B. Eating Disorders

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Questions and Answers

What is a primary characteristic of an episode of binge eating?

Eating a larger amount of food than usual in a short time (correct)

Eating slowly and savoring each bite

Eating until feeling completely full

Feeling satisfied and in control during the meal

Which of the following is NOT one of the associated behaviors during binge eating episodes?

Avoiding food when feeling emotionally upset (correct)

Feeling disgusted or guilty after eating

Eating alone due to embarrassment

Eating much more rapidly than normal

How frequently must binge eating episodes occur to meet the diagnostic criteria?

At least once a day for 1 month

At least twice weekly for 2 months

At least every 10 days for 6 weeks

At least once weekly for 3 months (correct)

What distinguishes binge eating disorder from bulimia nervosa?

Binge eating without inappropriate compensatory behavior Signup and view all the answers

What might indicate partial remission of binge eating disorder?

Episodes occur less than once a week after previously meeting full criteria Signup and view all the answers

What compensatory method might individuals with bulimia nervosa use to avoid weight gain?

Thyroid hormone intake Signup and view all the answers

Which behavior is considered excessive exercise among individuals with bulimia nervosa?

Exercising at inappropriate times and settings Signup and view all the answers

What is a common feature of individuals with bulimia nervosa regarding their body image?

They may resemble those with anorexia nervosa. Signup and view all the answers

What is one hallmark criterion that differentiates bulimia nervosa from anorexia nervosa?

Presence of binging episodes Signup and view all the answers

How do individuals with bulimia nervosa typically manage their weight between eating binges?

They employ restrictive caloric intake. Signup and view all the answers

What is a potential complication of purging behavior among individuals with bulimia nervosa?

Esophageal tears Signup and view all the answers

What distinguishes the prevalence of bulimia nervosa among different body weight categories?

It typically occurs in individuals with a BMI between 18.5 and 30. Signup and view all the answers

What factor is often uncertain in causing menstrual irregularities in females with bulimia nervosa?

Weight fluctuations Signup and view all the answers

What psychological feature is NOT present in individuals with Kleine-Levin syndrome despite disturbed eating behavior?

Excessive worry about weight Signup and view all the answers

Which disorder is associated with binge-eating behavior as part of its impulsive behavior criterion?

Borderline personality disorder Signup and view all the answers

In individuals with bulimia nervosa, what is the percentage lifetime prevalence of substance use disorder?

30% Signup and view all the answers

What typically improves following effective treatment of bulimia nervosa?

Anxiety symptoms Signup and view all the answers

When may mood disturbances in individuals with bulimia nervosa begin?

Both A and B Signup and view all the answers

What is the BMI threshold for determining severe anorexia nervosa severity in adults?

BMI 15–15.99 kg/m2 Signup and view all the answers

Which behavior is characteristic of individuals with the binge-eating/purging type of anorexia nervosa?

Regularly engaging in self-induced vomiting Signup and view all the answers

What is a distinguishing feature of major depressive disorder with atypical features compared to bulimia nervosa?

Inappropriate compensatory behaviors Signup and view all the answers

What is commonly observed in individuals with bulimia nervosa regarding mood disorders?

Low self-esteem Signup and view all the answers

Criterion A for diagnosing anorexia nervosa includes maintaining a body weight that is:

Below a minimally normal level for age or developmental trajectory Signup and view all the answers

Which personality disorder is most frequently associated with bulimia nervosa?

Borderline personality disorder Signup and view all the answers

What is the minimum BMI required to classify as having mild anorexia nervosa in adults?

BMI ≥ 17 kg/m2 Signup and view all the answers

How is body mass index (BMI) calculated?

Weight in kilograms divided by height in meters squared Signup and view all the answers

What is a common challenge when assessing body weight in individuals?

Normal weight range varies among individuals. Signup and view all the answers

What is the estimated 12-month prevalence of anorexia nervosa in men according to U.S. studies?

0% to 0.01% Signup and view all the answers

Which statement best describes the impact of age on the assessment of anorexia nervosa?

Children may fail to gain expected weight rather than lose weight. Signup and view all the answers

Which group seems to have the lowest prevalence of anorexia nervosa among U.S. ethnoracial groups?

Latinx Americans Signup and view all the answers

Which of the following is NOT an essential feature of anorexia nervosa?

Regular excessive exercise Signup and view all the answers

At what life stage is anorexia nervosa most commonly initiated?

Adolescence or young adulthood Signup and view all the answers

What is the general crude mortality rate for anorexia nervosa per decade?

5% Signup and view all the answers

Which factor is often associated with the onset of anorexia nervosa?

Stressful life events Signup and view all the answers

What aspect of anorexia nervosa may differ in older individuals compared to younger individuals?

Longer duration of illness Signup and view all the answers

What is Criterion B associated with anorexia nervosa typically inferred from?

