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HealthEnhancing Behaviors

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Turned off when rats ate high fat foods and gained belly fat ... Belly fat higher in steroid receptors. Genetic loading in humans? ... – PowerPoint PPT presentation

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Title: HealthEnhancing Behaviors


1
Health-Enhancing Behaviors
  • Chapter four

2
Battling Obesity
  • Do you want that combo supersized?

3
Monitor on Psychology, Jan 2004
  • 65 of Americans are obese or overweight
  • 1960 45

4
Why??
  • Multiple, complex factors
  • Mismatch between physiology and environment
  • Food is everywhere
  • Good tasting
  • Abundant
  • Large portions
  • inexpensive

5
Physiology says
  • Eat whenever food is available

6
Other factors
  • Lack of physical activity
  • Sit down jobs with increasing hours

7
costs
  • Diabetes
  • Stroke
  • Heart attacks
  • Health-care system estimate of 117 billion a year

8
Environment
  • Easy access to junk food
  • Sedentary jobs
  • High stress rate
  • Environmental epidemic

9
Unhealthy foods
  • Accessible
  • Convenient
  • Engineered with fat and sugar to be tasty
  • Heavily promoted
  • cheap

10
Healthy foods
  • Less accessible
  • Less convenient
  • Less tasty
  • Not promoted
  • More expensive

11
Restaurant food
  • Tends to be higher in fat, calories and larger
    portions than home cooking
  • Increased amount of people eating away from home

12
restaurants
  • People tend to eat what is put in front of them
  • Ever-larger sizes of low-cost , calorie laden
    foods (fries and soft drinks)
  • 5 cents of popcorn in large vs. medium and charge
    39 cents more
  • Huge profit with great deals

13
Some research findings
  • We eat more when given more
  • Package size influences us to eat more
  • We dont compensate for eating too much at one
    sitting by eating less at the next
  • Having larger portions can override natural sense
    of fullness

14
Fullness and hunger
  • No matter what portion size, ratings were similar
  • Popcorn study those given more, ate more
  • Those who rated popcorn unfavorably ate more
  • Packaging use more detergent, dog food

15
Land of the overweight
  • French portion size 25 less than American, even
    fast food
  • French remain relatively slim despite regular
    consumption of fat-rich foods
  • Better to eat foods low in energy density
    (fruits, vegetables, whole grains, lean protein)

16
Television
  • Clear , significant relationship between
    TV-viewing and obesity in children
  • Children consume 25 of daily food in front of
    TV will decreased viewing decrease intake?

17
enter the beer belly
  • Study of mostly white, middle aged workers
  • Higher stress levels ate less healthy, fattier
    diets, less exercise and smoked more than workers
    reporting lower stress

18
Those poor rats..
  • Chronically stressed rats (physical restraint or
    exposure to cold)
  • Chose fattier, more sugary diets
  • Gained weight in their bellies
  • Became calmer

19
Rats.
  • Negative hormonal feedback system in response to
    stress
  • Turned off when rats ate high fat foods and
    gained belly fat
  • Reduced activation of stress response
  • Belly fat higher in steroid receptors

20
Genetic loading in humans?
  • Obese people have gene variant that increases
    amount of GABA than do non-obese relatives
  • GABA stimulates appetite
  • 50 of population may have this variant

21
Treatment adults
  • Success defined at 10 reduction of initial
    weight maintained for at least one year
  • Self-monitoring systematic observing recording
    of target behaviors, i.e.,
  • Calorie fat intake, exercise
  • Need to self monitor at least 75 of the time to
    succeed in weight loss

22
Treatment adults
  • Accentuated CBT
  • Modified fasting
  • Appetite suppressants
  • Antidepressants

23
Treatment adults Meditation
  • Mindfulness
  • How food is used emotionally
  • Incorporating nonjudgmental awareness
  • People with eating disorders generally less aware
    of hunger and satiation cues

24
Treatment adults Meditation
  • Focus on current moment of eating, nothing else

25
Treatment children
  • Prevention
  • 15 of children overweight
  • Higher risk for depression, suicide, ostracism
  • Encouraging positive attitudes towards eating is
    critical

26
Treatment children
  • Down Syndrome high risk for obesity and greater
    than average risk for heart disease and diabetes
  • Good news parents may be well versed in positive
    behavioral interventions children tend to be
    outgoing eager to participate

27
Eating Disorders An Overview
  • Two Major Types of DSM-IV Eating Disorders
  • Anorexia nervosa and bulimia nervosa
  • Both involve severe disruptions in eating
    behavior
  • Both involve extreme fear and apprehension about
    gaining weight
  • Both have strong sociocultural origins
    Westernized views
  • Other Subtypes of DSM-IV Eating Disorders
  • Binge-eating disorder
  • Rumination disorder
  • Pica
  • Feeding disorder

