mental health, theme 4

eating disorder

disorder that is characterized by a persistent disturbance in eating behavior

Anorexia Nervosa

pursuit of thinness that is relentless and that involves behaviors that result in a significant low body weight

DSM-5 criteria for anorexia nervosa (3)

• low body weight due to not eating enough

• intense fear of gaining weight, or persistent behavior that interferes with weight gain

• disturbance in the way one’s body weight or shape is experienced

amenorrhea

no menstruation (not a criteria anymore)

2 types of anorexia

• restrictive type: every effort is made to limit the quantity of food consumed

• binge-eating/purging type: in addition to restrictive eating, they also binge and purge

binge-eating

out-of-control food consumption —> higher amount of food than is normal

purging

removing the food from the body by self-induced vomiting, laxatives, excessive exercise or fasting

bulimia nervosa

disorder that is characterized by uncontrollable binge eating and efforts to prevent weight gain resulting form the eating —> different from binge-eating/purging type of anorexia because they are not underweight

DSM-5 criteria for bulimia nervosa (4)

• recurrent episodes of binge eating —> eating a high amount of food in a short time period (abnormal) & lack of control over eating

• inappropriate compensatory behaviors (purging)

• both binge-eating and purging occurs at least once a week for 3 months

• self-evaluation is based on body weight and shape

Binge eating disorder

disorder characterized by binge-eating

DSM-5 criteria for BED (5)

• recurrent episodes of binge eating (lack of control & eating a lot of food in a short time period)

• the binge eating episodes are associated with 3 or more of the following (eating faster than normal, eating until uncomfortable full, eating large amounts when not hungry, eating alone because of embarrassment, feeling disgusted with oneself)

• experiences distress regarding binge eating

• the binge eating occurs on average, once a week for at least 3 months

• no inappropriate compensatory behaviors

prevalence of 3 types of eating disorders

• BED —> 2%

• Bulimia —> 1%

• Anorexia —> 0.9%

biological factors of eating disorders

• genetics (both bulimia & anorexia are highly heritable)

• brain abnormalities —> triggering the hypothalamus or lateral hypothalamus can either inhibit or trigger eating (look at drawing)

• set points (our body trying to keep our weight at a certain set point —> leads to hunger)

• serotonin —> modulates appetite and feeding behavior

• reward sensitivity (food releases dopamine)

sociocultural factors of eating disorders

thin ideal or curvy ideal depending on country and culture

family influences on eating disorders

dysfunctional families can contribute to an ed as well as other family members preoccupation with thinness

individual risk factors of eating disorders

• gender

• internalizing the thin ideal

• perfectionism

• negative body image

• trauma’s

• dieting

• negative emotionality

thin ideal

buying into the notion that thin is highly desirable

perfectionism

the pursuit of unattainably high standards combined with an intolerance of mistakes

treatment for anorexia nervosa

view the disorder as chronic, and are pessimistic about their potential of recovery —> high drop-out rates

1. hospitalization & intravenous feeding: the first concern is to get the patient back to a weight that is no longer life threatening

2. medications: antidepressant or antipsychotics —> often help with the disturbed thinking

3. Family therapy: often family problems and issues are addressed that contribute to the eating disorder

4. CBT: changing behavior and maladaptive styles of thinking —> recommended length = 1-2 years

—> only limited success with CBT because of the cognitive rigidity of anorexic patients

treatment for bulimia nervosa

CBT —> a lot of succes for bulimic patients

• behavioral component: normalizes the eating patterns

• cognitive component: changes the cognition and behaviors initiating the binge cycle

Antidepressants —> because a lot of bulimic patients also deal with mood disorders

Interpersonal psychotherapy —> helps with interpersonal functioning (mood disorders)

CBT-E: enhanced cognitive behavioral therapy, special form of CBT designed for eating disorders

treatment of BED

interpersonal psychotherapy —> the most suitable treatment based on a study, but CBT is also used

conclusion of article (early childhood appetite traits linked to eating disorders)

early childhood appetite traits can predict adolescent eating disorder symptoms