Deck 15: Eating and Exercise Disorders

Question 1

What does a diagnosis of eating disorder not otherwise specified (EDNOS) imply?

A) The patient does not meet the strict diagnostic criteria for anorexia nervosa or bulimia nervosa but does exhibit partial symptoms consistent with an eating disorder.
B) The allied health professional suspects an eating disorder but the patient has not yet been evaluated by a physician.
C) The patient has a family history of an eating disorder.
D) The physician is unable to determine which eating disorder is impacting the patient.

Answer 1

The patient does not meet the strict diagnostic criteria for anorexia nervosa or bulimia nervosa but does exhibit partial symptoms consistent with an eating disorder.

Question 2

Which type of anorexia nervosa is characterized by the use of laxatives or enemas?

A) Restrictive type
B) Not otherwise classified type
C) Pharmacologic-assisted type
D) Binge-eating/purging type

Answer 2

Binge-eating/purging type

Question 3

Which of the following is a possible consequence of anorexia nervosa?

A) Stroke
B) Abnormalities in cognitive functioning
C) Type 2 diabetes
D) Metabolic syndrome

Answer 3

Abnormalities in cognitive functioning

Question 4

Which of the following best describes a binge-eating episode?

A) Planning and then consuming a specific amount of calories that will far exceed recommendations
B) Eating in an effort to consume more calories than anyone else present
C) Having little control while eating significantly larger-than-recommended amounts in a specific period of time (e.g., 2 hours)
D) Consuming calories at a rate in excess of 10,000 cal/hour

Question 5

Which of the following patients is exhibiting an avoidant/restrictive eating disorder?

A) A 10-year-old who is so picky about what she eats that she is exhibiting nutritional deficiencies.
B) A 17-year-old who severely restricts food intake and then purges after eating each meal.
C) A 21-year-old who binges and then avoids food completely for 5 days.
D) A 5-year-old who eats only one meal each day but seems to be growing at a normal rate.

Question 6

An individual who exhibits all of the criteria for anorexia nervosa but maintains a weight within the normal range would meet the criteria for which of the following diagnoses?

A) Idiopathic anorexia nervosa
B) Bulimic anorexia nervosa
C) Atypical anorexia nervosa
D) Avoidant/restrictive eating disorder

Question 7

Steve is a 28-year-old triathlete who constantly consumes a healthy diet. He refuses to eat anything that he deems "unhealthy." He will rarely eat out with friends and even refused to eat a meal that his grandmother cooked for his birthday. He is extremely calorie and nutrient conscious. Which condition might you suspect?

A) Subthreshold anorexia nervosa
B) Orthorexia nervosa
C) Restrictive nutrition syndrome
D) Avoidant nutrition syndrome

Question 8

For which of the following conditions is muscle dysmorphic disorder a substantial risk factor?

A) Avoidant/restrictive behavior
B) Orthorexia nervosa
C) Obesity
D) Anabolic steroid abuse

Question 9

An elite tennis player practices for approximately 4 hours each day and then runs for an additional hour each evening in order to experience positive psychological effects. She is of normal weight and exhibits no evidence of an eating disorder. Which condition might you expect?

A) Primary exercise dependence
B) Secondary exercise dependence
C) Body dysmorphic disorder
D) Muscle dysmorphic disorder

Question 10

Which of the following athletes is at highest risk for participating in weight cycling practices?

A) Wrestler
B) Figure skater
C) Cross-country runner
D) Diver

Question 11

Which of the following athletes might participate in adipositas athletica in order to improve their performance?

A) Elite-level gymnast
B) Power lifter
C) Open water long-distance swimmer
D) Basketball center

Question 12

A coach is concerned that one of the members of his swim team is beginning to demonstrate behaviors consistent with an eating disorder. What action should he take?

A) Refer the athlete to an appropriate health or nutrition professional.
B) Confront the athlete about his concerns.
C) Begin to weigh the athlete for a period of several weeks to identify weight loss patterns.
D) Require the athlete to come in after practice for individual eating disorder educational sessions.

Question 13

The wrestling coach comes to you with concerns that one of his wrestlers is using laxatives and regularly restricting food in order to compete in his desired weight class. What suggestion might you make to the coach and the athlete?

A) Provide the athlete with healthy weight-loss strategies.
B) Reassure the coach that if laxatives are used appropriately they will not cause undue harm.
C) Consider using sound nutrition and strength-training practices to gain weight and compete in the next weight class up instead of constantly needing to cut weight.
D) Recommend that the coach hold the athlete from practice until he agrees to stop this unhealthy behavior.

Question 14

A client with whom you used to work has asked you to help establish an exercise routine as she continues to recover from an eating disorder. What is your first step?

A) Provide the client with a low-intensity cardiovascular exercise program.
B) Develop an exercise program that includes cardiovascular, resistance training, and flexibility components.
C) Politely tell the athlete that you think she should wait to exercise until she has totally recovered from the eating disorder.
D) Ask the client's permission to contact her physician for guidance and clearance.

Question 15

Which of the following criteria must be met for an anorexia nervosa diagnosis to be made? Select all that apply.

