Term
| Diagnostic Criterion: Anorexia Nervosa (A-D) |
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Definition
A - Adults: weight loss by food restriction. Children/adolescents: not making expected weight gain, while making height gains. Methods: food restriction, purging, hyper-exercising.
B - Fear of gaining weight or becoming fat; losing weight does not decrease the fear, but can actually increase the fear (the bar keeps lowering).
C - Body image distortion, importance of weight or shape, or denial of low weight; whole body, or certain body parts viewed as too big; obsessive or excessive weighing, measuring, viewing body; obsessive thinking about weight, shape, body; self-esteem linked to body weight and shape; weight loss = self-discipline/achievement; weight gain = failure of self-control; if being thin is acknowledged, significant/severity is not
D - Lack of menstruation (for 3 months or delayed – depending on pre/post puberty); due to low body weight, hormone levels drop and menstruation stops |
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Term
| Anorexia Nervosa: Restricting type |
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Definition
| restricts food intake; does not regularly engage in binge eating or purging |
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Term
| Anorexia Nervosa: Binge Eating/Purging Type |
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Definition
| has regularly engaged in binge eating or purging; purging after small amounts of food; hyper-exercise, laxatives |
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Term
| Diagnostic Criterion: Bulimia Nervosa (A-E) |
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Definition
A - 1. Binge eating episode
a. Large amount, short time; high calorie, sweet, carb based foods; episode can begin in one place and continue in another; usually occurs in secret because of shame.
2. Loss of control over eating
a. Cannot stop, driven to continue eating; keep eating despite feeling uncomfortably or painfully full; may or not be planned; usually rapid/fast-paced; possible dissociation; loss of control may not be total (can be interrupted by phone or person)
B - Inappropriate compensatory behavior: self-induced vomiting, laxatives, diuretics; immediate effect is relief of physical discomfort/pain or fears of weight gain
C - Binging and inappropriate compensatory behaviors, 2x/week 3 months
D – Self-evaluation is unduly influenced by body shape and weight; self-esteem is overly determined by appearance and sense of fatness; fear of gaining weight; dissatisfied with weight, shape and body; desire to lose weight; sense of failure for not losing weight
E - 1. Disturbance does not usually occur exclusively during episodes of AN.
2. If person meets all criteria for both AN and BN, AN should be diagnosis |
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Term
| Bulimia Nervosa: Purging Type |
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Definition
| regularly engages in vomiting, laxatives, diuretics, or enemas |
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Term
| Bulimia Nervosa: Non-purging Type |
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Definition
| uses other inappropriate compensatory behaviors (fasting, excessive exercising) |
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Term
| Eating Disorder Not Otherwise Specified (EDNOS)- including Binge Eating Disorder (BED)- Criterion A and B: Anorexia Nervosa |
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Definition
A. All criteria met for AN except have regular menses
B. All criteria met for AN except current weight is within normal range |
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Term
| Eating Disorder Not Otherwise Specified (EDNOS)- including Binge Eating Disorder (BED)- Criterion C and D: Bulimia Nervosa |
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Definition
C. All criteria met for BN except binge/purge less often or shorter time
D. Regular use of inappropriate compensatory behavior in normally weighted person after eating small amounts of food |
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Term
| Eating Disorder Not Otherwise Specified (EDNOS)- including Binge Eating Disorder (BED)- Criterion E: BED |
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Definition
| E. Recurrent episodes of binge eating; loss of control; no (or few) inappropriate compensatory behaviors; 2x/week 6 months |
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Term
| Eating Disorder Not Otherwise Specified (EDNOS)- including Binge Eating Disorder (BED)- Criterion F: Other |
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Definition
| F. Chewing and spitting (not swallowing); Pica (eating non-foods); “orthorexia” (obsession with health foods) |
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Term
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Definition
| perfectionism, strong need to control one’s environment, inflexible thinking, overly restrained emotional expression, concerns about eating in public, feelings of ineffectiveness, limited social spontaneity |
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Term
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Definition
| usually “normal” weight, focused on appearance, mood swings, use food to regulate moods, usually aware of problem and want weight loss solution, substance abuse, impulsivity, relationship problems, wants to be perfectionist but fails and feels like a failure |
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Term
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Definition
| eating more than most would in a two hour period |
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Term
| Examples of inappropriate compensatory methods for weight loss |
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Definition
| purging, hyper-exercising, taking laxatives, etc. |
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Term
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Definition
| a process of attitudinal and behavioral change undergone by individuals who reside in multicultural societies or who come in contact with a new culture. |
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Term
| Eating Disorders and Acculturation correlations |
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Definition
1. Higher acculturation = eating problems for cultures that don't idealize thinness (13.5% EDNOS vs. 0% for non-acculturated).
