails to appreciate the serious implications of her or his low weight.
What does vomiting fail to do?
It fails to prevent the absorption of half the calories consumed dduring a binge. Repeated vomiting affects one's general ability to feel satisfied so it leads to greater hunger and more frequent and intense binges.
What is the suicide rate among people with anorexia nervosa?
It is five times the rate found in the general population.
How does Western society influence eating disorders?
It glorifies thinness, and creates a climate of prejudice against overweight people.
Is the weight set point explanation supported?
It has received considerable debate but continue to be accepted by many.
How successful is cognitive-behavioral therapy?
It helps as many as 75% of patients stop or reduce bingeing and purging.
What is the rate of college students with bulimia nervosa?
It is high
What did Hilde Bruch argue?
DIsturbed mother-child interactions lead to serious ego deficiencies in the child (poor sense of independence and control) and to severe perceptual disturbances that jointly help produce disordered eating.
What are the psychological problems people with anorexia nervosa have?
Depression, anxiety, low self-esteem, and insomnia or other sleep disturbances. They also grapple with substance abuse, display obsessive compulsive patterns.
What happens if bulimia nervosa goes untreated?
It can last for years, sometimes improving but then returning.
Describe the striatum of a person with an eating disorder
It is hyperactive
WHat are binges preceded by?
Feelings of great tension. The person feels irritable, unreal, and powerless to control the overwhelming need to eat forbidden foods.
What are people with anorexia nervosa preoccupied with?
Food; they may spend time thinking and reading about food and planning their meals. Many report having dreams of food and eating.
What causes the preoccupation with food?
It is the result of food deprivation
Describe the orbitofrontal cortex of a person with an eating disorder
It is uncommonly large
Who have the highest rates of male eating disorders?
Jockeys, wrestlers, distance runners, body builders, and swimmers.
What is one way bulimia nervosa and binge-eating disorder are similar?
The binges are similar, particularly the amount of food eaten and the sense of loss of control
What is core pathology?
The deep-seated belief that a client should be judged by their shape and weight and by their ability to control these physical characteristics.
Why do some men develop anorexia nervosa or bulimia nervosa?
The disorder is linked to the requirements and pressures of a job or sport.
What do cognitive-behavioral theorists believe about ineffective parenting and people improperly labeling their internal sensations and needs?
These deficiencies contribute to a broad cognitive distortion that lies at the center of disordered eating, namely, people with anorexia nervosa and bulimia nervosa judge themselves based on their shape and weight and their ability to control them.
Most overweight people do not display binge-eating disorder, but most people with the disorder are overweight; true or false
True
What is at the core of eating disorders?
a morbid fear of gaining weight
Persons with ___________ have a low opinion of their body shape, consider themselves unattractive, and are likely to overestimate their actual proportions
anorexia nervosa
What is being overweight typically caused by?
biological, psychological, and sociocultural factors.
Under which of the following circumstances is a person least likely to eat nutritional food only?
boredom
Treatment for binge-eating disorder is similar to treatment for what?
bulimia nervosa
___________ is/are used to help people with bulimia nervosa recognize and change their maladaptive attitudes toward food, eating, weight, and shape.
cognitive techniques
WHat treatments are used for binge-eating disorders?
cognitive-behavioral therapy, other forms of psychotherapy, antidepressant medications are provided to help reduce or eliminate the binge-eating patterns and to change disturbed thinkingg such as being overly concerned with weight and shape. According to research, psychotherapy is more helpful than antidepressants.
What are people with binge-eating disorder preoccupied with?
food, weight, and appearance; tend to base their evaluation of themselves largely on their weight and shape; often misperceive their body size and are extremely dissatisfied with their body; often struggle with feelings of depression, anxiety, and perfectionism; and may abuse substances.
What did the 1995 study at the University of Arizona suggest?
non-Hispanic white American and African American adolescent girls had different ideals of beauty. the white girls described a girl of 5 foot 7 weighing between 100 and 110 pounds with supermodel proportions as perfect whereas African American girls did not care about physical appearance as long as she was well groomed.
