Chapter 9: Eating Disorders and Obesity
Multiple-Choice Questions
9.1-1. Which of the following accounts for more morbidity and mortality than all
eating disorders combined?
a. anorexia nervosa
b. bulimia nervosa
c. binge-eating disorder
d. obesity
Difficulty: 2
Question ID: 9.1-1
Page Ref: 294
Topic: Eating Disorders and Obesity
Skill: Factual
Answer: d. obesity
9.1-2. Which of the following is not a condition found in the DSM?
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge-eating disorder
d. Obesity
Difficulty: 2
Question ID: 9.1-2
Page Ref: 294
Topic: Eating Disorders and Obesity
Skill: Factual
Answer: d. obesity
9.1-3. Which of the following is a controversial aspect of the diagnostic criteria for
anorexia nervosa?
a. refusal to maintain normal body weight
b. distorted perception of body size and shape
c. amenorrhea
d. denial
Amenorrhea (the absence of at least three consecutive menstrual cycles) was
historically a criterion for diagnosing anorexia nervosa, and it was controversial
because not all individuals with anorexia nervosa experience amenorrhea.
Recognizing this limitation, the diagnostic criteria were revised in the DSM-5 to
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acknowledge that some individuals, particularly males and postmenopausal
females, may not meet the criteria of amenorrhea but can still have anorexia
nervosa. The removal of amenorrhea as a necessary criterion aimed to make the
diagnosis more inclusive and applicable to a broader range of individuals with
anorexia nervosa.
Difficulty: 1
Question ID: 9.1-3
Page Ref: 295
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Factual
Answer: c. amenorrhea
9.1-4. Which of the following is characteristic of the binge-eating/purging type of
anorexia?
a. the use of laxatives
b. 30 to 50 percent of those who begin by binge-eating and purging become restricting
type anorexics
c. body weight is within normal range
d. efforts to restrict food intake
Difficulty: 2
Question ID: 9.1-4
Page Ref: 296
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Factual
Answer: a. the use of laxatives
9.1-5. Andrea has anorexia nervosa, restricting type. Which of the following
behaviors would you expect her to have?
a. self-induced vomiting
b. cutting up her food into little pieces when she eats
c. normal menstrual periods
d. occasional bouts of overeating
Difficulty: 1
Question ID: 9.1-5
Page Ref: 296
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Factual
Answer: b. cutting up her food into little pieces when she eats
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9.1-6. Cindy is 5 ' 6" tall and weighs 92 pounds. She is very concerned about her
weight. However, at times she finds herself eating large amounts of food - several
boxes of cookies, gallons of ice cream, entire cakes - all in an evening. Afterwards,
she makes herself throw up. Cindy's most likely diagnosis is
a. bulimia nervosa, purging type.
b. anorexia nervosa, binge-eating/purging type.
c. anorexia nervosa, restricting type.
d. no disorder.
Difficulty: 1
Question ID: 9.1-6
Page Ref: 296
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Applied
Answer: b. anorexia nervosa, binge-eating/purging type.
9.1-7. Which of the following is a potential consequence of anorexia nervosa?
a. memory loss
b. excessive hair growth
c. hearing and vision impairment
d. death
Difficulty: 1
Question ID: 9.1-7
Page Ref: 302
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Factual
Answer: d. death
9.1-8. How do you distinguish between the binge-eating/purging type of anorexia
nervosa and bulimia nervosa, purging type?
a. The bulimic type involves throwing up, and the anorexic type involves fasting.
b. Altered eating and exercise habits result in missed periods in the bulimic type only.
c. The bulimic type results in more severe health consequences than the anorexic type.
d. People with the bulimic type are normal weight, people with the anorexic type are
underweight.
Difficulty: 2
Question ID: 9.1-8
Page Ref: 299
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Conceptual
Answer: d. People with the bulimic type are normal weight, people with the anorexic
type are underweight.
9.1-9. Which of the following do those with anorexia nervosa and bulimia nervosa
have in common?
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a. fear of being or becoming fat
b. a sense of control
c. below normal weight
d. restricted eating
Difficulty: 1
Question ID: 9.1-9
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Factual
Answer: a. fear of being or becoming fat
9.1-10. In order to make a diagnosis of bulimia nervosa, the client must
a. have a distorted body image.
b. not meet the criteria for anorexia nervosa.
c. have missed three consecutive menstrual periods.
d. admit that she has a problem.
Difficulty: 1
Question ID: 9.1-10
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Factual
Answer: b. not meet the criteria for anorexia nervosa.
9.1-11. Someone who binges and purges and is severely underweight is diagnosed as
anorexic, not bulimic. Treating physicians must be precise with this diagnosis
because
a. the patient will eventually stop bingeing and purging and start fasting.
b. anorexia is considered the more reliable diagnosis.
c. anorexia has a much higher death rate than bulimia.
d. bingeing and purging are not considered very important symptoms.
Difficulty: 2
Question ID: 9.1-11
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Factual
Answer: c. anorexia has a much higher death rate than bulimia.
9.1-12. Elena binges on high calorie foods and then makes herself throw up. She
feels terribly ashamed and horrified by what she does. You would predict
a. she will stop making herself throw up because she is ashamed and distressed.
b. she will not stop because her vomiting is reinforced by reducing her fear of gaining
weight.
c. she will stop because her vomiting is being punished by the feelings of disgust and
shame.
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d. she will not stop because she has become physiologically addicted to vomiting.
Difficulty: 2
Question ID: 9.1-12
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Applied
Answer: b. she will not stop because her vomiting is reinforced by reducing her fear of
gaining weight.
9.1-13. The mindset of people with bulimia and people with anorexia
a. is basically the same.
b. is very different - people with anorexia eventually become satisfied with their weight
loss and people with bulimia never do.
c. is very different - people with bulimia don't seem bothered by other people's opinion
(usually distress) about them and people with anorexia are very concerned and will do
their best to hide their disorder.
d. is very different - people with anorexia don't seem bothered by other people's opinion
(usually distress) about them and people with bulimia are very concerned and will do
their best to hide their disorder.
Difficulty: 2
Question ID: 9.1-13
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Conceptual
Answer: d. is very different - people with anorexia don't seem bothered by other people's
opinion (usually distress) about them and people with bulimia are very concerned and
will do their best to hide their disorder.
9.1-14. The text presented the case of Catherine, a woman with bulimia nervosa. She
is typical of such individuals because she
a. had suffered few health problems.
b. had few thoughts of food except when she was eating.
c. experienced shame, guilt, and self-deprecation.
d. did not realize that her eating habits were abnormal.
Difficulty: 1
Question ID: 9.1-14
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Applied
Answer: c. experienced shame, guilt, and self-deprecation.
