Eating Disorders Overview and Anorexia Nervosa
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Eating Disorders Overview and Anorexia Nervosa

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Questions and Answers

Which eating disorder is characterized by repeated overeating without compensation?

  • Avoidant/restrictive food intake disorder
  • Bulimia nervosa
  • Binge eating disorder (correct)
  • Anorexia nervosa

    • Which eating disorder is associated with individuals having an abnormal circadian rhythm linked to obesity?

  • Rumination disorder
  • Bulimia nervosa
  • Avoidant/restrictive food intake disorder
  • Night eating disorder (correct)

    • Pica is often associated with which of the following?

  • Binge eating disorder
  • Anorexia nervosa
  • Developmental disorders (correct)
  • Body image distortion

    • Which disorder involves the repeated regurgitation and re-chewing of food, mainly observed in children?

    <p>Rumination disorder</p> Signup and view all the answers

    Individuals with avoidant/restrictive food intake disorder experience what key difference compared to anorexia nervosa?

    <p>No fear of weight gain or body distortion</p> Signup and view all the answers

    What characterizes the onset of anorexia nervosa?

    <p>Abandonment of desserts, then meats, and finally all fat-containing foods</p> Signup and view all the answers

    Which of the following is a subtype of anorexia nervosa?

    <p>Restricting type</p> Signup and view all the answers

    What is an important medical consequence of anorexia nervosa?

    <p>Neuropsychological impairments and reduced hippocampal volume</p> Signup and view all the answers

    At what age does anorexia nervosa typically first appear?

    <p>Around 12-13 years, post-menarche</p> Signup and view all the answers

    What is not a distinguishing feature of anorexia nervosa?

    <p>Compulsive overeating behaviors</p> Signup and view all the answers

    What can be a psychological consequence of anorexia nervosa?

    <p>Increased risk of depression</p> Signup and view all the answers

    Which statement about the prevalence of anorexia nervosa is accurate?

    <p>It primarily affects women with a sex ratio of 10-20 to 1</p> Signup and view all the answers

    Which of the following is a common behavior seen in individuals with anorexia nervosa?

    <p>Restriction of fluid intake</p> Signup and view all the answers

    What is a critical diagnostic feature of anorexia nervosa (AN)?

    <p>Sufferers may deny the existence of their problem.</p> Signup and view all the answers

    What role do complex rituals play in the behavior of someone with anorexia nervosa?

    <p>They often evolve around weight measurement and dietary restrictions.</p> Signup and view all the answers

    What biological factor is suggested to help maintain the fasting behavior in anorexia nervosa?

    <p>Addiction-like behavior related to weight loss.</p> Signup and view all the answers

    What percentage of individuals with anorexia nervosa may never fully recover?

    <p>50%</p> Signup and view all the answers

    Why is refeeding considered the first treatment goal for anorexia nervosa?

    <p>To normalize weight under strict supervision.</p> Signup and view all the answers

    What might help contribute to the avoidance of dysphoria in individuals with anorexia nervosa?

    <p>Avoiding eating, leading to perceived emotional relief.</p> Signup and view all the answers

    What is a consequence of the highly stylized eating rituals associated with anorexia nervosa?

    <p>Social avoidance as disorder progresses.</p> Signup and view all the answers

    What is the typical caloric intake for refeeding in hospital treatment of anorexia nervosa?

    <p>2000-4000 Kcal/day</p> Signup and view all the answers

    What is a characteristic of binge eating in bulimia nervosa?

    <p>Eating in a large amount over a short period of time</p> Signup and view all the answers

    What is a common inappropriate compensatory behavior associated with bulimia nervosa?

    <p>Excessive exercise</p> Signup and view all the answers

    What percentage of the lifetime prevalence of bulimia nervosa is estimated in women?

    <p>1-3%</p> Signup and view all the answers

    Which of the following is NOT a medical consequence of bulimia nervosa?

    <p>Severe malnutrition</p> Signup and view all the answers

    How frequently must binge eating and inappropriate compensatory behaviors occur to meet the criteria for bulimia nervosa?

    <p>At least once a week for 3 months</p> Signup and view all the answers

    Bulimia nervosa primarily develops during which life stages?

    <p>Late adolescence and early adulthood</p> Signup and view all the answers

    Which of these characterizes bulimia nervosa's effect on self-evaluation?

    <p>Heavily influenced by body weight and shape</p> Signup and view all the answers

    What unique facial condition can result from bulimia nervosa due to parotid gland swelling?

    <p>Chipmunk face</p> Signup and view all the answers

    What is a significant genetic risk factor associated with anorexia nervosa (AN)?

    <p>Female relatives being 7-20 times more likely to develop AN</p> Signup and view all the answers

    Which behavioral trait is associated with the genetic vulnerabilities linked to AN?

