Overview of Negative Energy Balance Disorders
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What characterizes the weight loss associated with anorexia nervosa?

  • It occurs without any physical health implications.
  • It results from malnutrition without any psychological factors.
  • It is accompanied by a restriction of energy intake relative to requirements. (correct)
  • It is solely a consequence of hypermetabolism.

    • What is the lifetime prevalence of anorexia nervosa in women?

  • 0.3%
  • 1.5%
  • 0.9% (correct)
  • 2.7%

    • Which of the following statements accurately reflects the severity of anorexia nervosa?

  • It does not lead to physical health complications.
  • It is associated with a suicide rate that is lower than average.
  • It is considered the deadliest psychiatric illness with a high death rate. (correct)
  • It has a lower death rate compared to all other mental illnesses.

    • How does Avoidant Restrictive Food Intake Disorder (ARFID) primarily affect individuals?

    <p>It results in voluntary food intake restriction leading to malnutrition.</p> Signup and view all the answers

    What factor significantly contributes to the high hazard ratio associated with being underweight?

    <p>A BMI of 16.</p> Signup and view all the answers

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

    <p>An increase in energy expenditure without food intake.</p> Signup and view all the answers

    What is a common psychological consequence of the energy intake restriction seen in anorexia and ARFID?

    <p>Psychosocial disability stemming from malnutrition.</p> Signup and view all the answers

    Which disorder is specifically characterized by voluntary restriction of food intake without the presence of body image distortion?

    <p>Avoidant Restrictive Food Intake Disorder</p> Signup and view all the answers

    How is the energy expenditure affected in individuals with anorexia nervosa?

    <p>It adjusts downward to maintain a balance with food intake.</p> Signup and view all the answers

    What criterion must be met to be diagnosed with significantly low weight?

    <p>A weight less than minimally expected for children and adolescents</p> Signup and view all the answers

    Which BMI range qualifies as moderate severity in weight disorders?

    <p>16 - 16.99</p> Signup and view all the answers

    Which of the following is NOT a diagnostic criterion for Avoidant/Restrictive Food Intake Disorder (ARFID)?

    <p>Excessive concern over body shape and weight</p> Signup and view all the answers

    What is a common comorbidity associated with Avoidant/Restrictive Food Intake Disorder?

    <p>Sensory processing issues</p> Signup and view all the answers

    Which statement accurately describes a potential outcome of nutritional deficiencies from ARFID?

    <p>Micronutrient deficiencies are primarily involved</p> Signup and view all the answers

    What behavior is indicative of severe complications from low body weight?

    <p>Dependence on tube feeding for nutritional intake</p> Signup and view all the answers

    How is extreme low body weight severity defined?

    <p>BMI less than 15</p> Signup and view all the answers

    What psychological effect might result from a significant low weight diagnosis?

    <p>Undue influence of body shape on self-evaluation</p> Signup and view all the answers

    Which of the following describes a social impact of ARFID?

    <p>Avoidance of social events due to feared foods</p> Signup and view all the answers

    What is a key characteristic of the feeding or eating disturbance in ARFID?

    <p>Extreme fussy eating patterns</p> Signup and view all the answers

    What is a significant physiological consequence of low body weight in individuals with anorexia nervosa?

    <p>Amenorrhea and loss of fertility</p> Signup and view all the answers

    Cognitive flexibility involves the ability to:

    <p>Switch between different concepts or tasks</p> Signup and view all the answers

    How does cognitive inflexibility manifest in individuals with anorexia nervosa?

    <p>Fixation on specific foods or body parts</p> Signup and view all the answers

    What evidence suggests cognitive inflexibility is a trait rather than a mere consequence of starvation?

    <p>Similar levels of inflexibility in ill and well siblings</p> Signup and view all the answers

    Which therapy method is suggested to enhance cognitive flexibility in anorexia nervosa?

    <p>Psychedelic drug therapy combined with psychotherapy</p> Signup and view all the answers

    What is a key feature of cognitive inflexibility in anorexia nervosa?

    <p>Rigid thought patterns</p> Signup and view all the answers

    What is a characteristic behavioral symptom commonly associated with anorexia nervosa?

    <p>Preoccupation with details and perceived rules</p> Signup and view all the answers

    Which of the following hormones is typically found at low levels in patients with anorexia nervosa?

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

    Chronic starvation in anorexia nervosa leads to elevated levels of which hormone?

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

    How does ARFID differ from anorexia nervosa in terms of body image perception?

    <p>ARFID has no evidence of body image disturbance.</p> Signup and view all the answers

    What physiological change occurs in response to chronic stress in patients with anorexia nervosa?

    <p>Remodeling of end organ receptors</p> Signup and view all the answers

    What is a prominent psychological characteristic associated with ARFID?

    <p>Hyperactive fear processing of unfamiliar foods.</p> Signup and view all the answers

    What cytokines are consistently elevated in patients with anorexia nervosa?

    <p>IL-1 beta, IL-6, and TNF alpha</p> Signup and view all the answers

    What type of foods do individuals with ARFID typically prefer?

    <p>Heavily processed, predictable, and homogenous foods.</p> Signup and view all the answers

    Which of the following is NOT typically associated with the hormone profile in anorexia nervosa?

