Title 13 AbPsy - Feeding and Eating Disorders.pdf ✅

● Individual attempts to compensate for the binge eating and potential weight gain, almost always by purging technique ● 57% of a group of patients with bulimia nervosa exercised excessively while 81% of a group with anorexia did ● DSM-IV-TR ○ Purging type (e.g., vomiting, laxatives, or diuretics) ○ Non-purging type (e.g., exercise and/or fasting); very rare ● No weight loss is typically accomplished unlike anorexia; many are at normal weight ● Usually present with anxiety and mood disorders ○ 80.6% of individuals with bulimia had an anxiety disorder at some point ○ 66% of adolescents with bulimia presented with a co-occurring anxiety disorder ● The median age of onset for all eating-related disorders occurred in a narrow range of 18 to 21 years Medical Consequences ● Salivary gland enlargement ● Eroding in the dental enamel on the inner surface of the front teeth ● Tearing of the esophagus ● Electrolyte Imbalance: chemical imbalance, including sodium and potassium levels ● Intestinal problems such as severe constipation or permanent colon damage ● Marked calluses on fingers or the backs of hands DIAGNOSTIC CRITERIA A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: 1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances. 2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. D. Self-evaluation is unduly influenced by body shape and weight. E. The disturbance does not occur exclusively during episodes of anorexia nervosa. CAUSES / RISK FACTORS Temperamental Risks ● Weight concerns, low self-esteem, depressive symptoms, social anxiety disorder, and overanxious disorder of childhood Environmental Risks ● Internalization of a thin body ideal has been found to increase risk for developing weight concerns ● Individuals who experienced childhood sexual or physical abuse are also at increased risk Genetic and Physiological Risks ● Childhood obesity and early pubertal maturation ● Familial transmission of bulimia nervosa may be present ● Genetic vulnerabilities for the disorder DIAGNOSTIC ISSUES Gender ● Far more common in females than in males ● Among women, adolescent girls are most at risk ● Males are especially underrepresented in treatment-seeking samples ● Males with bulimia have a slightly later age of onset, and a large minority are predominantly gay males or bisexual Culture ● Occurs most in industrialized countries ● United States, Canada, many European countries, Australia, Japan, New Zealand, and South Africa DIFFERENTIAL DIAGNOSIS AND COMORBIDITY Anorexia Nervosa, binge-eating/purging type ● A diagnosis of bulimia nervosa should be given only when all criteria for bulimia nervosa have been met for at least 3 months Binge-Eating Disorder ● Some individuals binge eat but do not engage in regular inappropriate compensatory behaviors ● In these cases, the diagnosis of binge-eating disorder should be considered TREATMENT Drug Treatments ● Fluoxetine (Prozac): effective particularly during the binging and purging cycle Psychological Treatments ● Short-term cognitive-behavioral treatments 4 | @studywithky