    <p>Tendency towards excessive exercise</p> Signup and view all the answers

    What role does cortisol play when cortisol levels are chronically high due to stress?

    <p>It leads to muscle wasting</p> Signup and view all the answers

    What impact does childbirth trauma have on the development of AN in children?

    <p>It significantly increases the risk of developing AN</p> Signup and view all the answers

    Which factor is associated with the activation of the HPA axis in relation to AN?

    <p>Acute stress events preceding AN onset</p> Signup and view all the answers

    What are the three components of the HPA axis?

    <p>Hypothalamus, Pituitary gland, Adrenal gland</p> Signup and view all the answers

    How does the hypothalamus affect appetite regulation in individuals with AN?

    <p>It regulates appetite through abnormal CRH release</p> Signup and view all the answers

    In what way do overprotective parental behaviors affect children at risk of developing AN?

    <p>They impact stress management abilities</p> Signup and view all the answers

    Which trait is typically observed in individuals with disorders related to abnormalities in serotonin metabolism?

    <p>Perfectionism and inflexibility</p> Signup and view all the answers

    What biological change during puberty may contribute to an increased vulnerability for AN?

    <p>Changes in fat distribution and hormonal levels</p> Signup and view all the answers

    What is the relevance of prematurity in relation to AN risk?

    <p>It is associated with a higher incidence of AN</p> Signup and view all the answers

    How does the culture of weight loss relate to the incidence of AN among populations?

    <p>It contributes to increased body dissatisfaction</p> Signup and view all the answers

    What does chronic release of Neuropeptide Y inhibition result in for those with AN?

    <p>Loss of appetite and weight loss</p> Signup and view all the answers

    What is one of the predisposing factors for bulimia nervosa (BN)?

    <p>Childhood and parental obesity</p> Signup and view all the answers

    Which physiological change is associated with the development of bulimia nervosa?

    <p>Delayed gastric emptying</p> Signup and view all the answers

    Which of the following statements about bulimia nervosa treatment is correct?

    <p>Combining CBT and antidepressants is effective</p> Signup and view all the answers

    What percentage of individuals with bulimia nervosa is likely to experience chronic symptoms?

    <p>20%</p> Signup and view all the answers

    What is one identified potential trigger for binge eating in bulimia nervosa?

    <p>Dysphoria</p> Signup and view all the answers

    How does bulimia nervosa generally compare in treatability to anorexia nervosa?

    <p>Bulimia nervosa is easier to treat than anorexia</p> Signup and view all the answers

    What change in serotonin function is associated with bulimia nervosa?

    <p>Abnormal serotonergic function</p> Signup and view all the answers

    Which psychological condition shows higher rates among individuals with bulimia nervosa?

    <p>Anxiety and depression</p> Signup and view all the answers

    Which binge eating characteristic is true regarding bulimia nervosa?

    <p>Binged foods can vary greatly in caloric content</p> Signup and view all the answers

    What role does critical commentary about weight play in the development of bulimia nervosa?

    <p>It is a predisposing factor</p> Signup and view all the answers

    Study Notes

    Eating Disorders: Overview

    • This lecture focuses on anorexia nervosa (AN) and bulimia nervosa (BN).
    • Other eating disorders include: other specified feeding or eating disorders (OSFED), binge eating disorder (BED), and night eating disorder.
    • OSFED is a category for those who don't meet AN or BN criteria, but show characteristics of one or both.
    • BED is characterized by repeated overeating without compensatory behaviors, and is common in obese individuals (9-18% of obese).
    • Night eating disorder is linked to obesity and abnormal circadian rhythm potentially linked to leptin dysfunction.
    • Rumination disorder involves repeated regurgitation and rechewing.
    • Avoidant/restrictive food intake disorder is similar to anorexia, but without fear of weight gain.

    Anorexia Nervosa (AN): Clinical Definition

    • Restriction of energy intake, leading to significantly low body weight (determined by BMI relative to age, gender, and health expectations).
    • Intense fear of gaining weight or becoming fat, or persistent behaviors interfering with weight gain (even at low weight).
    • Disturbance of perception of shape or body weight, and denial of the seriousness of current low body weight.
    • Subtypes: Restricting (dieting, fasting, exercise) and binge-eating/purging (vomiting, laxatives, diuretics, enemas).

    Anorexia Nervosa (AN): Prevalence

    • Lifetime prevalence of AN is 0.5-2% in women.
    • Predominantly affects women in middle to upper middle class Caucasian.
    • Higher rates in those involved in dance, fashion, and elite sports.
    • Typically appears around 12-13 years (post-menarche).

    Anorexia Nervosa (AN): Onset

    • Starts with minor dietary changes, abandoning desserts, then meats, then fat-containing foods.
    • Vegetarianism or "safe-foods" (like lettuce and fruit) are sometimes used to justify, with decreased eating speed and longer intervals between meals.