2. Increase Anti-fat attitude with acculturation and was correlated with body dissatisfaction and eating issues
3. Stress as a result of acculturation is correlated with body dissatisfaction (Adapting to US culture associated with disliking your body). |
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Term
| Stereotypical image of eating disorders and consequences |
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Definition
| White, heterosexual woman with anorexia. When you don’t meet this criteria, less likely to be diagnosed (E.g. men, black, Latina, Asian). |
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Term
| Ethnic Differences in EDs |
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Definition
1. Most consistent finding: higher rates of AN among white women than blacks and Latinas
2. Less of a prevalence difference for BN (black, white, Latina)
3. Rates of BED are similar across whites,blacks, and Latinas |
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Term
| Why do people think men don't get EDs? |
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Definition
A. Historical association with ideas of femininity (women and gay men presumed)
B. Men don’t recognize it in self
C. Criteria based on women’s presentation of ED
D. Doctors diagnose men with other illnesses
E. Additional stigma of ED for men |
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Term
| Unique risk factors for men with EDs |
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Definition
1. Overweight: men focus on not being fat
2. Sports: more pressure for men to participate in sports
3. Sexuality: gay/bi men overrepresented in ED population |
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Term
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Definition
1. Only white women
2. People of color are protected from eating disorders
3. If men, only gay men |
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Term
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Definition
1. men view body as too small, not muscular enough
2. Hyper exercising, diet manipulation, steroids, not an actual ED but still an issue |
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Term
| Multidisciplinary treatment team |
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Definition
| medical doctor, psychiatric doctor, nutritionist, therapist |
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Term
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Definition
| stabilization, core treatment, recovery/maintenance |
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Term
| Medical treatment for EDs |
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Definition
| assess physical symptoms, monitor physical progress [vital signs, cardiac symptoms (too fast/slow), skin: lanugo (fine, fur-like hair), bone density, neurological irritability, confused, disoriented, etc.] |
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Term
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Definition
1. Beginning: re-establish balanced eating though structured meal plan
2. Middle: increase food variety; develop internal regulation
3. End: develop flexible, unstructured eating; decrease reliance on meal plan |
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Term
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Definition
| balance, pleasure, flexibility, and mindful/body awareness |
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Term
| Nutrition Strategies for EDs |
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Definition
| meal plans, food/mood logs, monitor hunger and satiety |
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Term
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Definition
| paying attention/observing the present moment; non-judgmentally, no opinion, just noticing |
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Term
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Definition
| awareness of hunger and satiety; aware of how food tastes; aware of how fast one is eating; eating non-judgmentally; aware of what is enjoyable and nourishing |
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Term
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Definition
| to understand cause, adaptive function or purpose; Identify underlying issues and address them; transference interpretations; connect past, personality, relationships, and ED |
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Term
| Family/Maudsely Treatment |
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Definition
| family is central to cure (not problem); re-feeding, explore relationships, return control, explore feelings underlying ED |
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Term
| Cognitive Behavioral Therapy (CBT) |
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Definition
| identify and replace irrational thoughts; ABC Model (activating event, belief, consequence); structured therapy |
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Term
| Dialectical Behavior Therapy (DBT) |
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Definition
| combines CBT with mindfulness |
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Term
| Cognitive Behavioral Therapy - Enhanced (CBT-E) |
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Definition
| CBT + perfectionism, low self-esteem, interpersonal problems |
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Term
| What works best for AN, BN, EDNOS? |
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Definition
1. AN: possibly CBT-E (no complete evidence)
2. BN: CBT/CBT-E
3. EDNOS: probably CBT |
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Term
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Definition
| work best with therapy; no evidence to support using it alone; medication treats symptoms of disorder (doesn’t treat eating habits directly); address symptoms and learn new skills; new skills are more effective |
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Term
| Diet - way of eating definition + examples |
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Definition
| kinds of foods one eats, habitual nourishment; ex. Weight Watchers, Mediterranean Diet |
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Term
| Diet - restriction definition + examples |
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Definition
| to lose weight sparingly or according to certain rules; ex. cabbage soup diet, Atkins |