    <p>High leptin levels</p> Signup and view all the answers

    Which treatment method is specifically mentioned for younger children with ARFID?

    <p>The messy food picnic technique.</p> Signup and view all the answers

    What aspect of the body’s response is altered due to receptor remodeling in anorexia nervosa?

    <p>Response to noradrenaline and adrenaline</p> Signup and view all the answers

    What common methods are used for older children with ARFID?

    <p>Cognitive behavioral therapy (CBT).</p> Signup and view all the answers

    What is a key difference between anorexia nervosa and primary malnutrition regarding cytokine levels?

    <p>Cytokine levels are dysregulated in anorexia nervosa</p> Signup and view all the answers

    Which of the following conditions is often associated with ARFID?

    <p>Sensory processing issues.</p> Signup and view all the answers

    What was a primary goal for including ARFID in the DSM-V?

    <p>To replace 'disorders not otherwise specified' with clearer classifications.</p> Signup and view all the answers

    Which psychological disorders show significant diagnostic overlap with anorexia nervosa?

    <p>Anxiety disorders and obsessive-compulsive disorders</p> Signup and view all the answers

    How might individuals with ARFID describe their feelings towards unfamiliar foods?

    <p>They perceive them as threatening or terrifying.</p> Signup and view all the answers

    What aspect of ARFID severity must be considered when diagnosing the disorder?

    <p>It must exceed expectations based on any primary disorder.</p> Signup and view all the answers

    Why might ARFID be particularly challenging to classify within eating disorders?

    <p>It does not always involve significant weight loss.</p> Signup and view all the answers

    Study Notes

    Overview of Negative Energy Balance Disorders

    • Underweight conditions can result from psychiatric disorders like Anorexia Nervosa and Avoidant Restrictive Food Intake Disorder (ARFID), as well as hypermetabolic states such as cancer cachexia and hyperthyroidism.
    • Underweight individuals face significant health risks; a BMI of 16 presents as high a hazard ratio as obesity.

    Anorexia Nervosa

    • Considered the deadliest psychiatric illness with a 20% mortality rate over 20 years.
    • Physical death rates in this age group exceed expected levels by 5 times; suicide rates are 32 times higher than expected.
    • Lifetime prevalence: 0.9% in women, 0.3% in men.
    • Diagnostic criteria require:
      • Significant restriction of energy intake leading to low body weight.
      • Intense fear of gaining weight and persistent behaviors preventing weight gain.
      • Disturbance in body weight or shape perception.
    • Severity classifications:
      • Mild: BMI over 17
      • Moderate: BMI 16-16.99
      • Severe: BMI 15-15.99
      • Extreme: BMI less than 15

    Avoidant/Restrictive Food Intake Disorder (ARFID)

    • Characterized by extreme fussy eating, often seen in individuals with autism; may relate to childhood illnesses.
    • Diagnostic criteria highlight disturbances in eating leading to inadequate nutritional intake, including:
      • Apparent lack of interest in food.
      • Avoidance of foods due to sensory characteristics.
      • Results can include significant weight loss, nutritional deficiencies, reliance on tube feeding, and interference with social functions.
    • ARFID lacks the body image disturbances seen in anorexia nervosa.
    • Development of ARFID emerged from DSM-V to clarify eating disorders, particularly linked to hyperactive fear processing associated with unfamiliar foods.

    Treatment Approaches for ARFID

    • Treatment varies; younger children may utilize engagement techniques like messy food picnics to safely introduce food.
    • Older individuals often undergo Cognitive Behavioral Therapy (CBT) to address food-related fears.

    Physiological and Hormonal Changes in Anorexia Nervosa

    • Cognitive symptoms may include perfectionism, rigid behavior, and obsessive preoccupations.
    • Diagnostic overlap exists with anxiety disorders, obsessiveness, and autism spectrum disorders.
    • Hormonal changes include:
      • Low leptin and insulin; high ghrelin levels characteristic of low body weight.
      • Chronic starvation leads to elevated cortisol and sympathetic nervous system responses, altering receptor sensitivity and tissue breakdown.
      • Elevated pro-inflammatory cytokines (IL-1 beta, IL-6, TNF alpha) signify an inflammatory state distinct from primary malnutrition.
    • Amenorrhea and anemia are common physiological manifestations due to low body weight.

    Cognitive Flexibility in Anorexia Nervosa

    • Cognitive flexibility is the ability to adapt to changing situations or tasks, crucial for responsive behavior.
    • Cognitive inflexibility is a prominent feature, leading to fixations on food types and rituals, which can be a trait predisposing disorder onset.
    • Improvements in cognitive flexibility correlate with symptom reduction in anorexia.
    • Psychotherapy aids in adapting rigid thinking; potential treatments are being explored using psychedelics like psilocybin to enhance cognitive adaptability.

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    Lecture 12: Disorders of Negative Energy Balance PDF

    Description

    This quiz covers important aspects of negative energy balance disorders, focusing on conditions like Anorexia Nervosa and ARFID. It examines diagnostic criteria, prevalence, and the health risks associated with being underweight. Understand the classifications of severity and the alarming statistics related to mortality and mental health.

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