    Anorexia Nervosa (AN): Medical Consequences

    • Overactivity and cold sensitivity.
    • Multiple endocrine abnormalities (e.g., type 1 diabetes).
    • Low blood pressure, slow heart rate.
    • Diminished libido, amenorrhea (absence of menstruation).
    • Osteoporosis (post-recovery).
    • Neuropsychological impairments in learning and memory.
    • Anxiety and depression.
    • Estimated lifetime mortality rate of 5-10%.

    Anorexia Nervosa (AN): Cause

    • Earliest documentation is in the 15th-16th centuries.
    • No single cause identified.
    • Multiple interacting factors include genetics, biological, psychological, and social/cultural factors.

    Anorexia Nervosa (AN): Genetics

    • Significant genetic component; female relatives 7-20x more likely to develop AN.
    • Monozygotic (MZ) twins show higher concordance for AN than dizygotic (DZ) twins.
    • Estimates suggest 58-76% of variance in AN is due to genetics.
    • Related to certain personality traits (e.g., perfectionism, inflexibility, and restraint), abnormality in serotonin metabolism, and chronic anxiety.

    Anorexia Nervosa (AN): Developmental Factors

    • 25% of AN parents have a history of obstetric difficulty or loss.
    • Higher incidence of prematurity and birth trauma in AN children.
    • Parents of AN children report higher anxiety during pregnancy.
    • Parents often controlling and overprotective.
    • Abnormal attachment styles (e.g., dismissive, insecure) in AN parents.

    Anorexia Nervosa (AN): HPA Axis

    • The HPA axis is composed of hypothalamus, pituitary, and adrenal glands, involved in stress response.
    • Stress chronically high cortisol leads to muscle wasting, high glucose, immune suppression, and hippocampal damage.
    • AN shows abnormal HPA function and multiple biological causes.
    • Profound changes during puberty potentially increase vulnerability.

    Anorexia Nervosa (AN): Causal Synthesis

    • Predisposing factors include abnormal HPA, increased serotonin, anxiety enhanced satiety, biological window, situational factors, chronic stress.
    • Results in manifestation of AN.

    Anorexia Nervosa (AN): Maintenance

    • Weight loss initially is satisfying, but increasingly punitive measures are implemented.
    • Highly stylized eating rituals develop including food types becoming restricted.
    • Social avoidance increases
    • Pursuit of weight loss becomes the sole goal.
    • Biological factors suggest potential addiction of weight loss.

    Anorexia Nervosa (AN): Prognosis & Treatment

    • 50% achieve full recovery.
    • 30% experience occasional relapse.
    • 20% exhibit chronic AN.
    • Treatment combines CBT (cognitive behavioral therapy) and antidepressants.
    • CBT helps with identifying triggers for bingeing and coping mechanisms.
    • Antidepressants may be effective after refeeding to prevent relapse.

    Bulimia Nervosa (BN): Clinical Definition

    • Recurrent episodes of binge eating (large amounts of food in a discrete period with lack of control).
    • Inappropriate compensatory behaviors (vomiting, laxatives, excessive exercise) to avoid weight gain.
    • Binge eating and compensation occur at least once a week for 3 months, and self-evaluation is heavily influenced by body weight and shape.

    Bulimia Nervosa (BN): Prevalence and Medical Consequences

    • Lifetime prevalence is ~1-3% in women.
    • Typically appears in late adolescence/early adulthood.
    • Benign relative to AN, but can include dental erosion, parotid gland swelling ("chipmunk face") electrolyte imbalances, and complications like esophageal tears.

    Bulimia Nervosa (BN): Cause

    • History of AN may be a factor in some cases.
    • Potential predisposition may include dieting, childhood/parental obesity, family environment, critical comments about weight, sexual abuse, anxiety and depression.

    Bulimia Nervosa (BN): Instigation and Maintenance

    • A plausible model of BN onset involves dieting, preoccupation with weight, quick weight loss methods, perceived control over food/purging.
    • Frequency/duration of binges and triggers generally increases.
    • Physiologic changes related to abnormal satiety are observed, including enlarged gastric capacity, delayed emptying, diminished elasticity of the stomach, impaired CCK release (diminished post-meal satiety), and abnormal serotonergic function.

    Bulimia Nervosa (BN): Prognosis & Treatment

    • Treatment response varies but a successful outcome is achievable.
    • CBT and antidepressants often provide good results.

    General Conclusion

    • AN and BN are common and complex eating disorders.
    • Causation is not fully understood but a range of factors and interactions play a role in their onset.
    • BN is generally easier to treat than AN.

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    Description

    This quiz covers key concepts related to eating disorders, focusing on anorexia nervosa and bulimia nervosa. It delves into various types of eating disorders, their characteristics, and clinical definitions, offering a comprehensive understanding of this critical subject.

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