The behavioral technique of ___________ is used to help break the binge-purge cycle of bulimia nervosa.
exposure and response prevention
Research into the spread of eating disorders to non-Western countries found that on the island(s) of __________, the introduction of Western television shows via satellite television preceded significant increase in eating disordered behaviors.
fiji
What do cognitive-behavioral therapists have clients with bulimia nervosa do?
keep diaries of their eating behavior, changes in sensations of hunger and fullness, and the ebb and flow of other feelings. This helps clients observe their eating patterns more objectively and recognize the emotions and situations that trigger their desire to binge.
Many people suffering from eating disorders also suffer from:
mood disorders
What percent of female college athletes suffer from an eating disorder?
more than 9%
How many binge-eating disorder clients show total improvement in follow-up studies?
only 1/3; as with the other disorders they also have a high risk of relapse.
When was binge-eating first identified?
over 60 years ago as a pattern common among many overweight people.
The neurotransmitter that may be associated with eating disorders is:
serotonin
In people suffering from bulimia nervosa, binges are usually preceded by feelings of:
tension
WHat is metabolic rate?
the rate at which the body uses energyT
What are the goals for treating eating disorders?
to correct the dangerous eating pattern as quickly as possible and to address the broader psychological and situational factors that have led to and maintain the eating problem. Family and friends can also play an important role in helping overcome the disorder.
According to research into college athletes, a full _____ percent of female college gymnasts appear to suffer from an eating disorder.
20%
If a fraternal twin has anorexia nervosa, the other twin also develops the disorder in how many cases?
20%
What percent of gymnasts have an eating disorder?
20%
If an identical twin has bulimia nervosa the other twin also develops the disorder in how many cases?
23%
What percent of binge-eating hospitalized patients were still overweight 12 years after hospitalization in one study?
36%
How many women have negative thoughts about their bodies each day?
07%
What has led some theorists to suggest that depressive disorders set the stage for eating disorders?
1. many people with an eating disorder qualify for a clinical diagnosis of major depressive disorder than do the general population. 2. the close relatives of people with eating disorders have higher rates of depressive disorders than do close relatives of people without eating disorders. 3. the depression-related brain circuit of people with eating disorders shows abnormalities similar to those of people with depression. 4. people with eating disorders are sometimes helped by the same antidepressant drugs that reduce depression.
How many negative body thoughts do women have every day?
13
What is the typical onset age for anorexia nervosa, bulimia nervosa, and binge-eating disorder?
14-20, 15-20, 22-30
In 2007, what percentage of all undergraduate male college students reported being dissatisfied with their weight?
15%
If one identical twin has anorexia nervosa, the other twin also develops the disorder in how many cases?
70%
What percent of girls and women are dissatisfied with their bodies?
73%; most believe they are overweight
What is body project?
A program developed and expanded by psychologists Eric Stice and Carolyn Black Becker and their colleagues. This offers a total of 4 weekly group sessions for high school and college-age women where group members are guided through a range of intense verbal, written, role-playing, and behavioral exercises that critique Western society's ultra thin ideal. Participants also engage in body acceptance exercises, eating and related activities that run counter to the ultra-thin ideal, motivation enhancement techniques, skill-building training and social support exercises.
What does the escalation of anorexia nervosa follow?
A stressful event such as separation of parents, a move away from home, or an experience of personal failure.
What is the insula?
A structure in the anxiety-related circuit
How many people with bulimia nervosa receive treatment?
ARound 43%
What medical problems are caused by starvation?
Amenorrhea, low blood pressure, body swelling, reduced bone mineral density, slow heart rate, and metabolic and electrolyte imbalances which may cause death by heart failure or circulatory collapse, rough dry and cracked skin, brittle nails, cold and blue feet and hands, hairloss, lanugo.
How many cases of anorexia nervosa occur in females?
Between 75 and 90% of all cases.
What are the areas of the hypothalamus activated by?
CHemicals from the brain and body that depend on whether the person is eating or fasting
WHat do biological theorists suspect leaves people susceptible to eating disorders?
Certain genes.
What determines a person's weight set point?
Genetic inheritance and early eating practices.
What are examples of compensatory behaviors?
Forcing oneself to vomit, misusing laxatives, diuretics, enemas, fasting, exercising excessively.
What are cognitive-behavioral therapists careful in doing?
Helping patients with anorexia nervosa recognize their need for independence and teach them more appropriate ways to exercise control. They may also teach them to better identify and trust their internal sensations and feelings.
