PSYC 134 Lecture Notes - Lecture 2: Eating Disorder, Binge Eating, Rumination Syndrome
PSYC 134 Lecture 2
4/11/2018
• Wh are ED’s iportat
o Increase over the last several decades
o Serious health consequences
▪ rai stared
▪ cognitive delay vs. malnourished
o Low recovery rates
o Highest mortality rate of all psychiatric disorders
▪ E.g. death in sleep from heart complications like bradycardia
▪ E.g. from suicide w/ primary dx as an ED
• Common misconception: only underweight
• Types of DSM-V feedig ad ED’s
o Pica
o Rumination disorder
o Avoidant/restrictive food intake disorder
o AN
o BN
o BED
o OSFED
o Unspecified feeding or eating disorder
• Pica
o Persistent eating of nonnutritive, nonfood substances over a period of at least 1
month
o The eating is inappropriate to the developmental level of the individual
o E.g. eating chalk
o The eating bx is not part of a culturally supported or socially normative practice
o If the eating bx occurs within the context of another mental disorder (e.g.
intellectual disability, autism, etc.), it is sufficiently severe to warrant additional
clinical intervention
o Seen sometimes with pregnant women→cravings for a nonfood substance
• Rumination disorder
o Repeated regurgitation of food over at least month
o Regurgitated food made be re-chewed, re-swallowed, or spit out
o Not in response to another GI/medical issue
o Does not occur during the course of AN, BN, BED, or ARFID
o If the symptoms occur in the context of another mental disorder, they are
sufficiently severe to warrant additional clinical attention
• ARFID
o New diagnosis in DSM-5
o Picky-eating gone awry
o Primarily seen in children
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o An eating or feeding disturbance as manifested by persistent failure to meet
appropriate nutritional and/or energy needs associated w/
▪ Significant weight loss
• Can be a dramatic decline in growth chart
▪ Significant nutritional deficiency
• Often times limitations of the scope of food a kid eats
▪ Dependence on enteral feeding or oral nutritional supplements
▪ Marked interference w/ psychosocial functioning
o The disturbance cannot be better explained by lack of available food or a
culturally sanctioned practice
o Does not occur exclusively during the course of another ED and there is no
evidence of a disturbance in body weight or shape
▪ Important difference between this and AN
o Not attributable to another mental disorder or medical condition
o Low hunger cues can be seen
• AN
o Restriction of energy intake relative to requirements leading to a relatively low
body weight in the context of age, sex, developmental trajectory. Defined as less
than minimally normal, or for children, less than that is minimally expected for
age and height
o Intense fear of weight gain or becoming fat, despite being underweight or having
persistent behaviors to gain weight, even if at a significantly low weight
o Denial in weight loss, disturbance in experience of body weight/shape, undue
influence of body weight or shape on self-evaluation
o Two subtypes: restricting and binge-purge
o Specifiers
▪ In partial remission
▪ In full remission
▪ Current severity (based on BMI)
o Having ED rules
o Significantly reduced quantity of food eaten
▪ Calorie/fat counting, reading labels
o Significantly reduced variation in types of food eaten
▪ Good vs bad foods leading to similar food choices every day
• Not always logical
▪ Vegetarian/vegan
• Easy to hid behind, especially publicly
o Ritualistic, obsessive qualities, often odd food combinations
▪ Overlap with OCD
▪ Justifications can be hard to see if in the disorder for a long
time→thikig it’s oral, ut the’e just ee doig it for so log the
do’t otie ho pathologial it is
o Slow eating, cutting food into small pieces
o Obsessive interest in food (cooking for others, etc.)
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• Orthorexia
o Branch-off from AN
o Not in the DSM
o Pursuit of health and wellness to the extreme
o righteous eatig
o show significant signs of social, occupational, and/or nutritional problems
o neglect of other areas of life
o inordinate amount of time thinking about food, excessive guilt/compensatory bx
if imperfect
o goal may not be skinny→obsession with being healthy
• BN
o Binging-recurrent episodes of binging eating including both
▪ Eating an amount of food that is definitely larger than most people would
eat during a similar period of time and under similar circumstances
▪ A sense of a lack of control over eating during the episode
▪ Different than stress-eating in the pathology of it, but stress-eating is not
necessarily not binging
▪ Lots of shame surrounding binges
▪ Can have binge-triggering foods
o Purging-recurrent inappropriate compensatory bx
▪ Self-induced vomiting
▪ Misuse of laxatives, diuretics, enemas, or other medications
▪ Fasting
▪ Excessive exercise
o Binge eating and purging both occur at least once a week for 3 months
o Self-evaluation is unduly influenced by body shape and weight
▪ Not as severe as AN
o Specifiers:
▪ In partial remission
▪ In full remission
▪ Severity (based on average # of episodes/week): mild, moderate, and
severe
o Impulse-control disorder
▪ Beause i part of this, is h BN is’t glaorized as AN is
▪ Societal value of control
o Cycle
▪ Dieting causing cravings then binging, purging, shame and disgust kicks
in, rinse and repeat
o Eating rapidly
o Secret eating bxs
o Excessive or secretive exercise routines
▪ Seen a lot in teen population→at night, behind closed doors
o Prioritizing compensatory bxs over other activities
o Emotional dysregulation
find more resources at oneclass.com
find more resources at oneclass.com
