Eating Disorders

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Eating Disorders
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An Overview of Eating Disorders

• Two Main Types
• Anorexia Nervosa
• Bulimia Nervosa
• Share Strong Drive to be Thin
• Largely a Female Problem
• Largely a Westernized Problem
• Largely an Upper SES Problem
• Many Die as a Result!

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Do I Have an Eating Disorder?

• I worry about gaining weight.
• I am preoccupied with losing weight.
• I frequently diet or feel the need to be on a
  diet.
• My mood depends on my weight (e.g., if I gain 1
  pound I am depressed, irritable, etc.)
• I feel bad about myself if I gain weight.

4
Do I Have an Eating Disorder?

• If I gain one pound, I worry that I will continue
  to gain weight.
• I think of certain foods as being either good
  or bad and feel guilty about eating bad
  foods.
• I use food to comfort myself.
• When I am eating I, at times, feel I have lost
  control.

5
Do I Have an Eating Disorder?

• I spend a significant amout of time thinking
  about food and when I will eat.
• I try to hide how much I eat.
• I have thought about (or have) self-induced
  vomiting as a means of weight control.

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Do I Have an Eating Disorder?

• After eating, I may use laxatives, diuretics,
  exercise, etc. to prevent weight gain.
• I am dissatisfied with my body size and shape.
• I eat until I feel stuffed.

IS YOUR TOTAL gt 5??
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The Nature of Bulimia Nervosa

• Clinical Description

• Binging
• Eat Large Amounts of Food
• Eating is Out of Control

• Compensatory Behaviors
• Purging via Self-Induced Vomitting
• Laxatives, Diuretics, Exercise

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The Nature of Bulimia Nervosa
Restrictors
Amt of Milk Shake
Normals
TIME 1
TIME 2
TIME 3
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The Nature of Bulimia Nervosa
SNACK
Bulimics
Body Size Estimate
Normals
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The Nature of Bulimia Nervosa

• Medical Consequences

• Salivary Gland Enlargement
• Eroded Dental Enamel
• Electrolyte Imbalance
• Intestinal Problems
• Calluses on Fingers and Hands

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The Nature of Bulimia Nervosa

• Associated Features

• More Severe Form Purging Type
• Most Have Other DSM Disorders
• Paradoxically
• Purging is an Inefficient Means to Reduce Weight
• A Closely Related Disorder
• Binge-Eating Disorder

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The Nature of Bulimia Nervosa

• Facts and Statistics

• 90-95 are Women
• White Middle-to-Upper Middle Class
• Onset 16-19 Years of Age
• 6-8 College Women
• About 2.8 Population Overall
• Chronic if Left Untreated

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The Nature of Anorexia Nervosa

• Clinical Description

• Morbid Fear of
• Gaining Weight
• Losing Control Over Eating

• Deliberate Weight Loss
• 15 Below Expected Normal
• Life-Threatening Consequences

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The Nature of Anorexia Nervosa

• Two Subtypes

• Restricting Type
• Excessive Dieting

• Binge-Eating-Purging Type
• Rely on Purging
• About Half of All Cases
• More Impulsive Behavior

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The Nature of Anorexia Nervosa

• Distorted Body Image

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MALES ATTRACTIVE
Females Ideal
Females Current
Females Attractive
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The Nature of Anorexia Nervosa

• Medical Consequences

• Amenorrhea
• Dry Skin
• Brittle Hair or Nails
• Sensitivity to Cold
• Lanugo
• Heart Problems
• Electrolyte Imbalance

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The Nature of Anorexia Nervosa

• Associated Features and Facts

• Begins Early in Adolescence
• Perfectionistic High-Achievers
• All-or-None Thinking
• Obsessive and Orderly
• Comorbid DSM Disorders
• Obsessive-Compulsive Disorder
• Substance Abuse

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The Nature of Anorexia Nervosa

• Causes

• Social and Cultural Factors
• Thinness Equals Success
• Has Increased Over Time
• Media
• Sets Impossible Idealized Images

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The Nature of Anorexia Nervosa

• Causes

• When Food is Restricted
• We Become Preoccupied With It!
• Media
• Sets Impossible Idealized Images

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The Nature of Anorexia Nervosa

• Causes

• Family Influences
• Successful and Driven
• Concerned About Appearances
• Eager to Maintain Harmony
• Deny or Ignore Conflicts
• Lack of Open Communication

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The Nature of Anorexia Nervosa

• Causes

• Biological Influences
• Runs in Families
• Unclear What is Inherited
• Psychological Influences
• Diminished Sense of Control
• Low Self-Esteem

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The Treatment of Eating Disorders

• Psychosocial Treatments

• Bulimia Nervosa
• Education About Eating Behavior
• Scheduled Eating
• Alter Thinking About Shape, Eating, and Weight
• Treatment Works!

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The Treatment of Eating Disorders

• Psychosocial Treatments

• Anorexia Nervosa
• Must Restore Normal Weight!
• Most Will Gain Weight (Easy)
• Keeping the Weight On (Hard)
• Treatment Similar to Bulimia
• Treatment Can Work!

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Other Eating Disorders

• Rumination Disorder

• Regurgitating and Reswallowing Food
• Disorder of Infancy--Adolescence
• Can Occur With Bulimia
• High Mortality Rate (25)

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Other Eating Disorders

• Rumination Disorder

• Pica

• Infants and MR Populations
• Eating Non-Nutritive Substances
• paint, string, hair, feces,

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Other Eating Disorders

• Rumination Disorder

• Pica

• Feeding Disorder

• Infants and Very Young
• Failure to Thrive Syndrome

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Food For Thought
Are Eating Disorders
a Form of Addiction?
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Food For Thought

• Severe Craving
• Loss of Control
• Used to Cope With Negative Feelings
• Preoccupied with Substance
• Unsuccessful Attempts to Quit
• Denial
• Adverse Psychosocial Consequences