Where is anorexia nervosa increasing?
In North America, Europe and Japan
When does bulimia nervosa begin?
In adolescence or young adulthood (most often between 15 and 20 years old) and often lasts years with periodic letup.
Is body project prevention program successful?
In comparison to other young women who received education-only prevention programs or no prevention programs at all, participants in Body Project develop fewer eating disorders, hold more realistic and healthful appearance ideals, display fewer maladaptive eating attitudes and behaviors, have greater body satisfaction, and experience more positive emotions in follow-up studies conducter a year or more after the program.
WHat does family do for a patient with anorexia nervosa?
It helps the person separate their feelings and needs from those of other members of the family. Research suggests this type of therapy can be helpful in the treatment.
Why is there a gender difference with eating disorders?
It is not yet clear but Western society's double standard for attractiveness is one reason along with the methods used to lose weight
What happens to the weight of a person with bulimia nervosa?
It normally stays within a normal range, although it may fluctuate markedly within that range. Sometimes these people become so overweight they could be diagnosed with anorexia nervosa instead.
How does hearing about bulimia nervosa behaviors affect people?
MAny teenagers and young adults go on occasional eating binges or experience with vomiting or laxatives after they hear about these behaviors from friends or the media.
What is reverse anorexia nervosa or muscle dysmorphia?
Men with this disorder are very muscular but still see themselves as scrawny and small and strive for a perfect body through extreme measures such as excessive weight lifting or abuse of steroids. People with this typically feel shame about their bodies and have a history of depression, anxiety, and self-destructive compulsive disorder. 1/3 of them also engage in related dysfunctional behaviors such as binge eating.
What is the cycle that develops with bulimia nervosa?
People purge which allows for more bingeing, and bingeing necessitates more purging. This cycle causes people to feel powerless and disgusted with themselves.
What does research show about anorexia nervosa and obsessive compulsive disorder?
People with these disorders score equally high for obsessiveness and compulsiveness.
What factors are most closely tied to body dissatisfaction?
Perfectionism and unrealistic expectations
Who are more prone to anorexia nervosa and bulimia nervosa?
Performers, models, and athletes.
WHat is the weight thermostat?
Researchers believe the hypothalamus, related brain structures, and chemicals such as glucagon-like peptide-1 work together comprising a weight thermostat which is responsible for keeping an individual at a particular weight level called the weight set point.
How does body image affect men?
Some men who develop anorexia nervosa or bulimia nervosa have body image as a key factor. They want a lean, toned, thin shape rather than the muscular broad-shouldered shape.
What happens when the ventromedial hypothalamus is stimulated in an animal?
THe animal stops eating
What occurs after a binge?
THe person feels extreme self-blame, shame, guilt, and depression, along with fears of gaining weight and being discovered.
What happens when people shut down their inner thermostat?
They control their eating almost completely and move toward restricting-type anorexia nervosa.
What do family system theorists argue about families of people who develop eating disorders?
That they are dysfunctional to begin with and the eating disorder of one member is a reflection of the larger problem.
What did the 1995 study at the University of Arizona discover?
The eating behaviors and attitudes of young AFrican American women were more positive than those of young non-Hispanic white American women. Only 70% of the African American respondents were dissatisfied with their weight and body shape compared with nearly 90% of the non-Hispanic white American teens.
What is lanugo?
The fine, silky hair that covers some newborns. It may grow on the trunk, extremities, and face of anorexics.
What brain circuits are dysfunctional in people with eating disorders?
The same circuits linked to generalized anxiety, obsessive-compulsive, and depressive disorders.
What do people with binge-eating disorder do?
They do not fear weight gain to the same degree as those with anorexia nervosa and bulimia nervosa, but they do have many of the other features found in eating disorders.
What is restricting-type anorexia nervosa?
This is a pattern of anorexia nervosa where people restrict their intake of food. Ex; they tend to cut out sweets and fattening snacks, then, increasingly, they eliminate other foods. These people show no variability in diet.
What is the pro-Ana movement?
This is people who are pro anorexia
What are the positive aftermath effects of anorexia nervosa treatment?
Weight is often restored quickly and treatment gains may continue for years. Also 75% of patients continue to show improvement-either full or partial- when they are interviewed several years or more after their initial recovery. Females also begin to menstruate again and other medical improvements occur.
