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Eating Disorders


Eating Disorders Flesh is in, Food is out. Join us for the 4th meal. Eating Disorder Defined An eating disorder is a complex illness that develops over time from a ... – PowerPoint PPT presentation

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Title: Eating Disorders

Eating Disorders
  • Flesh is in, Food is out.
  • Join us for the 4th meal.

Eating Disorder Defined
  • An eating disorder is a complex illness that
    develops over time from a combination of
    physiological, psychological, interpersonal,
    cultural, and spiritual factors resulting in a
    disturbance of thoughts and behaviors about food
    and weight, and body image issues.
  • It is progressive in nature, affects females and
    males, and can have life-threatening consequences.

Presentation Outline
  • History of Eating Disorders
  • Current Research
  • Eating Disorders Defined
  • Treatment
  • Questions

The History of Disordered Eating
  • Ancient Romans big feasts and vomitoriums
  • Early Chinese dynasties binding of feet and tape
  • African tribal lore times of famine and the
    praise of voluntary restrictors healed by
    shamans using hypnotherapy
  • In early Europe rib removal surgery and tape
  • The first formal description of anorexia nervosa
    in medical literature was made by Richard Morton
    in London in 1689 "a skeleton clad only with

  • Two other physicians, Lasegue in 1873 in France
    and Gull in 1874 in England, wrote the first two
    articles about anorexia nervosa in modern medical
  • Hilde Burch, MD, is considered the grandmother of
    anorexia research (shortly after WWII)
  • The starving consumption
  • Bulimia only began to be recognized in 1970
  • And compulsive overeating or binge eating is
    still not considered a specific diagnosis in the

Current ResearchThe Numbers Talk!
General Statistics
  • Eating disorders are now the third most common
    chronic illness in adolescent girls (Canadian
    Pediatric Society, 2001)
  • Eating Disorders are found in children as young
    as 6 years old (Cavanaugh Lemberg, 1999)
  • It is estimated that 3 of women will be affected
    by eating disorders in their lifetime (Zhu AJ,
  • Among female athletes, eating disorders are
    reported to be between 15 and 62 (Costin, 1999)

  • For both sexes, the rates are higher among
    athletes participating in sports that emphasize a
    lean body type (i.e. dancing, gymnastics,
    skating, etc) and individuals under strong
    pressure to achieve (i.e. medical students,
    models, competitive sports, etc)
  • 10 of people with eating disorders are male

Mortality Rates
  • Eating Disorders have the highest mortality rate
    of any other psychiatric illness.
  • Death rates range between 18 and 20 of
    individuals with eating disorders (Cavanaugh,
  • Death rates of anorexia is more than 12 times
    higher than the annual death rate due to all
    other causes combined for females 15 to 24 years
    old (Sullivan, 1995 Cavanaugh, 1999)
  • The top five countries with Eating Disorder
    Mortality rates are USA, Japan, Germany, Brazil,
    and Canada (Nation Master, 2004)

Dieting and Fear of Fat
  • 81 of 10-year-olds restrict eating and at least
    46 of 9-year-olds (Mellin, Scully, Irwin,
  • The fear of fat is so overwhelming that young
    girls have indicated in surveys that they are
    more afraid of becoming fat than they are of
    cancer, nuclear war or losing their parents
    (Berzins, 1997)
  • A survey of parents found that one in 10 would
    abort a child if they knew it had a genetic
    tendency to be fat (Fraser, 1997)

  • 51 of 9 and 10 year old girls feel better about
    themselves if they are dieting (Mellin et al.,
  • 49 of 9 to 10 year olds are sometimes or very
    often on diets, where 82 of their families are
    sometimes or very often on diets
    (Gustafson-Larson Terry, 1992)
  • 93 of women have tried to lose weight
  • 34 of women would be willing to still try and
    lose weight even at the slight risk of medical

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Eating Disorders Defined
  • The Continuum of Eating
  • Anorexia Nervosa
  • Bulimia Nervosa
  • Eating Disorder NOS
  • Behaviors to watch for
  • Medical Concerns

The continuum of healthy eating, disordered
eating, and eating disorders.
  • Anorexia Nervosa
  • Refusal to maintain body weight at or above 85
    of normal weight for age and height
  • Intense fear of gaining weight or becoming fat,
    even though underweight
  • Disturbance in the way in which ones body weight
    or shape is experienced, undue influence of body
    weight or shape on self-evaluation, or denial of
    the seriousness of the current low body weight
  • In postmenarcheal females, amenorrhea (the loss
    of three consecutive menstrual cycles)
  • Subtypes of restricting type or
    binge-eating/purging type (the person regularly
    engaged in binge-eating or purging behavior such
    as self-induced vomiting or misuse of laxatives,
    diuretics, or enemas)

Behaviors to look for - Anorexia
  • Tight clothes or layers
  • Excessive liquids/caffeine
  • Poor sleep habits
  • Excessive movement/exercise
  • Pleasure restrictive
  • Finicky eating - only safe foods
  • Hoarding food
  • Emotional at meal times
  • Controlling behavior around kitchen/shopping
  • Excessive preoccupation with food
  • Bizarre and rigid eating rituals
  • Wont eat in front of others
  • Vegetarian
  • Weighing rituals
  • Reads food labels

