Psychological eating disorder in which there is an intense fear of becoming obese?

AIIMS Raipur NO - 2019 (Shift-2)

Mental Health Nursing

Easy

Appeared in: AIIMS Raipur NO - 2019 (Shift-2)

Explanation

Anorexia nervosa is fundamentally defined by a relentless drive for thinness and a morbid fear of becoming fat, which is a core psychopathological feature of the disorder.
This intense fear is coupled with self-induced starvation to a significant degree, leading to a body weight that is dangerously low.
Unlike other eating disorders, the primary motivation in anorexia nervosa is the avoidance of weight gain, driven by a distorted perception of one's own body.
The diagnosis is based on three criteria: behavioral (self-starvation), psychopathological (fear of fatness), and physiological (medical signs of starvation).

Option A: Bulimia nervosa is characterized by binge eating followed by compensatory behaviors. While there is a fear of weight gain, the defining feature is the binge-purge cycle, and individuals are typically of normal weight.
Option C: Pica is an eating disorder that involves eating non-nutritive, non-food substances (e.g., dirt, clay, paper). It is not related to a fear of gaining weight or body image distortion.
Option D: Dieting is a common behavior of restricting food intake for weight loss. It is not a classified psychological disorder and lacks the severe, pathological fear and distorted body image seen in anorexia nervosa.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating features of common eating disorders as background academic context rather than a clinical decision trigger.
Nurses play a critical role in the multidisciplinary care of patients with anorexia nervosa, focusing on medical stabilization, nutritional rehabilitation, and psychological support.
A key nursing priority is monitoring for refeeding syndrome, a potentially fatal complication that can occur when a severely malnourished person is refed too quickly. This involves closely tracking electrolytes, especially phosphate, potassium, and magnesium.
What if? If the patient was of normal weight but reported binge eating and purging, the most likely diagnosis would shift from Anorexia Nervosa to Bulimia Nervosa. The nursing care would then focus more on managing electrolyte imbalances from purging and implementing cognitive-behavioral strategies.

How to Approach the Question

First, identify the key phrases in the question stem: 'psychological eating disorder,' 'intense fear,' and 'becoming obese.'
Next, analyze each option based on its core definition.
Anorexia nervosa is defined by an intense fear of gaining weight and a distorted body image, leading to severe restriction and low body weight. This directly matches the question.
Bulimia nervosa involves binge-purge cycles, and individuals are usually normal weight.
Pica involves eating non-food items.
Dieting is a behavior, not a disorder.

Concept Tested & Keywords

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1496-1498, 1503-1505