CDN Eating Disorder Treatment 5 — Questions and Answers
Question 1: Which psychological comorbidity is most commonly co-occurring with anorexia nervosa?
- Bipolar I disorder
- Anxiety disorders (OCD, social anxiety) (Correct answer)
- Antisocial personality disorder
- Schizophrenia
Correct answer: Anxiety disorders (OCD, social anxiety)
Anxiety disorders, particularly OCD and social anxiety disorder, are highly prevalent comorbidities in anorexia nervosa and often predate the eating disorder.
Question 2: A patient completes a 3-day food record showing 900 kcal/day. The dietitian uses this to identify which component of the cognitive-behavioral model of eating disorders?
- Interpersonal deficits
- Dietary restraint perpetuating the disorder cycle (Correct answer)
- Trauma history underlying food avoidance
- Family systems dysfunction
Correct answer: Dietary restraint perpetuating the disorder cycle
In CBT-E, dietary restraint is a central maintaining factor that perpetuates the binge-purge or restriction cycle.
Question 3: When working with a male patient with an eating disorder, which clinician consideration is most important?
- Males require higher caloric restoration targets than females
- Males are less likely to engage with treatment due to under-recognition and stigma (Correct answer)
- Males exclusively present with muscle dysmorphia
- Males respond better to pharmacotherapy than psychotherapy
Correct answer: Males are less likely to engage with treatment due to under-recognition and stigma
Eating disorders in males are frequently under-recognized and stigmatized, leading to delayed diagnosis and treatment-seeking.
Question 4: Phosphate supplementation during refeeding should be initiated when serum phosphorus drops below:
- 2.5 mg/dL (Correct answer)
- 3.5 mg/dL
- 1.5 mg/dL
- 4.0 mg/dL
Correct answer: 2.5 mg/dL
Phosphate supplementation is typically initiated when serum phosphorus falls below 2.5 mg/dL to prevent refeeding syndrome complications.
Question 5: Enhanced Cognitive Behavioral Therapy (CBT-E) for eating disorders adds which modules compared to standard CBT?
- Pharmacotherapy and nutritional counseling
- Perfectionism, low self-esteem, interpersonal difficulties, and mood intolerance (Correct answer)
- Mindfulness, yoga, and body scan techniques
- Family therapy and parent training components
Correct answer: Perfectionism, low self-esteem, interpersonal difficulties, and mood intolerance
CBT-E's 'enhanced' modules address perfectionism, low self-esteem, interpersonal difficulties, and mood intolerance as additional maintaining mechanisms.
Question 6: A patient recovering from bulimia nervosa reports eating past fullness at most meals. The dietitian recommends mindful eating practices to address:
- Caloric restriction
- Interoceptive awareness of hunger and satiety cues (Correct answer)
- Avoidance of trigger foods permanently
- Increasing meal frequency to six times daily
Correct answer: Interoceptive awareness of hunger and satiety cues
Bulimia nervosa disrupts interoceptive signals; mindful eating rebuilds awareness of internal hunger and fullness cues.
Question 7: Which vitamin deficiency is most clinically relevant to monitor in long-term anorexia nervosa due to its role in bone density loss?
- Vitamin C
- Vitamin D (Correct answer)
- Vitamin B12
- Vitamin K
Correct answer: Vitamin D
Vitamin D deficiency, combined with low estrogen and inadequate calcium intake, significantly accelerates bone loss (osteopenia/osteoporosis) in anorexia nervosa.
CDN Eating Disorder Treatment 5
Which psychological comorbidity is most commonly co-occurring with anorexia nervosa?