Eating Disorders Practice Questions

Q: A 25-year-old female presents with recurrent episodes of binge eating followed by self-induced vomiting. What is the most appropriate treatment?

Cognitive-behavioral therapy. ***Cognitive-behavioral therapy*** - **CBT** is the most established and effective psychotherapy for **bulimia nervosa**, targeting the dysfunctional thoughts and behaviors associated with binge eating and purging. - It helps patients identify triggers, develop coping mechanisms, and normalize eating patterns. *Interpersonal therapy* - **IPT** focuses on improving interpersonal relationships and social functioning, which can indirectly help with eating disorders but is **less directly effective** than CBT for bulimia nervosa. - While it may be helpful for some patients, it is not considered the **first-line treatment** for this condition. *Family-based therapy* - **FBT** (Maudsley Method) is primarily used for **anorexia nervosa** in adolescents, involving parents in the re-feeding process. - While family dynamics can play a role in eating disorders, FBT is **not the primary intervention** for an adult with bulimia nervosa. *Dialectical behavior therapy* - **DBT** is highly effective for conditions involving **emotion dysregulation** and **impulsivity**, such as borderline personality disorder. - While some aspects of DBT, like emotion regulation skills, might be helpful, it is **not the primary evidence-based treatment** for bulimia nervosa.

Q: A 19-year-old woman with bulimia nervosa is likely to exhibit which of the following behaviors?

Frequent binge eating followed by purging. ***Frequent binge eating followed by purging*** - **Bulimia nervosa** is characterized by recurrent episodes of **binge eating**, which is consuming an amount of food much larger than most people would eat in a similar period under similar circumstances, accompanied by a sense of lack of control. - These binge episodes are followed by **compensatory behaviors** such as self-induced vomiting (purging), misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. *Significant weight loss and refusal to eat* - This description is more indicative of **anorexia nervosa**, characterized by restriction of energy intake leading to a significantly low body weight. - Individuals with bulimia nervosa typically maintain a normal weight or are overweight, and their compensatory behaviors are aimed at preventing weight gain after binge eating. *Excessive fasting and exercise without binging* - While excessive exercise and fasting can be compensatory behaviors in bulimia nervosa, the absence of **binge eating** suggests a different eating disorder or a subthreshold presentation. - This pattern may be seen in some forms of **anorexia nervosa** (restricting type) but lacks the hallmark binge-purge cycle of bulimia. *Normal eating patterns with occasional overeating* - **Occasional overeating** is common and does not meet the diagnostic criteria for an eating disorder. - **Bulimia nervosa** involves a recurrent and distressing pattern of binge eating and inappropriate compensatory behaviors that significantly impacts quality of life.

Q: A 16-year-old girl has intense cravings for food and consumes large amounts of it, followed by purging behaviors. What is the most likely diagnosis?

Bulimia nervosa. ***Bulimia nervosa*** - **Bulimia nervosa** is characterized by recurrent episodes of **binge eating** (consuming large amounts of food with a sense of lack of control), followed by inappropriate **compensatory behaviors** such as self-induced vomiting, laxative abuse, or excessive exercise. - The patient's presentation of "intense cravings for food," consuming "large amounts," and "purging behaviors" directly aligns with DSM-5 diagnostic criteria for bulimia nervosa. - Peak onset is typically in **adolescence and early adulthood**, and it is more common in females. *Anorexia nervosa* - **Anorexia nervosa** is primarily characterized by **restriction of energy intake** leading to significantly low body weight, intense fear of gaining weight, and disturbance in body image. - While the binge-eating/purging subtype of anorexia exists, the defining feature is **persistent restriction** and significantly **low body weight**, which is not mentioned in this clinical scenario. *Major depressive disorder* - **Depression** is a mood disorder with persistent sadness, anhedonia, and neurovegetative symptoms. - While depression commonly co-occurs with eating disorders and may cause appetite changes, the specific cyclical pattern of **binge eating followed by compensatory purging** is not a characteristic feature of depression itself. *Binge eating disorder* - **Binge eating disorder** involves recurrent episodes of consuming large amounts of food with a sense of lack of control, accompanied by marked distress. - The key distinguishing feature is the **absence of regular compensatory behaviors** (purging, excessive exercise, fasting) that are present in bulimia nervosa.

Q: Which of the following is not typically seen in anorexia nervosa?

