Eating Disorders

1
Eating Disorders

• Characterized by disturbances in
• Body image
• Eating behavior
• Lack of research
• Anorexia nervosa (AN) 1st recognized during the
  19th century
• Bulimia recognized as distinct disorder in 1980
• EDs affect10 of female adolescents and women

2
Classification of Eating Disorders

• Diagnostic criteria published by American
  Psychiatric Association, 2000
• 4 categories
• Anorexia Nervosa (Exhibit 2.1)
• Bulimia Nervosa (Exhibit 2.2)
• Eating Disorder Not Otherwise Specified (NOS
  Exhibit 2.3)
• Binge-Eating Disorder (Exhibit 2.4)

3
Long term effects of EDs

• Reproductive irregularities
• Fluid and electrolyte imbalances
• Cardiovascular problems
• Gastrointestinal disturbance
• Dental erosion
• Bone density problems
• Obesity

4
Risk Factors

• Gender (90 female)
• Adiposity
• Body dissatisfaction?
• Social pressure to be thin?
• Sociocultural pressures (family, peers, mass
  media)

5
Study on Impact of Media

• Teen girls given 15 month subscription to fashion
  magazine
• Post-test revealed
• Increased body dissatisfaction
• Dieting
• Bulimic symptoms in at-risk girls
• At-risk girls had deficits in social support,
  body dissatisfaction prior to study

6
Risk factors, contd.

• Thin-ideal internalization (can be altered)
• Negative affectivity (prone to emotional
  distress)
• Perfectionism
• Timing of puberty?
• Externalizing behaviors (deal with problems
  through impulse behaviors, e.g. drinking)

7
Gender and Eating Disorders

• Does a womans biology predispose her to eating
  disorders?
• How does calorie restriction impact on female
  physiology?

8
Womens Biology and EDs

• Dieting affects serotonin (5HT) levels by
  reducing L-tryptophan levels
• Effect only observed in females
• Low 5HT results in carbohydrate cravings,
  overeating (binging?)
• Low 5HT due to dieting is associated with
  depression
• No specific genetic factor uncovered
• Genetics temperament vulnerability to eating
  disorder??

9
Antidepressants and EDs

• SSRIs reduce risk of relapse in weight-restored
  AN patients
• Not helpful for low weight patients
• Unable to generate 5HT response?
• Antidepressants decrease frequency of eating
  vomiting in BN patients
• Cognitive-behavioral therapy must be included
  under all circumstances!!