What are symptoms of anorexia nervosa?
When a person purposely maintains a significantly low body weight, intensely fears becoming overweight, has a distorted view of their weight and shape, and are excessively influenced by their weight and shape in their self-evaluations
What does the weight set theory say?
When people diet and fall to a weight below their weight set point, their brain starts trying to restore the lost weight. Ex; hypothalamic and related brain activity produce a preoccupation with food and a desire to binge. They also trigger bodily changes that make it harder to lose weight and easier to gain weight.
Is cognitive-behavioral helpful for people with bulimia nervosa?
Ye, perhaps more helpful than in cases of anorexia nervosa.
Are image concerns, dysfunctional eating patterns and anorexia and bulimia nervosa rising for young African American women and women of other minority groups?
Yes
Is treatment for binge-eating disorder effective?
Yes, at least short term. 60% of clients no longer fit the criteria for binge-eating disorder by the end of treatment.
Is antidepressant drug therapy helpful for people with bulimia nervosa?
Yes, it is of limited help to people with anorexia nervosa but appears to be quite effective in cases of bulimia.
Do anorexia nervosa sufferers have distorted thinking?
Yes, it often takes the form of maladaptive attitudes and misperceptions; "I must be perfect in every way" or " I will become a better person if I deprive myself" or "I can avoid guilt by not eating"
Is family therapy combined with treatments for bulimia and anorexia nervosa?
Yes.
What is the successful long-term recovery after treatment rate for people with anorexia nervosa, bulimia nervosa, or binge-eating disorder?
75%;75%; 60%
How many people with anorexia nervosa, bulimia nervosa, or binge-eating disorder are female?
75-90%; 75-90%; 64-70%
Studies have found that when those with anorexia nervosa are given supportive nursing care, nutritional counseling, and a relatively high-calorie diet, the patients usually gain the necessary weight in about _________ weeks.
8-12
What is nutritional rehabilitation?
This is a phase of treatment to help patients with anorexia nervosa gain weight quickly and return to health within weeks.
Although most victims of anorexia nervosa recover, between ____ and ___ percent of them become so seriously ill that they die, either from starvation or suicide
2 and 6%
Although some people who suffer from anorexia nervosa recover from the illness, studies suggest that as many as _____ percent of these patients remain seriously troubled for many years.
25%
What percent of female college athletes display eating behaviors that put them at risk of developing an eating disorder?
33%
WHat is the percentage of people with anorexia nervosa, bulimia nervosa, and binge-eating disorder who receive treatment?
34%; 43%; 44%
What percent of men with eating disorders had jobs or played sports for which weight control was important?
37%; only 13% for women.
What percent of people with binge-eating disorder receive treatment?
44%
What percent of boys and men are dissatisfied with their bodies?
56%; half believe they are overweight, half believe they are underweight
Relatives of people with eating disorders are up to ____ times more likely to develop the disorder themselves.
6
What percent of people with binge-eating disorder are women?
64%
What percent of teen boys and girls have been body shamed?
64%, 90%
If a fraternal twin has bulimia nervosa, the other twin also develops the disorder in how many cases?
9%
____is the percentage of people with bulimia nervosa who also develop another psychological disorder during their lives.
95%
What is glucagon-like peptide-1? (GLP-1)
A brain chemical that affects the areas of the hypothalamus. It is the natural appetite suppressant.
What is the ventromedial hypothalamus?
A brain region that depresses hunger when activated
WHat is the lateral hypothalamus?
A brain region that produces hunger when activated
What is the hypothalamus?
A brain structure that helps regulate various bodily functions, including eating and hunger.
What is the most popular nutritional rehabilitation approach?
A combination of supportive nursing care, nutritional counseling, and a relatively high-calorie diet. With this, nurses can gradually increase a patient's diet over the course of several weeks to more than 3,000 calories a day.
What is binge-eating disorder?
A disorder marked by frequent binges without extreme compensatory acts.
What is bulimia nervosa?
A disorder marked by frequent eating binges followed by forced vomiting or other extreme compensatory behaviors to avoid gaining weight. Also known as binge-purge syndrome
What is a brain circuit?
