Psychopathology Chapter 9: Eating Disorders and Obesity

According to the DSM-5, eating disorders are characterized as…

a persistent disturbance in eating behaviors.

Anorexia Nervosa

literally means “lack of appetite induced by nervousness”. A pursuit of thinness that is relentless and that involves behaviors that result in a significantly low body weight.

Binge eating

involves an out-of-control consumption of an amount of food that is far greater than what most people would eat in the same amount of time and under the same circumstances.

Purge

is to remove from the body the food that has been eaten.

Descriptions of extreme fasting that were probably signs of anorexia nervosa were found in…

early religious texts.

What are the two types of anorexia nervosa?

1. The Restricting Type: where every effort is used to limit the quantity of food being consumed.

2. Binge-eating and purging.

Bulimia Nervosa

characterized by an uncontrollable binge eating and efforts to prevent resulting weight gain by using inappropriate behaviors such as self-induced vomiting and excessive excessive.

Bulimia comes from which greek words?

bous (“0”) and limos (“hunger”)

Binge-Eating Disorder

has become clinical features in common with bulimia nervosa, but with one important difference: The person with BED binges but does not engage in inappropriate “compensatory” behavior. Much less dietary restraint and associated with being overweight or obese.

Anorexia Nervosa is most likely to develop in…

16 - 20 year olds

For bulimia nervosa, the age group at the highest risk is…

young women from 21 to 24.

Most people with binge-eating disorder are…

older, generally between 30 and 50 year olds.

What is the most common form of eating disorder?

Binge-Eating Disorder

Mortality rate for people with anorexia nervosa is more than ___ times higher than that for…

(5)

young females ages 15-34 in the general U.S population.

Thiamin deficiency may lead to…

depression and cognitive changes.

People can die from Heart Arrhythmias which is…

sometimes caused by major imbalances in key electrolytes such as potassium.

Laxative abuse can lead to:

• dehydration

• electrolyte imbalance

• kidney disease

• damage to bowels and gastrointestinal tract

Ipecac Syrup

a poison that causes vomiting, can damage the heart muscle.

What are some more side effects of Bulimia Nervosa?

Small red dots around the eyes, caused by the pressure of throwing up: swollen parotid (salivary) glands, caused by repeated vomiting (puffy cheeks or chipmunk cheeks)

Majority of women in one study experienced diagnostic crossover, which means…

that once someone has been diagnosed with an eating disorder, they are more likely to be diagnosed later on with another eating disorder.

Obsessive-Compulsive Disorder is often diagnosed with people with…

anorexia nervosa and bulimia nervosa.

Cluster C disorders are associated with:

both anorexia nervosa and bulimia nervosa.

Cluster B disorders are more typically associated with:

builimia nervosa.

Studies suggest that which disorders are heritable?

anorexia nervosa and bulimia nervosa

What area of the brain plays a part in eating?

The hypothalamus

Damage to the ___ and ___ cortex seem to be linked with the development of anorexia nervosa in some cases, bulimia in others.

frontal and temporal

Neurotransmitter ____ is implicated in obsessionally, mood disorders, and impulsivity; also modulates appetite and feeding behavior.

serotonin

Reward Sensitivity

research centers on brain pathways and neurotransmitters (such as dopamine) involved in reward sensitivity.

More than 1/3 of patients reported that ____ contributed to the development of their anorexia.

Family Dysfunction

Bulimic family characteristics include:

• high parental expectations

• perceiving one’s family to be less cohesive

• other family members who are dieting, preoccupied with their appearance, or prone to make critical comments about shape, weight or eating.

Binge-eating Disorders onset is usually…

typically well after adolescence, and binge-eating disorder is much more likely to be found in males.

Internalizing the thin ideal is…

associated with the body dissatisfaction, dieting and negative effect.

Perfectionism

is the pursuit of unattainably high standards combined with intolerance of mistakes.

Negative affect (feeling bad)

is a causal risk factor for body dissatisfaction; may also work to maintain binge eating, predict dietary restraint in anorexia nervosa.

Healthy BMI

18.5-24.9

In terms of treating anorexia nervosa…

patients are generally pessimistic about potential for recovery; view disorder as chronic; have a high therapy dropout rate.

Antidepressants may be used to treat anorexia nervosa, but…

no evidence that they are affective.

The antipsychotic medicine ___ may be beneficial in ____

(1) Olanzapine

(2) Anorexia Nervosa

What is the most affective therapy approach for anorexia nervosa in adolescent patients?

Family Therapy

What is the best studied approach to anorexia nervosa?

Maudsley Model:

• typical treatment program includes 10-20 sessions over 6-12 months

• Parents as support team; focus on developing healthier relationships

Randomized controlled trials show…

that patients treated with family therapy for 1 year do better than the control group.

CBT is ____ in treating bulimia nervosa, but ____ in treating anorexia nervosa.

(1) Very effective

(2) Limited Success

The use of antidepressants to treat Bulimia Nervosa is common.

True

What is the leading treatment of Bulimia?

CBT:

• “behavioral” component focuses on meal planning, nutritional education, ending binging-and-purging cycles

• “Cognitive” element aims at changing the cognitions and behaviors that initiate or perpetuate a binge cycle.

Due to the high level of comorbidity between ___ and ____, antidepressant medication is sometimes used to treat the disorder.

(1) binge eating

(2) depression

Appetite Suppressants and Anticonvulsant medications are used to treat?

Binge-Eating Disorders

Body Mass Index (BMI)

is a measure of a person’s weight relative to height.

Obesity

is defined as having a BMI above 30.

What are the medical issues of obesity:

increased risk of high cholesterol, hypertension, heart disease, arthritis, diabetes and cancer.

Reduced life expectancy of 5-20 years

Is obesity an eating disorder in the DSM-5?

No.

Genetic mutation associated in binge-eating is found in what % of the obese population?

5%

Leptin

a hormone that acts to reduce our intake of food.

Inability to produce leptin is associated with…

morbid obesity.

People who are overweight tend to have…

high levels of leptin in their blood stream, but are resistant to its effects.

Ghrelin

a hormone produced by the stomach, is a powerful appetite simulator.

What medications have been approved by the FDA for us in conjunction with a reduced-calorie diet:

1. Orlistat (Xenical)

2. Iorcaserin (Belviq)

3. Contrave

What is the most effective long-term treatment for people who are morbidly obese?

Bariatric Surgery

What does catherine from the text book suffer with?

Bulimia with purging.

What does Eisha from the textbook suffer with?

Anorexia Nervosa, which no purging.

What does Jenna from the textbook suffer with?

Bulimia with no purging.