Observational data and collateral history Signup and view all the answers

How do individuals with anorexia nervosa often perceive their body weight?

They feel certain body parts are too fat Signup and view all the answers

What percentage of individuals with anorexia nervosa may experience remission within 5 years of presentation?

Most individuals Signup and view all the answers

What typically motivates individuals with anorexia nervosa to seek professional help?

Distress over physical and psychological issues from starvation Signup and view all the answers

What is a common outcome for those admitted to hospitals for anorexia nervosa?

Lower overall remission rates Signup and view all the answers

Which of the following is a common physiological disturbance associated with anorexia nervosa?

Amenorrhea Signup and view all the answers

Which statement accurately describes the self-esteem of individuals with anorexia nervosa?

It heavily depends on their weight and body shape perceptions. Signup and view all the answers

What is a common misconception individuals with anorexia nervosa have regarding their condition?

They are often unaware of the medical implications of their state. Signup and view all the answers

Which symptom may indicate the severity of medical issues in anorexia nervosa?

Vital sign abnormalities Signup and view all the answers

Why is obtaining collateral information from family members crucial in assessing anorexia nervosa?

They can assist in evaluating the history of weight loss. Signup and view all the answers

Study Notes

Comorbidity

Anxiety disorders, obsessive-compulsive disorder, and neurodevelopmental disorders (autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability) are commonly observed with avoidant/restrictive food intake disorder.

Anorexia Nervosa - Diagnostic Criteria

A. Restriction of energy intake relative to requirements, leading to a significantly low body weight. Low weight is defined as less than minimally normal for age, sex, and development.
B. Intense fear of gaining weight or becoming fat; persistent behaviors that impede weight gain despite low weight.
C. Disturbance in the perception of body weight or shape, undue influence of weight/shape on self-evaluation, or persistent lack of recognition of the dangerousness of the low weight.

Coding note

The specific ICD-10-CM code depends on the subtype.

Subtypes

F50.01 Restricting type: No recurrent binge-eating or purging (self-induced vomiting, laxative/diuretic misuse, enemas) during the last three months. Weight loss primarily achieved through dieting, fasting, or excessive exercise.
F50.02 Binge-eating/purging type: Recurrent binge-eating or purging behaviors in the last three months.

Severity

Severity is based on BMI (body mass index). Ranges for adults and children/adolescents are different and detailed below.
- Mild: BMI ≥ 17 kg/m²
- Moderate: BMI 16–16.99 kg/m²
- Severe: BMI 15–15.99 kg/m²
- Extreme: BMI < 15 kg/m²

Partial & Full Remission

Partial remission: Criterion A (low body weight) is no longer met but either B (intense fear) or C (disturbance in self-perception) is still met.
Full remission: None of the criteria are met for a sustained period.

Diagnostic Features (Anorexia Nervosa)

Persistent restriction of energy intake
Intense fear of gaining weight or becoming fat
Disturbance in self-perception of weight/shape.
Weight significantly below a healthy level.

Subtypes (Anorexia Nervosa)

Individuals with binge-eating/purging type tend to purge (self-induced vomiting or use of laxatives, diuretics, or enemas) as well as binge eat.
Some individuals with this type do not binge eat but regularly purge.

Diagnostic Markers (Anorexia Nervosa)

Commonly observed are: leukopenia (loss of all blood cells), lymphocytosis, mild anemia, thrombocytopenia, and bleeding problems.
Elevated blood urea nitrogen
Elevated cholesterol
Elevated liver enzymes
Hypomagnesemia, hypozincemia, hypophosphatemia, or hyperamylasemia
Hypokalemia, hypochloremia, and metabolic acidosis.
Low levels of thyroid hormones (T3 and T4)
Low estrogen (females)
Low testosterone (males)

Associated Features (Anorexia Nervosa)

Physiological disturbances (amenorrhea, vital sign abnormalities, etc) are common.
Depressive signs and symptoms like withdrawal, irritability, insomnia, and diminished interest in sex are common.
Obsessive-compulsive features related to food
Concerns about eating in public
Difficulty with decision-making, inflexibility, and emotional restraint.
Higher risk of suicide attempts.

Prevalence (Anorexia Nervosa)

12-month prevalence: 0.0% to 0.05% (with higher rates in women).
Lifetime prevalence: 0.60% to 0.80% (with higher rates in women)
Prevalence is highest in post-industrialized, high-income countries.

Development and Course (Anorexia Nervosa)

Commonly begins in adolescence or young adulthood.
May manifest atypical symptoms in younger individuals.

Risk Factors (Anorexia Nervosa)

Temperamental traits (anxiety, obsessionality)
Environmental factors (cultures that value thinness, specific occupations like modeling).

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Test your knowledge on the diagnostic criteria for Anorexia Nervosa, including its subtypes and comorbidities. Explore the key features and definitions that distinguish this eating disorder from others. Ideal for students and professionals in the fields of psychology and medicine.