9.1-15. Callie and Raquel both have problems with binging and purging. They both
eat large evening meals and both then purge what they have eaten. Callie engages in
this three to four times a week, and Raquel does so once a week on Sundays. What
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would be the diagnosis for each of these individuals?
a. Callie’s diagnosis would be bulimia nervosa; Raquel does not meet DSM criteria.
b. Callie’s diagnosis would be anorexia nervosa; Raquel does not meet DSM criteria.
c. Callie’s diagnosis would be bulimia nervosa; Raquel’s diagnosis would be anorexia
nervosa.
d. Callie’s diagnosis would be bulimia nervosa; Raquel’s diagnosis would be bulimia
nervosa.
Difficulty: 1
Question ID: 9.1-15
Page Ref: 297-298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Applied
Answer: d. Callie’s diagnosis would be bulimia nervosa; Raquel’s diagnosis would be
bulimia nervosa.
9.1-16. In her mid-thirties, Cheryl became preoccupied with her weight and began
dieting and exercising. After losing a substantial amount of weight, she was still not
happy with how she looked and continued to restrict her food intake. After several
fainting spells resulting from her low calorie intake, her employer referred her to a
clinician who recognized the signs of anorexia nervosa. Which of the following is
unique about Cheryl's case?
a. Eating disorders rarely start during the mid-thirties.
b. The likelihood of anorexia being so readily recognized and diagnosed is slim.
c. Few women with anorexia exercise.
d. A diagnosis of anorexia is rarely made before the condition becomes life-threatening.
Difficulty: 2
Question ID: 9.1-16
Page Ref: 300
Topic: Clinical Aspects of Eating Disorders/Age of Onset and Gender Differences
Skill: Applied
Answer: a. Eating disorders rarely start during the mid-thirties.
9.1-17. Which of the following has been identified as a risk factor for eating
disorders in men?
a. heterosexuality
b. bicycling
c. homosexuality
d. painting
Difficulty: 1
Question ID: 9.1-17
Page Ref: 300
Topic: Clinical Aspects of Eating Disorders/World Around Us
Skill: Factual
Answer: c. homosexuality
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9.1-18. Felicia has been diagnosed with bulimia nervosa with purging. We should
expect that she
a. purges only once every few years
b. is unconcerned about becoming fat.
c. experiences electrolyte imbalances and mineral deficiencies.
d. is less than 85 percent of normal body weight but still considers herself "fat."
Difficulty: 2
Question ID: 9.1-18
Page Ref: 302
Topic: Clinical Aspects of Eating Disorders/Medical Complications of Eating Disorders
Skill: Applied
Answer: c. experiences electrolyte imbalances and mineral deficiencies.
9.1-19. Lanugo
a. is a soft hair that grows on the body of people with anorexia.
b. is another name for an eating binge.
c. is the term for the stopping of a woman's menstrual periods.
d. is the lack of concern people with anorexia show about their condition.
Difficulty: 2
Question ID: 9.1-19
Page Ref: 302
Topic: Clinical Aspects of Eating Disorders/Medical Complications of Eating Disorders
Skill: Factual
Answer: a. is a soft hair that grows on the body of people with anorexia.
9.1-20. A common sign of bulimia nervosa is
a. lanugo.
b. intolerance to cold.
c. kidney failure.
d. damaged teeth and mouth ulcers.
Difficulty: 2
Question ID: 9.1-20
Page Ref: 302
Topic: Clinical Aspects of Eating Disorders/Medical Complications of Eating Disorders
Skill: Factual
Answer: d. damaged teeth and mouth ulcers.
9.1-21. Ellen is underweight but not less than 85 percent of normal body weight. She
often restricts her eating because she is intensely fearful of becoming fat. She purges
at least twice a week, even though she does not eat large amounts of food at any
sitting. According to the DSM-5 she should be diagnosed
a. with anorexia nervosa, binge/purge subtype.
b. with eating disorder not otherwise specified.
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c. with binge eating disorder.
d. with purging disorder.
Difficulty: 2
Question ID: 9.1-21
Page Ref: 300
Topic: Clinical Aspects of Eating Disorders/Age of Onset and Gender Differences
Skill: Applied
Answer: d. with purging disorder.
9.1-22. Delilah is overweight. She likes to eat cookies and other sugary snacks, and
often eats an entire package at one sitting. She is upset by this because she knows
how important weight is to health, but she does not engage in any compensatory
behaviors. Which of the following would be a likely diagnosis?
a. anorexia nervosa
b. bulimia nervosa
c. binge eating disorder
d. purging disorder
Difficulty: 2
Question ID: 9.1-22
Page Ref: 299
Topic: Clinical Aspects of Eating Disorders/Binge Eating Disorder
Skill: Applied
Answer: c. binge eating disorder
9.1-23. Binge-eating disorder
a. is an extremely rare variant of bulimia nervosa.
b. is diagnosed when a person binges and then purges by using laxatives or self-induced
vomiting.
c. cannot be diagnosed if a person is overweight.
d. involves binges comparable to those in bulimia but without any inappropriate
"compensatory" behavior to limit weight gain.
Difficulty: 1
Question ID: 9.1-23
Page Ref: 299
Topic: Clinical Aspects of Eating Disorders/Other Forms of Eating Disorders
Skill: Factual
Answer: d. involves binges comparable to those in bulimia but without any inappropriate
"compensatory" behavior to limit weight gain.
9.1-24. Binge-eating disorder
a. is an eating disorder diagnosis most recently added to the DSM-5.
b. has not yet been formally recognized as a distinct clinical syndrome.
c. usually develops into anorexia, binge-eating/purging subtype.
d. is more common in males than in females.
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Difficulty: 2
Question ID: 9.1-24
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Other Forms of Eating Disorders
Skill: Conceptual
Answer: a. is an eating disorder diagnosis most recently added to the DSM-5.
9.1-25. What is unique about binge-eating disorder (BED) as compared to the eating
disorders currently found in the DSM?
a. Those with BED are commonly of normal body weight.
b. The patient age is usually older.
c. It develops earlier in life than other eating disorders.
d. Few of those with BED develop weight-related health problems.
Difficulty: 2
Question ID: 9.1-25
Page Ref: 300
Topic: Clinical Aspects of Eating Disorders/Age of Onset and Gender Differences
Skill: Conceptual
Answer: b. The patient age is usually older.
9.1-26. Which statement about the diagnosis of eating disorders is accurate?
a. A person meeting the criteria for bulimia rarely, if ever, has been diagnosed with
anorexia.
b. There is quite a lot of diagnostic crossover in eating disorders.
c. Although the symptoms of anorexia and bulimia do not overlap, women with eating
disorders often have other diagnosable psychiatric conditions.
d. Although anorexia and bulimia are quite similar, women with eating disorders rarely
have a comorbid psychological condition.
