English summary of Problem 5, Includes the notes of the assigned literature and the corrections during tutorials. The grade obtained for the course was 8.1
Block 1.6 Clinical Psychology
Problem 5. Eating disorders
Diagnosis & Prevalence of Eating
Disorders
Anorexia Nervosa
Anorexia nervosa: An eating disorder with main features of self-starving,
refusal to maintain a minimally normal body weight
o Body mass index; BMI (measurement of weight range using weight and
height). The lower limit is 18.5 kg/m 2, below that level it is a trigger for
anorexia diagnosis.
pathological fear of gaining weight and
distorted body image in which sufferers continue to insist that they are overweight.
Types of anorexia:
1. Restricted type AN: Self-starving is not associated with concurrent purging (e.g.
taking laxatives or self-causing vomiting)
2. Binge-eating/purging type AN: Regular engagement in purging activities to help
control weight gain.
Symptoms caused by self-imposing starvation: tiredness, arrhythmias, hypotension, low bp,
slow heartbeats because of the irregular levels of electrolytes (Na, K). Dry skin, weak hair.
Amenorrhoea and hypothermia.
o Weaken heart muscles in some cases
Prevalence/Rates:
Mortality is 5-8% (very high)
Begins around adolescence form early to middle teenage years, or after 40 years of
age.
Onset associated with stressful event and is preceded by extensive dieting periods.
Remission within 5 years, some need hospitalization mainly for weight restoring
0.4%/year, ratio 1:10 in favor of females.
Comorbidity with major depression (50-70%), OCD, social anxiety, phobias and
substance abuse.
Bulimia Nervosa
Bulimia nervosa: Eating disorder with main feature the recurrent episodes of binge eating
(they eat more than one person’s daily intake in one episode) followed by periods or purging
or fasting
Repeated binge-eating
, Block 1.6 Clinical Psychology
Problem 5. Eating disorders
Recurrent inappropriate compensatory behaviors to prevent gain weight (vomiting,
laxatives, diuretics, enemas)
Binge-eating and compensation occurring for at least 1/week for 3 months.
Self-evaluation based on body image and weight
Comparison with anorexia: Similar to binge- eating/purging type but different in BMI. In
bulimia nervosa the BMI is normal most of the times neither overweight nor underweight.
Fewer physical symptoms
o Permanent loss of dental enamel
o Swollen parotid glands can produce a typical puffy face appearance
o Menstrual problems
More common than anorexia
Prevalence/Rates:
Onset late adolescence –early adulthood. 16-20 peak
Life prevalence 1-3%
Many years until they manage to achieve remission. Research showed that about
75% of women suffering from bulimia nervosa were in remission after 20 years.
90% of sufferers from bulimia are women.
Preoccupation with gain weight, more intense during period of dieting
Controlling situation:
Despite being concerned with their weight gain they indulge 2-12 bouts of binge-
eating per week and this suggest they have lost control over their eating habits.
Because of that they become guilty, ashamed of their binges and they try to conceal
them.
Secret binges, planned and triggered by periods of dysphoria or depressed mood,
intense hunger after diet.
Self-disgust, low self-esteem, feelings of inadequacy, high levels of depression.
Bulimia is high related with the ideas and influences of each culture. That is supported by
less cases of bulimia in women that have not been exposed in Western ideas.
Comorbidity:
Mostly with major depression
Seasonal affectionate disorder (increase in winter), dysphoric symptom
Link with borderline personality disorder
Substance abuse and bipolar.
In sense it is considered that bulimia is a part of multi-impulsive syndrome where
the individual cannot control many aspects of the behavior like eating, drugs, alcohol
etc.
Binge-Eating Disorder
Binge eating disorder: An eating disorder that is characterized by recurrent episodes of
binge eating without purging or fasting.
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