Feeding and Eating Disorders ch 14

Feeding and Eating Disorders

Persistent disturbance of eating or eating-related behavior resulting in altered consumption or absorption of food.

Anorexia Nervosa (AN)

Restriction of energy intake leading to significantly low body weight, intense fear of gaining weight, and disturbance in body image.

Bulimia Nervosa (BN)

Recurrent binge eating with inappropriate compensatory behaviors such as vomiting, excessive exercise, or fasting.

Binge-Eating Disorder (BED)

Recurrent episodes of binge eating without compensatory behaviors.

Pica

Persistent eating of non-nutritive, non-food substances over a period of at least 1 month.

Rumination Disorder

Repeated regurgitation of food for at least 1 month not due to a medical condition.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidance or restriction of food intake leading to weight loss or nutritional deficiency without body image disturbance.

DSM-5 Criteria for Anorexia Nervosa

Restriction of energy intake, intense fear of gaining weight, and disturbance in self-perceived weight or shape.

DSM-5 Criteria for Bulimia Nervosa

Recurrent binge eating and compensatory behaviors, occurring at least once a week for 3 months.

DSM-5 Criteria for Binge-Eating Disorder

Recurrent binge eating without compensatory behaviors, with marked distress and occurring at least once a week for 3 months.

DSM-5 Criteria for Pica

Persistent eating of non-food substances for at least 1 month inappropriate to developmental level.

DSM-5 Criteria for Rumination Disorder

Repeated regurgitation of food for at least 1 month.

DSM-5 Criteria for ARFID

Avoidance or restriction of food leading to weight loss or nutritional deficiency, not due to body image concerns.

Subtypes of AN

Restricting type (no binging/purging) and binge-eating/purging type.

Etiology of Eating Disorders

Includes genetic, biological, psychological, and sociocultural factors.

Psychological Factors in AN and BN

Includes perfectionism, low self-esteem, distorted body image, and control issues.

Sociocultural Factors

Cultural pressure for thinness, media exposure, and weight stigma.

Medical Complications of AN

Bradycardia, osteoporosis, amenorrhea, electrolyte imbalance.

Medical Complications of BN

Electrolyte imbalance, gastrointestinal issues, dental erosion.

Medical Complications of BED

Obesity-related conditions like hypertension and diabetes.

Functional Impact of AN

Severe impact on health, social withdrawal, cognitive impairments.

Functional Impact of BN

Impacts self-esteem, physical health, and interpersonal relationships.

Functional Impact of BED

May lead to obesity, shame, and social avoidance.

Treatment of AN

Nutritional rehabilitation, psychotherapy, and possible hospitalization.

Treatment of BN

CBT is first-line; SSRIs may help reduce binge/purge behavior.

Treatment of BED

CBT, interpersonal therapy, and medications like lisdexamfetamine.

Prognosis of AN

High mortality rate; early treatment improves outcomes.

Prognosis of BN

Better than AN with appropriate treatment.

Prognosis of BED

Generally favorable with treatment; associated with obesity risks.

Difference: AN vs. BN

AN involves significant weight loss; BN involves normal or above-normal weight.

Difference: BN vs. BED

BN includes compensatory behaviors; BED does not.

Comorbidity

High with depression, anxiety, and substance use disorders.