Difficulty: 2
Question ID: 9.1-26
Page Ref: 303
Topic: Clinical Aspects of Eating Disorders/Diagnostic Crossover
Skill: Conceptual
Answer: b. There is quite a lot of diagnostic crossover in eating disorders.
9.1-27. What disorders are often comorbid with eating disorders?
a. post-traumatic stress disorder and depression
b. panic disorder and personality disorders
c. generalized anxiety disorder and substance abuse
d. depression and personality disorders
Difficulty: 2
Question ID: 9.1-27
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Page Ref: 303-304
Topic: Clinical Aspects of Eating Disorders/Association with Other Forms of
Psychopathology
Skill: Factual
Answer: d. depression and personality disorders
9.1-28. Which of the following complicates the study of personality traits and eating
disorders?
a. Personality disorders are always seen in those with eating disorders.
b. Personality may be altered by malnourishment.
c. Eating disorders may merely be a symptom of a personality disorder.
d. Both personality disorders and eating disorders are highly subjective diagnostic
categories, thus the collection of empirical data is tainted by the nature of these
conditions.
Difficulty: 2
Question ID: 9.1-28
Page Ref: 304
Topic: Clinical Aspects of Eating Disorders/Association with Other Forms of
Psychopathology
Skill: Conceptual
Answer: b. Personality may be altered by malnourishment.
9.1-29. Ginger suffers from anorexia. She is often angry and irritable. These feelings
a. may be the result of her starving herself.
b. were probably modeled by her father and mother.
c. suggest that she does not suffer from "neuroticism."
d. must have predated the onset of the anorexia.
Difficulty: 1
Question ID: 9.1-29
Page Ref: 304
Topic: Clinical Aspects of Eating Disorders/Association with Other Forms of
Psychopathology
Skill: Applied
Answer: a. may be the result of her starving herself.
9.1-30. Which of the following statements about the prevalence of eating disorders in
the 20th century is true?
a. While the incidence of anorexia has been increasing, the incidence of bulimia seems to
be declining.
b. While there is no evidence to indicate that the incidence of anorexia has been
changing, the incidence of bulimia has been declining.
c. While the incidence of anorexia has been increasing, there is no evidence to suggest a
change in the incidence of bulimia.
d. While there is no evidence to indicate that the incidence of anorexia has been
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changing, bulimia appears to be increasing in frequency.
Difficulty: 1
Question ID: 9.1-30
Page Ref: 301
Topic: Clinical Aspects of Eating Disorders/Prevalence of Eating Disorders
Skill: Factual
Answer: a. While the incidence of anorexia has been increasing, the incidence of bulimia
seems to be declining.
9.1-31. Which of the following is likely to put whites at higher risk of developing an
eating disorder than non-whites?
a. body dissatisfaction
b. living in an industrialized society
c. fear of stomach bloating
d. desire to please the family
Difficulty: 1
Question ID: 9.1-31
Page Ref: 304
Topic: Clinical Aspects of Eating Disorders/Eating Disorders Across Cultures
Skill: Factual
Answer: a. body dissatisfaction
9.1-32. Rates of eating disorders tend to be much lower in black women than in
white women. However, one factor that can increase risk in black women is
a. their age - younger black women have higher rates of eating disorders than older.
b. assimilation into white culture and middle class values.
c. their weight - very overweight black women have the same rates of eating disorders as
whites do.
d. whether they were recent immigrants.
Difficulty: 2
Question ID: 9.1-32
Page Ref: 305
Topic: Clinical Aspects of Eating Disorders/Eating Disorders Across Cultures
Skill: Factual
Answer: b. assimilation into white culture and middle class values.
9.1-33. Which of the following characterizes the prevalence of eating disorders in
Iran?
a. Iran does not recognize eating disorders.
b. Iran has a low incidence of eating disorders.
c. Iran’s prevalence of eating disorders is comparable the United States.
d. Iran has a very high prevalence of eating disorders.
Difficulty: 2
Question ID: 9.1-33
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Page Ref: 304
Topic: Clinical Aspects of Eating Disorders/Eating Disorders Across Cultures
Skill: Factual
Answer: c. Iran’s prevalence of eating disorders is comparable the United States.
9.1-34. What is the prognosis for anorexia nervosa?
a. Relapse rates are high, but recovery can often happen in the long run.
b. Most people improve fairly quickly and don't relapse.
c. Anorexia has an excellent recovery rate, but the other disorders don't.
d. The prognosis is extremely poor, with few recovering from it.
Difficulty: 2
Question ID: 9.1-34
Page Ref: 303
Topic: Clinical Aspects of Eating Disorders/Course and Outcome
Skill: Factual
Answer: a. Relapse rates are high but recovery can often happen in the long run.
9.1-35. In studies of the long-term outcomes of women treated for eating disorders,
which of the following predicted poor outcomes for those diagnosed with anorexia
or bulimia?
a. Depression
b. Presence of a personality disorder
c. Substance abuse
d. OCD
Difficulty: 2
Question ID: 9.1-35
Page Ref: 303
Topic: Clinical Aspects of Eating Disorders/Course and Outcome
Skill: Factual
Answer: c. Substance abuse
9.1-36. Which of the following statements about the role of genetics as a risk factor
for eating disorders is true?
a. While the gene underlying the restrictive type of anorexia nervosa has been identified,
the role of genes in the development of other forms of eating disorders is not clear.
b. The lack of adoption studies has made it impossible to determine the heritability of
eating disorders.
c. Due to the complex nature of eating disorders and the probability that multiple genes
contribute to their development, a role for genes in such disorders has yet to be
established.
d. Although the findings to date are mixed, the evidence does indicate that a susceptibility
to eating disorders may be inherited along with a diathesis for other psychological
conditions.
Difficulty: 3
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Question ID: 9.1-36
Page Ref: 306
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Conceptual
Answer: d. Although the findings to date are mixed, the evidence does indicate that a
susceptibility to eating disorders may be inherited along with a diathesis for other
psychological conditions.
9.1-37. What neurotransmitter seems to be involved in both eating disorders and
depression?
a. dopamine
b. serotonin
c. GABA
d. norepinephrine
Difficulty: 1
Question ID: 9.1-37
Page Ref: 306
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Factual
Answer: b. serotonin
9.1-38. According to set-point theory
a. anorexics have successfully adjusted their bodies to a new lower set-point.
b. hunger serves to maintain the body at its established set-point.
c. behavioral means of altering body weight can never overcome the body's ability to
compensate physiologically.
d. the body weight that is maintained in the absence of dieting is the one at which health
is maximized.