A) Body mass index of less than 18.5.
B) Restriction of caloric intake that results in a body weight that is significantly low for age, sex, and developmental stage.
C) Intense fear of gaining weight despite low weight status.
D) Failure to recognize seriousness of current low body weight.
E) Evidence of osteopenia on diagnostic scan.

Question 16

Which of the following factors might predispose a patient to anorexia nervosa? Select all that apply.

A) Perfectionist personality traits
B) Family history of obesity
C) Anxiety
D) Family history of eating disorders
E) Participation in an endurance sport

Question 17

Which of the following criteria must be met for a diagnosis of bulimia nervosa to be made? Select all that apply.

A) Recurrent uncontrolled binge-eating episodes
B) Behaviors occur exclusively during periods of anorexia nervosa
C) Body weight well below normal ranges
D) Inappropriate compensatory behaviors to prevent weight gain
E) Binge eating and inappropriate compensatory behaviors occur at least once a week for 3 months

Question 18

Which of the following are characteristics of a binge-eating episode? Select all that apply.

A) Eating very slowly
B) Eating large amounts of food when not feeling hungry
C) Eating alone out of embarrassment from the amount of food being consumed
D) Eating until feeling uncomfortably full
E) Feeling guilty or disgusted afterwards

Question 19

Besides restriction of food intake to the extent that nutritional deficiency exists, what other criteria indicate a patient is suffering from avoidant/restrictive eating disorder? Select all that apply.

A) No evidence exists to indicate that patient lacks an available source of food.
B) No evidence of a disturbance in the patient's perception of their body weight.
C) The patient suffers from intermittent bouts of anorexia or bulimia.
D) The eating disorder may be associated with a concurrent medical condition.
E) The disorder predominates but is not limited to children.

Question 20

Which of the following behaviors will occur at some point in a patient diagnosed with body dysmorphic disorder? Select all that apply.

A) Restricting caloric intake
B) Lifting weight excessively
C) Seeking constant reassurance that one's appearance is acceptable
D) Repeatedly comparing appearance with that of others
E) Excessive grooming

Question 21

Which of the following criteria adapted from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) might be applied to a person with exercise dependence? Select all that apply.

A) Limiting the activity only when physical, psychological, and/or interpersonal problems are identified
B) Making unsuccessful attempts to reduce exercise level or cease exercising for a certain period of time
C) Lack of exercise resulting in anxiety, irritability, and restlessness
D) Increasing the amount of exercise to feel the same desired effect
E) Prescribing to strict routine for intensity and duration of the exercise bout

Question 22

Identify the three components that make up the female athlete triad. Select all that apply.

A) Dysmenorrhea
B) Amenorrhea
C) Exercise dependence
D) Osteoporosis
E) Disordered eating

Question 23

Dieting is commonly considered to be a precursor to an eating disorder in athletes. Which of the following factors are considered to be risk factors for dieting behavior in athletes? Select all that apply.

A) Traumatic events such as injury or loss of a coach
B) High self-esteem
C) Early onset of sport-specific training
D) Family dysfunction
E) Poor performance

Question 24

Which of the following are recommendations from the National Eating Disorders Association that coaches and trainers can use to reduce the development of eating disorders?

A) Restrict practice and gym privileges in an athlete with a suspected eating disorder.
B) Emphasize the health risks of low body weight and body fat percentage.
C) Weigh athletes often.
D) Educate staff, parents, and athletes on signs of eating disorders and how to address them.
E) Remind athletes of the positive correlation between low body weight and body fat and performance.

Question 25

What approaches should you consider when confronting a client who shows signs of an eating disorder? Select all that apply.

A) Do not attempt to diagnose the condition during the confrontation.
B) Agree to serve as the client's therapist as the condition is addressed.
C) Do not get into a battle of wills if the client denies the condition.
D) Provide immediate advice that the client can put into action to address the condition.
E) Do not oversimplify the condition.

Question 26

Which of the following are criteria for return to competitive athletics following treatment for an eating disorder? Select all that apply.

A) Athlete must be complying with their individualized treatment plan and making progress toward treatment goals.
B) Athlete must be eating sufficient calories in order to meet treatment goals.
C) Athlete must have a body mass index of greater than 22.
D) Athlete must be able to maintain at least 90% of ideal body weight.
E) Athlete must be able to maintain a body fat percentage of at least 6% for males and 12% for females.

Question 27

Of adults with anorexia severe enough to require hospitalization, 25% to 50% fully recover.

Question 28

Bulimia nervosa is typically easy to detect because the patient appears underweight and easily admits to purging behaviors.

Question 29

Exercise dependence is an official diagnosis outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and describes a condition in which a person is preoccupied with exercise and training to the extent that the person engages in excessive levels of exercise that result in physiological and psychological consequences.

Question 30

Approximately 25% of elite female athletes in endurance, aesthetic, or weight-class sports suffer from disordered eating or some form of the female athlete triad.

Question 31

The National Eating Disorders Association recommends that coaches and trainers routinely monitor the weight of their athletes in order identify an eating disorder at its onset.