PSY3032 Study Guide - Final Guide: Serotonin Receptor Agonist, Child Abuse, Etiology
21 Jun 2018
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Week 3 Eating Disorder
Normal eating
A pattern of eating behaviours which:
Maintains normal weight
Ensures adequate nutrition
Confirms with cultural/ religious requirement
Enjoyable
When eating becomes “abnormal” several consequences:
Constant ‘dieting”
Morbid Obesity
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
DSM 5 Criteria
-Restriction of energy intake
Relative to requirements, leading to significantly
low body wright (for age, sex, etc)
-Intense fear of gaining weight
Or becoming fat, or persistent behaviour that
interferes with weight gain
-Disturbance
In the way one’s body weight or shape is
experienced.
Two sub types:
Restricting type: Not regularly engaged in binge eating or
purging behaviour
Purging Type: Regularly engaged in binge eating and purging
behaviours
Anorexia Nervosa: Outcomes
oChronic starvation= Physical and psychological changes
oPhysical: B.P & H.R slow significantly
: Kidney and GI problems
: Bone mass reduce significantly
: Skin dries
: Neurological impairments
: Reduction of important electrolytes (e.g. Na+,
K+)
: Endorphins may be released
Psychological: Patient is no longer rational, personality
change
Anorexia Nervosa: Prognosis
oTypically a disease of young female adolescents (90%).
oRare disease –1% or less of the population (but 3rdmost common
disease in young girls)
oStarvation = typical body changes
oBinging/purging cycle can disturb electrolyte balance in the blood which
may be fatal
oCo-morbidity
oPrognosis: about 70% recover to some extent, takes about 5-7 years
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Week 3 Eating Disorder
-Death rate- from physical complications and suicide is high
-Most of the disorder is Ego dystonic
BULIMIA NERVOSA
1. Recurrent episodes of binge eating
In 2 hours food intake > normal
Lack of control over eating during the period
2. Recurrent inappropriate compensatory behavior to prevent weight gain
Vomiting/laxatives/diuretics/excessive exercise
3. Symptoms at least once a week for 3 months
4. Self evaluation is unduly influenced by body shape and weight
5. The disturbance does not occur exclusively during periods of Anorexia Nervosa
Bulimics are usually normal weight- separated them from Anorexics
Prognosis:
Typically found in older adolescents/ young women
o 90% of cases are female
oLow incidence: 1-2% of the population
Comorbidity
oSuicide rates are high but lower than with Anorexia Nervosa
oFrequent purging can- electrolyte imbalance/depletion
oFrequent vomiting- severe dental problems (ph balance destroyed- excessive
acidic gastric secretions destroy enamel on teeth)
About 70% recover
oDepends on stage of disorder where intervention begins. Comorbity with other
disorders
Binge Eating Disorder
1. Recurrent episodes of binge eating
o>Food intake in 2 hours
oLack of control
2. The binge eating episodes are associated with 3 or more of the following:
oEating more rapidly than normal
oEating until uncomfortably full
oEating large amounts when not hungry
oEating alone because of embarrassment
oFeeling disgusted/ guilty/upset afterwards
3. Marked distress regarding binge eating episode
4. Binge eating occurs 1week for >3 months
5. NO compensatory behavior
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Week 3 Eating Disorder
Not all obese individuals have BED (<25% meet the criteria)
Factors leading to BED: Childhood obesity, Negative weight comment,
depression, childhood abuse
Outcomes?
Prognosis
Both major disorders are familial
Anorexic Patients –1stdegree relatives 10times more
likely to have the same disorder.
Bulimic Patients –1stdegree relatives’ 4times more
likely to have the same disorder.
Nature or Nurture?
Monozygotic twins ↑concordance rate than dizygotic twins.
Some genetic factors been identified but low power, and
further work required.
Aetiology of Eating Disorder
Role of the hypothalamus?
Endogenous opioids
-Enhances mood, suppresses appetite
-High during starvation & exercise
-Reinforcing state?
Serotonin promotes satiety thus are binges due to serotonin deficit?
- AN and BN ↓ _serotonin metabolites
- AN who recover less well respond worse to serotonin
agonists.
- SSRIs effective for eating disorder treatment
Psychodynamic/Environment Factors:
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Relative to requirements, leading to significantly low body wright (for age, sex, etc) Or becoming fat, or persistent behaviour that interferes with weight gain. In the way one"s body weight or shape is experienced. Restricting type: not regularly engaged in binge eating or purging behaviour. Purging type: regularly engaged in binge eating and purging behaviours. Anorexia nervosa: outcomes: chronic starvation= physical and psychological changes, physical: b. p & h. r slow significantly. Psychological: patient is no longer rational, personality change. Death rate- from physical complications and suicide is high. Most of the disorder is ego dystonic. Bulimia nervosa: recurrent episodes of binge eating. Lack of control over eating during the period: recurrent inappropriate compensatory behavior to prevent weight gain. Vomiting/laxatives/diuretics/excessive exercise: symptoms at least once a week for 3 months, self evaluation is unduly influenced by body shape and weight, the disturbance does not occur exclusively during periods of anorexia nervosa. Bulimics are usually normal weight- separated them from anorexics.