Difficulty: 2
Question ID: 9.1-38
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Applied
Answer: b. hunger serves to maintain the body at its established set-point.
9.1-39. Set-point theory explains why
a. losing those last few pounds is easier than losing the first few.
b. the desire for fatty high calorie foods decreases over time when deprived of food.
c. binge eating is likely after a period of caloric restriction.
d. serotonin levels change with fasting.
Difficulty: 2
Question ID: 9.1-39
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
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Skill: Applied
Answer: c. binge eating is likely after a period of caloric restriction.
9.1-40. Set-point theory about weight suggests that
a. dieting can establish a new set-point that stabilizes the near-starvation seen in people
with anorexia.
b. people with anorexia are biologically programmed to be underweight.
c. the hunger that occurs by being well below one's set-point can trigger binges.
d. sociocultural factors play very little role in the development of unrealistic body image
goals.
Difficulty: 1
Question ID: 9.1-40
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Conceptual
Answer: c. the hunger that occurs by being well below one's set-point can trigger binges.
9.1-41. A dysfunction in which of the following neurotransmitters has been observed
in both anorexics and bulimics?
a. dopamine
b. epinephrine
c. GABA
d. serotonin
Difficulty: 1
Question ID: 9.1-41
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Factual
Answer: d. serotonin
9.1-42. One of the reasons it is difficult to know if a disruption in the serotonin
system causes eating disorders is
a. research has not supported the theory.
b. people with eating disorders often have depression as well.
c. serotonin doesn't seem to have anything to do with appetite or eating behaviors.
d. after recovery from eating disorders, serotonin levels don't change.
Difficulty: 3
Question ID: 9.1-42
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Factual
Answer: b. people with eating disorders often have depression as well.
9.1-43. The influence of television on the attitudes toward eating in Fiji demonstrate
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that
a. biological factors play a minimal role in the etiology of eating disorders.
b. environmental factors can alter societal attitudes such that the risk of developing eating
disorders is increased.
c. definitions of beauty are not changed over time.
d. there is no relationship between physical standards of beauty and desirable personality
traits.
Difficulty: 1
Question ID: 9.1-43
Page Ref: 308
Topic: Risk and Causal Factors in Eating Disorders/Sociocultural Factors
Skill: Factual
Answer: b. environmental factors can alter societal attitudes such that the risk of
developing eating disorders is increased.
9.1-44. Families of people with anorexia
a. do not have any characteristic features.
b. tend to provide few rules and limits.
c. exhibit tendencies towards perfectionism.
d. emphasize individuality.
Difficulty: 2
Question ID: 9.1-44
Page Ref: 309
Topic: Risk and Causal Factors in Eating Disorders/Family Influences
Skill: Factual
Answer: c. exhibit tendencies towards perfectionism.
9.1-45. Which of the following is most commonly found in families of girls with
anorexia?
a. Parents who are unconventional, dramatic, and antisocial.
b. Parents who emphasize rules, control, and good physical appearance.
c. Sibling rivalry that breaks out into physical and verbal aggression.
d. Children who reduce psychological tension in the family by dominating their parents.
Difficulty: 2
Question ID: 9.1-45
Page Ref: 309
Topic: Risk and Causal Factors in Eating Disorders/Family Influences
Skill: Applied
Answer: b. Parents who emphasize rules, control, and good physical appearance.
9.1-46. Which of the following is the strongest predictor of a person developing
bulimic symptoms?
a. The amount of control families tried to have over the person
b. The degree of overprotectiveness parents displayed
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c. The amount of marital conflict between the parents
d. The amount of critical comments family members made about the person's appearance
Difficulty: 2
Question ID: 9.1-46
Page Ref: 309
Topic: Risk and Causal Factors in Eating Disorders/Sociocultural Factors
Skill: Factual
Answer: d. The amount of critical comments family members made about the person's
appearance
9.1-47. The most common quality of parents' interactions with their daughters who
have eating disorders is
a. unconditional love and acceptance.
b. neglect.
c. criticism.
d. lack of direction and rules.
Difficulty: 2
Question ID: 9.1-47
Page Ref: 309
Topic: Risk and Causal Factors in Eating Disorders/Family Influences
Skill: Conceptual
Answer: c. criticism.
9.1-48. Internalizing the "thin ideal" is strongly associated with
a. body satisfaction.
b. negative affect.
c. recovery from eating disorders.
d. attitudes about interpersonal relationships.
Difficulty: 2
Question ID: 9.1-48
Page Ref: 309
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Factual
Answer: b. negative affect.
9.1-49. A lack of body distortions among the Amish
a. provides evidence against a role for sociocultural factors in the development of eating
disorders.
b. indicates that the Amish do not value physical beauty.
c. suggests that the influence of the Western media is not as great as commonly
perceived.
d. suggests that there should be a low prevalence of eating disorders among these
peoples.
Difficulty: 2
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Question ID: 9.1-49
Page Ref: 310
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Conceptual
Answer: d. suggests that there should be a low prevalence of eating disorders among
these peoples.
9.1-50. When it comes to comparing one's actual body image with the ideal body,
a. young men are just as likely to see themselves as too fat as young women.
b. most young women want a body that is more "curved" than the media-encouraged
ideal.
c. young women often falsely believe that men prefer larger women than they actually do.
d. young women are more likely to be dissatisfied than young men.
Difficulty: 2
Question ID: 9.1-50
Page Ref: 310
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Factual
Answer: d. young women are more likely to be dissatisfied than young men.
9.1-51. Which statement best describes trends in actual and ideal weight in
American young women?
a. While the weight of the average woman is decreasing, the average weight of the ideal
woman is decreasing even faster.
b. While the weight of the average woman is increasing, the average weight of the ideal
woman is decreasing.
c. While the weight of the average woman is increasing, the average weight of the ideal
woman is increasing even faster.
d. Weight of the average woman doesn't seem to be affected by the average weight of the
ideal woman.
Difficulty: 1
Question ID: 9.1-51
Page Ref: 310
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Factual
Answer: b. While the weight of the average woman is increasing, the average weight of
the ideal woman is decreasing.
9.1-52. What is the link between dieting and eating disorders?
a. Dieting is a risk factor for both anorexia and bulimia.
b. Dieting is a risk factor for bulimia.
c. Dieting is not a risk factor for the development of eating disorder.
d. When done properly, dieting seems to decrease eating disorder symptoms for a while
and then leads to a sharp increase in symptoms.
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Difficulty: 2
Question ID: 9.1-52
Page Ref: 311
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Factual
Answer: a. Dieting is a risk factor for both anorexia and bulimia.
