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Eating Disorders

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Title: Eating Disorders


1
Eating Disorders
  • An eating disorder is a complex compulsion to
    eat, or not eat, in a way which disturbs physical
    and mental health.
  • The eating may be excessive (compulsive
    over-eating)
  • too limited (restricting)
  • may include normal eating punctuated with
    episodes of purging
  • may include cycles of binging and purging

2
Eating disorders
  • The most commonly known eating disorders are
    Anorexia nervosa and Bulimia nervosa.
  • The most widely and rapidly spreading eating
    disorder is compulsive overeating or Binge eating
    disorder. These are also the three most common
    eating disorders.
  • All three can cause severe, immediate and
    long-term health issues and can cause death.

3
Anorexia Nervosa
  • The American Psychiatric Association defines
    anorexia nervosa as the presence of an abnormally
    low body weight (15 below normal body weight for
    age and height),
  • the intense fear of gaining weight or becoming
    fat,
  • disturbance and preoccupation with body weight
    and shape,
  • and amenorrhea (the absence of three consecutive
    menstrual cycles).
  • Anorexia can be life-threatening as victims
    commonly refuse to eat and drastically lose
    weight in which causes the lack of nutrients
    within the their body.

4
Anorexia nervosa
  • Anorexics are commonly perfectionists, driven to
    succeed yet they set unattainable standards of
    performance for themselves.
  • When they fail to meet these standards, they look
    for a part of their lives they can control food
    and weight become that control for them.
  • Low self-esteem and constant self-criticism cause
    anorexics to constantly fear losing control, and
    even consuming a small amount of food could be
    considered a loss of control.
  • One thousand women die of anorexia nervosa each
    year, and millions more suffer from the
    destructive physical complications.

5
Characteristics of Anorexia Nervosa
  • It is primarily suffered by females. Females
    outnumber males by a factor of 20-1 although some
    psychologists say 10-1.
  • It usually starts in adolescence but can occur in
    adults or children.
  • Leminson et al (1993) reported that 4 in 1000
    females experience the disorder in America. In
    Britain, the figure is higher 2 separate
    figures have been published 10 in 1000 and 40
    in 1000. 70,000 people suffer from anorexia
    (Brooke 1996).
  • The disease is characterized by a refusal to eat
    and deliberate weight loss.
  • Most anorectics stop having periods.

6
Characteristics of anorexia nervosa
  • There is a deterioration in general health which
    includes low blood pressure, low body
    temperature, constipation and dehydration. In 5
    - 15 anorexia is fatal.
  • They always avoid calorie-rich foods.
  • They are almost always hungry and often look at
    things to do with food, like recipes, books etc.

7
Characteristics of anorexia nervosa
  • They report that they do not get any pleasure
    from eating and do not enjoy taste sensations.
    Fat tastes revolting.
  • They have a fear of being overweight. There are
    2 main types of anorectics fasters and bingers
    (a person who occasionally eats a lot and then
    throws it up). Binge eating creates guilt which
    is why they vomit it up.
  • Anorectics do not recognize how thin they are,
    even when they are looking in the mirror.

8
Bulimia Nervosa
  • Bulimia nervosa is characterized by the recurrent
    episodes of bingeing (eating large quantities of
    food over short periods of time)
  • followed by attempts to compensate for the
    excessive caloric intake by such purging
    behaviours as self-induced vomiting, laxative
    abuse, severe restrictive dieting or fasting, or
    excessive exercise.
  • Bulimics often have "binge food," which is the
    food they typically consume during binges.
  • Some have described their binge episodes as a
    physical high they feel, numbing out, going into
    auto-pilot, losing all control, immediate
    comfort, etc.

9
Bulimia nervosa
  • The reasoning or triggers behind a binge may
    serve different purposes for different people.
  • This binge episode leads the individual to feel
    guilt, shame, embarrassment, and complete
    failure.
  • Bulimics try to regain control of themselves and
    the situation by purging the food making up for
    their mistake.

10
Bulimia nervosa
  • This leads to feeling famished and empty again,
    and therefore, another uncontrollable binge,
    followed by feeling powerless, and the vicious
    binge/purge cycle continues.
  • Bulimics have extreme eating and exercising
    habits, instead of demonstrating moderation.
  • This compulsive behaviour is often echoed in
    similar destructive behaviour such as sexual
    promiscuity, pathological lying, and shoplifting.

11
There are 2 types of bulimics
  • The purging type who expels the food as soon as
    it is consumed.
  • The non-purging type who, between binges, goes
    on strict diets and vigorous exercise schedules.
    The binges are between 2 and 30 times a week,
    depending upon the individual.

12
Characteristics of bulimia nervosa
  • Cooper (1995) says that most bulimics are women.
    Only 5 are male.
  • It usually begins in adolescence but appears
    later than anorexia nervosa.
  • There are more bulimics than anorectics. 5 of
    the population is said to be bulimic.

