Bulimia Nervosa

1
Bulimia Nervosa

• Geoffrey S, Elizabeth H, Mark, Maria, Becky P.

2
Evaluate psych research through theories and
studies relevant to the study of abnormal
behavior.

• According to the body-image distortion
  hypothesis, (Bruch, 1962), many eating disorder
  patients suffer from the illusion that they are
  overweight.
• Research has confirmed that these people
  overestimate their body size. Studies have shown
  that the degree of distortion varies considerably
  with contextual factors.
• - Strober (2000) has found that first-degree
  relatives of women with bulimia nervosa are ten
  times more likely than average to develop the
  disorder.

3
Cont.

• Carraso (2000) found lower levels of serotonin in
  patients suffering from bulimia.
• - Smith (1990) found that when serotonin levels
  were reduced in recovered patients with bulimia,
  they engaged in cognitive patterns related to
  eating disorders, such as feeling fat.
• - Slade and Brodie (1994) suggest that those who
  suffer from an eating disorder are in fact
  uncertain about the size and shape of their own
  body, and that when they are compelled to make a
  judgment they err (being incorrect, mistaken,
  wrong) on the side of reporting an overestimation
  of their body size

4

• These are just some images, one to show you how
  women or men may think of themselves and two, to
  show you everything associated with Bulimia.

5
Interaction of Biological Factors

• Seratonin also seems to play a role in bulimia.
  Increased serotonin levels stimulate the medial
  hypothalamus and decrease food intake which can
  be related to the biological factors in someone
  who suffers from bulimia.
• When looking at studies, it appears that at least
  some of the reports given by patients reflect
  their emotional appraisal rather than their
  perceptual experience.

6
Interaction of Cognitive Factors

• When looking at cognition, someone who suffers
  from bulimia may have an all-or-nothing approach
  to judging themselves which is called cognitive
  disinhibition. Thoese suffering from bulimia have
  a very strict diet and when they break their own
  rules, they tend to binge eat. They have thoughts
  about eating act to release all dietary
  restrictions.
• The cognitive explanation that people with eating
  disorders suffer from perceptual distortion and
  maladaptive cognitive patterns is more
  descriptive than explanatory, as it does not
  explain how these distortions arise. It is
  difficult to establish cause and effect, since
  distorted eating patterns may result in distorted
  thinking, rather than vice versa.

7
Integration of SocioculturalFactors

• When looking at the sociocultural factors that
  may attribute to people who suffer from bulimia,
  you have to keep in mind the media! TV,
  magazines, billboards and more expose us to
  beautiful people a lot, making this
  beautifulness seem easy to be and have when it
  may be completely the opposite to attain.
• The aspect of a womans personal history may
  contribute to her dissatisfaction with her body
  shape but the desire of wanting to be thin can be
  extremely influenced by the media. The media BOTH
  reflects and helps to shape a strong cultural
  pressure towards thinness.
• The rise in the incidence of eating disorders
  which has become evident in recent years
  throughout Europe, and in the US and Japan, is
  frequently attributed to an increase in this
  cultural emphasis on thinness as an ideal body
  shape.

8
Symptoms of Bulimia

• Rapid and out of control eating
• Dehydration from vomitting
• Binging and purging to control weight

9
Prevalence

• Psychologist Schwitzer et al (2001) discovered
  that up to 50 of female surveyed periodic
  binges. 6 had tried vomiting and 8 had used
  laxatives on at least one occasion. Few, however,
  had engaged in these behaviours sufficiently for
  them to be considered a disorder

10
Etiologies

• Bulimia is genetic- Kendler et al. (1991) studied
  2000 female twins and found a concordance rate of
  23 in MZ twins and 9 in DZ twins. Strober
  (2000) has found that first-degree relatives of
  women that suffer with bulimia nervosa are 10
  times more likely than average to develop the
  disorder.
• Serotonin- an increased amount of serotonin
  levels stimulate the medial hypothalamus and
  decrease food intake. Carraso (2000) found lower
  levels of serotonin in patients who suffered with
  bulimia. Smith et al. (1990) found that when
  serotonin levels were reduced in recovered
  bulimic patients, they engaged in cognitive
  patterns related to eating disorders, such as
  feeling fat.
• Young females are subject to bulimia if they feel
  uncomfortable with the way their body looks. In
  order to feel more confident, they will binge on
  their favorite foods and then make themselves
  throw it back up- this way they have the feeling
  of eating but will not gain weight from it.