9.1-53. Which of the following appears to be an enduring personality trait of people
who are susceptible to developing an eating disorder?
a. neuroticism
b. perfectionism
c. pessimism
d. individualism
Difficulty: 1
Question ID: 9.1-53
Page Ref: 310
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Factual
Answer: b. perfectionism
9.1-54. Which of the following statements best summarizes the relationship between
sexual abuse and the development of eating disorders?
a. There appears to be a relationship, but it appears to be indirect, involving an array of
intervening variables.
b. There is no relationship between early sexual abuse and the development of eating
disorders later in life.
c. Early sexual abuse may lead to a denial of one's sexuality and a desire to maintain a
child-like appearance, resulting in attempts to prevent the development of a more mature
figure through dieting.
d. While sexual abuse has been found to increase the risk of developing anorexia, no
relationship has been observed between abuse and other eating disorders.
Difficulty: 2
Question ID: 9.1-54
Page Ref: 311
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Conceptual
Answer: a. There appears to be a relationship, but it appears to be indirect, involving an
array of intervening variables.
9.1-55. What is the most serious challenge in treating eating disorders?
a. making a diagnosis before the disorder becomes life threatening
b. engaging the family in the treatment process
c. finding an effective pharmacological treatment
d. overcoming the patient's ambivalence toward treatment
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Difficulty: 2
Question ID: 9.1-55
Page Ref: 312
Topic: Treatment of Eating Disorders
Skill: Conceptual
Answer: d. overcoming the patient's ambivalence toward treatment
9.1-56. After her dentist commented on the damage her practice of vomiting had
caused to her teeth, Hilda realized that she had a problem. After seeing a
psychiatrist, Hilda was diagnosed with anorexia, binge-eating/purging sub-type. Due
to the severity of her condition, her doctor suggested that she be hospitalized. Hilda
immediately entered an inpatient treatment program and embraced all aspects of
the treatment regimen. What is unique about Hilda's case?
a. Dental problems are not seen in those with anorexia.
b. Psychiatrists rarely suggest hospitalization for this type of anorexia.
c. Hilda's lack of ambivalence about treatment.
d. The failure to use outpatient treatment before hospitalization.
Difficulty: 2
Question ID: 9.1-56
Page Ref: 312
Topic: Treatment of Eating Disorders
Skill: Applied
Answer: c. Hilda's lack of ambivalence about treatment.
9.1-57. Which of the following best explains the lack of well-controlled studies on the
effectiveness of treatment for anorexia nervosa?
a. Few people with anorexia who are in treatment are willing to participate with bulimics.
b. Few people with anorexia achieve full remission.
c. The high mortality rate with anorexia results in sample sizes too small to yield valid
conclusions.
d. Few people with anorexia are willing to seek treatment, and they are likely to drop out
prematurely from treatment.
Difficulty: 2
Question ID: 9.1-57
Page Ref: 312
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa
Skill: Factual
Answer: d. Few people with anorexia are willing to seek treatment, and they are likely to
drop out prematurely from treatment.
9.1-58. Which statement about the treatment of eating disorders is most accurate?
a. There are very few options available in the treatment of eating disorders.
b. Family support and the patient's commitment to change are important to lasting
recovery.
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c. There are virtually no situations in which hospitalization is necessary to treat eating
disorders.
d. Family involvement in treatment tends to undercut the chances of lasting recovery in
the patient.
Difficulty: 1
Question ID: 9.1-58
Page Ref: 312
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa
Skill: Factual
Answer: b. Family support and the patient's commitment to change are important to
lasting recovery.
9.1-59. In the treatment of eating disorders, medications
a. have proven to be especially helpful in treating patients with anorexia.
b. may be useful, but are not a primary treatment.
c. are commonly used to stimulate appetite.
d. have been found to be more effective than most psychological interventions.
Difficulty: 2
Question ID: 9.1-59
Page Ref: 313
Topic: Treatment of Eating Disorders
Skill: Factual
Answer: b. may be useful, but are not a primary treatment.
9.1-60. Why is family therapy currently being investigated as a treatment for
anorexia?
a. Family therapy has been found to be the most effective form of therapy for bulimia.
b. Healthier family relationships have been found to affect treatment outcome.
c. The well-established role of the family in the development of eating disorders
necessitates the involvement of the family in their treatment.
d. CBT and other forms of individual psychotherapy have been found to be ineffective.
Difficulty: 2
Question ID: 9.1-60
Page Ref: 312
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa
Skill: Conceptual
Answer: b. Healthier family relationships have been found to affect treatment outcome.
9.1-61. Which of the following best explains why cognitive-behavioral therapy is a
logical approach to the treatment of eating disorders?
a. It is the therapy of choice for most disorders.
b. The role of learning in the development of eating disorders is well-established.
c. Medical interventions have proven ineffective.
d. Both thoughts and behaviors need to be altered to achieve a lasting outcome.
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Difficulty: 2
Question ID: 9.1-61
Page Ref: 313
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa and
Bulimia Nervosa
Skill: Conceptual
Answer: d. Both thoughts and behaviors need to be altered to achieve a lasting outcome.
9.1-62. Research suggests that ________ provides the best immediate and long-term
outcomes in the treatment of bulimia nervosa.
a. systematic desensitization
b. family therapy
c. antidepressant medication
d. cognitive-behavioral therapy
Difficulty: 1
Question ID: 9.1-62
Page Ref: 313
Topic: Treatment of Eating Disorders/Treatment of Bulimia Nervosa
Skill: Factual
Answer: d. cognitive-behavioral therapy
9.1-63. Family therapy for anorexia appears to be most effective when it is used to
treat
a. adolescents.
b. adults.
c. men.
d. those with comorbid depressive and/or anxiety symptoms.
Difficulty: 1
Question ID: 9.1-63
Page Ref: 312
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa
Skill: Factual
Answer: a. adolescents.
9.1-64. Which of the following is an effect of antidepressants on symptoms of bulimia
nervosa ?
a. Decreased mood.
b. Decreased appetite.
c. Lessened preoccupation with physical appearance.
d. Increased frequency of binges.
Difficulty: 1
Question ID: 9.1-64
Page Ref: 314
Topic: Treatment of Eating Disorders/Treatment of Bulimia Nervosa
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Skill: Factual
Answer: c. Lessened preoccupation with physical appearance.
9.1-65. Our current knowledge of the efficacy of treating eating disorders
a. is quite thorough because there are many controlled studies comparing long-term
outcomes.
b. is much more detailed for anorexia nervosa than for bulimia nervosa.
c. suggests that hospitalization is most effective for long-term maintenance of treatment
gains.
d. suggests that cognitive-behavioral therapy is one of the treatments of choice.
