Lecture 10: Eating Disorder Flashcards Preview

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Flashcards in Lecture 10: Eating Disorder Deck (15):

Disordered Eating

-Abnormal eating practices to lose weight
-Usually mild or short-term and does not cause long-term consequences or illness
-Unhealthy relationship with food & body image
-Disordered eating can cross-over into an eating disorder, which is a clinical psychiatric disorder


Disordered Eating & Students

-91% of students surveyed on a college campus had attempted to control their weight through dieting
->50% of teenage girls and ~33% of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives
-25% of college-aged women engage in bingeing and purging as a weight-management technique


Eating Disorders

-Clinical psychiatric disorder characterized by severe disturbances in body image & eating behaviors
*Severe food restrictions, bingeing, purging, weight changes
*Perceptions of body image cause extreme distress/ concern

-Starts with a diet + stress & lack of coping= loss of control
*Puberty, school, sports, dysfunctional family

-Must involved professional intervention
-May result in heart conditions, kidney failure and death
-ED have the highest mortality rate of any mental illness
-5% American women will develop AN or BN in their lifetime

-Frequently occur with other psychological disorders: depression, obsessive-compulsive disorder, borderline personality disorder, anxiety, substance abuse
*20-25% AN have a co-morbid psychological disorder
*~50% ED patients have depression

-6-10 times more common in females
-Occurs in all ethnic, SES, age & gender groups



-47% of girls in 5th-12th grade reported wanting to lose weight because of magazine pictures.

-69% of girls in 5th-12th grade reported that magazine pictures influenced their idea of a perfect body shape.


Anorexia Nervosa “Loss of appetite; Disgust with one’s body”

Characterized by:
-Self-starvation with extreme weight loss
-Irrational fear of weight gain & obesity
-Distorted body image with a discrepancy between actual vs perceived wt
-Exhibit obsessive-compulsive behaviors and perfectionism

Psychological conflict, rigid control:
-Family structure, overbearing mother, absent father, high family expectations, overprotection, rigidity
-Lack of coping mechanisms, so they can control eating

-Life-threatening thinness: 5-10% will die within 10 yrs of dx


Anorexia Nervosa

-Refusal to maintain body weight at or above a minimally normal weight for age and height (usually <17.5).
-Intense fear of weight gain or being fat even though they are considered underweight.
-Disturbed experience with weight. Feeling overweight despite dramatic weight loss. -Extreme concern with body weight and shape. -Denial of the seriousness of the low body weight.


Anorexia Nervosa Treatment

-Multidisciplinary Team : physicians/NP, dietitians, psychologists, family, friends, coach/trainer

-Medical care: hospitalization or outpatient care
-Psychological : address underlying emotional problems

-Build trust
-Prevent further weight loss with slow gain
-Restore appropriate food habits


Bulimia Nervosa “Great hunger; Disgust with one’s body”

-Recurrent episodes of binge eating:
*Eating increase amount food w/in 2 hr period & lack of control during binge
-Recurrent compensatory behavior: self-induced vomiting, laxatives, diuretics, enemas, medications, excessive exercise, fasting
-2 X per week for at least 3 months
-Extreme concern with body weight and shape, self-evaluation based on this.

Often have elaborate foods rules: avoiding all sweets, breaking rule causes guilt and leads to binge/purge


Bulimia Nervosa

-Turn to food in crisis vs anorexia
-Recognize behavior as abnormal vs anorexia
*They feel ashamed, frustrated, out of control, guilt (especially after a binge)
-Low self-esteem, 50% have depression
-4% adolescents & college-age women have -BN, occurs in men too
*Prevalence underestimated because
~most are at or above normal weight
~ secretive


Bulimia Nervosa: Health Risks

-Dehydration & electrolyte imbalance: irregular
heartbeat & heart failure, death
-GI: inflammation, ulceration, rupture of esophagus & stomach
-Irregular BM, constipation w/laxatives
-Teeth (dental decay/ staining)
-Mouth (swollen salivary glands)
-Blood (Anemia)
-Kidney problems with over diuretic use


Bulimia Nervosa Treatment

-Multidisciplinary Team : Physicians/NP, dietitians, psychologists and others

-Psychological : Address underlying emotional problems, improve self-acceptance

-↓ episodes of binge & purge & amount of food at binge
-Change the “all-or-none” attitude & misconceptions about food
-Establish normal eating habits


Binge Eating Disorder

-Binge eating at least 2x/wk x 6 mo, without compensatory purging
-Triggered by stress, depression, anger etc.
-8% obese population has binge-eating disorder

-Professional help: address hidden emotions
-Learn to eat in response to hunger & in moderation
-Avoid restrictive diets which can intensify problems


Eating Disorder Not Otherwise Specified

Diagnostic and Statistical Manual of Mental Disorders*

Clinically significant problems but do not meet set criteria:
-Criteria for AN met except regular menses
-AN criteria met, but despite wt loss, wt in normal range (started obese)
-BN criteria except binge < 2 X/week or < 3 mos
-BN criteria but after normal food intake (ex. self-induced vomiting after the consumption of 2 cookies).
-Chewing/spitting out - no swallowing


Other Eating-Related Disorders

-Muscle Dysmorphia: obsessive concern of having underdeveloped muscles even though they are muscular

-Orthorexia: obsession with eating healthfully & the “right” foods, “health food disorder” , “pure” food. Can lead to significant weight loss and mental preoccupation.


Preventing Eating Disorders

-Recognize it is normal to think about food, diet, weight, have fluctuations in weight, variations in diet
-Learn healthy behaviors as a child
-Intuitive eating
-Build self-esteem
-Targeted prevention for those with warning signs