Menorrhagia. ***Menorrhagia*** - **Anorexia nervosa** is typically associated with **amenorrhea** (absence of menstruation) or **oligomenorrhea** (infrequent menstruation) due to hormonal imbalances caused by malnutrition and low body fat. - **Menorrhagia** (heavy or prolonged menstrual bleeding) is not a common feature and would suggest a different underlying cause. *Osteoporosis* - **Osteoporosis** is a common and serious complication of **anorexia nervosa** due to prolonged low estrogen levels, poor nutrition, and hormonal dysregulation affecting bone density. - Reduced **bone mineral density** is prevalent, especially in chronic cases. *Food refusal* - **Food refusal** is a hallmark symptom of **anorexia nervosa**, driven by an intense fear of gaining weight and a distorted body image. - Patients restrict food intake, often leading to severe caloric deficit. *Weight loss* - Significant **weight loss** is a diagnostic criterion for **anorexia nervosa**, as individuals maintain a body weight that is minimally normal or even below normal for their height and age. - This weight loss is intentionally achieved through restrictive eating behaviors.

Q: Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?

Bulimia nervosa. ***Bulimia nervosa*** - This disorder is characterized by recurrent episodes of **binge eating** followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise, while the individual generally maintains a **normal body weight**. - The key differentiator from anorexia nervosa is the **normal weight** and the cyclical pattern of binging and compensatory behaviors. - According to **DSM-5 criteria**, bulimia nervosa requires both binge eating episodes and inappropriate compensatory behaviors occurring at least once weekly for 3 months. *Anorexia nervosa* - This eating disorder is primarily characterized by an intense fear of gaining weight, leading to **severe restriction of food intake** and significantly **low body weight**. - Individuals with anorexia nervosa do not maintain a normal weight; rather, their weight is often **below minimally normal** (BMI < 18.5 kg/m² in adults). *Binge eating disorder* - This disorder involves recurrent episodes of **binge eating**, defined as consuming an unusually large amount of food in a short period with a sense of loss of control, but it does **not involve recurrent compensatory behaviors** like purging. - Individuals with binge eating disorder are often **overweight or obese**, contrasting with the normal weight seen in bulimia nervosa. *Night eating syndrome* - This disorder is characterized by recurrent episodes of **nighttime eating** (consuming food after evening meal or upon awakening from sleep) with full awareness. - Unlike bulimia nervosa, it does **not involve binge eating** in the classic sense, and there are **no compensatory behaviors** like purging or excessive exercise. - Individuals may maintain normal weight but the eating pattern is distinctly different from the binge-purge cycle.

Q: What does Pica refer to?

An appetite for non-nutritive substances. ***An appetite for non-nutritive substances*** - Pica is an eating disorder characterized by a persistent and compulsive craving for and consumption of **non-nutritive, non-food substances** for at least one month. - Common ingested substances include **dirt, clay, ice, hair, paint chips, and laundry starch**, often associated with **nutritional deficiencies** like iron deficiency anemia or **developmental disabilities**. *Ice sucking* - While **pagophagia (ice craving)** is a specific form of Pica, it represents only one manifestation and not the overarching definition of the disorder. - Isolated ice sucking can sometimes be a sign of **iron deficiency anemia**. *Thumb sucking* - **Thumb sucking** is a common habit, especially in infants and young children, typically associated with self-soothing and comfort. - It is not considered an eating disorder and does not involve the consumption of non-nutritive substances. *None of the options* - This option is incorrect because "An appetite for non-nutritive substances" accurately defines Pica.

Q: Disorder where amenorrhea was once needed for diagnosis is?

Anorexia nervosa. ***Anorexia nervosa*** - Historically, **amenorrhea** (absence of menstruation) was a diagnostic criterion for **anorexia nervosa**, reflecting the severe physiological impact of malnutrition and low body weight on the **endocrine system**. - While still common in patients with anorexia, it is **no longer a mandatory diagnostic criterion** in the DSM-5. *Metabolic syndrome* - Metabolic syndrome is a cluster of conditions that includes **increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels**. - It is **not directly associated with amenorrhea** and does not have amenorrhea as a diagnostic criterion. *Bulimia nervosa* - Bulimia nervosa is characterized by **recurrent episodes of binge eating** followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or misuse of laxatives. - While it can be associated with menstrual irregularities due to nutritional imbalances, **amenorrhea is not a diagnostic criterion** for bulimia nervosa. *Binge eating disorder* - Binge eating disorder involves **recurrent episodes of eating large quantities of food**, often rapidly and to the point of discomfort, without the regular use of inappropriate compensatory behaviors. - This disorder is **not directly linked to amenorrhea as a diagnostic feature**, although nutritional status can affect menstrual cycles.

