Issues of

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Issues of
Appetite, Eating,
And Weight
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Appetite Issues

• Appetite 1. a desire for food or drink. 2. a
  desire to satisfy any bodily need or craving.
• You may have too big of an appetite or too small
  both of which may become serious problems.
• Too big of an appetite or too small of an
  appetite may be connected to independent
  psychological and/or medical issues.

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Are we in control of appetite?

• No Through interaction between internal organs,
  hormones, and the brain, the body as a whole
  controls when we get hungry, the intensity of
  hunger and the urgency we feel to consume
  nutritious foods.

4
Are we in control of appetite?

• Yes If we do not replace what is consumed, our
  body thinks it is STARVING that is the body
  believes that there is not enough food in the
  environment to sustain itself. Because we are
  biologically programmed to do whatever it takes
  to survive, our system shift gears to consuming
  less and saving more.

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Eating issues Possible Reasons

• The causes of eating disorders tend to be
  heterogeneous and multifactorial.
• Genetic
• Many researchers believe that there is an
  inherited predisposition to having an eating
  disorder. Studies have shown that the
  co-occurrence of eating disorders among identical
  twins is greater than fraternal twins.
• Other research on the genetic component of
  eating disorders has focused on neurochemistry.
  Researchers have found that the neurotransmitters
  serotonin and norepinephrine are significantly
  decreased in acutely ill patients suffering from
  Anorexia and Bulimia Nervosa (Depression and
  PTSD). Besides creating a sense of physical and
  emotional satisfaction, the neurotransmitter
  serotonin also produces the effect of feeling
  full and having had enough food.
• Individuals with eating disorders have been
  shown to have a higher levels of the hormones
  vasopressin and cortisol than the general
  population. Both these hormones are normally
  released in response to physical and possible
  emotional stress, and may contribute to some of
  the dysfunction seen in eating disordered
  individuals.

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Eating issues Possible Reasons

• Sociological
• Environmental conditions reinforce the practice
  of an eating disorder. We live in a society that
  reinforces the idea to be happy and successful we
  must be thin. Today, you cannot read a magazine
  or newspaper, turn on the television, listen to
  the radio, or shop at the mall without being
  assaulted with the message that fat is bad.
  During adolescence, a particularly vulnerable
  time to the development of an eating disorder,
  the influence of peers becomes important. Self
  monitoring and comparing ourselves to others
  becomes central to our psyche. Peer teasing and
  pressures to conform to the norm are common in
  the background of eating disorder individuals. As
  our bodies developed and changed, how others and
  we reacted to these changes influenced our
  eventual body acceptance. Other societal issues
  include dysfunctional families, sexual abuse,
  physical abuse, domineering coaches and
  controlling relationships.

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Eating issues Possible Reasons

• Psychological
• The practice of an eating disorder can be viewed
  as a survival mechanism. Just as an alcoholic
  uses alcohol to cope, a person with an eating
  disorder can use eating, purging or restricting
  to deal with feelings and emotions that may
  otherwise seem overwhelming. Through the practice
  of the eating disorder, the individual may feel a
  sense of partial control over their seemingly
  uncontrollable life. Some of the underlying
  issues that are associated with an eating
  disorder include low self-esteem, depression,
  feelings of loss of control, feelings of
  worthless, identity concerns, family
  communication problems and an inability to cope
  with intense emotions. The practice of an eating
  disorder may be an expression of something that
  the eating disordered individual has found no
  other way of expressing.

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Eating issues types

• Bulimia Nervosa
• Anorexia Nervosa
• Eating Disorder Not Otherwise Specified

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Some facts about Bulimia

• Affects 3 to 10 of adolescent and college-aged
  women in the US
• Twenty-five per cent are initially anorexic
• Commonly occurs with affective disorders, impulse
  control disorders, BPD, posttraumatic symptoms,
  substance abuse, and drug abuse
• Successful outcome is negatively impacted by
  familial obesity

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Diagnostic criteria for bulimia

• Recurrent episodes of binge eating
• Feeling of lack of control over bingeing
• Purging through vomiting, fasting, diuretics,
  strict dieting, or exercise

• Two binge episodes a week over three months
• Self-evaluation unduly influenced by shape or
  weight

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Causes of Bulimia Nervosa

• No organic cause has been isolated
• Societal pressure to be thin
• Family dysfunction such as chaos, open conflict,
  hunger for attachment, caretaker
  underinvolvement, disconnection

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Some facts about anorexia

• 5 die
• less than 40 recover spontaneously
• 70 can be helped with competent tx
• twin studies show inheritability at 55
• may be a gene involved

• 1 in 200 persons in the US will develop AN
• 90 are women
• Diagnosis most common at puberty or age 18
• 50-75 have major depression
• 25 have OCD

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Diagnostic criteria for anorexia nervosa

• She is the restricting type because of dieting,
  fasting, or excessive exercise
• She is the binge/purge type because of vomiting,
  laxatives, enemas, or diuretics in addition to
  restricting

• She refuses to maintain weight above 15 of
  normal
• She has intense fear of gaining weight
• She has a disturbed body image
• She has not menstruated for at least 3 cycles

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A person with anorexia can

• Have low body temp, heart rate, and blood
  pressure
• have heart arrhythmias from low potassium
• die from cardiac arrest, pneumonia, or suicide

• be depressed, irritable, and insomniac
• have swollen joints
• have dry hair and skin
• have brittle nails
• be lethargic and constipated
• lose bone mass
• have arrested sexual development

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WEIGHT ISSUES

• Rough formula for minimum normal weight
• 5 100 every 1 5 lbs 57 135
  lbs
• It is always highly recommended to have a full
  blood work and a complete check-up to make sure
  the cause of excessive weight is not medical.
• Best way to control your weight in a healthy way
  is to have 6 well-balanced meals per day.
• Exercising up to 90 minutes / day is considered
  healthy.

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Treatment

• The ideal treatment team Psychiatrist,
  individual therapist, family therapist, group
  therapist (can be the same as individual
  therapist), and dietitian.
• In some cases inpatient treatment is necessary,
  some cases it is recommended, and in other cases
  it is not necessary.
• Antidepressants, when combined with psychotherapy
  can be beneficial.
• Motivation for change is critical for success.