A network of particular brain structures that work together, triggering each other into action to produce a distinct kind of behavioral, cognitive, or emotional reaction.
What is the core pathology?
According to cognitive-behavioral theorists this is that people with anorexia nervosa and bulimia nervosa nudge themselves on their shape and weight and ability to control them.
Which is not an accurate statement about the comparison between females with anorexia nervosa and those with bulimia nervosa?
Girls with bulimia have less sexual experience than do girls with anorexia.
Are antidepressant drugs helpful for people with bulimia nervosa?
In contrast to people with anorexia nervosa, those with bulimia nervosa are often helped considerably by these antidepressnats.
How do people with anorexia nervosa think?
In distorted ways; they have a low opinion of their body shape, and believe they are unattractive. They are also likely to overestimate their proportions.
What does treatment do for people with bulimia nervosa?
It produces immediate significant improvement in approximately 40% of clients; they stop or greatly reduce their bingeing and purging, eat properly, and maintain a normal weight. After years of treatment follow-up studies have found 75% of people with bulimia nervosa have recovered either partially or fully.
Who died from an eating disorder?
Karen Carpenter died in 1983 from medical problems related to anorexia.
What have studies on humans and animals shown about bingeing?
Normal research participants placed on very strict diets also develop a tendency to binge; some of the participants in the conscientious objector starvation study later binged when they were allowed to return to regular eating, and a number continued to be hungry after large meals.
What treatment programs are offered for bulimia nervosa?
Nutritional rehabilitation, which, for bulimia nervosa, means helping clients to eliminate their binge-purge patterns and establish good eating habits; and a combination of therapies aimed at eliminating the underlying causes of bulimic patterns.
What do clinicians using behavioral weight-restoration approaches do?
Offer rewards whenever patients eat properly or gain weight and offer no rewards when they eat improperly or fail to gain weight.
Is psychodynamic therapy effective for people with bulimia nervosa?
Only a few research studies have tested and supported its effectiveness.
What are enmeshed family patterns like?
Parents are too involved in the lives of their children, allowing little space for individuality and independence.
How are bulimia nervosa and anorexia nervosa different?
People with bulimia nervosa tend to be more concerned about pleasing others, being attractive to others, and having intimate relationships. THey also tend to be more sexually experienced and active than people with anorexia nervosa. They also have long histories of mood swings, become easily frustrated or bored, and have trouble coping effectively or controlling their impulses and strong emotions. More than one-third of them display characteristics of a personality disorder, particularly borderline or avoidant personality disorder.
What do people who have suffered from anorexia nervosa continue to have years after treatment?
Psychological problems-particularly depression, obsessiveness, and social anxiety. These are common in people who did not reach a normal weight by the end of treatment.
What medications are used in treating anorexia nervosa?
Psychotropic drugs, particularly antipsychotic drugs, are sometimes used when patients do not respond to the other forms of treatment but research has found that such medications are of typically limited benefit.
WHat is the dX checklist for binge-eating disorder?
Recurrent binge-eating episodes, binge-eating episodes include at least three of these features- unusually fast eating, absence of hunger, uncomfortable fullness, secret eating due to sense of shame, subsequent feelings of self-disgust, depression, or severe guilt-- significant distress, binge-eating episodes take place at least weekly over the course of three months, absence of excessive compensatory behaviors.
What is the dx checklist for bulimia nervosa?
Repeated binge-eating episodes, repeated performance of ill advised compensatory behaviors to prevent weight gain, symptoms take place at least weekly for a period of three months, and inappropriate influence of weight and shape on appraisal of oneself.
How was overestimated body size studied in a laboratory?
Research participants looked at photos of themselves through an adjustable lens. They were asked to adjust the lens until the image they see matches their body size. It can be between 20% bigger and smaller than what is real. In one study, more than half of the individuals with anorexia nervosa overestimated their body size, stopping the lens when the image was larger than they actually were.
What are the cognitive-behavioral aspects of Bruch's theory?
She held that as a result of ineffective parenting, people with eating disorders improperly label their internal sensations and needs, generally feel little control over their lives, and in turn, want to have excessive levels of control over their body size, shape, and eating habits.
What has made the public interested in eating disorders?
The frightening medical consequences that can result from them. Also, another reason for the current concern is the disproportionate prevalence of anorexia nervosa and bulimia nervosa among adolescent girls and young women
What happens when a person's weight falls below their weight set point?
