Title: Dieting Gone too Far How to Identify an Eating Disorder
1Dieting Gone too Far? How to Identify an Eating
Disorder
- Presented By Laura May-Roelse,MA RD/LD
2Overview 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
3Eating Disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Eating Disorder Not Otherwise Specified (EDNOS)
- Binge Eating Disorder
4Eating 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
5Who 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
6A 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
7Factors 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
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9Anorexia 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
10Signs
- Hyperactivity Yellow skin
- Bradycardia Lanugo hair
- Dry skin Cyanotic
- Emaciation Edema
- Hypotension
- Brittle Hair
- Brittle nails
- Hair loss
11Symptoms
- Weight loss Polyuria
- Amenorrhea Constipation
- Irritability Cold intolerance
- Fatigue
- Weakness
- Headache
- Dizziness
- Fainting
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13Common 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
14Medical 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
16Bulimia
- 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
17Bulimia 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
18Common 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
19Common Personality Traits of Bulimia
- Guilt
- Shame
- Unstable Mood
- High Achiever
- Substance Abuse
- Low Self esteem
- empty
20Signs of Bulimia
- Petechiae
- Dental carries
- Salivary Gland Hypertrophy
- Periodontal disease
- Erosion of dental enamal
- Mouth ulcers
- Calluses on hands
21Signs of Bulimia
- Irregular menses
- Esophageal burning
- Abdominal pain and bloating
- Fatigue
- Headache
- Constipation
- Swollen cheeks
- Depression
22Binge-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
23The Face of a Binge Eater
- Self loathing
- Disgust about body size
- Depressed and Anxious
- Shame/Guilt
- People pleasing
- Takes in Food/relationships without selection
24Medical Issues related to Binge Eating Disorder
- Obesity
- Elevated Cholesterol levels
- Diabetes
- Heart Disease
- Heart Attack
- Obstructive Sleep Apnea
25Eating Disorders
- Eating Disorders NOS (307.50) Any disorder of
eating that does not meet the full criteria for
any specific eating disorder.
26Co-Morbid Conditions seen with Eating Disorders
- Diagnosis Co-MorbidityDepression/Anxiety 66
Obsessive-Compulsive 40Bipolar 12Substa
nce Abuse 25PTSD 30-60Had above
illnessbefore ED 50
27How 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.
28How 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
29Levels 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.
30Multidisciplinary Treatment Team
- Pediatrician , Specialist
- Psychiatrist
- Dietitian
- Therapist
- School Counselor/educator
- Patient
- Family
31Treatment Considerations
- Weight restoration as needed
- Meal plan
- Support of family and school
- Education about ED
- Medication when necessary
- Cognitive Behavioral therapy
32Pertinent Medications
- Antidepressants- Effexor, Prozac, Zoloft, Paxil,
Celexa, Lexapro - Antipsychotic- Zyprexa, Risperdal, Seroquel,
Geodon
33Eating 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
34Eating 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
35Informational 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
36Eating Disorder Advocacy Groups
- The Elisa Project- www.TheElisaProject.org
- Eating Disorders Anonymous- www.eatingdisorderanon
ymous.org - Lifelines Foundation for Eating Disorders-
www.lfed.org
37Art by patient