PS280 Lecture Notes - Lecture 7: Binge Eating Disorder, Binge Eating, Water–Electrolyte Imbalance
Eating
Overview of Eating Disorders
● Three main types in DSM 5
○ Anorexia Nervosa
○ Bulimia Nervosa
○ Binge Eating Disorder
● Largely a…
○ Female problem
○ Westernized problem
● Very serious
○ Can result in death
Anorexia Nervosa
Clinical description
● Deliberate restriction of food intake
● Low body weight → no exact number anymore, clinical judgement
● Morbid fear of gaining weight and becoming fat → fear gets worse as weight gets lower
● Body weight/shape strongly influences self-evaluation OR person is not concerned about
current low body weight (can have both but need one to be diagnosed)
● People who are high on distorted eating are overestimating their current size, and have
a low ‘ideal’ weight
● Subtypes (can change over time)
○ 1. Restricting Type - no binging and purging
○ 2. Binge Eating / Purging Type - could be smaller amounts than in bulimia
● Medical consequences
○ Amenorrhea: absence of 3 menstrual cycles - used to be part of diagnostic
criteria, now instead seen as consequence
○ Sensitivity to cold
■ Lanugo: soft and fine hair that can develop to try to retain warmth
○ Heart problems: eg decreased blood pressure or heart rate can lead to heart
failure or even death
○ Electrolyte imbalance: happens when people vomit to purge
○ Other: dry skin/hair/nails, decreased bone mass
Prevalence
● <1%
● Gender difference - about 10x more common in women
Onset
● Early teens (13)
Comorbidity
● Depression is common, OCD, some anxiety disorders
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find more resources at oneclass.com
Bulimia Nervosa
Clinical Description
● Binge: eat large amounts of food, eating is out of control - people are usually very private
about it, usually high calorie foods - eating more than what is considered normal in 2
hour period - could occur due to high levels of stress
● Compensatory behaviours
○ Self-induced vomiting: not as effective as people think it will be… often only
removes half of the calories
○ Laxatives, diuretics
○ Exercise: more common in anorexia but also occurs here
● Typically at or above normal weight
● 1x per week on average for 3 months: severity is determined by number of binges
● Self-evaluation is unduly influenced by body shape and weight
● Types
○ Purging Type
○ Non-purging Type
Medical Consequences
● Vomiting:
○ Salivary gland enlargement
○ Eroded dental enamel
○ Electrolyte imbalance
○ Calluses on fingers and hands
● Laxative Use:
○ Intestinal problems
Prevalence and Onset
● Prevalence 1-2%, much more common in women
● Age of onset = teens (usually later teens)
Comorbidity
● Depression, anxiety
Binge-Eating Disorder
● Some similarity to Bulimia Nervosa (without the purging)
● Recurrent binge eating: large amount of food (2 hour period), lack of control, 1x per
week for 3 months
● No compensatory behaviours (vomiting/exercising)
● Normally overweight
● Not the same as obesity - most obese people do not take part in recurrent binge eating
● Binge episodes occur with 3 or more of the following:
○ Eating more rapidly than normal
○ Eating until uncomfortably full MISSED THE REST WIFI WENT OUT
Prevalence
● 1-2%
● More common in women but only about twice as common
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Low body weight no exact number anymore, clinical judgement. Morbid fear of gaining weight and becoming fat fear gets worse as weight gets lower. Body weight/shape strongly influences self-evaluation or person is not concerned about current low body weight (can have both but need one to be diagnosed) People who are high on distorted eating are overestimating their current size, and have a low ideal" weight. Binge eating / purging type - could be smaller amounts than in bulimia. Amenorrhea: absence of 3 menstrual cycles - used to be part of diagnostic criteria, now instead seen as consequence. Lanugo: soft and fine hair that can develop to try to retain warmth. Heart problems: eg decreased blood pressure or heart rate can lead to heart failure or even death. Electrolyte imbalance: happens when people vomit to purge. Gender difference - about 10x more common in women. Depression is common, ocd, some anxiety disorders.