The lateral hypothalamus and certain other brain areas are activated and seek to restore the lost weight by producing hunger and lowering the body's metabolic rate
What have studies found about the weight, bust, and hip measurements of Playboy?
The measurements decrease year by year.
How are bulimia nervosa and anorexia nervosa different? pt.2
The medical complications are different. Only half of women with bulimia nervosa are amenorrheic or have very irregular menstrual periods, compared with almost all of those with anorexia nervosa. Repeated vomiting bathes teeth and gums in hydrochloric acid, leading some women with bulimia to have severe dental problems, such as breakdown of enamel and loss of teeth. Frequent vomiting or chronic diarrhea can cause dangerous potassium deficiencies, which may lead to weakness, intestinal disorders, kidney disease, or heart damage.
What do cognitive-behavioral therapies focus on for bulimia nervosa?
The unique features of bulimia; bingeing and purging, along with the specific beliefs at work.
What is a primary focus of cognitive-behavioral therapy?
These therapists help clients with bulimia nervosa recognize and change their maladaptive attitudes toward food, eating, weight, and shape. The therapists teach the patients to identify and challenge the negative thoughts that regularly precede their urge to binge. They also guide them to recognize, question, and change their perfectionistic standards, sense of hopelessness, and low self-concept.
What do sufferers of anorexia nervosa believe?
They are convinced they need to be extremely thin, and they lose so much weight that they may starve themselves to death.
What is likely of adolescents who are teased about their weight by family?
They are twice as likely as nonteased teens to become overweight within five years and 1.5 times more likely to become binge eaters and use extreme weight control measures.
How are bulimia nervosa and anorexia nervosa similar?
They both begin after a period of dieting by people who are fearful of becoming obese; driven to become thin; preoccupied with food, weight and appearance; and struggling with depression, anxiety, obsessiveness and the need to be perfect; heightened risk of suicide attempts and fatalities; substance abuse beginning with excessive use of diet pills; people believe they weigh too much and look too heavy regardless of their actual weight or appearance; disturbed attitudes towards eating/
What have studies found about Hispanic American female adolescents?
They engage in disordered eating behaviors and express body dissatisfaction at rates about equal to those of non-hispanic white American women.
WHat did Hilde Bruch say ineffective parents do?
They fail to attend to their children's needs deciding that their children are hungry, cold, or tired without correctly interpreting the children's actual condition. Children who receive this type of parenting may grow up confused and unaware of their own internal needs, not knowing for themselves when they are hungry or full and unable to identify their own emotions.
What do people with bulimia nervosa do?
They go on frequent eating bingers, during which they uncontrollably consume large quantities of food and then force themselves to vomit or take extreme steps to keep from gaining weight.
How did researchers study the effectiveness of an online version of the cognitive-behavioral diary technique?
They had 31 clients with bulimia nervosa, each an outpatient in a 12 week cognitive-behavioral therapy program, send nightly texts to their therapists, reporting on their bingeing and purging urges and episodes. The clients received feedback messages, including reinforcement and encouragement for the treatment goals they had been able to reach that day. The researchers reported that by the end of therapy the clients showed significant decreases in binges, purges, other bulimic symptoms, and depression.
What are the effects of antidepressants for people with bulimia nervosa?
They help 40% of patients, reduce their binges by 67% and vomiting by 56%
What do nurses do?
They increase a patient's diet, they educate patients about the program, track their progress, provide encouragement, and help patients appreciate that their weight is under control and will not lead to obesity.
What happens when research participants with an eating disorder are anxious or upset?
They may mistakenly think they are also hungry and respond as they would respond to hunger; by eating.
What is an example of an obsessive compulsive pattern for someone with anorexia nervosa?
They may set rules for preparation or cut food into specific shapes. They also may exercise compulsively.
What happened when rats were injected with a substance that blocked glucagon-like peptide-1 in the hypothalamus?
They more than doubled their food intake.
How do binge episodes go?
They occur in secret, a person eats massive amounts of food rapidly, with minimal chewing. Usually the foods are sweet high-calorie foods with a soft texture, such as ice cream, cookies, doughnuts, and sandwiches. It is hardly tasted or thought about.