Q: Excessive eating of non-nutritive substances is called:

Pica. ***Pica*** - Pica is an eating disorder characterized by the persistent eating of **non-nutritive, non-food substances** over a period of at least one month. - Common substances ingested include **dirt, clay, ice, paint chips, paper, and laundry starch**, indicating an unusual craving for non-food items. - More common in **children, pregnant women, and individuals with developmental disabilities**. *Anorexia Nervosa* - Anorexia nervosa is an eating disorder characterized by **restriction of energy intake** relative to requirements, leading to a significantly low body weight. - It involves an intense **fear of gaining weight** or becoming fat, and a disturbance in the way one's body weight or shape is experienced. - Does not involve eating non-nutritive substances. *Bulimia Nervosa* - Bulimia nervosa is characterized by **recurrent episodes of binge eating** followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise. - Unlike Pica, it involves eating **excessive amounts of regular food**, not non-nutritive substances. *Rumination Disorder* - Rumination disorder involves **repeated regurgitation of food** that may be re-chewed, re-swallowed, or spit out, occurring after feeding or eating. - It involves **normal food substances**, not the persistent eating of non-nutritive items as seen in Pica.

Q: Repeated involuntary regurgitation of food is associated with which of the following disorders?

Rumination disorder. ***Rumination disorder*** - This disorder is specifically characterized by the **repeated regurgitation of food** either back into the mouth for rechewing and reswallowing or spitting out. - The regurgitation is **involuntary** and not due to a medical condition or another eating disorder. *Binge eating disorder* - Characterized by recurrent episodes of **eating a large amount of food** in a short period, accompanied by a feeling of loss of control. - Does not typically involve the **regurgitation of food** after consumption. *Bulimia nervosa* - Involves recurrent episodes of **binge eating followed by compensatory behaviors** such as self-induced vomiting, excessive exercise, or laxative misuse. - While vomiting occurs, it is a **compensatory behavior** after a binge, not an involuntary regurgitation as seen in rumination disorder. *Anorexia nervosa* - Primarily defined by a **restricted energy intake** leading to significantly low body weight, intense fear of gaining weight, and a disturbed perception of body shape or weight. - Does not involve the **repeated involuntary regurgitation of food** as a primary feature.

Question 1

A 25-year-old female presents with recurrent episodes of binge eating followed by self-induced vomiting. What is the most appropriate treatment?

Accepted Answer

Cognitive-behavioral therapy

Answer

Interpersonal therapy

Answer

Family-based therapy

Answer

Dialectical behavior therapy

Question 2

A 19-year-old woman with bulimia nervosa is likely to exhibit which of the following behaviors?

Accepted Answer

Frequent binge eating followed by purging

Answer

Significant weight loss and refusal to eat

Answer

Excessive fasting and exercise without binging

Answer

Normal eating patterns with occasional overeating

Question 3

A 16-year-old girl has intense cravings for food and consumes large amounts of it, followed by purging behaviors. What is the most likely diagnosis?

Accepted Answer

Bulimia nervosa

Answer

Anorexia nervosa

Answer

Major depressive disorder

Answer

Binge eating disorder

Question 4

Which of the following is not typically seen in anorexia nervosa?

Accepted Answer

Menorrhagia

Answer

Osteoporosis

Answer

Weight loss

Answer

Food refusal

Question 5

Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?

Accepted Answer

Bulimia nervosa

Answer

Anorexia nervosa

Answer

Binge eating disorder

Answer

Night eating syndrome

Question 6

What does Pica refer to?

Accepted Answer

An appetite for non-nutritive substances

Answer

Ice sucking

Answer

Thumb sucking

Answer

None of the options

Question 7

Disorder where amenorrhea was once needed for diagnosis is?

Accepted Answer

Anorexia nervosa

Answer

metabolic syndrome

Answer

bulimia nervosa

Answer

Binge eating disorder

Question 8

Excessive eating of non-nutritive substances is called:

Accepted Answer

Pica

Answer

Anorexia Nervosa

Answer

Bulimia Nervosa

Answer

Rumination Disorder

Question 9

Repeated involuntary regurgitation of food is associated with which of the following disorders?

Accepted Answer

Rumination disorder

Answer

Binge eating disorder

Answer

Bulimia nervosa

Answer

Anorexia nervosa

Eating Disorders — MCQs

Eating Disorders — MCQs

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