Anorexia Nervosa

What is Anorexia Nervosa (AN)?

An eating disorder with persistent energy restriction, low body weight, fear of gaining weight, and distorted body perception.

What are the behavioral and cognitive components of Anorexia Nervosa?

Behavioral: restriction, avoidance, excessive exercise. Cognitive: fear of fatness, body image distortion.

What does DSM-5-TR emphasize about Anorexia Nervosa?

It is both a psychological disorder and a medical condition.

What are the primary clinical themes of Anorexia Nervosa?

Drive for thinness, fear-based avoidance of food, inability to perceive healthy weight.

What are some examples of restrictive behaviors in Anorexia Nervosa?

Rigid dieting, avoidance of “fear foods,” fasting, or compulsive exercise.

What is the basis for determining the severity of Anorexia Nervosa in adults?

Current body mass index (BMI).

What is the minimum BMI for moderate Anorexia Nervosa severity?

16–16.99 kg/m2

What are common vital sign abnormalities in Anorexia Nervosa?

Bradycardia and hypotension.

What is a common mood symptom in severely underweight Anorexia Nervosa patients?

Low mood.

What is a common obsessive-compulsive feature in Anorexia Nervosa?

High preoccupation with food, recipes, or collecting/hoarding food items.

What are some additional behavioral and personality features of Anorexia Nervosa?

Anxiety about eating in public and strong need for control.

What is the typical age of onset for Anorexia Nervosa?

14–19 years old.

What is a common comorbidity with Anorexia Nervosa?

Major Depressive Disorder.

What is a common trigger for Anorexia Nervosa development?

Stressful life events.

What is the mortality rate associated with Anorexia Nervosa?

~5% per decade.

What are some cognitive distortions associated with Anorexia Nervosa (AN)?

Overvaluation of weight/shape, distorted body image, perfectionism, rigid thinking.

How do Barlow & Durand describe Anorexia Nervosa (AN)?

Cognitive distortions, overvaluation of weight/shape, distorted body image, perfectionism, rigid thinking, emotional regulation problems.

What role does starvation play in Anorexia Nervosa according to Barlow & Durand?

It becomes a way to reduce anxiety.

What feelings are triggered by eating in individuals with Anorexia Nervosa?

Intense guilt and panic.

Describe the behavioral maintenance cycle in Anorexia Nervosa.

Calorie restriction leads to physiological starvation, obsessive thoughts, weight loss, and fear of weight gain.

What positive reinforcement can result from weight loss in Anorexia Nervosa?

Compliments and a sense of control.

What are some sociocultural factors in the context of Anorexia Nervosa?

Sociocultural thin ideal, high-achieving, enmeshed families, reinforcement for perfectionism.

What is the estimated genetic heritability of Anorexia Nervosa (AN)?

Approximately 50-60%.

What neurotransmitter dysregulation is associated with Anorexia Nervosa?

Serotonin and dopamine dysregulation.

How does starvation affect neurocircuitry in Anorexia Nervosa?

It alters neurocircuitry and worsens symptoms.

What psychological traits are associated with Anorexia Nervosa?

Perfectionism, rigid cognitive style, high harm avoidance, anxiety sensitivity, poor interoceptive awareness.

What is poor interoceptive awareness?

Difficulty recognizing hunger/fullness.

What social/cultural factors influence Anorexia Nervosa?

Thin-ideal internalization, social media influence, family dynamics, peer teasing, weight-focused sports.

How does Bulimia Nervosa (BN) differ from Anorexia Nervosa (AN)?

BN involves normal weight or overweight; AN involves being underweight.

How is Anorexia Nervosa binge/purge subtype diagnosed?

If underweight, diagnose AN – binge/purge subtype, not BN.

How does Avoidant/Restrictive Food Intake Disorder (ARFID) differ from Anorexia Nervosa (AN)?

ARFID has no weight or shape concerns.

What motivates restriction in Anorexia Nervosa (AN)?

Fear of weight gain and body-image disturbance.

How does Major Depressive Disorder (MDD) with low appetite differ from Anorexia Nervosa (AN)?

Appetite loss in MDD is not weight/shape driven.

How do medical causes of weight loss differ from Anorexia Nervosa (AN)?

No fear of fatness or body-image disturbance; weight loss is unwanted.

How does Obsessive-Compulsive Disorder (OCD) differ from Anorexia Nervosa (AN)?

Avoidance not related to weight/shape or desire for thinness; motivated by obsessions/compulsions.

What is a key difference between Anorexia Nervosa (AN) and Bulimia Nervosa (BN) regarding body weight?

AN requires significantly low body weight; BN involves normal or above-normal weight.

What distinguishes Anorexia Nervosa-Binge/Purge subtype from Bulimia Nervosa (BN)?

AN-B/P subtype is still underweight; BN must include recurrent binge episodes + compensatory behaviors.

How does Binge-Eating Disorder (BED) differ from Anorexia Nervosa (AN)?

BED does not include compensatory behaviors and has binge eating at least 1x/week.

How does Avoidant/Restrictive Food Intake Disorder (ARFID) differ from Anorexia Nervosa (AN) in motivation?

ARFID motivated by sensory features, fear of choking, or lack of interest in eating.

What motivates restriction in Anorexia Nervosa (AN) compared to ARFID?

AN restriction motivated by desire for thinness.

How does Body Dysmorphic Disorder (BDD) differ from Anorexia Nervosa (AN)?

Focus on perceived flaws not related to weight/body fat.

How does Major Depressive Disorder (MDD) differ from Anorexia Nervosa (AN) in weight/shape concerns?

Appetite/weight loss is not driven by weight/shape concerns; no fear of fatness.

What are the main components of medical stabilization for Anorexia Nervosa?

Hospitalization, monitoring electrolytes/cardiac status, nutritional rehabilitation.

What is Family-Based Treatment (FBT / Maudsley) for Anorexia Nervosa?

Parents take charge of refeeding, gradual return of independence, addresses family patterns.

What is Cognitive Behavioral Therapy-Enhanced (CBT-E) for Anorexia Nervosa?

Addresses body image distortions, reduces restrictive behaviors, focuses on cognitive rigidity.

What role do SSRIs play in treating Anorexia Nervosa (AN)?

May help with depression/anxiety AFTER weight restoration.

What does nutritional rehabilitation involve in treating Anorexia Nervosa?

Structured meal plans, weight restoration targets, psychoeducation.