28
Bulimia Nervosa Overview and Defining Features
  • Binge Eating Hallmark of Bulimia
  • Binge Eating excess amounts of food
  • Eating is perceived as uncontrollable
  • Compensatory Behaviors
  • Purging Self-induced vomiting, diuretics,
    laxatives
  • Some exercise excessively, whereas others fast
  • DSM-IV Subtypes of Bulimia
  • Purging subtype Most common subtype (e.g.,
    vomiting, laxatives, enemas)
  • Nonpurging subtype About one-third of bulimics
    (e.g., excess exercise, fasting)

29
Bulimia Nervosa Overview and Defining Features
(cont.)
  • Associated Features
  • Most are within 10 of target body weight
  • Most are over concerned with body shape, fear
    gaining weight
  • Most are comorbid for other psychological
    disorders
  • Purging methods can result in severe medical
    problems

30
Bulimia Nervosa Overview and Defining Features
(cont.)
  • Figure 8.2
  • Lifetime cumulative risk for bulimia among female
    twins

31
Anorexia Nervosa Overview and Defining Features
  • Successful Weight Loss Hallmark of Anorexia
  • Defined as 15 below expected weight
  • Intense fear of obesity and losing control over
    eating
  • Anorexics show a relentless pursuit of thinness,
    often beginning with dieting
  • DSM-IV Subtypes of Anorexia
  • Restricting subtype Limit caloric intake via
    diet and fasting
  • Binge-eating-purging subtype About 50 of
    anorexics
  • Associated Features
  • Most show marked disturbance in body image
  • Most are comorbid for other psychological
    disorders
  • Methods of weight loss can have severe life
    threatening medical consequences

32
Binge-Eating Disorder Overview and Defining
Features
  • Binge-Eating Disorder Appendix of DSM-IV
  • Experimental diagnostic category
  • Engage in food binges, but do not engage in
    compensatory behaviors
  • Associated Features
  • Many persons with binge-eating disorder are obese
  • Most are older than bulimics and anorexics
  • Show more psychopathology than obese people who
    do not binge
  • Share similar concerns as anorexics and bulimics
    regarding shape and weight

33
Bulimia and Anorexia Facts and Statistics
  • Bulimia
  • Majority are female, with onset around 16 to 19
    years of age
  • Lifetime prevalence is about 1.1 for females,
    0.1 for males
  • 6-8 of college women suffer from bulimia
  • Tends to be chronic if left untreated
  • Anorexia
  • Majority are female and white, from
    middle-to-upper middle class families
  • Usually develops around age 13 or early
    adolescence
  • Tends to be more chronic and resistant to
    treatment than bulimia
  • Both Bulimia and Anorexia Are Found in
    Westernized Cultures

34
Causes of Bulimia and AnorexiaToward an
Integrative Model
  • Media and Cultural Considerations
  • Being thin Success, happiness....really?
  • Cultural imperative for thinness translates into
    dieting
  • Standards of ideal body size change as much as
    clothes
  • With improved nutrition, media standards of the
    ideal are difficult to achieve
  • Developmental Considerations
  • What is normal growth and development around
    puberty?
  • Psychological and Behavioral Considerations
  • Food restriction often leads to a preoccupation
    with food
  • Low sense of personal control and self-confidence
  • An Integrative Model of Eating Disorders

35
Causes of Bulimia and AnorexiaToward an
Integrative Model (cont.)
  • Figure 8.4
  • Male and female ratings of body size

36
Causes of Bulimia and AnorexiaToward an
Integrative Model (cont.)
  • Figure 8.6
  • An integrative causal model of eating disorders

37
Medical and Psychological Treatment of Bulimia
Nervosa
  • Medical Treatment
  • Antidepressants can help reduce binging and
    purging behavior
  • Antidepressants are not efficacious in the
    long-term
  • Psychological Treatment
  • Cognitive-behavior therapy (CBT) is the treatment
    of choice
  • Interpersonal psychotherapy results in long-term
    gains similar to CBT

38
Medical and Psychological Treatment of Anorexia
Nervosa
  • Medical Treatment
  • There are none with demonstrated efficacy
  • Psychological Treatment
  • Weight restoration First and easiest goal to
    meet
  • Treatment involves education, behavioral, and
    cognitive interventions
  • Treatment often involves the family
  • Long-term prognosis for anorexia is poorer than
    for bulimia

39
Other Eating Disorders
  • Rumination Disorder
  • Chronic regurgitation and reswallowing of
    partially digested food
  • Most prevalent among infants and persons with
    mental retardation
  • Treatment often involves use of aversives (e.g.,
    lemon juice)
  • Pica
  • Repetitive eating of inedible substances
  • Seen in infants and persons with severe
    developmental or intellectual disabilities
  • Treatment involves operant procedures

40
Other Eating Disorders (cont.)
  • Feeding Disorder
  • Failure to eat adequately, resulting in
    insufficient weight gain
  • Disorder of infancy and early childhood
  • Treatment involves regulating eating and family
    therapy
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