13
Characteristics of bulimia nervosa
  • Bulimia is also fear of fatness, although
    bulimics have a normal body weight.
  • There is a tendency for weight to fluctuate.
  • Bulimics tend to feel guilty and therefore binge
    eat in private.
  • They can have a puffy facial appearance because
    vomiting swells the parotid gland.

14
Bulimia nervosa
  • The digestive tract is damaged and bulimics are
    often dehydrated.
  • The tooth enamel is also damaged by the acids
    that come up with the vomit.
  • They also suffer from anxiety, sleep disturbances
    and depression.

15
Bulimia nervosa
  • Some bulimics indulge in self-mulitative
    behaviour.
  • Parkin and Eagles (1993) reported cases of
    blood-letting. Blood-letting is inserting some
    sort of implement into the vein to let the blood,
    and it appears to give as much satisfaction as
    binge eating.
  • Vomiting usually relieves feelings of anxiety.

16
Binge-Eating Disorder
  • This is often referred to as Compulsive
    Overeating. Binge-eating disorder is similar to
    bulimia in the recurrent episodes of bingeing
  • however, binge-eaters do not engage in any
    purging behaviour or attempt to rid themselves of
    the food in any way.
  • Binges often take place in secret, when the
    person is alone, since feelings of shame and
    disgust often accompany the binge.

17
Binge-Eating Disorder
  • Binge eaters typically eat very rapidly, hide
    food, and stuff themselves to the point of
    feeling sick.
  • Some binge eaters may eat to fill an emotional
    void or spiritual emptiness they feel, in a
    desperate effort to be satisfied.
  • This is called emotional eating, which is a
    coping mechanism for stress, depression, anxiety,
    anger, and many other negative emotions.

18
Causes environmental factors
  • Environmental factors
  • The media may be a significant influence on
    eating disorders through its impact on values,
    norms, and image standards accepted by modern
    society.
  • Both societys exposure to media and eating
    disorders have grown immensely over the past
    decade.
  • Researchers and clinicians are concerned about
    the relationship between these two phenomena and
    finding ways to reduce the negative influence
    thin-ideal media has on womens body perception
    and susceptibility to eating disorders.

19
Environmental factors
  • The dieting industry makes billions of dollars
    each year by consumers continually buying
    products in an effort to be the ideal weight.
  • Hollywood displays an unrealistic standard of
    beauty that makes the public feel incredibly
    inadequate and dissatisfied and forces people to
    strive for an unattainable appearance.
  • This takes an enormous toll on one's self-esteem
    and can easily lead to dieting behaviours,
    disordered eating, body shame, and ultimately an
    eating disorder.

20
The Behavioural Model
  • The behavioural model states that anorexia is a
    phobia a weight phobia.
  • There is an idealization in society of thin women
    which may be creating a weight problem/phobia in
    certain people.
  • There is some support that there are pressures to
    be slim in western societies.
  • Lee et al (1992) argue that non-western cultures
    have a much lower incidence of anorexia nervosa.
  • Sui Wah (1989) suggests that in many non-western
    cultures importance is attached to food and
    families tend to eat together, so if someone is
    not eating properly, it will not go unnoticed.

21
Family Relationships
  • Many studies have found that women lack control
    over their bodies.
  • Especially in conditions of criticism and
    coercive parental control during childhood, girls
    use food refusal to gain autonomy and control
    over their environment.
  • Many studies have showed that many women who
    experienced physical or sexual abuse as a child
    end up with eating disorders as a method of
    punishing oneself due to the feeling of being
    worthless, or to strive to be good enough so
    they can finally receive the love and acceptance
    they lacked during childhood.

22
Family relationships
  • Women may have developed low self-esteem and poor
    body image, but they can find achievement in
    abiding by food rules
  • they gain a sense of control and independence in
    being disciplined and avoiding "bad" food.
  • These distorted thoughts are correlated with
    perfectionism and obsessive behaviour, giving
    women a false sense of control when, in reality,
    the eating disorder has totally consumed them.

23
Developmental etiology
  • Research from a family systems perspective
    indicates that eating disorders stem from both
    the adolescent's difficulty in separating from
    over-controlling parents, and disturbed patterns
    of communication.
  • When parents are critical and unaffectionate,
    their children are more prone to becoming
    self-destructive and self-critical, and have
    difficulty developing the skills to engage in
    self-care giving behaviours.
  • When coping strategies have not been developed in
    the family system, food and drugs serve as a
    substitute.

