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Dieting Gone too Far How to Identify an Eating Disorder

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Title: Dieting Gone too Far How to Identify an Eating Disorder


1
Dieting Gone too Far? How to Identify an Eating
Disorder
  • Presented By Laura May-Roelse,MA RD/LD

2
Overview For Presentation
  • Identify recognized eating disorders
  • Discuss common triggers and associated causes of
    eating disorders
  • How can an educator help
  • Recourses and where to turn to

3
Eating Disorders
  • Anorexia Nervosa
  • Bulimia Nervosa
  • Eating Disorder Not Otherwise Specified (EDNOS)
  • Binge Eating Disorder

4
Eating Disorders Present View
  • -Extreme expressions of a range of weight and
    food issues as well as a substitute for
    confronting painful feelings or experiences
  • -All forms of eating disorders are a
    compilation of serious emotional problems that
    have potential of life-threatening consequences

5
Who Struggles?
  • 10 million females and 1 million males struggle
    with an eating disorder
  • 25 million people suffer from a binge eating
    disorder
  • 20 of people with anorexia nervosa will die as a
    result of their eating disorder
  • source National Eating Disorders Association

6
A Look Into the Future
  • 42 of 1st-3rd grade girls want to be thinner
  • 81 of 10 year-old children are afraid of being
    fat
  • 13 of high school girls purge
  • 91 of women on college campuses have dieted
  • 80 of American women are dissatisfied with their
    appearance
  • source National Eating Disorder Association

7
Factors That May Contribute to an Eating Disorder
  • Biological predisposition-Brain Chemistry
  • Temperament- addictive personality
  • Self Esteem/Identity Issues-Perfectionism
  • The Cultural Beauty Standard-Appearance oriented
    and disregarding health
  • An Adaptation or re-enactment of sexual
    abuse-Response to stress
  • Family of origin issues-Chaotic home or feelings
    are suppressed
  • Restrained Eating-Dieting

8
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9
Anorexia Nervosa
  • Anorexia Nervosa (307.1) An intense and
    IRRATIONAL fear of body fat and weight gain.
    Psychological characteristics of the disease
    results in a misperception of body weight and
    shape and a defiant refusal to maintain a healthy
    weight for height and for age

10
Signs
  • Hyperactivity Yellow skin
  • Bradycardia Lanugo hair
  • Dry skin Cyanotic
  • Emaciation Edema
  • Hypotension
  • Brittle Hair
  • Brittle nails
  • Hair loss

11
Symptoms
  • Weight loss Polyuria
  • Amenorrhea Constipation
  • Irritability Cold intolerance
  • Fatigue
  • Weakness
  • Headache
  • Dizziness
  • Fainting

12
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13
Common Characteristics of Anorexia
  • Obsessed with weight
  • Extreme fear of becoming fat
  • Secretive eating habits
  • Commonly hide food, move food on plate
  • Difficulty sleeping
  • Withdrawn from family and friends
  • Hungry all the time, yet deny
  • Distortion of body image

14
Medical Complications in Response to Starvation
  • Blood pressure drops
  • Breathing slows
  • Menstruation ceases (or never starts)
  • Growth retardation
  • Hair falls out
  • Lightheadedness
  • Cold intolerance
  • Bone mass reduction
  • Brain abnormalities
  • Cardiac Arrest with unstable electrolytes

15
Common Personality Traits of Anorexia
  • Perfectionistic
  • Anxious
  • Self Critical
  • High Achievers
  • Low Self-Esteem
  • Sensitive
  • People Pleasers

16
Bulimia
  • Bulimia Nervosa (307.51) Is characterized by
    self-perpetuating and self-defeating cycles of
    binge-eating and purging. A binge is considered
    when a person consumes a large amount of food in
    a rapid, automatic, and helpless fashion. Binging
    often initially anesthetizes painful feelings but
    after the binge the anxiety about weight gain
    causes the person to purge by inducing vomiting
    ,restrictive dieting, excessive exercising,
    laxatives and diuretics.
  • Adapted from the National Eating Disorders
    Association

17
Bulimia Nervosa
  • Person usually within healthy weight range or
    slightly above
  • Fluctuating weight
  • Binges on Foods
  • Purges by vomiting or overexercising
  • Secretive
  • Tries to be anorexic

18
Common Characteristics of Bulimia
  • Extreme fear of becoming fat
  • Secretive with eating habits
  • Difficulty sleeping
  • Withdrawn from family and friends
  • Hungry all the time
  • Often restricts intake during day and binges at
    night

19
Common Personality Traits of Bulimia
  • Guilt
  • Shame
  • Unstable Mood
  • High Achiever
  • Substance Abuse
  • Low Self esteem
  • empty

20
Signs of Bulimia
  • Petechiae
  • Dental carries
  • Salivary Gland Hypertrophy
  • Periodontal disease
  • Erosion of dental enamal
  • Mouth ulcers
  • Calluses on hands

21
Signs of Bulimia
  • Irregular menses
  • Esophageal burning
  • Abdominal pain and bloating
  • Fatigue
  • Headache
  • Constipation
  • Swollen cheeks
  • Depression

22
Binge-Eating Disorder
  • Binge-Eating Disorder (Compulsive Eating)
    Characterized by periods of impulsive binge
    eating or continuous eating without purging
    behaviors.
  • See DSM-IV for specific Criteria

23
The Face of a Binge Eater
  • Self loathing
  • Disgust about body size
  • Depressed and Anxious
  • Shame/Guilt
  • People pleasing
  • Takes in Food/relationships without selection

24
Medical Issues related to Binge Eating Disorder
  • Obesity
  • Elevated Cholesterol levels
  • Diabetes
  • Heart Disease
  • Heart Attack
  • Obstructive Sleep Apnea

25
Eating Disorders
  • Eating Disorders NOS (307.50) Any disorder of
    eating that does not meet the full criteria for
    any specific eating disorder.