Difficulty: 1
Question ID: 9.1-65
Page Ref: 314
Topic: Treatment of Eating Disorders/Treatment of Bulimia Nervosa
Skill: Factual
Answer: d. suggests that cognitive-behavioral therapy is one of the treatments of choice..
9.1-66. Which of the following has been indicated as the best approach in the
treatment of binge eating disorder?
a. psychodynamic psychotherapy
b. behavior therapy
c. mindfulness therapy
d. interpersonal psychotherapy
Difficulty: 2
Question ID: 9.1-66
Page Ref: 314
Topic: Treatment of Eating Disorders/Treatment of Binge-Eating Disorder
Skill: Applied
Answer: d. interpersonal psychotherapy
9.1-67. In addition to altering the eating patterns of clients with Binge Eating
Disorder, therapists using cognitive-behavioral therapy will also
a. teach the clients to be greater risk-takers.
b. educate the clients that fat people have certain character flaws.
c. provide factual information about eating and dieting.
d. help the client to emotionally separate from her family.
Difficulty: 2
Question ID: 9.1-67
Page Ref: 314
Topic: Treatment of Eating Disorders/Treatment of Binge-Eating Disorder
Skill: Conceptual
Answer: c. provide factual information about eating and dieting.
9.1-68. Obesity
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a. is based on an individual’s subjective opinion of their own weight.
b. rates vary little across Western cultures.
c. is not associated with any form of stigma.
d. has been increasing in many countries, including the United States.
Difficulty: 1
Question ID: 9.1-68
Page Ref: 315-317
Topic: The Problem of Obesity
Skill: Factual
Answer: d. has been increasing in many countries, including the United States.
9.1-69. In which of the following countries are at least one-third of adults obese?
a. China
b. Japan
c. United Kingdom
d. United States
Difficulty: 1
Question ID: 9.1-69
Page Ref: 315
Topic: The Problem of Obesity
Skill: Factual
Answer: d. United States
9.1-70. What is the relationship between obesity and social class?
a. There is none.
b. Obesity occurs much more frequently in lower social class adults and children.
c. Obesity occurs much more frequently in lower social class adults but higher SES
children.
d. Obesity occurs much more frequently in higher social class adults and children.
Difficulty: 1
Question ID: 9.1-70
Page Ref: 315
Topic: The Problem of Obesity Skill: Factual
Answer: b. Obesity occurs much more frequently in lower social class adults and
children.
9.1-71. Which of the following is a danger associated with obesity?
a. asthma
b. cancer
c. low blood pressure
d. joint disease
Difficulty: 1
Question ID: 9.1-71
Page Ref: 315
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Topic: The Problem of Obesity
Skill: Factual
Answer: b. cancer
9.1-72. Which of the following statements about obesity and health is true?
a. The heavier the person, the greater the health risks.
b. Only when obesity has a behavioral cause is it dangerous.
c. Individuals who are obese, but active, are not at a higher risk of cardiovascular disease.
d. Obesity is only a threat to health in cultures where the obesity is due to the
consumption of fatty foods and relative inactivity.
Difficulty: 1
Question ID: 9.1-72
Page Ref: 316
Topic: The Problem of Obesity
Skill: Factual
Answer: a. The heavier the person, the greater the health risks.
9.1-73. Which of the following factors is associated with an increased risk for
obesity?
a. High socioeconomic status
b. Living in an Asian culture
c. Being well-cared-for as a child
d. Low parental education
Difficulty: 2
Question ID: 9.1-73
Page Ref: 324
Topic: The Problem of Obesity
Skill: Factual
Answer: d. Low parental education
9.1-74. Which of the following best explains the current trend in the prevalence of
obesity?
a. Obesity is no longer a factor that decreases survival, thus genes for obesity are
becoming more prevalent in the general population.
b. the tendency to underfeed children who then overeat as adults
c. the adoption of unhealthy life styles
d. the popularity of dieting
Difficulty: 1
Question ID: 9.1-74
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Sociocultural Influences
Skill: Factual
Answer: c. the adoption of unhealthy lifestyles
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9.1-75. Leptin
a. is a hormone that usually leads to decreased food intake.
b. is a hormone that is not related in any way to obesity.
c. is a hormone that helps the body regain its set-point.
d. is a hormone that is an appetite stimulator.
Difficulty: 2
Question ID: 9.1-75
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Hormones Involved in Appetite and
Weight Regulation
Skill: Factual
Answer: a. is a hormone that usually leads to decreased food intake.
9.1-76. Grehlin
a. is a hormone that usually leads to decreased food intake.
b. is a hormone that is not related in any way to obesity.
c. is a hormone that helps the body regain its set-point.
d. is a hormone that is an appetite stimulator.
Difficulty: 2
Question ID: 9.1-76
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Hormones Involved in Appetite and
Weight Regulation
Skill: Factual
Answer: d. is a hormone that is an appetite stimulator.
9.1-77. Why are family attitudes about obesity important?
a. because they reflect the genetic influences on obesity
b. because they will cause people to be happier when obese
c. because the consequences are likely to remain with us
d. they aren't - peer influence is more important
Difficulty: 2
Question ID: 9.1-77
Page Ref: 320
Topic: Risk and Causal Factors in Obesity/Family Influences
Skill: Conceptual
Answer: c. because the consequences are likely to remain with us
9.1-78. Comfort food
a. does nothing physiologically, any effects are due to expectation.
b. may help reduce activation in the stress response system.
c. changes the hormonal balance of the body and makes people want to eat more.
d. affects the brain in such a way as to make it unable to tell when the body is full.
Difficulty: 2
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Question ID: 9.1-78
Page Ref: 320
Topic: Risk and Causal Factors in Obesity/Stress and "Comfort Food"
Skill: Factual
Answer: b. may help reduce activation in the stress response system.
9.1-79. What cyclical pathway can develop that eventually leads to obesity?
a. A child stops eating because of low self-esteem, becomes anorexic and then is
successfully treated but still has negative feelings about her- or himself.
b. A thin child eats normally but is teased about his or her weight and begins to diet
further.
c. A child eats because of feelings of depression and low self-esteem, gains weight, is
rejected by peers, binges, and continues to gain weight.
d. A thin child binges because of depression and low self-esteem, purges and feels better,
then feels safe to binge again, eating more later.
Difficulty: 2
Question ID: 9.1-79
Page Ref: 321
Topic: Risk and Causal Factors in Obesity/Pathways to Obesity
Skill: Conceptual
Answer: c. A child eats because of feelings of depression and low self-esteem, gains
weight, is rejected by peers, binges, and continues to gain weight.
