EatingDisorders5

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Author:
jakeschis
ID:
90923
Filename:
EatingDisorders5
Updated:
2011-06-16 16:50:57
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Pscyhology eating disorders
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Description:
MP - Eating Disorders
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  1. Eating disorder prevalance
    • 90% girls, 40% new anorexia ages 15-19
    • physically active populations -- athletes and military
  2. Anorexia Nervosa
    • 1. failure to maintain weight or reach expected weight during pd of growth....less than 85% expected
    • 2. binge eating and purging distinguishes between restricted and bing/purging subtypes
    • 3. males 1/10th prevalence
    • 4. features: pride and sense of "specialness," competitiveness, moral certitude
    • 5. co-morbid disorders: depression, obsessive compulsive disorders, substance abuse, anxiety
  3. Anorexia Symptoms/complications
    • 1. amenorrhea
    • 2. constipation, GI distress
    • 3. cold intolerance
    • 4. lanugo - fine hairs
    • 5. anemia
    • 6. hypotension
    • 7. impaired renal function
    • 8. cardiac arrhythmia
    • 9. osteoporosis
    • 10. death - 12 times more likely than general population
  4. Bulimia Nervosa
    • 1. recurrent episodes of binge eating - with sense of lack of control
    • 2. recurrent inappropriate compensatory behavior in order to prevent weight gain
    • 3. binge eating and compensatory behavior both occur, on average, at least twice a week for three months
    • 4. self-evaluation is excessively influenced by body shape and weight
    • 5. does not occur exlusively during anorexia nervosa
    • 6. subtypes distinguished by purging or not purging
  5. CO-morbidities of Bulemia
    • 1. mood disorders
    • 2. anxiety disorders - social anxiety, PTSD
    • 3. Substance abuse
    • 4. personality features
  6. Risk Factors for Anorexia and Bulemia
    • 1. maternal pregnancy or birth related consequences
    • 2. female sex
    • 3. early childhood eating problems or GI problems
    • 4. elevated weight and shape concerns
    • 5. sexual abuse
    • 6. negative self-evaluation
  7. Risk Factors for just Anorexia
    • 1. dieting
    • 2. perfectionism
    • 3. criticism from family
    • 4. family member with eating disorder
    • 5. increased levels of cortisol in brain, decreased levels of seratonin and norepinephrine
  8. Risk factors for just Bulemia
    • 1. childhood overweight
    • 2. social phobia
    • 3. parental depression and substance abuse
    • 4. adverse family experiences
  9. Prognosis Anorexia vs. Bulemia vs BED
    • anorexia lasts on average 1.7 yrs
    • bulemia lasts on average 8 years
    • BED - 8 years
  10. Bulemia physical features
    sores around mouth, calluses/scars on knuckles, dry/flaky skin, cold sensitivity, constipation, edema, stress fractures, puffy cheeks, discolored teeth, frequent fluctuations in weight
  11. Eating Disorders Not Otherwise Specified
    • -all criteria for anorexia nervosa, but has regular menses and in normal weight range
    • -all criteria for bulemia, but binging and compensatory eating behavior less that twice a week
    • -inappropriate compensatory behavior after eating small amount of food
    • -repeatedly chewing and spitting out, but not swallowing, small amounts of food

    prevalence: more than half of all adult and 3/4 of all communties cases being treated for eating disorders
  12. Binge Eating Disorder
    • 1. recurrent episodes of binge eating
    • 2. associate with eating a lot when not hungry, being disgusted, depressed or guilty after eating, eating alone due to embarassment, eating until uncomfortably full, eating a lot faster than normal
    • 3. occurs more than twice a week for 6 months
    • 4. marked distress

    prevalence: 15-50% of adults in weight control programs, women 1.5x more likely
  13. Bing eating disorder vs obesity
    • 1. more calories, more chaotic eating habits
    • 2. more psychopathology
    • 3. more impact on work
    • 4. more co-morbitities and health problems
  14. risk factors for Binge eating disorder
    • 1. adverse childhood experiences
    • 2. parental depression
    • 3. vulnerability to obesity
    • 4. repeated exposure to negative comments about weight, shape and eating (anorexia just has criticism from family, bulemia has no assoc. criticism)
    • 5. female

    more emotional signs than bulemia
  15. **contributing factors of eating disorders in the military
    • 1. strict height/weight standards
    • 2. stress over weigh-ins
    • 3. stigma of being over weight
    • 4. lifestyle
    • 5. access to/surrounded by high calorie. high fat foods
    • 6. limited time
    • 7. societal pressure
    • 8. overweight
    • 9. previous psychiatric treatment
    • 10. hx of verbal abuse
    • 11. female
  16. ED in military
    more recently, over half in marines, 21% of all female adolescent dependents met criteria for ED, including binge eating
  17. Female Solders and ED
    • -22% w/in last 3 months
    • -12% regular basis
    • -40% of new recruit weight dissatisfaction (which is shown to predict development of ED)
    • -In AD women, overall prevalences: 1.1% AN, 8.1% BN, 62.8% for EDNOS
    • -in the marines, those numbers for women are 5, 16, and 77
  18. Subgroups with higher proportion new-onset ED
    • 1. combat exposure
    • 2. born after 1980
    • 3. white, non-hispanic
    • 4. marine
    • 5. active duty
    • 6. enlisted
  19. Role of physician**?
    • organize and oversee multi-component treatment team OR refer responsibilty to health professional. treatment options include:
    • 1. individual therapy
    • 2. medical monitoring
    • 3. nutritional counseling
    • 4. group/family therapy
    • 5. collaborate with psychologist or mental health provider
    • 6. *do not refer solely for nutritional counseling
    • 7. monitor health co-morbities
    • 8. prescribe and monitor meds
    • 9. be supportive

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