Anorexia Nervosa
  • Dehydration/Electrolyte imbalances
  • Hypoglycemia
  • Amenorrhea or irregularities
  • Osteoporosis
  • Anemia/Weakness/Fatigue
  • Organ failure
  • Abdominal pain
  • Cold intolerance
  • Reduced muscle mass
  • Lanugo
  • Emaciation
  • Swollen parotid glands
  • Edema
  • Lowered pulse rate, irregular heart rhythms,
    heart failure
  • Constipation with occasional diarrhea
  • Brittle nails, hair, and dry skin
  • Refeeding is the most medically dangerous time

1 in 10 women will die of starvation, cardiac
arrest, or other medical complications, making it
the highest death rate for a psychiatric illness
  • Bulimia Nervosa
  • Recurrent episodes of binge eating
  • Eating, in a discrete period of time, an amount
    of food that is definitely larger than most
    people would eat during a similar period of time
    and under similar circumstances
  • A sense of lack of control over eating during the
  • Recurrent inappropriate compensatory behavior in
    order to prevent weight gain, such as
    self-induced vomiting misuse of laxatives,
    diuretics, enemas, or other medications
    fastingand/ or excessive exercise.
  • The binge eating and inappropriate compensatory
    behaviors both occur, on average, at least twice
    a week for 3 months
  • Self-evaluation is unduly influenced by body
    shape and weight
  • Subtypes of purging type (self-induced vomiting
    or misuse of laxatives, diuretics, or enemas) or
    nonpurging type (fasting or excessive exercise)

Behaviors to look for - Bulimia
  • Self destructive behaviors
  • Erratic eating patterns
  • Hoarding food
  • Frequent trips to bathroom
  • Somatic complaints
  • Unexplained lapses of time
  • Extreme cycles of socializing and isolating
  • Compulsive, self-destructive behaviors
  • Plumbing problems
  • Hoarding of vomit
  • Provocative dress
  • Outbursts of anger/rage, Labile mood
  • More likely to struggle with substance abuse

Bulimia Nervosa
  • Digestive problems
  • GI tract dysfunction
  • Risk for cardiac arrest due to low potassium
  • Dehydration/Electrolyte imbalances
  • Menstrual irregularities
  • Inflammation of esophagus
  • Damage to salivary glands
  • Muscle cramps
  • Dental problems such as erosion of tooth enamel
  • Severe constipation
  • Swollen parotid glands
  • Red eyes
  • Weakness/lightheadedness
  • Ulcers
  • Abdomen pain
  • Have to be weaned off of excessive laxative,
    diuretic, or enema use

  • Eating Disorder NOS
  • Disorders of eating that do not meet the other
  • Examples
  • Binge eating disorder
  • Compulsive overeating
  • Purging disorder
  • Anorexia athletica
  • Night-eating syndrome
  • Chewing and spitting
  • Nocturnal sleep-related eating disorder

Behaviors to look for - Binge/Compulsive
  • Severe isolating
  • Decrease in hygiene care
  • Labile mood
  • Buying of high caloric foods
  • Often empty cupboards/refrigerators
  • Medical complications, disability

Binge Eating or Compulsive Overeating
  • Obesity
  • Heart Disease
  • Stroke
  • High blood pressure
  • High cholesterol levels
  • Secondary diabetes
  • Loss of physical mobility
  • Joint pain and degeneration
  • Gallbladder disease
  • Some types of Cancer
  • Sleep apnea

  • Increased risk of low birth weight
  • Preterm labor, placental abruption, and breech
  • Miscarriage or stillbirth
  • Difficulties with daily tasks due to easily
  • Osteoporosis
  • Postpartum Depression (thoughts of hurting self
    or baby)
  • May underfeed or overfeed newborn
  • 35 increased rate of coronary death
  • 6xs more likely to develop diabetes
  • Low Apgar score
  • Child high risk for
  • Cerebral palsy
  • Respiratory illnesses
  • Liver disorders
  • Cleft palate
  • Blindness
  • Mental disorders (lower IQ, learning
    disabilities, mood disorders)

The Etiology of Eating Disorders Biopsychosocial
construction of psychiatric diagnoses
  • Biological and genetic factors
  • Psychological factors
  • Family dynamics
  • Social and Cultural pressures

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Aspects Unique to Men
  • Weight restrictions necessitated by sports
    participated in, such as body building,
    wrestlers, dancers, swimmers, runners, rowers,
    gymnasts, and jockeys
  • Negative reactions to their bodies by peers
    growing up
  • More likely to compulsively exercise
  • Less likely to seek help and be recognized by
  • More likely to abuse steroids

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Social Cultural Pressures
  • Societal pressures are one of the environmental
    trigger that releases the genetic risk
  • Socially acceptable symptoms
  • Pressure on appearances
  • Stereotypes of certain body types
  • Peer groups
  • Internalized racism, sexism,
  • and other -isms
  • Acculturation

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Treatment of Eating Disorders
  • Individual, Group, and Family Therapy
  • Pharmacological Treatment
  • Medical and Nutrition Treatment
  • Community Support Groups and Activism

Community Support Groups and Activism
  • Policies and lobbing media (Spain companies only
    able to use healthy range models)
  • Atlanta Anti-Eating Disorder League
  • ANAD (Anorexia Nervosa and other Associated
  • Overeaters Anonymous
  • NEDA (National Eating Disorders Association)
  • FED (Family Friends of people with eating
  • BEWARE of Pro-eating disorder websites

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