26
Co-Morbid Conditions seen with Eating Disorders
  • Diagnosis Co-MorbidityDepression/Anxiety 66
    Obsessive-Compulsive 40Bipolar 12Substa
    nce Abuse 25PTSD 30-60Had above
    illnessbefore ED 50

27
How to approach someone you are worried about
  • Do and Donts
  • Do tell her you want to help. Let her know you
    care and express your concern without judgment.
  • Do find a time and location to tell her that will
    be free of distractions.
  • Do try and get her to seek professional help as
    soon as possible. Suggest experts who specialize
    in eating disorders. If she refuses this,
    encourage her to reach out to another helping
    professional such as a counselor, teacher, clergy
    person or school nurse.
  • Do learn everything you can about eating
    disorders.
  • Do be prepared to hear her deny that there is a
    problem. People often experience eating disorders
    as shameful, embarrassing and difficult to
    acknowledge.
  • Do respond by saying that you are still concerned
    about what you have observed.
  • Do be patient. Show caring, support by listening
    and attempting to understand her perceptions
    about the situation.
  • Do watch for signs of deteriorating physical or
    emotional health.
  • Do refuse to get caught up in arguments or
    battles of will with her.
  • Do be aware of any prejudices or preconceptions
    you may have about thin or obese
  • people.

28
How to approach someone you are worried about
  • Dont try to solve her problem or cure the eating
    disorder on your own.
  • Dont make comments about her appearance (or your
    own).
  • Dont get involved in discussions about dieting,
    weight, calories consumed or particular eating
    habits.
  • Dont compare her to other individuals. In
    general, avoid making flattering comments about
    thin people or disapproving remarks about obese
    people.
  • Dont refer to foods as good or bad. Try not
    to discuss food or reinforce her preoccupation
    with food.
  • Dont try to make her eat or insist that she gain
    weight.
  • Taken from Renfrew Center Foundation Brochure on
    eating disorders Signs, Symptoms, How to Help.
    www.renfrew.org

29
Levels of Treatment
  • Outpatient Care- Individual appointments with
    various treatment providers in an office or
    clinic setting
  • Intensive Outpatient Care-Individual or group
    meetings with various treatment providers in 1-4
    hour increments several times per week.
  • Day Treatment-Daily groups or individual
    appointments during the work day/week.
  • Partial Hospitalization- Full hospitalization
    care except the patient sleeps at home.
  • Inpatient Hospitalization- Full hospital care
  • Residential Treatment- A freestanding treatment
    facility that may or may not be affiliated with a
    hospital.

30
Multidisciplinary Treatment Team
  • Pediatrician , Specialist
  • Psychiatrist
  • Dietitian
  • Therapist
  • School Counselor/educator
  • Patient
  • Family

31
Treatment Considerations
  • Weight restoration as needed
  • Meal plan
  • Support of family and school
  • Education about ED
  • Medication when necessary
  • Cognitive Behavioral therapy

32
Pertinent Medications
  • Antidepressants- Effexor, Prozac, Zoloft, Paxil,
    Celexa, Lexapro
  • Antipsychotic- Zyprexa, Risperdal, Seroquel,
    Geodon

33
Eating Disorders are a disease of secrets
  • Remember, weight can be normal or above normal in
    someone with a severe eating disorder
  • Someone struggling with an eating disorder will
    go to great lengths to keep this a secret because
    of shame associated with this disease
  • Someone with an eating disorder will likely deny
    they have a problem
  • Someone with an eating disorder needs lots of
    support to seek treatment and to stay in recovery

34
Eating Disorders Professional Organizations
  • International Association of Eating Disorder
    Professionals- www.iaedp.org
  • Academy of Eating Disorders- www.aed.org
  • National Eating Disorders Organization-www.nationa
    leatingdisorders.org
  • Eating Disorder Referral and Information
    Center-www.edreferral.com
  • Treatment Facilities- www.disordered-eating.com

35
Informational Websites
  • Something Fishy- www.somethingfishy.org
  • National Eating Disorder Screening Program-
    www.mentalhealthscreening.org
  • Gurze Books- www.bulimia.com
  • Anorexia and Related Disorders- www.anred.com

36
Eating Disorder Advocacy Groups
  • The Elisa Project- www.TheElisaProject.org
  • Eating Disorders Anonymous- www.eatingdisorderanon
    ymous.org
  • Lifelines Foundation for Eating Disorders-
    www.lfed.org

37
Art by patient
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