Conditions Test 2

Anorexia Nervosa

• profound refusal to maintain normal body weight (about 85% of expected weight),

• excessive concern with and distorted body image

• failure to recognize problem

• relentless pursuit of thinness through diet and exercises with an accompanying intense unremitting fear of gaining weight

• food always on the mind

Bulimia Nervosa

• episodic and recurring bing eating and purging foods to avoid weight gain

• disorder begins with strict dieting and weight loss over time transforms into hallmark behaviors (self induced vomiting, misuse of laxatives, diuretics, enemas, or other meds to avoid weight gain), causes oral issues

Binge Eating Disorder

• most common, yet most unrecognized

• recurrent episodes of excessive eating within discrete period of time and a perceived sense of lack of control over the eating

• individuals do not engage in compensatory behaviors like purging, misuse of laxatives, diet pills, etc

• individuals tend to eat in secrecy due to embarrassment

Rumination

• rare and chronic

• repeated non-purposeful regurgitation of recently ingested food from stomach to the mouth where it is rechewed, reswallowed, or expelled

• occurs almost daily, not associated with other GI disorders

• Sensation feels like pressure and need to belch, nausea, pain, discomfort

• no concern about weight/body shape

• done in secret

Avoidant/Restrictive Food Intake Disorder (ARFID)

• created as a result of increasing number of children/adolescents who had an eating disorder but did not meet criteria for other categories

• different presentations

  • some individuals demonstrate interest in very narrow range of foods, others avoid certain foods due to sensory issues, and others restrict food intake in response to emotional crises, unpleasant experiences, untoward feelings

• demonstrate higher rates of coexisting conditions such as ADHD, ASD, OCD, anxiety other than feeding/eating disorders

• five types of feeding refusals

  • learning dependent food refusal, medical complications-related food refusal, selective food refusal, fear based food refusal, appetite awareness and autonomy-based food refusal

Pica

• persistent eating of and appetite for nonnutritive, nonfood substances such as clay, soil, laundry starch, hair, chalk, crayons, and ashes

• complex, dangerous form of eating behaviors

• can lead to death or life threatening consequences due to choking ot intestinal obstruction

• can also lean to malnutrition, poisoning, burns, and parasitic infections and cause significant harm to dental and digestive structures

Etiology - physiological

• neurochemical imbalances (effect mood, appetite and reward)

• hormonal dysregulation (influences hunger, satiety, stress response)

• interoception difference

Etiology - genetics

strong hereditary predisposition

Etiology - psychological

• co-existing with other mental health disorders (anxiety, depression, OCD)

• low self esteem

• personality traits (perfectionism, anxiety, impulsivity)

Etiology - social emotional/interpersonal

• peer pressure, bullying, social comparison

• emotional trauma, neglect, attachment

Etiology - environmental

• diet culture, occupations, sports

• emphasizing weight control

• decreased access to food

• trauma

Etiology - cognitive

• distorted body image

• rigid all or nothing thinking

• impaired executive functioning (planning, impulse control)

Incidence of Eating Disorders

• 10-30 years

• anorexia = highest mortality

• males & females

• all socioeconomic classes

Signs of eating disorder

• restrictive behaviors, binge eating, fixations, purgative behavior, fluid intake, body checking, body avoidance, diminished bone density, poor concentration, weight loss/failure to grow, anxiety/depression, bulky clothing, refusal to look in mirror, preoccupation with body weight/shape, hair loss, tooth decay, ulcers, parentheses diet, oral motor skills

Eating disorder treatment

• psychological therapies

  • cognitive behavior therapy

  • family based therapy (children/teens)

• medications (antidepressants, mood stabilizers, baclofen)

• applied behavior analysis (pica)

• nutritional counseling and behavioral approaches (ARFID)

• impatient hospitalization may be needed