What is the role of the family in eating disorders?
They play a role in the development and maintenance of eating disorders; half of families with people who have anorexia or bulimia nervosa have a long history of emphasizing thinness, physical appearance, and dieting. The mothers of these families are more likely to diet themselves and be generally perfectionistic than mothers in other families.
What happened when Bruch interviewed the mothers of 51 children with anorexia nervosa?
They proudly recalled they always anticipated their young child's needs, never permitting the child to feel hungry.
What happened when the glucagon-like peptide-1 was injected into lab rats?
They reduced their food intake almost entirely even though they had not eaten for 24 hours.
What happens if cognitive-behavioral therapy doesn't work for a bulimic patient?
They try other less impressive but promising therapies such as interpersonal psychotherapy or psychodynamic therapy.
What do children do who cannot rely on internal signals?
They turn to external guides such as their parents. They appear to be model children, but they fail to develop genuine self-reliance and to experience themselves as not being in control of their needs, behaviors, and impulse as not owning their own bodies.
How do therapists achieve lasting changes?
They use a combination of education, psychotherapy, and family therapy.
What do cognitive-behavioral therapists do to break the binge-purge cycle?
They use exposure and response prevention. This means they require clients to eat particular kinds and amounts of food and then prevent them from vomiting to show that eating can be a harmless and even constructive activity that needs no undoing.
What do studies find about patients in nutritional rehabilitation programs?
They usually gain the necessary weight over 8 to 12 weeks.
Are the eating behaviors, values, and goals of young AFrican American women healthy?
They were healthier than those of young non-hispanic white american women in the 1990s
what has become a national obsession in the US?
Thinness
What is the goal for people with anorexia nervosa and what provides the motivation?
Thinness; fear
What is binge-eating/purging-type anorexia nervosa?
This is a pattern of anorexia nervosa where people lose weight by focing themselves to vomit after meals or by abusing laxatives or diuretics, and they may even engage in eating binges.
What do nurses use motivational interviewing for?
This is an intervention that uses a mixture of empathy and inquiring review to help motivate clients to recognize they have a serious eating problem and commit to making constructive choices and behavior changes.
What is multidimensional risk perspective?
This is used by most of today's theorists and researchers to explain eating disorders. That is, they identify several key factors that place a person at risk for these disorders.
What is an enmeshed family pattern?
This is when family members are overinvolved in each other's affairs and overconcerned with the details of each other's lives. This can be good as families are affectionate and loyal but can be bad as they are clingy and foster dependency.
What was found in the starvation study?
This was done in the late 1940s and it took 36 normal-weigh conscientious objectors and placed them on a semistarvation diet for six months. Like those with anorexia nervosa, the volunteers became preoccupied with food and eating. The spent hours planning their small meals, talked about food more than anything else, studied cookbooks and recipes, mixed food in odd combinations, and had vivid dreams about food.
What women have high rates of anorexia nervosa and bulimia nervosa?
Those who consider themselves more oriented to non-hispanic white American culture.
When does anorexia nervosa occur?
Though it can appear at any age, the peak of onset is between 14 and 20.
Is Salvador Minuchin's theory of enmeshed family patterns supported?
Though some studies have supported this family system explanation, they have failed to show that particular family patterns consistently set the stage for the development of eating disorders.
What is the goal of cognitive-behavioral therapy?
To help clients appreciate and alter the behaviors and thought processes that help keep their restrictive eating going.
What is the goal of treatment for anorexia nervosa?
To help people regain their lost weight, recover from malnourishment, and eat normally again. Therapists must then help them to make psychological and perhaps family changes to lock in those gains.
When is binge-eating disorder developed?
Typically in a person's 20s
Who does anorexia nervosa affect typically?
Typically the disorder begins after a person who is slightly overweight or of normal weight has been on a diet.
Is exposure treatment helpful?
Typically, the therapist sits with the client while they eat and stay until the urge to purge has passed. STudies find this treatment often helps reduce eating-related anxieties, bingeing, and vomiting.
WHat do laxatives or diuretics fail to do?
Undo the caloric effects of bingeing.
Are cognitive-behavioral approaches effective in treating anorexia nervosa?
Yes, they are more effective than psychodynamic therapies, psychoeducation, or supportive therapy alone.
