L23 | Eating Disorders

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following eating disorders is characterized by repeated overeating without compensatory behaviors?

Binge eating disorder (correct)

Night eating disorder

Anorexia nervosa

Bulimia nervosa

What distinguishes avoidant/restrictive food intake disorder from anorexia nervosa?

Includes extreme weight loss criteria

Avoids certain foods due to texture and taste preferences (correct)

Is only diagnosed in children

Involves significant fear of weight gain

Which category does pica fall under in the DSM V?

Other specified feeding or eating disorders (correct)

Bulimia nervosa

Anorexia nervosa

Binge eating disorder

What is one potential physiological link mentioned for night eating disorder?

Malfunctioning leptin levels Signup and view all the answers

In which population is binge eating disorder most commonly found?

Obese females Signup and view all the answers

Which of the following is NOT a characteristic of bulimia nervosa?

Eating small, frequent meals to maintain body weight Signup and view all the answers

What is the primary defining feature of rumination disorder?

Regurgitation and re-chewing of food Signup and view all the answers

Which eating disorder is characterized by eating non-food substances, like soil or paint?

Pica Signup and view all the answers

What is the significant characteristic of Anorexia Nervosa?

Restriction of energy intake relative to requirements Signup and view all the answers

Which subtype of Anorexia Nervosa involves purging behaviors?

Binge-eating/purging subtype Signup and view all the answers

What is the estimated lifetime prevalence of Anorexia Nervosa in women?

0.5-2% Signup and view all the answers

At what age does Anorexia Nervosa typically appear?

Around 12-13 years, post menarche Signup and view all the answers

Which of the following is a common medical consequence associated with Anorexia Nervosa?

Diminished libido and amenorrhea Signup and view all the answers

What behavioral change often marks the onset of Anorexia Nervosa?

Abandoning desserts, then meats, followed by all fats Signup and view all the answers

Which group has higher rates of Anorexia Nervosa prevalence?

Individuals in dance, fashion, and elite sports Signup and view all the answers

Which of the following defines the severity of Anorexia Nervosa?

Body Mass Index (BMI) classification Signup and view all the answers

What is a characteristic behavior of individuals with restrictive Anorexia Nervosa?

Progressive reduction in caloric intake Signup and view all the answers

What psychological impairments are often associated with Anorexia Nervosa?

Neuropsychological impairments in learning and memory Signup and view all the answers

Which trait is commonly associated with Anorexia Nervosa due to serotonin metabolism abnormalities?

Inflexibility Signup and view all the answers

What impact does chronic high cortisol levels have on the body?

Hippocampal damage Signup and view all the answers

What psychological factors are heightened in parents of children with Anorexia Nervosa during pregnancy?

Anxiety Signup and view all the answers

Which component of the HPA axis releases cortisol in response to stress?

Adrenal gland Signup and view all the answers

What is a common heritable trait associated with Anorexia Nervosa?

Perfectionism Signup and view all the answers

How much higher is the incidence of prematurity and birth trauma in children with Anorexia Nervosa compared to matched controls?

What role does the HPA axis play in relation to stress?

Regulates blood glucose and immune function Signup and view all the answers

Which behavior is a tendency observed in individuals predisposed to Anorexia Nervosa?

Excessive exercise Signup and view all the answers

What effect does maternal stress during pregnancy have on the developing fetus, in terms of HPA functioning?

It weakens the HPA axis Signup and view all the answers

What characterizes chronic anxiety in relation to Anorexia Nervosa?

Serotonergic abnormalities Signup and view all the answers

What is one consequence of abnormal HPA axis function in individuals with Anorexia Nervosa?

Increased vulnerability to stressors Signup and view all the answers

What is an abnormal satiety response linked to Anorexia Nervosa?

Reduced feelings of fullness Signup and view all the answers

Which attachment style is more prevalent among parents of children with Anorexia Nervosa?

Dismissive attachment Signup and view all the answers

What generally triggers the onset of Anorexia Nervosa, according to research?

Severe life events Signup and view all the answers

Study Notes

Eating Disorders Overview

This lecture focuses on anorexia nervosa (AN) and bulimia nervosa (BN).
Other less-studied eating disorders include other specified feeding or eating disorders (OSFED) and binge eating disorder (BED).
OSFED is a category for individuals not fitting AN or BN criteria, but exhibiting characteristics of one or both.
BED is characterized by repeated overeating without compensatory behaviors.
Night eating disorder is linked to abnormal circadian rhythms and possibly leptin dysfunction.
Rumination disorder involves repeated regurgitation and re-chewing of food, often in children.
Avoidant/Restrictive Food Intake Disorder (ARFID) is similar to anorexia but without fear of weight gain.