9.1-80. Which of the following is a medication currently approved by the FDA for
use in the treatment of obesity?
a. amphetamine
b. phentermine
c. fenfluramine
d. sibutramine
Difficulty: 1
Question ID: 9.1-80
Page Ref: 322
Topic: Risk and Causal Factors in Obesity/Treatment of Obesity
Skill: Factual
Answer: d. sibutramine
9.1-81. Orlistat, which works by interfering with the absorption of fat,
a. works very well for obesity.
b. works very well for extreme obesity but not regular obesity.
c. works modestly well for obesity.
d. results have been uncertain.
Difficulty: 1
Question ID: 9.1-81
Page Ref: 322
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Topic: Risk and Causal Factors in Obesity/Treatment of Obesity
Skill: Factual
Answer: c. works modestly well for obesity.
9.1-82. Sibutramine acts to reduce appetite by
a. inhibiting the reuptake of serotonin and norepinephrine.
b. decreasing the activity of serotonin and norepinephrine.
c. blocking receptors for serotonin and norepinephrine.
d. interfering with digestion.
Difficulty: 1
Question ID: 9.1-82
Page Ref: 322
Topic: Risk and Causal Factors in Obesity/Treatment of Obesity
Skill: Conceptual
Answer: a. inhibiting the reuptake of serotonin and norepinephrine.
9.1-83. After bariatric surgery,
a. patients stay normal weight the rest of their lives.
b. some patients do not lose any weight.
c. most patients do not survive.
d. some patients regain their weight, but most lose a great deal of weight.
Difficulty: 1
Question ID: 9.1-83
Page Ref: 323
Topic: Risk and Causal Factors in Obesity/Treatment of Obesity
Skill: Factual
Answer: d. some patients regain their weight, but most lose a great deal of weight.
9.1-84. Gastric bypass surgery makes it
a. possible to binge and not gain weight.
b. slightly more likely that people will lose weight.
c. impossible to regain weight once it is lost.
d. impossible to binge eat but still possible to regain weight.
Difficulty: 1
Question ID: 9.1-84
Page Ref: 323
Topic: Risk and Causal Factors in Obesity/Treatment of Obesity
Skill: Factual
Answer: d. impossible to binge eat, but still possible to regain weight.
Fill-in-the-Blank Questions
9.2-1. Three types of purging or compensatory behaviors that people with bulimia
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may engage in are __________ , laxative abuse, or excessive exercise.
Difficulty: 1
Question ID: 9.2-1
Page Ref: 296
Topic: Clinical Aspects of Eating Disorder/Anorexia Nervosa
Skill: Factual
Answer: vomiting
9.2-2. ____________is the most common form of eating disorder.
Difficulty: 1
Question ID: 9.2-2
Page Ref: 301
Topic: Clinical Aspects of Eating Disorders/Prevalence of Eating Disorders
Skill: Factual
Answer: Binge-eating disorder
9.2-3. The neurotransmitter called __________ is implicated in obesity.
Difficulty: 2
Question ID: 9.2-3
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Factual
Answer: serotonin
9.2-4. For adolescents with anorexia nervosa, the best studied family therapy
approach is known as the __________ model.
Difficulty: 2
Question ID: 9.2-4
Page Ref: 312
Topic: Treatment of Eating Disorders/Treatment of Anorexia Nervosa
Skill: Factual
Answer: Maudsley
9.2-5. The hormone __________ is the hormone produced by the stomach that
stimulates appetite.
Difficulty: 1
Question ID: 9.2-5
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Hormones Involved in Appetite and Weight
Regulation
Skill: Factual
Answer: grehlin
9.2-6. The hormone __________ reduces our intake of food.
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Difficulty: 1
Question ID: 9.2-6
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Hormones Involved in Appetite and
Weight Regulation
Skill: Factual
Answer: leptin
Short Answer Questions
9.3-1. Why is the term "anorexia nervosa" a misnomer?
Difficulty: 1
Question ID: 9.3-1
Page Ref: 295
Topic: Clinical Aspects of Eating Disorders/Anorexia Nervosa
Skill: Factual
Answer: The term "anorexia nervosa" literally means a lack of appetite. The individual
with anorexia nervosa does not lack an appetite. The true problem with the anorexic is a
fear of gaining weight, which leads to not eating, as opposed to a true lack of desire for
food.
Abstract. Anorexia nervosa, literally translated, means a nervous loss of appetite.
However, as research on this disorder has evolved, it has become clear that anorexics do
indeed experience strong physiological and cognitive feelings of hunger and an intense
preoccupation with food (Garfinkel, 1974).
9.3-2. What most clearly separates the anorexic from the bulimic?
Difficulty: 1
Question ID: 9.3-2
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Bulimia Nervosa
Skill: Applied
Bulimia is characterised by compensatory behaviours such as purging after eating.
Whereas Anorexia is more of restriction of food, less or no compensatory behaviours.
Sometimes they overlap which is confusing. Not a good defining characteristic.
While individuals with anorexia maintain a significantly low body weight, those with
bulimia maintain a normal to above-normal weight.
Answer: While the binge-eating/purging anorexic and the bulimic may share many
features, the clear factor that distinguishes the two is the below normal weight that is a
defining feature of anorexia.
9.3-3. What are the differences between binge-eating disorder and bulimia nervosa?
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Difficulty: 2
Question ID: 9.3-3
Page Ref: 298
Topic: Clinical Aspects of Eating Disorders/Other Forms of Eating Disorders
Binge eating disorder is not associated with purging, a compensatory behaviour
associated with bulimia.
Binge eating disorder is characterised by recurrent episodes of consuming large amounts
of food without regular compensatory behaviours, while bulimia nervosa involves similar
binge-eating episodes but with recurrent inappropriate compensatory behaviours like
purging, excessive exercise for example.
People with bulimia severely restrict their diet between binges whereas people with
binge-eating disorder do not.
People with binge-eating disorder tend to be older and more overweight than people with
bulimia.
Skill: Applied
Answer: People with binge-eating disorder have food binges like people with bulimia but
don't do any compensatory behaviors. They don't restrict their diet between binges as
much as people with bulimia. People with binge-eating disorder tend to be older than
people with bulimia and are more likely to be overweight or obese.
9.3-4. What puts whites at higher risk for eating disorders as compared to nonwhites?
Difficulty: 2
Question ID: 9.3-4
Page Ref: 304
Topic: Clinical Aspects of Eating Disorders/Eating Disorders Across Cultures
Skill: Factual
Answer: Research finds that whites show much more body dissatisfaction, dietary
restraint, and a drive for thinness than their non-white counterparts. Clearly, these are all
factors that set the stage for the development of abnormal eating patterns and, possibly,
diagnosable eating disorders.