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Term
| Food Politics (book): Issues with food politics |
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Definition
| wording issues/debates (people can be confused by wording; people are misinformed or uninformed) |
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Term
| What constitutes a healthy diet? |
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Definition
1. Eating when you are hungry, stopping when you are full
2. Making sure you have enough energy
3. Making sure you get all the nutrients you need
4. Enjoying what you eat
5. Having a way of eating that is sustainable
6. Eating whole foods, limiting processed foods
7. Always a good idea to consult a Registered Dietician when making diet changes |
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Term
| General benefits of exercise |
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Definition
| decreased risk for cardiovascular disease, type II diabetes, some types of cancer; skeletal health; improves mood; increases energy level, sexual arousal, socializing, life span; better sleep |
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Term
| Signs of lack of exercise |
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Definition
| feeling stiff, easily fatigued, limited movements |
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Term
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Definition
| preoccupation interferes with other aspects of life; feelings of anxiety, guilt, anger if unable to exercise; driven by desire to control weight, shape, and/or body composition; performance-based self-worth; etc. |
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Term
| Excessive Exercise Consequences |
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Definition
| abnormal sex hormones; increased risk of bone fractures; overuse injuries; decreased immune function; dehydration or heat stroke; hyponatremia: low sodium concentrations in body fluids |
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Term
| Excessive Exercise: Overtraining |
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Definition
| decline in performance, belief that it’s due to not training hard enough, negative physical/psychological consequences |
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Term
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Definition
| too much weight loss, playing through injury, can’t keep up |
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Term
| Relationship between Exercise and ED risk |
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Definition
| can be risk factor for each other; ED present when there is an exercise injury; during eating disorder recovery, there is an increased risk for developing compulsive exercise behaviors |
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Term
| Protective factors of sports |
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Definition
| positive effect on attitudes and behaviors to eating or the body, self-efficacy, self-perceptions of competence and ability |
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Term
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Definition
| pressure to perform; belief that lower weight will improve performance; social influences about athletic ability and performance; performance is at least partially influenced by aesthetics |
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Term
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Definition
| disordered eating, menstrual dysfunction, osteoporosis |
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Term
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Definition
| intentional repeated cycles of weight loss/gain for athletic performance |
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Term
| High risk sports + examples |
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Definition
| weight class, aesthetics, endurance; ex. Wrestling, body building, gymnastics, distance running, horse racing/equestrian |
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Term
| Athlete risk factors for EDs |
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Definition
| coach/parental pressure, perfectionistic, low self-esteem, overly invested in winning, no pleasure |
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Term
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Definition
| larger weight than deemed healthy; increase risk of diseases and health conditions; abnormal or excessive fat accumulation that may impair health |
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Term
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Definition
| 37.5% US adults; 17% US children |
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Term
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Definition
| 8.3% - diagnosed + undiagnosed |
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Term
| Body Mass Index (BMI)Classes |
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Definition
1. Underweight ("unhealthy"): <18.5%
2. “Healthy” weight: 18.5-24.9%
3. Overweight ("unhealthy"): 25-29.9%
4. Obese ("unhealthy"): 30 or higher |
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Term
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Definition
| easy, single equation to estimate health outcomes for a population |
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Term
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Definition
| doesn’t distinguish between fat and muscle, where fat is located, or what type of body shape a person has |
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Term
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Definition
| encourage body concerns and complacency |
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Term
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Definition
| waist circumference measurement, HAES paradigm |
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Term
| Past vs. present view of weight |
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Definition
| Past: obesity = early death. Present: very low/high weight = mortality risk. |
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Term
| Weight of the Nation (movie) Pros and Cons |
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Definition
1. Pros – attempting to address a real problem; providing free information
2. Cons – reinforcing stereotypes; offering advice can promote EDs; obesity is the problem, not the disease associated with it |