24
The psychodynamic model
  • The psychodynamic model has proposed many
    possible reasons
  • A girl is afraid of reaching puberty and sexual
    maturity, and so does not eat in order to look
    pre-pubescent. They argue if the girl becomes
    sexually mature, she fears having to become more
    independent. Menstruation usually stops, which
    is another reason preventing a girl from growing
    up.
  • If a girl doesnt eat, she can continue to look
    like a boy. In addition to this, if her period
    stops, it considerably reduces the issue of her
    sexuality.
  • The parents of anorectics often tend towards
    domineering behaviour, and not eating is one way
    that a girl can assert her individuality.

25
Biological/Genetic factors
  • Research has shown that many people who suffer
    from an eating disorder are highly correlated
    with having depression and obsessive compulsive
    disorder.
  • Depressed, obsessive compulsive and bulimic
    patients were found to have lower than normal
    serotonin levels.
  • Neurotransmitters, such as serotonin, dopamine,
    and noradrenaline, are released as you eat.

26
Biological factors
  • Cortisol is a hormone released by the adrenal
    cortex which promotes blood sugar and increases
    metabolism.
  • High levels of cortisol were found in people with
    eating disorders.
  • This imbalance may be caused by a problem in or
    around the hypothalamus.
  • A study in London at Maudsley Hospital found that
    anorexics were found to have a large variation of
    serotonin receptors and a high level of
    serotonin.
  • Many of these chemicals and hormones are
    associated with the hypothalamus in the brain.

27
Biological factors
  • Damage to the hypothalamus can result in
    abnormalities in temperature regulation, eating,
    drinking, sexual behaviour, fighting, and
    activity level.
  • Uher Treasure (2005) performed a study
    researching brain lesions effects on eating
    disorders.
  • They evaluated 54 formally published cases of
    eating disorders and brain damage.

28
Biological factors
  • They found many correlations between eating
    disorders and damage to the hypothalamus.
  • People with brain lesions in the hypothalamus had
    abnormal eating behaviours unprovoked and self
    induced vomiting, over concern with becoming fat,
    cheating with eating, frequent sleepiness,
    depression, obsessive compulsive behaviour and
    diabetes.

29
Statistics on Eating Disorders
  • Eating Disorders

30
Gender and eating disorders
  • Gender imbalance

31
Using behaviour therapy and positive
reinforcements
  • In the first stage of therapy, the therapist
    establishes a reinforcer to be given every time
    the patient eats.
  • After a while, eating gradually increases.
  • The parents are then instructed in ways to
    continue the reinforcements for appropriate
    eating behaviours.
  • Although it is accepted that therapies based on
    the behavioural model can alter behaviour,
    critics argue that such therapies fail to
    identify a disorders underlying causes.
  • Hence, removing one symptom of a disorder may
    simply result in another occurring in some form.

32
Worldwide statistics on eating disorders
  • STATISTICS
  • Prevalence
  • 1 in 5 women struggle with an eating disorder or
    disordered eating.
  • Up to 24 million people suffer from an eating
    disorder in the United States
  • Up to 70 million people world wide struggle with
    an eating disorder.

33
Statistics
  • Almost 50 of people with eating disorders meet
    the criteria for depression.
  • Nearly half of all Americans personally know
    someone with an eating disorder. Eating disorders
    have the highest mortality rate of any mental
    illness.
  • The mortality rate associated with anorexia
    nervosa is 12 times higher than the death rate of
    ALL causes of death for females 15-24 years old.
  • 20 of people suffering from anorexia will
    prematurely die from complications related to
    their eating disorder, including suicide and
    heart problems.

34
Treatments
  • Eating disorder treatment depends on your
    specific type of eating disorder. But in general,
    it typically includes psychotherapy, nutrition
    education and medication.
  • If your life is at risk, you may need immediate
    hospitalization to stabilize your health.
  • You may have a treatment team of medical doctors,
    mental health providers and dieticians.

35
Psychotherapy
  • Individual psychotherapy can help you learn how
    to exchange unhealthy habits for healthy ones.
  • You learn how to monitor your eating and your
    moods, develop problem-solving skills, and
    explore healthy ways to cope with stressful
    situations.
  • Psychotherapy can also help improve your
    relationships and your mood.
  • A type of psychotherapy called cognitive
    behavioural therapy is commonly used in eating
    disorder treatment.
  • Family therapy and group therapy also may be
    helpful for some people.

36
Nutritional information
  • Dieticians and other health care providers can
    offer information about a healthy diet and help
    design an eating plan to achieve a healthy weight
    and healthy-eating habits.
  • If you have binge-eating disorder, you may
    benefit from medically supervised weight-loss
    programs.

37
Medications
  • MedicationsMedication can't cure an eating
    disorder.
  • However, medications may help you control urges
    to binge or purge or to manage excessive
    preoccupations with food and diet.
  • Medications such as antidepressants and
    anti-anxiety medications may also help with
    symptoms of depression or anxiety, which are
    frequently associated with eating disorders.
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