9.3-5. There is evidence of serotonergic abnormalities in anorexics and bulimics.
Can it be concluded that a dysfunction in the serotonin system underlies these eating
disorders? Why or why not?
Difficulty: 2
Question ID: 9.3-5
Page Ref: 307
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Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Conceptual
Answer: Although altered serotonergic levels have been observed in individuals with
eating disorders, causal conclusions cannot be made. Changes in neurochemical function
may be a cause and/or consequence of the psychological disorder. In order to conclude
that altered serotonin function plays a causal role in eating disorders, changes in
serotonergic function would need to be observed prior to the development of the eating
disorder.
9.3-6. How does the set-point impact eating disorders?
Difficulty: 2
Question ID: 9.3-6
Page Ref: 307
Topic: Risk and Causal Factors in Eating Disorders/Biological Factors
Skill: Conceptual
The set-point theory is the tendency for the body to maintain a certain weight that is
normal and functional. Hence restriction to diet to ensure weight loss may be countered
by binge eating food.
Answer: This is the tendency of the body to resist variation from a biologically
determined set-point. As someone loses weight, hunger rises and can trigger strong
impulses to binge eat.
The set-point refers to the body's biologically determined weight range, and the tendency
to resist deviations from this range.
When someone loses weight, the body may respond by increasing hunger, which can lead
to strong impulses to binge eat. This process is relevant to understanding how the body
regulates weight and how disruptions in this regulation can contribute to eating disorders.
9.3-7. Why is dieting a risk factor for the development of eating disorders?
Difficulty: 2
Question ID: 9.3-7
Page Ref: 311
Topic: Risk and Causal Factors in Eating Disorders/Individual Risk Factors
Skill: Applied
Answer: The desire to diet suggests that there is some body dissatisfaction, a clear risk
factor for the development of an eating disorder.
In addition, the practice of dieting increases the likelihood of overeating, as caloric
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restriction leads to hunger. When the dieter gives in to temptation, this is likely to lead to
negative affect. Resumed dieting then continues this pattern, which may then evolve into
any one of the recognized eating disorders.
As research has demonstrated, going on a diet may actually make us eat more and, as a
consequence, feel worse about ourselves and evolve into even more problematic eating
patterns.
9.3-8. What medications are commonly used in the treatment of bulimia nervosa?
What evidence is there that medications are beneficial in treating this condition?
Difficulty: 2
Question ID: 9.3-8
Page Ref: 315-316
Topic: Treatment of Eating Disorders/Treatment of Bulimia Nervosa
Skill: Factual
Answer: Antidepressants are commonly used, alone or, ideally, in addition to CBT.
Many patients with bulimia also suffer from mood disorders. In addition to the potential
beneficial effects of antidepressants on mood, they have also been shown to decrease
both the frequency of binges and the typical preoccupation with shape and weight that is
characteristic of those with bulimia.
9.3-9. What are leptin and grehlin and how do they influence appetite and weight?
Difficulty: 2
Question ID: 9.3-9
Page Ref: 318
Topic: Risk and Causal Factors in Obesity/Hormones Involved in Appetite and
Weight Regulation
Skill: Factual
Answer: Leptin is a hormone that is produced by fat cells. It acts to reduce intake of
food. An increase in body fat leads to an increase in leptin, which leads in turn to a
decrease in food intake. However, overweight people are resistant to the effects of leptin.
Grehlin is a hormone produced by the stomach. It is a powerful appetite stimulator. It
rises before meals and decreases after eating. If there is a disturbance in its normal
process, this can lead to overeating.
Essay Questions
9.4-1. Discuss the risk of suicide in anorexia and bulimia.
Difficulty: 2
Question ID: 9.4-1
Page Ref: 302-303
Topic: Clinical Aspects of Eating Disorders/Course and Outcome
Skill: Conceptual
Answer:
328
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With medical complications being the number one cause of death, the second most
common cause of death in those who suffer from anorexia
nervosa is suicide. Recent estimates suggest that
one out of five deaths in individuals with anorexia
nervosa is the result of suicide (Arcelus et al., 2011).
Somewhere between 3 and 23 percent of patients
with anorexia will make a suicide attempt, and rates
of completed suicide are 50 times greater than they
are in the general population (Franko & Keel, 2006;
Keel et al., 2003). It has been suggested that patients
who have lost their ability to maintain an “emotionally
protective” low body weight are at particularly
high risk of suicide (Crisp et al., 2006). Patients who
are older when they first receive clinical attention for their disorder are also more likely
to have a premature death (Arcelus et al., 2011). Bulimia nervosa is not associated with increased risk
of completed suicide, although suicide attempts are made in 25 to 30 percent of cases (Franko & Keel,
2006).
GRADING RUBRIC - 8 points total, 4 points for each of two factors discussed.
9.4-2. What factors put males at risk for developing eating disorders?
Difficulty: 2
Question ID: 9.4-2
Page Ref: 300-301
Topic: Clinical Aspects of Eating Disorders/Age of Onset and Gender Differences
Skill: Factual
Answer:
One established risk factor for eating disorders in men is
homosexuality. Gay and bisexual men have higher rates of eating
disorders than heterosexual men do (Feldman & Meyer, 2007).
Gay men (like heterosexual men) value attractiveness and youth in
their romantic partners. Because gay men (like women) are seeking
to be sexually attractive to men, body dissatisfaction may therefore
be more of an issue for gay men than it is for heterosexual men. In
support of this idea, Smith and colleagues (2011) found that gay
men were more dissatisfied with their bodies and had higher levels of disordered eating than heterosexual
men did. Moreover, gay men tended to believe that a potential mate would want them to be
leaner than they themselves wanted to be. Other specific subgroups
of men who are at higher risk of eating disorders are wrestlers and
jockeys, who need to “make weight” in order to compete or work
(Carlat et al., 1997). GRADING RUBRIC: 2 points introduction, 4 points factor 1, 4 points
factor 2 = 10 total
9.4-3. Discuss the studies on rats and "comfort food."
Difficulty: 2
Question ID: 9.4-3
Page Ref: 320
329
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Topic: Risk and Causal Factors in Obesity/Stress and "Comfort Food"
Skill: Factual
Answer: Like many humans, rats under chronic stress selected high fat and sugar diets.
They gained weight in their bellies and became calmer in the face of new, acute stress.
People may also eat in response to aversive emotional states as well, and experience the
same calming effect. This shows that learning is involved, as well as biochemical effects.
Eating in response to emotional cues is reinforced because tension is reduced, leading to
an increased likelihood of eating in response to those cues later on. GRADING
RUBRIC: 6 points total, 2 for rat behavior description, 2 each for implications in humans
330
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