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The Physiology of Anorexia Nervosa and Bulimia Nervosa

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Abstract

Feeding and eating disorders (FEDs) are psychological disorders that are characterized by abnormal eating, dysfunctional relationships with food, and a preoccupation with one’s weight and shape. Among others, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes two specific FEDs: anorexia nervosa (AN) and bulimia nervosa (BN), although there are subtypes associated with each. The DSM-5 and the International Classification of Diseases (ICD-10) have different criteria for diagnosing AN and BN. Early identification of a FED is associated with shorter duration and fewer medical complications. Yet it is estimated that only about 33% of AN patients and 6% of BN are receiving proper treatment for their illnesses. Gastrointestinal upset, fluid, and electrolyte imbalances are common with AN and may lead to complications such as, pernicious anemia, osteoporosis, and heart disease. On the other hand, BN can cause adverse effects, such as erosion of the teeth, enlargement of the parotid salivary glands, and acidic stomachs leading to heartburn. Long-term adverse effects caused by BN are gynecological problems, hormonal disturbances, hypercholesterolemia, and hypertension. Successful treatment of FEDs should be managed with a team-based approach including the physician, psychologist, and registered dietitian.

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Author information

Authors and Affiliations

  1. Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA

    Kembra D. Albracht-Schulte, Laura Flynn, Caleb M. Perry & Jacalyn J. Robert-McComb

  2. School of Nursing, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Annette Gary

Authors
  1. Kembra D. Albracht-Schulte
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  2. Laura Flynn
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  3. Annette Gary
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  5. Jacalyn J. Robert-McComb
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Correspondence to Kembra D. Albracht-Schulte .

Editor information

Editors and Affiliations

  1. Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA

    Jacalyn J. Robert-McComb

  2. Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Mimi Zumwalt

  3. Functional Biology, University of Oviedo, Oviedo, Asturias, Spain

    Maria Fernandez-del-Valle

Chapter Review Questions

Chapter Review Questions

  1. 1.

    Incidence of Feeding and Eating Disorders is of significant concern due to Feeding and Eating Disorders association with

    1. (a)

      Mental illness

    2. (b)

      Substance use

    3. (c)

      Low Socioeconomic status

    4. (d)

      Adverse acute and chronic health consequences

  2. 2.

    Known predictors at the core of Anorexia Nervosa include all except

    1. (a)

      Concerns about weight

    2. (b)

      Fear of being fat

    3. (c)

      A desire to please others

    4. (d)

      An extreme desire to be thin

  3. 3.

    Factors associated with the rate of crossover from Anorexia Nervosa to Bulimia Nervosa include

    1. (a)

      Common traits such as obsessiveness and high self-directedness

    2. (b)

      A history of anxiety and/or childhood sexual abuse

    3. (c)

      A tendency to strive for perfectionism

    4. (d)

      Symptom overlap between the two disorders

  4. 4.

    Which is not a characteristic that impacts Feeding and Eating Disorder health outcomes?

    1. (a)

      Low self-esteem

    2. (b)

      Experiences in adolescence

    3. (c)

      Medical and psychological comorbidity

    4. (d)

      Occupation

  5. 5.

    Which Feeding and Eating Disorder is more common?

    1. (a)

      Anorexia Nervosa

    2. (b)

      Bulimia Nervosa

    3. (c)

      Anorexia type 2

    4. (d)

      Anorexia-exercise type c

  6. 6.

    Which is a subtype of Anorexia Nervosa?

    1. (a)

      Restricting subtype

    2. (b)

      Exercise subtype

    3. (c)

      Anorexia type 2

    4. (d)

      Nervosa subtype

  7. 7.

    _______________ is the most common medical cause of death in people with Anorexia Nervosa.

    1. (a)

      neuropathy

    2. (b)

      Bradycardia

    3. (c)

      Heart Disease

    4. (d)

      Osteoporosis

  8. 8.

    Often times, individuals with Anorexia Nervosa feel bloated and full because food can stay in the stomach for ________ hours) as opposed to the normal passage time of _____ hour(s).

    1. (a)

      4–5, 1

    2. (b)

      6–7, 4–5

    3. (c)

      2–3, 3–4

    4. (d)

      1, 4–5

  9. 9.

    Which of the following is known to stimulate hunger?

    1. (a)

      Leptin

    2. (b)

      Cholecystokinin

    3. (c)

      Ghrelin

    4. (d)

      Peptide Y-Y

  10. 10.

    ____________ is synthesized extensively in the human gastrointestinal tract, and helps regulate appetite, sleep patterns, and mood.

    1. (a)

      Leptin

    2. (b)

      Serotonin

    3. (c)

      Dopamine

    4. (d)

      Catechol-O-methyltransferase

Answers

  1. 1.

    b

  2. 2.

    c

  3. 3.

    a

  4. 4.

    d

  5. 5.

    b

  6. 6.

    a

  7. 7.

    c

  8. 8.

    a

  9. 9.

    c

  10. 10.

    b

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Albracht-Schulte, K.D., Flynn, L., Gary, A., Perry, C.M., Robert-McComb, J.J. (2023). The Physiology of Anorexia Nervosa and Bulimia Nervosa. In: Robert-McComb, J.J., Zumwalt, M., Fernandez-del-Valle, M. (eds) The Active Female. Springer, Cham. https://doi.org/10.1007/978-3-031-15485-0_6

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