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Term
| Obesity and poverty relationship |
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Definition
1. Assumptions vs. evidence, income gap is closing, most now low socioeconomic status (SES), women: obesity increases as income decreases, men: similar across income
2. Food desert – limited access to fresh food |
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Term
| Obesity: genetics vs. environmental causes |
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Definition
| both play a role; obesity has risen faster than genetics can account for, means it is mainly environmental |
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Term
| Obesity: disease vs. public health problem |
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Definition
1. Disease – weight loss is the goal; solution is treatment (pills, surgery, behavior modification, therapy: CBT, DBT)
2. Health problem – weight loss is a tool, solution: treat specific disease person has |
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Term
| Cultural beliefs about weight |
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Definition
| thin people live in fear of fat and what it’s associated with; fat people embody what fat is associated with |
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Term
| Health At Every Size (HAES) Model Beliefs |
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Definition
| Fat is not good or bad; accept/respect diversity of body shapes and weights; multidimensional health and wellness; promotes pleasure in physical activity, weight loss is not the goal; awareness of hunger, satiety, pleasure, individual nutritional needs; social support; freedom from stigma/discrimination |
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Term
| Health At Every Size (HAES) Model: weight neutral stance definition |
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Definition
| being fat is not and of itself pathological (not a disease); being fat ≠ eating disorder; normal BMI ≠ health; fat people do not necessarily develop diabetes or die sooner; obese people can improve health, without losing weight; people who binge, purge, and restrict can come in all sizes |
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Term
| Obesity and Eating Disorders: categories vs. continuums |
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Definition
1. Categories: EDs and obesity are different, disease vs. not
2. Continuums: major similarities (focus on weight/thinness, emotion regulation) |
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Term
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Definition
| both multifactorial (genes and environment play a role); stress and coping strategies; strong reactions or denial from others; stereotypes about who gets an ED/gets fat; nutritional therapy |
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Term
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Definition
1. ED: psychotherapy is always needed, genes play a bigger role
2. Obesity: psychotherapy when eating is highly linked to emotions, or other mental health diagnosis exist; environment play bigger role |
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Term
| Food Politics (book): major players |
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Definition
| industry (growers, processors, transporters, sellers), USDA, FDA/DHHS (Department of Health and Human Services), researchers, nutritionists, physicians |
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Term
| Food Politics (book): conflicts of interest |
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Definition
| USDA both making/selling food, and regulating the advice given to consumers about what to eat |
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Term
| Food Politics (book): major points |
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Definition
1. Food advice changed with population’s needs: eat more to eat less; gained most weight during eat less
2. Food industry has always had a lot of influence over the food environment
3. Marketing to kids is highly effective (early and often)
a. Pouring rights: exclusive contracts between companies and school districts
4. Food industry has lobbied to…
a. Make health claims to sell/market products
i. At best, with limited evidence; at worst, manipulative
ii. Free speech vs. safety/evidence
b. Influence public health advice |
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Term
| Food Politics (book): artificial vs. natural flavor processes |
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Definition
| Natural doesn’t necessarily mean healthier – both are chemical processes |
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Term
| Food Politics (book): New York City Initiatives (2) |
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Definition
1. calories posted next to food (not always correct calorie count)
2. ≥ 16oz drinks banned |
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Term
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Definition
A.Includes exercise guidelines, no longer just about food
B.More specific information:
1.Dairy -> low-fat dairy
2.Grains -> whole grains
3.Fruits/veggies -> fresh, limit juice
4.Healthy fats, limited sugar
5.Meat and dairy no longer equivalent |
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Term
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Definition
| Confusion: the amount that is recommended is not in proportion to the size of the corresponding amount in the picture. Ex. dairy and grains are the same size in the picture of the pyramid, but the amount of the portions recommended are different. |
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Term
| Food environment: Definition |
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Definition
| where/how, what/where we eat, marketing, cost, politics |
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Term
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Definition
| Children have purchasing power, captive audience, developmental limitations, cross-marketing (Teletubby on McDonalds' Happy Meals) |
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Term
| Obesity and TV relationship |
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Definition
| The more you watch, the more you weigh |
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