Anorexia Nervosa (AN)

Clinical definition: Restriction of energy intake relative to requirements, leading to significantly low body weight (judged by BMI relative to age, gender, and health). Intense fear of gaining weight, persistent behaviors preventing weight gain, and distorted body image.
Subtypes: Restricting (dieting, fasting), or binge-eating/purging (vomiting, laxatives).
Specification: Severity is based on BMI, ranging from mild (BMI 17) to extreme (BMI < 15). Conditions can be full, partial, or in remission.

Anorexia Nervosa (AN) Prevalence

Lifetime prevalence is 0.5–2% in women.
Primarily affects women, with a sex ratio between 10-20 to 1.
Common in middle to upper-middle class Caucasian women.
More common in those involved in dance, fashion, and elite sport.
Typically appears in adolescence (around 12–13 years), post-menarche, but range is 10–60 years.

Anorexia Nervosa (AN) Onset

Begins with minor dietary changes, often starting with eliminating desserts, meat, and fat.
Vegetarianism is sometimes adopted as a justification.
Increasing focus on safe foods (e.g., lettuce, fruit).
Restriction of fluids is often seen.
Eating speed and food frequency decreases.
Gradual decrease in caloric intake, often not apparent to family initially.
Body thinness becomes the dominant goal.

Anorexia Nervosa (AN) Clinical Consequences

Overactivity and cold sensitivity (fidgeting, excessive walking).
Multiple endocrine abnormalities (e.g., Type 1 diabetes possible).
Low blood pressure and slow heart rate.
Diminished libido and amenorrhea (absence of menstruation).
Increased risk of osteoporosis.
Neuropsychological impairments (learning/memory/hippocampal volume).
Increased risk of anxiety and depression.
Highest mortality rates of any psychiatric condition. (Estimates of lifetime mortality rate 5-10%)

Anorexia Nervosa (AN) Causes

Earliest documentation in 15th and 16th centuries.
No single cause but multiple interacting factors including genetics, biological, psychological, and social/cultural variables.
Pre-disposing traits may include obsessive-compulsive personality traits, heightened sensitivity to hunger, and tendency for high levels of exercise.

Anorexia Nervosa (AN) Development

25 percent of parents of children with AN have experienced complications in pregnancy/childbirth and loss.
Parents report increased anxiety levels during their children's pregnancy.
High rate of prematurity/birth trauma in children with AN parents.
Parents who tend to be controlling and overprotective.
Abnormal attachment styles are often observed in families with AN.

Anorexia Nervosa (AN) HPA Axis

The hypothalamic-pituitary-adrenal (HPA) axis regulates stress responses in the body.
Chronic high cortisol levels can lead to muscle wasting, high blood glucose, impaired immune function, and hippocampal damage.
HPA function is abnormal during the course of AN and may be abnormal following recovery with multiple biological causes.

AN and BN Maintenance

AN is often highly resistant to treatment because individuals may deny that there's a problem (egosyntonic).
Several biological factors may maintain AN behavior, including:
- Heightened body-weight awareness and the feeling of loss of control
- Complex, ritualistic behaviors around food and weight maintenance.
- Potential biological addiction to the process of weight loss, especially increased levels of b-endorphins.

Bulimia Nervosa (BN) Clinical Definition

Recurrent episodes of binge eating (eating a large amount of food quickly, with a lack of control over the behavior.)
Recurrent inappropriate compensatory behaviours to prevent weight gain (e.g., self-induced vomiting, laxatives, diuretics, or excessive exercise).
Both behaviors occur at least once a week for 3 months.
Self-evaluation unduly influenced by body weight and shape.
BN occurs independently of periods of Anorexia Nervosa (AN)

Bulimia Nervosa (BN) Prevalence and Consequences

Lifetime prevalence: 1–3% in women.
Predominantly a female disorder, with a significantly smaller number of cases in males.
Medical consequences include: dental erosion, swelling of the parotid glands, electrolyte abnormalities, esophageal tears.

Bulimia Nervosa (BN) Cause and Predisposing Factors

BN may share some genetic risk factors with AN.
Early experiences of dieting and critical comments about body weight may lead to onset.
A history of AN is a predisposing factor, but it does not affect all patients diagnosed with BN.
Childhood experiences, family environment, and critical comments about weight can also play a significant role.

Bulimia Nervosa (BN) Prognosis and Treatment

50% of patients appear to have full recovery from BN, with 30% experiencing occasional relapse, and 20% chronic BN.
Treatment often involves a combination of Cognitive Behavioral Therapy (CBT) and antidepressants.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz provides an overview of various eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder. It also covers lesser-known conditions like OSFED and ARFID, explaining their characteristics and clinical definitions. Test your knowledge on the complexities of eating disorders and their classifications.