11
Cultural and Gender Variations

• Bulimia is a popular disorder with mostly women.
  It is found in Canada, Europe, Australia, Japan,
  New Zeland and South Africa. It is most popular
  between the ages 13-21. I believe that the reason
  that young girls suffer from Bulimia is because
  it is around this time where they feel that looks
  are the only thing that matters. They are
  surrounded by beautiful women and they want to
  be like them so they do what it takes to lose
  weight and come close to looking like their role
  model. 90 of women have this disorder and only
  10 of men have. Some men may have to do this due
  to the sport they participate in. for example UFC
  fighters do this in order to reach the weight
  class theyre supposed to be in order to fight.

12
Examine Biomedical Treatment

• Fluoxentine (Prozac) has been approved by the
  Food and Drug Administration for the treatment of
  Bulimia.
• Found to decrease the number of episodes of
  binging, as well the desire to vomit, in people
  who suffer from Bulimia moderately to severely.
• Antidepressants have been also found to decrease
  your urges. They help the person have less
  depressed feelings about themselves

13
Cont.

• McGilly and Pryor (1998)- found that Prozac had
  very promising results. A trial was done with 382
  patients, which 29 had a reduction of vomiting
  compared to the 5 who had taken a placebo. It
  was shown that binge eating was reduced to 67
  and purging was reduced to 56 when the drug was
  taken.

14
Examine Individual Treatment

• Cognitive Behavioural Therapy
• Adresses the cognitive aspects of Bulimia
• Aim to reinstate control over eating while
  avoiding dieting because that is a trigger.
• Patients have record what they eat and how they
  feel about it, and what triggers the need to
  binge and purge.

15
Examine Group Approaches

• Group Therapy and Family Therapy
• Group
• Provides a safe environment for honest
  discussions regarding the individuals struggle
  with the disorder (Riess and Rutan 1992).
• McKisack et al. 1997- found that group therapy
  was very successful if patients had similar
  characteristics.

16
Cont.

• Family Therapy
• Helps a person who suffers from Bulimia see and
  understand the role they play within the family
  and how their behaviour maintain that role.
• Helps the family understand the role they play in
  supporting that person.
• Schmidt et al. 2007- Found that using both
  methods resolved the disease more rapidly than
  other types of treatment.

17
Evaluate the use of Biomedical Treatment of
Bulimia

• Strength

• Limitations

• In using biomedical treatment, success has been
  seen numerous times with numerous types of drugs.
• The meds help treat more than one symptom

• There might be a side affect that brings on
  another issue in that persons life.
• Some patients dont need what that drug controls.

18
Evaluate the use of Individual Treatment

• Strength

• Limitation

• Only you and one other person know what youre
  struggling with.
• You get to learn more about yourself and become
  more aware of yourself.

• You only have one person helping.
• Others are not there to help you and support you.

19
Evaluate the use of Group Treatment

• Strength

• Limitation

• You have people around you who are struggling
  with the same issue.
• You can confide in many people.

20
Eclectic Approached to Treatment

• Cognitive/Behavioral therapy
• Meetings in which the therapist helps the patient
  break the habit of bingeing purging and cycle of
  dieting.
• Also the therapist helps the patient to moniter
  their thoughts on self-esteem, body image and
  beliefs about food.
• Interpersonal group therapy
• The therapist tries to find the root cause of
  this behavior.This type of therapist spends more
  time and work with a group than other
  therapists. 
• Nutritional therapy
• This type of therapy helps the patient learn a
  normal eating behavior since the sunject may
  not be eating properly or even at all.

21
Relationship Between Etiology and Theraputic
Approach

• On TV we constantly see beautiful women
  advertising something that will supposedly make
  you feel better about yourself and make you feel
  prettier. When young girls see this, they
  automatically want to buy that product, hoping
  that they will become like the woman they saw on
  the commercial. This mainly affects high school
  girls. A survey in Nadroga, Fiji showed that
  before the introduction of TV in that area, the
  reported incidents of purging went from 0 to
  11.3. These young girls want to become the women
  they see because they begin to believe that if
  they are not like that woman they saw on TV then
  they wont get far in life.

22
Cont.

• The most common therapeutic approach for bulimia
  is psychotherapy. Psychotherapy consists of
  significant time and financial commitment. The
  focus of psychotherapy is to find out the
  underlying emotional and cognitive issues that
  result in the disordered eating. Another form is
  Cognitive-Behavioral therapy. It is considered
  the treatment of choice for people with Bulimia.
  CBT helps the person understand how their
  thinking and negative self-talk and self-image
  can directly impact their eating and negative
  behaviors. It also helps the person with bulimia
  break their pattern of unhealthy eating.