In which psychological disorder, there is an intense fear of becoming obese?

Appeared in: AIIMS Raipur lecturer 2021

Explanation

Anorexia Nervosa is a serious eating disorder defined by a relentless drive for thinness and a morbid fear of gaining weight.
A core psychopathological feature is the intense fear of becoming obese, which persists even when the individual is severely underweight.
This fear leads to self-induced starvation, a refusal to maintain a minimally normal body weight, and a disturbed perception of body image.
The diagnosis is based on this pronounced fear of fatness, significant weight loss, and the absence of another medical explanation.

Option A: Amnesia is a disorder of memory function. It does not involve a fear of weight gain or distorted body image.
Option C: A hallucination is a false sensory perception (seeing, hearing, etc.) without an external stimulus. It is a symptom of psychosis, not an eating disorder.
Option D: Pica is an eating disorder involving the compulsive eating of non-nutritive substances (like dirt, clay, or paper). It is not related to a fear of obesity.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Eating Disorders: Anorexia Nervosa as background academic context rather than a clinical decision trigger.
Nurses play a critical role in the multidisciplinary team managing Anorexia Nervosa, focusing on nutritional rehabilitation, monitoring for life-threatening medical complications, and providing psychological support.
Key safety priorities include monitoring vital signs for bradycardia and hypotension, checking electrolytes for hypokalemia (which can cause fatal arrhythmias), and implementing suicide precautions if necessary, as mortality rates are high.
What if? If the patient had an intense fear of weight gain and engaged in bingeing and purging but maintained a normal or slightly overweight body weight, the diagnosis would more likely be Bulimia Nervosa. The nursing focus would shift to managing purging behaviors, addressing electrolyte imbalances, and providing therapy for impulse control.

How to Approach the Question

First, identify the key phrases in the question stem: 'intense fear' and 'becoming obese'.
Recognize that this describes a specific phobia related to body weight and shape, which is a core feature of an eating disorder.
Next, evaluate each option based on its definition.
Amnesia is a memory disorder. Eliminate it.
Hallucination is a perceptual disturbance. Eliminate it.
Pica is eating non-food items. Eliminate it.

Concept Tested & Keywords

QzjfOJw_5YVTd4kbfjP2vd

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1498-1500, 1495-1497

E6 Medicine Davidson Principles Practice 24e p. 1223-1225

Practise the full AIIMS Raipur lecturer 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.