Mental Health Chapter 21 eating disorders Exam 2

What part of the brain contains the appetite regulation center within the brain?

Hypothalamus

How does the hypothalamus control hunger?

•It regulates the body’s ability to recognize when it is hungry, when it  not hungry, and when it has been satisfied.

What are eating behaviors influenced by?

Society and culture

Anorexia nervosa: 

•Prevalence rate= 1% young women in USA

•Predominantly in girls and women ages 12 to 30 years.

•Characterized by a morbid fear of obesity

•Symptoms include gross distortion of body image, preoccupation with food, and refusal to eat

•Amenorrhea is typical and may even precede significant weight loss.

•There may be an obsession with food.

Anorexia nervosa signs and symptoms:

Hypothermia, bradycardia, hypotension, edema, lanugo, and a variety of metabolic changes

Feelings of anxiety and depression

Weight loss is extreme, usually more than 15 % of expected weight

Client writes a goal for themselves:

Client will perceive a personal ideal body weight and shape as normal by verbalizing 3 positive statements by the end of the month.

Bulimia Nervosa:

•More prevalent than anorexia, 4% female, late adolescence or early adulthood.

•Bulimia nervosa is an episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period

•The episode is followed by inappropriate compensatory behaviors to rid the body of the excess calories (self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Signs and symptoms of bulimia nervosa: 

•Fasting or excessive exercise may also occur.

•Most patients with bulimia are within a normal weight range, some slightly underweight, some slightly overweight.

•Depression, anxiety, and substance abuse are not uncommon.

•Excessive vomiting and laxative or diuretic abuse may lead to problems with dehydration and electrolyte imbalances.

May struggle with tooth decay.

Predisposing factors for anorexia and bulimia:

•Biological influences

Genetics a hereditary predisposition to eating disorders has been hypothesized.

•Anorexia nervosa is more common among sisters and mothers of those with the disorder than it is among the general population.

•Possible chromosomal linkage sites have been suggested.

•Anorexia nervosa may be associated with high levels of endogenous opioids.

Neuroendocrine abnormalities have been linked as a predisposing factor for anorexia, what is this?

There has been some speculation about a primary hypothalamic dysfunction in anorexia nervosa.

Neurochemical influences have been linked as predisposing factor of bulimia, what is this?

Bulimia nervosa may be associated with the neurotransmitters serotonin and norepinephrine

Psychodynamic predisposing factors of eating disorders:

•Suggests that eating disorders result for very early and profound disturbances in mother-infant interactions, resulting in

•Delayed ego development

•Unfulfilled sense of separation-individuation

Family influence as a predisposing factor of eating disorder:

Elements of power and control

•Home environment overprotected and demands perfection

•Ambivalence toward the parents develops and distorted eating patterns may represent rebellion against the parents.

Eating disorder is seen as a way to gain control.

Treatment for an eating disorder: 

•Behavioral Modification (coping skills)

•Focus to reduce anxiety

•Watch 1 on 1 during and after meals

Psychopharmacology

Psychopharmacology in treating eating disorders:

No medications are specifically indicated for eating disorders.

Various medications have been prescribed for associated symptoms,

such as

•Anxiety

depression

Medications that have been tired with some success for treating ANOREXIA include: 

•Fluoxetine (Prozac)

•Clomipramine (Anafranil)

•Chlorpromazine (Thorazine)

•Olanzapine (Zyprexa)

Medications that have been tired with some success for treating BULIMIA include: 

•Fluoxetine (Prozac)

•Imipramine (Tofranil)

•Desipramine (Norpramine)

•Amitriptyline (Elavil)

•Phenelzine (Nardil)